Workers’ comp fraud scheme burns cook for $46K

Northeast Ohio man guilty of 5th degree felony

A northeast Ohio man who worked as a cook for nearly three years while collecting disability benefits from the state owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $46,000 following his fraud conviction last week.

Walter M. Patterson, 58, of Olmsted Twp., pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.

“It’s a mistaken perception among some people that workers’ compensation fraud is not that big a deal, that BWC ‘can afford it,’” said Jim Wernecke, director of BWC’s special investigations department. “As this case demonstrates, we take fraud very seriously and intend to recoup every ill-gotten dollar fraudsters take from this agency so those funds can serve injured workers who truly need them.”

Acting on a tip, BWC investigators found Patterson working as a cook at the Valley Tavern in Valley View, Ohio, and learned that he had previously worked as a cook at the County Line Bar in Brecksville.

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

Restaurant safety: It’s not just about food safety

By Ben Hissam, BWC Industrial Safety Consultant

Having worked in restaurants as a chef or chef manager for more than 10 years, I have seen first-hand the hazards of the industry.

I remember the long hours, usually working six nights a week. It is a demanding job that you have to really love, getting satisfaction from making people happy through your work.

When I came to BWC, I decided to help develop the restaurant safety class because of my industry experience. My days in the kitchen gave me insights into restaurant operations in the front and back of the house.

I remember starting in the restaurant industry, when everything was made from scratch. This often included hand cutting vegetables and salads, meats, potatoes and more. Prep work was, and still is, a large part of the job. Ergonomic-related injuries – including repetitive hand motions, prolonged standing, lifting produce cases, etc. – are some of the most common injuries in the business.

Other common hazards include cuts, burns, and slips, trips and falls. Unlike the imminent danger hazards in construction and manufacturing, hazards in restaurants tend toward first-aid types of injuries. Rarer are reportable injuries such as amputations or fatalities from entanglement in a large industrial mixer or buffalo chopper, which are more likely in food processing than in a restaurant.

The restaurant industry is partially exempt from Occupational Safety and Health Administration (OSHA) recordkeeping requirements. People attending the restaurant safety courses I teach say they are often more concerned with health department inspections.

Restaurant staff usually attend food safety classes, like servsafe, that focus on the safety of food prep and storage, areas the health department regulates. However, it’s also important they not overlook the standards that OSHA regulates in the restaurant industry, including:

  • Hazard communication – exposure to corrosive sanitation and cleaning chemicals.
  • Walking working surfaces – slippery or cluttered floors.
  • Machine guarding – powered equipment, slicers, mixers, etc.
  • Lock out – cord and plug control single point lock out.
  • Personal protective equipment – slip-resistant shoes, cut-resistant gloves, thermal protection etc.
  • Emergency action plans – one-way exit discharge blocked by trash staging in back of house.
  • Electrical – ground-fault circuit interrupter protection where conductive services are located.

Other hazards restaurants should address include awkward lifting and bending, and workplace violence, such as robbery or fights among employees.

We offer classroom and online courses to help restaurants address hazards and develop comprehensive safety plans to protect their workers. You can learn more or register online. I hope to see you in class!

Special investigations department finishes FY2018 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 FY2018, 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 25th year as a department:

  • We closed 1,622 fraud cases, 448 more than in 2017.
  • 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 five ($4.81), or $1.33 more than last year.
  • We reduced our investigation time per case by 23 days on average, our lowest number on this measure since 2005.
  • All told, we saved the state fund $60.1 million in 2018, a 44 percent jump over 2017’s numbers.

We couldn’t have achieved this success without the 121 dedicated staff members who serve our department with great skill, resourcefulness and determination to bring justice to those who cheat our system. We also owe a great deal of credit to advances in technology and a key operational change we made last year to increase our efficiency and productivity.

Drones and Workplace Safety
The drone program we implemented in 2017 for our safety investigators proved itself a worthy investment in 2018. Our safety investigators relied on the tool at 10 workplace safety violation sites last year, including two that would have been especially difficult and dangerous, if not impossible, to properly investigate without it. The most challenging case involved flying the drone into an elevator shaft. Another involved an old factory site where the factory was being torn down. Thanks to our drones, our safety investigators could remain at a safe distance while navigating the drones to survey the sites and take accident scene pictures.

We have three drone pilots certified with the Federal Aviation Administration and three more waiting in the wings, so to speak. And while they find the drones fun and exciting, their enthusiasm is tempered in knowing that each operation is tied to tragedy and unfortunate events. Their drive is to ensure they gather accurate data and conduct unbiased investigations.

Hotline
In November we rolled out a new method for collecting fraud allegations. Until then, outside callers would report allegations to BWC personnel that staffed our customer contact centers. Now the callers reach our investigators directly, which allows our team to ask follow-up questions and obtain more precise information to jumpstart the investigation. It also reduced or eliminated the wait times for callers, which led to fewer dropped calls. The bottom line is the new hotline system led to a more comprehensive and detailed fraud allegation packet that we could send to our field teams.

Looking ahead
As we commence our 26th year in FY 2019, we remain united in our commitment to protecting the state insurance fund 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.

How a new data tool can make your workplace safer

BWC/NIOSH partnership makes injury data easier to understand  

By Mike Lampl, BWC Division of Safety & Hygiene Research Director

Wouldn’t it be useful to have a way to easily identify what’s causing injuries and what types of injuries have been rising in your industry?

We thought it would be. So, we partnered with the National Institute for Occupational Safety and Health (NIOSH) to produce data visualization charts that display summaries of 1.2 million Ohio workers’ compensa­tion injury claims.

These data visualization charts – also called dashboards – are an interactive way to share information and explore large datasets efficiently. This interactive tool, covering claims from 2001 to 2011, displays injury trends by year, industry, and diagnosis or cause of injury. In the coming months, BWC and NIOSH will add data for more calendar years.

With the dashboards, you can create personalized views of charts that display claim counts and rates by general cause of injury.You can use this information to target ergonomic and safety prevention activities by understanding injury trends by year, industry, and diagnosis or cause of injury. The dashboards include:

  • Dynamic and interactive charts that are user-friendly and easy to read.
  • Summaries of workers’ compensation claims (both counts and rates) by general cause of injury.
  • A detailed look at the largest and smallest industry sectors in the state.

The dashboards are user friendly and straightforward. For example, a user can go to the Detailed Industry Results page and select their industry from 267 options*. In this case, say Warehousing and Storage. From the dashboard, the user can then view claims count, frequency, full-time equivalent employees and prevention index. Prevention index is a method for ranking an industry in terms of frequency of injuries and injury rates.

Additionally, users can filter results to see what the prevention index is for ergonomic-related injuries; slips, trips and falls; and all other injuries. If the prevention index ranking is highest for ergonomic-related injuries, the industry should be focusing on preventing ergonomic injuries.

Our Division of Safety & Hygiene uses information from these dashboards to pinpoint industries and associated employers that could use specific, no-cost safety services we offer.

Thankfully, the overall trend for claims rates is going down in Ohio, which users can see in the General Industry Results page of the dashboard. A report that our research staff prepared shows the total recordable cases incidence rate of 2.7 in Ohio in 2016 was lower than the national rate of 3.2 cases per 100 full-time equivalent workers.

Ohio businesses and employees are already doing an excellent job of improving processes and practices related to occupational safety and health. We’re confident these dashboards, born out of our partnership with NIOSH, will be another powerful resource for making Ohio’s workplaces even safer.

* Industry options are based on the North American Industry Classification System codes.

AASCIF 2018: Connecting with industry peers and experts

By Kendra DePaul, BWC Other States Coverage Manager

Each year BWC staff participates in the Annual Conference of the American Association of State Compensation Insurance Funds (AASCIF).

This year, SFM Mutual Insurance Company hosted the conference in Minneapolis. SFM was a generous host providing educational sessions, informative panels and networking opportunities to the attendees.

BWC staff are involved in AASCIF in many ways. This year four BWC employees were members of AASCIF’s committees tasked with planning session topics and finding speakers.

Michael Rienerth, Ergonomics Technical Advisor, chaired the Safety and Health Committee. Bill Teets, Communications Director was on the Communications Committee. Barb Ingram, Chief Finance Officer was on the Finance and Investment Committee and I was on the Underwriting and Policyholder Services Committee.

Several BWC staff also traveled to the conference to attend sessions on a variety of topics from managing concussion claims to an overview of nationwide workers’ compensation legislation.

Shadya Yazback, BWC Chief of Enterprise Services, said that one session she really enjoyed was Telehealth – A Case Study. In this presentation, Workforce Safety and Insurance (WSI), the North Dakota State Fund discussed how they are piloting telemedicine options for a small group of employers. Some areas in North Dakota are very remote, so the pilot utilized technology to engage injured workers’ through telephone calls with triage nurses and follow-up video calls with physicians. The presentation included a live demonstration of a patient exam using the video technology (see photo below).

Shadya commented that she thought the presentation was useful in demonstrating how technological advances have the potential to improve access and quality of care to our injured workers.

I also participated in a panel titled Successfully Recruiting and Retaining the Workers’ Comp NextGen. The panel was moderated by Jennifer Wolf, Executive Director of the International Association of Industrial Accident Board and Commissions (IAIABC). The interactive discussion highlighted the value of hiring and retaining millennial talent and offered ideas such as fellowship programs and career progression paths as ways to get more young people into the industry.

In addition to the educational programming, AASCIF holds an annual Communication Awards competition. I am happy to report that BWC won four awards this year. The awards are:

  • Excellence in Writing: First Place for Saving Lives, Building a Pharmacy Program piece in IAIABC’s Perspectives Magazine
  • Radio/TV Advertising: Second Place for our Guardian Angel 30 second spot
  • Open Category: Second Place for the 2018 Ohio Safety Congress and Expo
  • Print Marketing: Third Place for BWC’s Opioid Infographic.

Perhaps the most exciting part of the conference was when our Administrator/CEO Sarah Morrison announced that AASCIF 2019 will be coming to Cleveland, Ohio.

The team at BWC is already hard at work gearing up to host the conference. Cleveland is a beautiful and vibrant city so save the date for July 21 – 24 and plan on joining in 2019.

Central Ohio handyman guilty of workers’ comp fraud

Pataskala man owes BWC $41,000 after felony conviction

A maintenance man for a mobile home park must reimburse his former employer more than $41,000 after pleading guilty Tuesday to a felony count of workers’ compensation fraud.

Acting on a tip, investigators with the Ohio Bureau of Workers’ Compensation discovered Jason C. Smith, 35, of Pataskala, working for a mobile home park and for private individuals for nearly two years while collecting $41,413 in disability benefits from his employer, TS Tech USA Corporation in Reynoldsburg.

“You can’t claim you’re disabled and collect benefits from BWC or your employer when you’re also working under the radar and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “Workers’ comp benefits are for people who truly can’t work because they were injured on the job, not people who want to cheat the system and pad their income.”

Smith pleaded guilty to a fifth-degree felony count of workers’ compensation fraud. A Franklin County judge ordered him to pay TS Tech restitution and sentenced him to a year in jail, which he suspended in exchange for three years’ probation.

In other fraud news: A northern Ohio man was ordered to reimburse BWC $11,566 after investigators found him running a drywall business while receiving disability benefits from the agency.

Drywall installer Grant Myers, 57, of Huron, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Aug. 8 in the Franklin County Court of Common Pleas. A judge suspended a 30-day jail sentence after Myers paid BWC restitution.

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

Back-to-school safety tips for drivers as distracted pedestrian numbers rise

By Michelle Francisco, BWC Safety Council Program Manager

It’s back-to-school time and that means you’ll probably find yourself driving through busy school zones a lot more often. It’s important to keep in mind the dangers these congested areas pose for both pedestrians and drivers and to prepare accordingly.

There were nearly 6,000 pedestrian fatalities in the United States in 2017, marking the second year in a row at numbers not seen in 25 years, according to a Governors Highway Safety Association report. One trend that may attribute to the rise is the growing use of smartphones, and distracted driving, walking or cycling as a result.

When you’re behind the wheel and in a school zone, or in an area with children walking and biking to school, follow these five simple tips to keep yourself and those around you safe.

  • Be extra watchful at intersections. Not paying attention to traffic signals, such as flashing school zone or crossing signals, is a major area of concern when it comes to pedestrian safety and distractions.
  • Always come to a full stop at stop signs and crosswalk warning signs and be sure to look both ways before pulling through. Remember, pedestrians have the right away, so beware of individuals crossing at the last second.
  • Be ready for jaywalkers. People don’t always use crosswalks and you need to be ready to react if someone steps off the sidewalk, especially if they are distracted.
  • If you see a bicyclist with headphones, exercise caution. They may not be able to properly hear what’s going on around them, including oncoming traffic.
  • While driving, don’t engage in distractions yourself. Put your phone away, refrain from playing with the radio and avoid doing anything that takes your attention off the road. In order to drive defensively, you must remain alert at all times.

For more driving-related safety tips from the Ohio Bureau of Workers’ Compensation, as well as advice on preventing slips, trips, falls and overexertion this fall, visit BeSafeOhio.com.