WORKERS’ COMPENSATION FRAUD

In Ohio, workers’ compensation fraud is a very serious matter. Allegations of fraud can lead to civil or criminal penalties and in some cases, can lead to both.  While fraud may involve employers, workers or health care providers, the Bureau of Workers’ Compensation (BWC) focuses the brunt of its attention on fraud involving injured workers.

The most common type of fraud involves working while also receiving workers’ compensation benefits for being off work. However, per ORC §2913.48, a person is also is guilty of workers’ compensation fraud when he or she:

  • Makes false or misleading statements with the purpose of securing goods or services under the Workers’ Compensation Act;
  • Alters, falsifies, destroys, conceals or removes records or documents necessary to establish the validity of a claim, or necessary to establish the nature of goods and services for which reimbursement is requested in a claim; or
  • Enters into an agreement for conspiracy to defraud the BWC or a self-insuring employer by making false claims for disability benefits.

An individual who is accused of workers’ compensation fraud may be charged with a misdemeanor of the first degree all the way up to a felony of the third degree, depending on the amount of money involved.

The BWC’s special investigation department (SID) is tasked with investigating fraud in Ohio. Their investigations most often start with a report by an employer, co-worker or even medical provider. Also, frequently, a tip from a neighbor or even a family member will lead to an investigation.

If you are approached by a BWC investigator or accused of wrongdoing in a workers’ compensation matter, it is best to talk to a lawyer first before you speak with an investigator. You have rights.  Dworken & Bernstein has attorneys experienced in both the civil and criminal aspects of allegations of workers’ compensation fraud.  Contact (216 )861-4211 for a free consultation that may prevent you from becoming the victim of an aggressive investigation when you have done nothing wrong.

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