Group Catches Worker's Comp Cheaters In The Act

Special agent Tamela Dixon is part of the team whose job it is to catch workers compensations cheaters in the act.

The Ohio Bureau of Worker's Compensation's Special Investigations Department has captured 159 workers, business and even doctors on camera in the past year, saving the BWC $73 million, Watchdog10's Kurt Ludlow reported.

"It's very disheartening to see people abuse the system because there are people who are genuinely hurt and who genuinely deserve this benefit," Dixon said.

Ludlow recently spent time with the Special Investigations Department, which works to deter, detect, investigate and prosecute fraud.

Special Agent Scott Lape showed Watchdog10 the inside of their undercover van that contained long-range cameras, pinhole cameras and hidden microphones.

The high-tech equipment is used to document workers' compensation abuse, get convictions and ultimately restitution, Ludlow reported.

"Video is the best evidence," Lape said.  "So if we can capture our target on video, that's what we want to show the jurors."

Before the team can catch criminals, they have to determine who is cheating.  Dan Fodor, who heads up the bureau's intelligence unit, said that since 2007, his team has uncovered fraud that has saved the bureau $25 million.

"Our team is primarily responsible for identifying potential fraudulent cases proactively," Fodor said.

His computer experts secretly mine BWC data, crunch the numbers and look for patterns that could lead them to a cheat, like a person who fakes an injury, is a drug addict or a drug trafficker.

"You have to know the system to know how to beat the system," Fodor said.  "We sit around in staffing meetings, trying to figure out if we're going to try to get money out of workers comp -- how would we go about doing it - and then we turn around and build data queries to go try to mine that data to see who else might have thought of that idea."

Most of the time, fraudsters simply claim that they were injured on the job and start collecting benefits, Ludlow reported.

On the day they were with Watchdog10, the unit used surveillance on a carpenter who was on temporary total disability while he continued to perform his remodeling business on the side.  He was seen brazenly leaving the site to attend a hearing about his benefits.

"We (watched) him performing the work, then coming to the (Ohio) Industrial Commission to talk about his claim and then he returned to work that day," Dixon said.  "He does not look injured."

The carpenter cheated the BWC out of $11,000 worth of benefits he received while operating his own hardware store.

The investigative unit also saw an injured trucker who collected $7,000 worth of benefits before he was caught chucking heavy pieces of metal.

A disc jockey who was seen carrying heavy equipment was a warehouse worker who was on disability.  Agents said he ripped off the BWC of more than $27,000.

All of the criminals shown in the report either paid or are in the process of paying restitution Ludlow reported.

The agency is funded by employers and is overseen by the State of Ohio.