Special investigations department concludes FY 2019 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY 2019, which closed June 30. The report details another impressive year of our department’s efforts to deter, detect, investigate, and prosecute workers’ compensation fraud.

Here are some highlights in what was our 26th year as a department:

  • We closed 1,732 fraud cases, 7% more than in 2018.
  • We secured 101 convictions of claimants, employers, and health care providers who defrauded our agency.
  • For every dollar we spent on our efforts, we saved the state fund nearly $5.
  • We reduced our investigation time per case by 2.9 days on average, to 189 investigative days, our lowest number on this measure since 2005.
  • All told, we saved the state fund $65.1 million in 2019, an 8 % increase over 2018’s numbers.

We couldn’t have achieved this success without the 119 dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law.

In 2019, our investigative teams continued to work closely with the law enforcement community at the local, state, and federal levels. We collaborated on several investigations, including cases involving physicians running pill mills in Ohio and surrounding states.

In addition, our teams joined other state and federal investigators participating in the Document and Benefit Fraud Task Force, the Ohio Medicaid Prescription Program Integrity Group, and the Pill Mill Coordination team for the Ohio Attorney General’s Medicaid Fraud Control Unit.

As we commence our 27th year in FY 2020, we remain united in our commitment to protecting the State Insurance Fund for injured workers and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

Former deputy sheriff owes BWC $235K for workers’ comp fraud

Zanesville man earns felon status after Monday’s conviction

A Zanesville man and former county deputy sheriff must reimburse the Ohio Bureau of Workers’ Compensation nearly $235,000 in restitution following his felony conviction for workers’ compensation fraud Monday in a Franklin County courtroom.

A judge ordered Gregory A. Fitzer, 56, to pay BWC $211,536 in restitution and $23,187 in investigative costs after Fitzer pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud. She also ordered the former Muskingum County deputy sheriff to serve four years of probation in lieu of a year in jail.

“Our investigators found Mr. Fitzer knowingly and with fraudulent intent deceived our agency and his physicians in order to receive disability benefits,” said BWC Administrator/CEO Stephanie McCloud.

Acting on a tip, BWC’s Special Investigations Department discovered Fitzer worked as a process server and investigator for several law firms in and around Zanesville from January 2007 to March 2016 while collecting disability benefits from BWC. The investigation, which included surveillance, multiple interviews and a review of bank and employment records, also found he worked as a truck driver and laborer for a local retailer.

In other fraud news:

BWC secured eight fraud-related convictions in August, bringing 2019’s total to 63. They include a Central Ohio nurse practitioner convicted on health care fraud charges.

BWC assisted in the investigation that led to the Aug. 30 sentencing of nurse practitioner Amy Wood-Kirk of Grove City and fiancé Ryan Edney on one count of conspiracy to commit health care fraud. Amy Wood-Kirk prescribed large quantities of medications, including prescriptions for compounded pain cremes, outside acceptable medical standards for the personal profit of herself and Edney.

The U.S. District Court for the Southern District of Ohio sentenced Wood-Kirk to five years of probation and ordered her and Edney to repay Medicaid, TriCare, and Medical Mutual of Ohio $751,809 in restitution. Wood-Kirk was also sentenced to 180 days home confinement.

In order of most recent court appearance, other August convictions include:

Jim Hesler, dba Robert’s Roofing, Batavia, Ohio
Hesler was found guilty Aug. 23 in Clermont County Common Pleas Court on two counts of workers’ compensation fraud, both fifth-degree felonies. BWC investigated Hessler after learning he had not been reporting his payroll to the agency and several injury claims had been filed.

Investigators found his business was still in operation. Sentencing is scheduled for Oct. 8, at which time a judge may determine the amount of restitution owed BWC.

Eric Johnson, Akron, Ohio
Johnson pleaded guilty Aug. 22 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving disability benefits. Prior to entering the plea, Johnson deposited full restitution of $1,062 at the clerk of court’s office.

Gregory White, dba White’s Auto Care LLC, Lorain, Ohio
White pleaded no contest Aug. 22 to one count of failure to comply, a second-degree misdemeanor, for not reinstating his BWC policy while operating his business. A second count was dismissed as White had brought his BWC account current prior to court. White was ordered to pay court costs of $167.

Everett Ferryman, Marysville, Ohio
Ferryman pleaded guilty Aug. 21 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered him working as a truck driver and receiving cash “under the table” while receiving BWC disability benefits. The court sentenced him to a term of probation not to exceed five years but could terminate sooner upon payment of $22,851 in restitution. The court also imposed a suspended sentence of 12 months in prison.

Tammy Hill, Jackson, Ohio
Hill pleaded guilty Aug. 12 in Jackson County Municipal Court to theft by deception, a first-degree misdemeanor, after BWC found her cashing BWC benefit checks belonging to an injured worker. A judge ordered Hill to serve up to five years of probation, complete 500 hours of community service, 180 days in jail (suspended), and pay a $100 fine and court costs within 12 months.

Paul Gall, dba Sun Masters, Brooklyn Heights, Ohio
BWC found Gall had been operating his business, Sun Masters LLC, without BWC coverage since March 2014. In lieu of conviction, Gall entered a payment plan with the Ohio Attorney General’s office after making a down payment of $12,000 toward his $44,000 balance.

Robert McWhorter, New Albany, Ohio
McWhorter pleaded guilty Aug. 7 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working for his landscaping company while receiving BWC disability benefits. A judge ordered McWhorter to pay $9,888 in restitution to BWC and serve one year of probation in lieu of a 6-month jail sentence.

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

Our $1.5 billion employer dividend a confluence of safety, savings and investment

By Stephanie McCloud, BWC Administrator/CEO

Local elected and business leaders join employees at American Producers Supply Inc. in Marietta Wednesday morning for a check presentation from Ohio Bureau of Workers’ Compensation Administrator/CEO Stephanie McCloud (holding check). The check represents the company’s share of BWC’s dividend of up to $1.5 billion for Ohio employers this fall.

You know it is a good day when everyone is smiling as you arrive at their door.

That’s the reception I received this morning from the good people of American Producers Supply Co. in Marietta, Ohio, where I gathered with local business and elected leaders to kick off our 2019 dividend check distribution.

I presented company leaders with a giant ceremonial check for $48,248.64 and told the audience a total of $14.1 million in checks were headed to the Marietta region over the next month. (The region includes Washington, Monroe, Noble, Morgan and Athens counties.)

All told, we’ll be sending roughly 177,000 checks to Ohio’s private and public employers covered by the State Insurance Fund starting Sept. 26.

The checks, which could reach up to $1.5 billion in all, represent 88% of the premiums employers paid in policy year 2017.

Our Board of Directors approved this dividend in June. This was the agency’s fifth billion-dollar dividend since 2013, and it marked the continuation of a remarkable run of strong investment returns and falling injury claims. BWC’s cost-saving initiatives also contributed to the dividend.

Those falling claims are in part due to our economy becoming more service-oriented. But they also show Ohio’s public and private employers are placing more importance on safety in the workplace. That is an approach we will always applaud.

The governor and I know Ohio’s economy prospers when more money is available for capital improvements, hiring, safety and innovation.

“We are committed to providing resources for Ohio businesses to expand, support their employees, and become stronger competitors in the global marketplace,” Governor DeWine said just before my Marietta trip. “Because of BWC’s leadership and strong investments, Ohio employers will now have the opportunity to make additional investments in their businesses.”

Joe Wesel, American Producers Supply’s executive vice president and general manager, is taking that to heart. His dividend check is going right back into the business.

American Producers Supply general manager Joe Wesel tells the crowd he will invest the dividend check in company safety programs.

“We plan to use these funds to enhance our safety program and support the health and wellness program we recently created for our employees,” Mr. Wesel said this morning.

“We employ more than 200 workers in 13 locations around Ohio and the Midwest, and safety is one of our core values. We absolutely believe workplace accidents are preventable with the right approach, and BWC has been instrumental in helping us make that part of our culture here.”

We look forward to sharing this good news with other employers across our state in the coming weeks.

We know these dividends aren’t a guarantee every year, but I sure enjoy the experience and all those smiles! It’s my honor and privilege to be a part of it. I want to thank everyone involved — Ohio’s employers, workers and BWC staff — for making it happen. Thank you.

Talk safety with us at the Farm Science Review

By Erik Harden, BWC Public Information Officer

With nearly 78,000 farms producing $9.3 billion in revenue, Ohio is one of the top five states in the U.S. for agriculture.

This robust industry remains a critical component of Ohio’s economy and one of the state’s major industries for employment. It’s also high-hazard work with great potential for workplace injuries and, unfortunately, even fatalities.

With all of this in mind, our Division of Safety & Hygiene (DSH) is once again promoting its programs and services at the Farm Science Review – one of the premier agricultural trade and education shows in the nation. Hosted by The Ohio State University, the event starts today and runs through Thursday at the Molly Caren Agricultural Center in London, Ohio.

For the fourth consecutive year, DSH representatives will be available at our booth to speak with attendees about the free programs and services we offer to assist employers and workers in Ohio’s agribusiness.

For example, our industrial hygienists can help farms guard against environmental hazards, including chemicals, pesticides, fertilizers, dust, mold, and extreme noise and temperatures.

Our ergonomists can illustrate ways to cut down on hazards resulting from:

  • Manual materials handling.
  • Repetitive, hand-intensive work.
  • Poor workstation design.
  • Sedentary work.

Our safety consultants can help prevent common but costly injuries to protect the bottom line of Ohio’s agriculture businesses and their workers.

If you’re going to Farm Science Review this week, stop by and see us! We’re booth No. 32 in Building 513.

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We’ll see you at the NE Ohio Safety Expo!

By Dave Costantino, BWC Loss Prevention Supervisor

It’s hard to believe our NE Ohio Safety Expo is celebrating its 12th anniversary this year. It seems like just yesterday we were planning the first one!

With 40 sessions covering a wide variety of workplace safety topics and with an exciting lineup of exhibitors, this year’s event is bigger and better than ever.

We’ll cover everything from Occupational Safety and Health Administration updates and the opioid crisis to managing workers’ comp claims and workplace wellness programs.

This year’s event is Oct. 11 at the Mahoning County Career and Technical Center. Registration is now open. Because sessions fill up fast, I encourage you to register and pre-pay by Oct. 4.

You can view the complete list of educational sessions and access the registration form here. The cost is $30 and includes a light continental breakfast and box lunch.

Like last year, the expo will offer free and confidential biometric health screenings to eligible attendees as part of our Better You, Better Ohio!® program. Workers who work for small employers (150 or fewer workers) in high-risk industries* are eligible to participate in the program. You can check if you’re eligible to participate here.

I’m proud to lead the dedicated team that puts on the expo, an event that helps make Ohio workers and workplaces safer and healthier.

I hope to see you there!

*Agriculture; automotive repair and service; construction; firefighters; health care; manufacturing; police and public safety; public employers; restaurant and food service; transportation and trucking; trash collection; wholesale and retail