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Defrauding Ohio’s Workers’ Compensation System Results In Convictions

January 25, 2013

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According to the Ohio Bureau of Workers’ Compensation Administrator, Stephen Buehrer, there were 125 fraud convictions of employers, injured workers, providers, and others who committed fraud against the State Insurance Fund in 2012. Buehrer announced that 26 individuals were either convicted of or pled guilty to defrauding Ohio’s workers’ compensation system in November and December alone. The Bureau’s Special Investigations Department (SID) is charged with investigating any allegations of fraud that are brought to its attention. The SID works solely to deter, detect, investigate and prosecute workers’ compensation fraud. Employers can be convicted of fraud for intentionally misidentifying their employees job titles or failing to accurately report the payroll on which their workers’ compensation premiums are based. Medical Providers can be convicted of fraud for billing the BWC for services they haven’t provided. Injured workers can be convicted of fraud for working while collecting Temporary Total or Permanent Total Disability benefits. Every participant in the workers’ compensation system should be aware of this. According to Claims Journal, a source for news and resources for the claims industry, in November 2012, Ohio resident Charles Morris was sentenced for workers’ compensation fraud and ordered to repay the BWC nearly $30,000.00 for monies he fraudulently collected. Apparently, Morris was receiving Temporary Total Disability benefits for being disabled from work. The SID received a complaint that Morris, who was receiving Temporary Total Disability benefits, was working as an HVAC technician at the company where his injury occurred. An audit of Morris’s bank records, numerous customers identified who confirmed that Morris had performed HVAC work for them during the period of time that he was receiving TTD benefits. Morris pled guilty on November 6, 2012 and was sentenced on January 3, 2013 by Judge Sheeren at Franklin County Court of Common Pleas. If you are receiving workers’ compensation benefits, make sure to abide by the law. Please review Ohio Law 2913.48, Workers’ Compensation Fraud, to avoid any possible convictions of fraud. By: Nicole Celebrezze, Workers’ Compensation

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