Thanks for your allegations, especially 34,634 calls to our Fraud Hotline!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In observance of Thanksgiving, we are giving thanks for the vigilance of everyday citizens and their willingness to detect and report suspected fraud committed against the Ohio workers’ compensation system.

We realize that such partnerships are necessary to achieve our fraud prevention goals. Since the creation of our Special Investigations Department (SID) in 1993, tens of thousands of our allegations have been furnished by external sources. Each and every reported allegation is entered by an agent into our secure database and reviewed. Effective this week, as a result of calls to our BWC Fraud Hotline, 34,634 allegations have helped us achieve over 1.7 billion in savings.

An investigative professional will promptly answer your call and conduct a brief and effective interview. These agents have years of investigative knowledge, skills and experience securing the essential information from sources like you. Whether your fraud hotline agent is Jake, Taylor, Karen, Connor, Jeff, or any of eight of our most experienced fraud analysts assigned to special investigations units (SIUs) statewide, you will know within seconds that you have reached a committed, successful professional.

Your fraud hotline agent will know and promptly secure the information needed by our teams of 125 SID employees. You do not need to have proven any facts; you do not even need to have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continue to occur. We will conduct the investigation and determine the facts. Your Fraud Hotline call initiates the process, and in as few as five minutes.

A suspicion can also be reported by means of any of the following: an “after hours” message to our Fraud Hotline voicemail 614.728.2617, online, an email to our secure BWC Allegations@bwc.state.oh.us account, the U.S. Postal Service or in-person at any BWC claims office. Calling the BWC Fraud Hotline is the most interactive and direct way that you, our partners in fraud prevention and detection, can help.

So, thank you for your 34,634 (and counting) calls to our Fraud Hotline! We are indeed thankful for each one.

BWC, State Fire Marshal outline safety resources available to Ohio’s firefighting community

By Melissa Vince, BWC Public Relations Manager

In light of recent media attention to cancer risks and other on-the-job dangers faced by firefighters, the Ohio Bureau of Workers’ Compensation (BWC) is partnering with the State Fire Marshal’s office to educate Ohio firefighters about safety resources available through their agencies.

“Firefighters face unique and life-threatening hazards as they protect the lives and property of their fellow Ohioans, and they deserve our best efforts to keep them safe on the job,” said BWC Administrator/CEO Sarah Morrison. “We have committed a number of resources to reduce these dangers and improve the safety and health of Ohio firefighters.”

Added State Fire Marshal Jeff Hussey: “Firefighters put their lives on the line on a daily basis. We want to ensure they’re equipped with the best resources to do their jobs safely.”

BWC resources include:

Fire department grants
BWC’s new Firefighter Exposure to Environmental Elements Grant Program awards dollars to Ohio fire departments, both career and volunteer, to purchase safety gear and equipment that protect against carcinogens and other harmful elements encountered during a fire fight. BWC has awarded more than $1.2 million to 120 Ohio fire departments to date.

Items eligible for purchase include diesel exhaust systems, extractors/washing machines for turn-out gear, hoods with barrier protection and washable gloves. The exhaust systems and extractors are also available for purchase through BWC’s Safety Intervention Grant Program. Many smaller fire departments are eligible to purchase equipment without any matching funds.

Safety Grants
The Safety Intervention Grant Program assists Ohio employers purchasing equipment that will reduce employee illnesses and injury. Over the last three years, Ohio fire departments have received more than $9.7 million in funding for safety equipment, including hydraulic cots used for heavy patients and automated chest compression devices.

Public Employment Risk Reduction Program
BWC’s Public Employment Risk Reduction Program has been promoting safe and healthy working conditions for Ohio’s public employees for 25 years. The program had no jurisdiction over firefighters, EMTs, paramedics and corrections officers until the legislature expanded the program in BWC’s most recent budget. Effective Sept. 29, BWC has greater authority to help these employers identify unsafe and hazardous working conditions, as well as conduct workplace inspections to prevent accidents and injuries.

Safety, ergonomics and industrial hygiene consulting services
BWC’s safety, industrial hygiene and ergonomics specialists visit workplaces to assist in the development of effective injury and illness prevention strategies.

Research services
The BWC Division of Safety & Hygiene library provides free research services on occupational safety and health, workers’ compensation and rehabilitation. Librarians have access to one the largest repositories of occupational safety and health information in the nation and provide accurate answers to questions about firefighter occupational safety and health.

Firefighter safety training
To ease costs to local governments, the State Fire Marshal’s office and Ohio Emergency Medical Services provide $500,000 to fund Firefighter I Training, a 120-hour certification class. BWC committed another $1 million for the training to help prevent accidents and improve preparedness and response times during emergencies.

Additionally, BWC funds research into firefighter injury and illness prevention through its Occupational Safety and Health Research Program. Six Ohio universities have received $3 million for 13 projects through the program, which includes more than $718,000 for research into firefighter safety.

Marshal Hussey said a number of training opportunities, grants and loans are available through his office in the Ohio Department of Commerce. While some grants directly fund safety equipment and training, others can free up dollars needed to invest in safety.

Fire Department Equipment Grant
This grant funds protective clothing, self-contained breathing apparatuses, communications equipment and other miscellaneous equipment. Eligible fire departments must serve a population of less than 25,000. The application period typically runs from December to the end of January.

Bureau of Underground Storage Tank Regulation (BUSTR) Revolving Loan
These zero-interest loans are available to any political subdivision, including Community Improvement Corporations, to begin, continue or complete the removal, assessment, or corrective action related to underground storage tanks.

Firefighter I Training Grant and Volunteer Firefighter I Training Grant
These grants fund the costs of Firefighter I or Firefighter I Transition certification courses. The application period begins July 1.

Fire Department Training Reimbursement Grant
Fire departments that provide primary fire protection to an area with a permanent population of 25,000 or less qualify for the grant. Reimbursement is available for specific fire training classes, including the cost of training manuals and student workbooks. The application period runs from mid-December to mid-January.

MARCS Grant
The MARCS (Multi-Agency Radio Communication System) Grant is available to fire departments that serve a population of 25,000 or less. The money can be used to purchase systems, equipment, and/or services that are part of, integrated into, or otherwise interoperable with the MARCS operated by the State of Ohio. Up to $50,000 per department is available. The application period runs from October to mid-November.

Revolving Loan
The Small Government Fire Department Services Revolving Loan Program assists local governments in funding certain fire department expenses. A revolving loan can be used to expedite the purchase of major firefighting, rescue or EMS equipment. It can also be used for the construction or renovation of fire department buildings.

Rural Community Financial Assistance (RCFA)
This is a matching grant program to cover the cost of tuition and lodging at the Division of State Fire Marshal’s Ohio Fire Academy. Only firefighters from communities serving a population of less than 10,000 qualify. Multi-community projects may exceed 10,000, provided none of the communities in the project serve more than 10,000 people. The application period begins July 1.

Visit the State Fire Marshal’s grants page for more information.

The Columbus Dispatch published a five-day series in October about the cancer epidemic among firefighters. The news organization conducted two statewide surveys of firefighters and fire chiefs from across Ohio. Among the findings: One in six of the nearly 1,300 firefighters who responded said they had been diagnosed with cancer at some point in their careers. About 50 percent said they believed cancer was their biggest threat on the job.

Nearly 95 percent of the 360 fire chiefs surveyed said that cancer is the greatest occupational threat to their firefighters, but only about half provided cancer-prevention training or had rules in place to reduce the cancer threat.

The Dispatch series can be found online at Dispatch.com/unmasked.

Ohio safety councils gave when others needed it most

By Erik Harden, BWC Public Information Officer

With Thanksgiving later this week, we’re officially entering the season of giving. However, for a group of Ohio safety councils and their members, the giving spirit arrived early this year.

In August and September, three powerful hurricanes (Harvey, Irma and Maria) ravaged the U.S. mainland as well as several U.S. territories in the Caribbean. The storms left horrific destruction, flooding and loss of life in their wake.

People from all over the country stepped up to donate their time, money and expertise to help the victims of the storms. Several Ohio safety councils and their members were no exception.

On the same date in late August, two safety councils (the Cleveland Southwest and Miami County safety councils) contacted BWC Safety Council Program Manager Michelle Francisco about a statewide initiative to raise money for Hurricane Harvey relief among all Ohio safety councils.

After receiving BWC’s approval, Cleveland Southwest Safety Council Administrator Kathy Kellums and Miami County Safety Council Program Director Jessica Stein sent a joint fundraising appeal to all 83 Ohio safety councils. “We felt this was a way to say Ohio cares,” said Kellums.

With fundraising already under way for Harvey relief, hurricanes Irma and Maria hit several Caribbean islands with a vengeance, with Puerto Rico and the U.S. Virgin Islands taking the brunt of the storms. In the aftermath of now three devastating storms, the fundraising focus shifted to a larger relief effort. The safety councils decided to donate any funds raised to the Cleveland Salvation Army’s hurricane relief fund.

One Cleveland Southwest Safety Council member, Quadax, Inc., held an employee charity drive, raising $1,694 in employee contributions, and another company from the same safety council donated $500. In the end, the Cleveland Southwest Safety Council, led the way with more than $4,000 in donations. Overall, more than a dozen safety councils and their members collected $8,770.

On Oct. 31, Kellums and Stein delivered the donations to the Cleveland Salvation Army for its relief work in the Caribbean. The safety councils’ donations made it possible for disaster workers to provide up to 15,000 meals each day to residents of St. John, Virgin Islands.

“As BWC’s safety council program manager, I’d like to give thanks to all of Ohio’s safety councils for making our state a safer place to live and work,” said Francisco. “And for going above and beyond when fellow citizens desperately need help.”

What do you know about workers’ comp fraud? Our sleuths have questions – and answers!

By Melissa Vince, BWC Public Relations Manager

We’ve had a great time talking workers’ comp fraud this International Fraud Awareness Week. We enjoyed sharing what we do to detect, deter and put a stop to workers’ compensation fraud in Ohio.

Our fraud investigators especially look forward to participating every year because they want to raise awareness and encourage tips from the public, but also because they truly enjoy what they do.

And we appreciate them because they do a great job. So, in honor of them, we let them take a little break to have some fun putting together this quiz challenging your knowledge of workers’ compensation fraud.

So, fire up that brain and let’s get started. Just flip your monitor over for the answers listed at the bottom.

Thanks for following us this week! We’ll be back next year for Fraud Awareness Week, but don’t go away because we’re here all year long on our blog, Twitter and Facebook.

  1. True or false?
    Fraud and abuse are the same.
  2. True or false?
    Proving fraud requires evidence of “knowledge and intent”
  3. True or false?
    Abuse can be criminally prosecuted under the law.
  4. BWC has teams focused on investigating the following types of fraud:
    a) Claimant
    b) Employer
    c) Medical provider
    d) All of the above
  5. Which is an example of fraud?
    a) Billing for services not rendered (a doctor bills for procedures not performed)
    b) Classifying full-time employees as independent contractors/subcontractors.
    c) A claimant performing physical activity outside of his or her restrictions
    d) All of the above
  6. What are the two most common fraud allegations our investigators receive related to medical providers?
    a) Billing for services not rendered (a doctor bills for procedures not performed)
    b) Unlicensed provider (not licensed to practice medicine in the State of Ohio)
    c) Unbundling (charging separately for bundled services)
    d) Upcoding (billing for a more expensive service than the one provided to the claimant)
  7. What is the most common fraud allegation our investigators receive related to employers?
    a) No coverage
    b) Lapsed coverage
    c) Falsified certificate of premium coverage
    d) Underreporting payroll
  8. What is the most common fraud allegation our investigators receive related to claimants?
    a) Physical activity (performing physical activity outside of his or her restrictions; malingering)
    b) Work/Comp (working while receiving lost time benefits)
    c) False claim (staged accidents; false injuries)
    d) Altered documents

 

It’s not easy being Green: Cleveland florist convicted of work comp fraud

Green Thumb Florists owes BWC $32,000

The owner of a Cleveland flower shop owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $32,000 in restitution after pleading guilty to workers’ compensation fraud in late September.

Mary Green, the owner of Green Thumb Florists, was ordered to pay BWC $31,562, sentenced to five years of community control and fined $315 after pleading guilty Sept. 27 to one fourth-degree felony count of workers compensation fraud in the Cuyahoga County Court of Common Pleas.

Acting on a tip, agents with BWC’s special investigations department (SID) discovered Green had altered a BWC certificate to make it appear her business had proper workers compensation coverage, as required by state law. Agents also discovered her actual policy had been in lapsed status since 2011.

“Our agents made multiple site visits, witnessed multiple employees and put Mary Green on notice to bring her BWC policy into compliance with the law,” said SID Director Jim Wernecke. “But when she wouldn’t cooperate, we brought her case to the county prosecutor and now she has a felony on her record. It didn’t have to go this far. We really need employers to reach out to BWC if they’re struggling to pay their premiums.”

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Spotlight: Our college interns

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In recognition of International Fraud Awareness Week 2017, we are highlighting careers in criminal investigations, especially those that commence with the study of criminology, criminal justice, law enforcement, digital forensics or data analytics.

History:  BWC’s Special Investigations Department (SID) created its college relations program in 1995 to promote the study and practice of criminology, criminal justice, law enforcement and public administration. On college and university campuses throughout Ohio (and beyond), SID staff members exchange insights with students, faculty and staff members on how to combat crime.

Since the program began 20 years ago, SID has recruited, selected and trained more than 300 paid interns and unpaid externs. Many have gone on to become law enforcement officers, criminal investigators, special agents, digital forensic analysts, assistant special agents in charge and special agents in charge. We currently employ in full time positions, thirteen graduates from our SID college internship program.

On Campus: BWC representatives travel to colleges and universities to meet with candidates. For example, on Nov. 14, BWC was represented at Bowling Green State University by SID Special Agent in Charge Craig Matthews and BWC Human Capital Management Analyst Megan Lentz.

They participated in a job fair specifically targeted toward criminal justice majors. Matthews described the internship program in the special investigations department at the Toledo service office and Lentz explained the application process.

Panel Discussion:  For two hours on Nov. 15, two investigative professionals, Taylor Scarberry and Paul Balzer, participated in our agency’s second panel event where five current permanent employees who started out at BWC as interns discussed their experiences with our current interns. Moderated by Megan Lentz, these successful professionals painted a picture of what it is like to permanently come on board with our agency.

The former SID interns described their success and career paths working in specialized units, including the intelligence and special investigations units (SIUs), as well the health care provider team and regional claimant SIU.

Megan Lentz, Kayla Michel, Luke Bogner, Nathan LaChappelle, Taylor Scarberry and Paul Balzer

They described their many important responsibilities as a college intern with SID. They also mentioned what they did not do, such as getting coffee or food for their co-workers, running any errand, or any other trivial activity.

Panelist Taylor Scarberry: Taylor started his career with BWC in November 2012 as an exemplary college intern with the Columbus SIU. On August 22, 2016, he commenced his permanent employment with BWC as a Criminal Investigator with the Southeast Regional Claimant SIU, assigned to the Cambridge service office. He reports to special agent in charge Scott Lape, a former SID college intern.

During today’s panel discussion, Taylor offered the following knowledge, understanding and wisdom:

“Following my experience as a college intern with the Special Investigations Department and obtaining my Bachelor’s degree in Criminology from The Ohio State University, it was important to me to find a career in criminal justice.  I discovered quickly during my internship that criminal justice was something I was passionate about and saw myself establishing a career in.  BWC provided me that opportunity and the team atmosphere within the SID is something I enjoy being a part of every day.”

Panelist Paul Balzer: Paul started his career with BWC in 2010 while a student at The Ohio State University. Following his internship, he joined BWC full-time as a criminal investigator with health care provider team (HCPT) in December 2011. On October 7, 2012, Paul was promoted to special agent with the HCPT. On Nov. 28, 2016, he was promoted to fraud analyst with the intelligence unit, a team supervised by a former SID college intern, special agent in charge Eric Brown.

As an experienced panelist who has already earned multiple promotions, Paul offered the following recollections and insights:

“I had no idea what this agency did or that it even existed. But the synopsis I read about the internship combined all three things I had wanted to do – work in health care, computer science and criminology. In my current position, I want to continue to make an impact. There are a lot of challenges in the criminal justice system, but we can still make an impact and improve the lives of others. I hope we continue to use critical resources in the most efficient manner possible to stop fraud, because fraud just drives up costs for the entire system.”

Reasons for Ongoing Success: The SID college relations program has been successful in hiring interns with a variety of backgrounds, majors and career goals who quickly become vital assets to BWC’s efforts to fight workers’ compensation fraud. We solicit and heed feedback from our interns to continually improve our program.

The Future: If you know of any students that would be a great fit in our program, please encourage them to submit an application via our Future Opportunities posting. We have an intern position that we are looking to fill right now and we are using the Future Opportunities posting to select our applications. Additionally, we have the specific intern positions posted:

Suspect fraud? Call our Fraud Hotline!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In recognition of International Fraud Awareness Week 2017, we are increasing awareness of fraud and the vigilance of everyday citizens to report suspected fraud committed against the Ohio workers’ compensation system.

A suspicion can be reported online, by email to our secure BWC Allegations@bwc.state.oh.us account, U.S. Postal Service or by calling our Fraud Hotline at 1-800-644-6292. Calling the BWC Fraud Hotline is the most interactive and direct way that you, our partners in fraud prevention and detection, can help.

We realize that such partnerships are necessary to achieve our fraud prevention goals. Since the creation of our Special Investigations Department (SID) in 1993, thousands of our closed, founded cases started with a call to our Fraud Hotline. For example, the conviction of Tim Tokles on August 30, 2017 was the result of just such a call.

You may suspect someone is working while receiving compensation, filed a false claim for an injury that did not happen or is committing another type of workers’ compensation fraud. Calling a fraud hotline may seem rather intimidating. We understand that it can be a nerve-wracking decision to make the call. The person you suspect of fraud could be a friend, a loved-one or even an immediate family member.

Above all, we realize the importance of personal security and safety to each caller.

When you call the SID Fraud Hotline, you will speak with a real person on the other end, one who is ready and willing to listen to your concerns and has years of investigative knowledge, skills and experience securing the essential information from sources like you. Whether your fraud hotline agent is Jake, Taylor, Karen, Connor, Jeff, or any of eight of our most experienced fraud analysts assigned to special investigations unit (SIUs) statewide, you will know within seconds that you have reached a committed, successful professional.

Your fraud hotline agent will know and promptly secure the information needed by our teams of 125 SID employees. Your identity will remain either anonymous or confidential, depending upon your preference. You do not need to have proven any facts; you do not even need to have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continue to occur. We will conduct the investigation and determine the facts.    

The entire process entails as few as five minutes. Nonetheless, collecting the right information from a caller requires our SID Fraud Hotline professionals to devote as much time as the caller’s unique allegation merits.

When calling, please provide the information you have, including:

  • The name and address (if known) of the subject you’re reporting;
  • A description of the suspect’s behavior; and
  • Any other information that might pertain to the suspected fraudulent activity.

It is through the vigilance of citizens like you, that we are combatting workers’ compensation fraud in Ohio.