In pursuit of fairness – #FraudWeek 2017

By Jim Wernecke, Director, BWC Special Investigations Department

I have always appreciated the importance of fairness and integrity. I have used these virtues as a guide throughout my career, from early on when I supervised 15 employees at a small manufacturing company, to my 25 years with the Ohio State Highway Patrol and now as head of the Ohio Bureau of Workers’ Compensation’s Special Investigations Department.

I am privileged to lead 122 professionals who work to deter, detect and investigate workers’ compensation fraud in the state of Ohio. We pursue cases of claimant, medical provider and employer fraud.

What drives a claimant to file a false claim; an employer to purposely misclassify their workers; or a physician to fudge paperwork to secure higher service payments? We can debate the reasons, and they probably vary in each case, but my drive to halt wrongdoing comes from an appreciation for standards, rules and enforcement of the law that are conducted uniformly, fairly and systematically. In short, I want to know that others are following the same rules you and I follow.

It is easy to translate this philosophy into the world of workers’ compensation when you think about employer premiums, medical services and protection of our injured workers. Injured workers deserve a fair system that’s focused on their care and recovery. Employers want their competitors to play by the same rules, and they want assurance that any employee who attempts to gain undeserved benefits will be held accountable. And we all want truthful and professional physicians delivering our medical care.

These are among the many reasons I count fairness and integrity among the most important qualities you’ll find in a person. Treat people fairly, and treat them the way you want to be treated. Our integrity is on the line when we don’t accept the responsibility and tell the truth. Once trust is lost, it’s likely gone forever. I’m sure many of you feel the same.

We take great care to protect the dollars Ohio employers set aside to care for their injured workers. We’re not too shy to say we think we do a pretty good job, but we’re always seeking improvement. That’s why we enjoy taking part in International Fraud Awareness Week each year. We’re not only able to highlight our successes, but also engage and learn from our fraud-fighting peers across the country. This year will be no different.

Those of you who follow workers’ comp fraud in Ohio know we share our fraud news weekly on “Fraud Friday,” but we always take it to another level during IFAW. Please join us this week and all year long as we share new cases, tips for identifying and preventing fraud, insights from our investigators, and much more on our Facebook and Twitter pages.

Happy Fraud Awareness Week!

Fraud scheme doesn’t float for Ohio swimming pool business owner

A Mansfield-area businessman must pay more than $33,000 in restitution to the Ohio Bureau of Workers’ Compensation for filing phony records and scheming to avoid his debt for past premiums.

Roger L. Graszl, the owner of Premier Gunite Unlimited Pools & Spas in Lexington, Ohio, also was sentenced to five years probation Wednesday in the Richland County Court of Common Pleas. The sentencing followed his guilty plea Sept. 13 to two third-degree felony counts of tampering with records.

“We discovered Mr. Graszl wasn’t carrying workers’ compensation insurance after one of his employees was injured and filed for benefits,” said Dan Fodor, assistant director of BWC’s special investigations department. “We tried multiple times to bring Mr. Graszl into compliance, but he failed to cooperate.”

Fodor said Graszl also tried several times to obtain a certificate of coverage from BWC using fictitious information on his application.

“He thought he could sneak in under our radar and obtain a certificate so he could continue to operate his business,” Fodor said. “Obviously, it didn’t work. It’s pretty hard to fool BWC and our agents.”

Ohio law requires businesses to carry workers’ compensation coverage.

Graszl owes BWC $27,516 for past premiums and $5,833 for the cost of the agency’s investigation.

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

Don’t trip for treats

By Erik Harden, BWC Public Information Officer

Fading daylight, uneven sidewalks and walkways, ill-fitting or restrictive costumes: What could possibly go wrong?

Trick-or-treating is fun for families, but it is also fraught with fall hazards.

Here are some tips from STEADY U Ohio on how to have a scary good time without the slipping and tripping that can lead to a frightening fall.

  • Eat a nutritious meal before heading out to trick-or-treating to make sure you have plenty of energy, and avoid blood sugar level spikes, which can cause dizziness.
  • Carry a flashlight and watch for uneven sidewalks, curbs, debris and other tripping hazards.
  • Choose costumes that fit well: If it’s too loose, it can cause trips; too tight, it can limit movement.
  • Avoid long gowns, capes and accessories that can snag on objects or wrap around legs and trip children or adults.
  • Use makeup instead of masks that limit peripheral vision.
  • Fabulous footwear might complete a costume, but sensible shoes will be less likely to cause a tumble.
  • If you decorate your yard or home for visitors, make sure walkways are free of cords and visitors can’t trip on decorations.
  • Battery-powered luminaries and mini-lights can provide extra lighting at foot level without spoiling spooky effects.
  • If you’re going for that “big scare,” make sure the area is level and clear of objects to prevent falls when people react.

STEADY U Ohio is a statewide collaborative falls prevention initiative, supported by Ohio government and state business partners to ensure that every county, every community and every Ohioan knows how they can prevent falls, one step at a time.

Visit www.steadyu.ohio.gov for more tips and resources to help you and your loved ones prevent falls.

Sharing insights and achievements in workers’ comp

By Kendra DePaul, BWC Other States Coverage Manager

In workers’ comp, we sure do love our acronyms. One of my favorites is the IAIABC which states for the International Association of Industrial Accident Board and Commission.

The IAIABC is an association that brings together workers’ compensation administrators, regulators and leaders to discuss policy and regulatory issues affecting workers’ compensation systems around the world.

Workers’ compensation is a state-based system and although rules and laws vary between states, we also have a lot in common. IAIABC’s annual convention provided an opportunity for the various states (and countries) to discuss common challenges, solutions and ways to impact the system.

The conference was held in Portland, Oregon this year and it was my first year attending. The topics discussed were familiar to those in the industry, including disability management and return to work, employee vs. independent contractor classification, promotion of health and safety, and the like.

A common topic that often comes up at these meetings is employee recruiting and how we are going to replace the knowledge and experience of many talented workers’ comp staff who may be retiring soon. The focus is often on how jobs in the workers’ compensation field have many good things to offer: stability, career advancement, opportunities for growth, the ability to help people, and the need to recruit millennials.

Since I am a millennial, I will say that all those things ring true and I very much enjoy spending my days in the workers’ comp world. I was honored this year to be recognized by IAIABC as a NextGen recipient.

The award recognizes professionals under the age of 40 who are making an impact on workers’ compensation.

As part of the award, I participated in a session titled A Conversation with the NextGen where we shared our thoughts and insights on the industry.

I had a great time meeting the other NextGen recipients and discussing the future of workers’ comp.

Although we are from different states and work in many different roles, there are common themes of needing to improve communication, leverage data and move towards a customer-focused system. There was agreement that for a lot of people, having a workers’ compensation claim is a very personal and potentially life-altering situation and it is important to not lose the people in the process.

If you’re looking for a career path in an industry on the verge of making important improvements, look no further!

Breathe easy: BWC can help tackle respirable silica in the workplace

By Jeffrey Hutchins, Industrial Hygiene Technical Advisor

Did you know the Occupational Safety and Health Administration (OSHA) began enforcing the construction standard for respirable crystalline silica (RCS) last month?

Do you know what the standard includes and how to stay in compliance with it?

The standard establishes a new eight-hour time weighted average permissible exposure limit of 50 µg/m3 for all covered industries. It also requires other employee protections, such as:

  • Performing exposure assessments;
  • Using exposure control methods and respiratory protection;
  • Offering medical surveillance;
  • Developing hazard communication information;
  • Keeping silica-related records.

BWC’s Division of Safety & Hygiene has a variety of resources to help Ohio employers understand and meet the requirements of the new standard. These resources are available at no charge as part of the loss-prevention services provided through Ohio workers’ compensation premiums. Services include:

  • On-site industrial hygiene consulting to determine airborne RCS levels and, if needed, assistance in developing a written exposure control plan. Request on-site consultation
  • Safety Intervention Grants to help purchase engineered dust-control solutions. Learn more
  • Training focused on awareness-level RCS hazards and respiratory protection. Learn more
  • Additional resources such as videos and the latest publications from the Division of Safety & Hygiene Library. Learn more

BWC’s industrial hygienists have years of experience in the field and conduct RCS sampling and analysis using the methods specified in the OSHA standard. Training courses focus on topics related to the standard (e.g., respiratory protection and respirator fit testing).

Our latest safety video provides an overview of respirable silica in the workplace, including where silica is found, requirements of the new OSHA standard and elements of a silica exposure control program.

Visit our website to request consulting services.

Toledo woman convicted for taking late boyfriend’s work comp benefits

Four others convicted in recent fraud cases

A Toledo woman who cashed her late boyfriend’s work comp benefits for more than a year after his death must reimburse the Ohio Bureau of Workers’ Compensation more than $18,000 or serve 10 months in prison, a Lucas County judge ruled Oct. 5.

The judge ordered Suzette Hedrick, 58, to reimburse BWC $18,576 and serve five years of probation after she pleaded guilty to attempted grand theft, a fifth-degree felony.

“Our investigation found that Ms. Hedrick deliberately withheld from BWC that her boyfriend had died, which enabled her to illicitly use his electronic benefits card for personal gain,” said Jim Wernecke, director of BWC’s special investigations department (SID). “We understand the financial hardship some people experience following the loss of a loved one, but that doesn’t diminish the seriousness of this crime.”

An internal claims specialist discovered last year that Hedrick’s boyfriend, who was on permanent total disability, had passed away on Oct. 3, 2015, but someone was still withdrawing his monthly benefits. The agency stopped paying benefits immediately. Hedrick admitted to agents that she used the card to pay her bills, and she accepted responsibility.

In other news:

Elizabeth Brown, of Groveport, Ohio, pleaded guilty Oct. 12 to one misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. Investigators discovered Brown had worked in customer service for four separate companies from September 2015 to January 2016 while on temporary disability benefits. After her plea, she reimbursed BWC $3,905.

Timothy Snedeker, of Newark, Ohio, was found guilty Oct. 3 of three misdemeanor counts of lapsed coverage for failing to carry workers’ compensation coverage on his business, Tim’s Tree Service. A Newark Municipal Court judge sentenced Snedeker to one year in prison, which he suspended for 90 days probation. Snedeker reimbursed BWC, and his business is now in active compliance.

Theodore Skwarski, of Cleveland, Ohio, pleaded guilty Sept. 6 to unauthorized use of property/computer system, a second-degree misdemeanor, after BWC investigators found him operating Ted’s Auto Service without proper work comp coverage. A judge sentenced Skwarski to 90 days in jail (suspended), one year of community control and 20 hours of community service to be completed within the next six months. Skwarski told BWC he was no longer operating his business, but investigators discovered otherwise. He entered a payment plan and is currently operating with active coverage.

Michael Humble, of London, Ohio, pleaded guilty Sept. 6 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working while receiving permanent total disability benefits. He was sentenced to one day of jail, which was suspended for the payment of $3,834 in restitution.

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

Don’t just talk about practice

Prepping for home fires saves lives

By Erik Harden,  BWC Public Information Officer

Fifteen years ago, Philadelphia 76ers star Allen Iverson went on his now-famous “we’re talking ‘bout practice” rant. In a moment of frustration, he argued that whether he practiced or not was ultimately irrelevant to his performance during games.

Lately it seems many Americans feel the same about practicing ways to escape a housefire. In fact, a recent survey by the National Fire Protection Association (NFPA), reveals almost three-quarters of Americans have an escape plan; however, less than half ever practiced it.

This year’s Fire Prevention Week, Oct. 8-14, focuses on helping us all to develop and practice a plan for escape in the event of a housefire.

In a typical home fire, you may have as little as one to two minutes to escape safely from the time the smoke alarm sounds. That’s why home escape planning is so critical in a fire situation. It ensures that everyone in the household knows how to use that small window of time wisely.

The NFPA offers the tips and recommendations below for developing and practicing an escape plan.

  • Draw a map of your home with all members of your household, marking two exits from each room and a path to the outside from each exit.
  • Practice your home fire drill twice a year. Conduct one at night and one during the day with everyone in your home, and practice using different ways out.
  • Teach children how to escape on their own in case you can’t help them.
  • Clearly mark the number of your home so the fire department can easily find it.
  • Close doors behind you as you leave – this may slow the spread of smoke, heat and fire.
  • Once you get outside, stay outside. Never go back inside a burning building.

The NFPA has a mapping grid (in English or Spanish) you can use to create a home escape plan with all members of your household. You can even practice it on National Fire Drill Day, this Saturday, Oct. 14.

Iverson was an NBA star who was good enough to sometimes blow off practice and coast on his jaw-dropping talent during games, but in the end he was just playing a game. When it comes to surviving a home fire, practice could literally be the difference between life or death.