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WORKERS' COMPENSATION FRAUD
Special Agent in Charge
BWC Special Investigations Department
As part of their mission to effectively and proactively prevent losses to the workers’ compensation system and to deter, detect, investigate and prosecute workers’ compensation fraud, the special investigations department recognizes the importance of educating and informing others about how they may join in combating fraud. Shawn Fox will share with our members
Information about SID:
The Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID) aggressively pursues cases of claims fraud, medical provider fraud and premium fraud. As a result of our investigations, the department declares overpayments, identifies actuarial savings, disallows claims, pursues prosecutions and recovers dollars — all of which directly impact the effectiveness BWC experiences in decreasing premium costs.
The SID is comprised of several types of teams:
Three regional claimant fraud special investigation units operate in most customer service offices;
The health care provider team, employer fraud team and safety violations investigation unit (SVIU) are each comprised of team members located throughout the state;
The intelligence unit; digital forensics unit; and BWC security services operate through BWC’s central office.
Ohio Revised Code (ORC 2913.48) permits the criminal prosecution of those who defraud the workers’ compensation system.
Since its inception in 1993, SID had achieved the following *: