jail_cellWhen an injured worker is receiving Temporary Total Disability (TTD) or Permanent Total Disability (PTD), work performed (remunerative employment for which payment is received) is prohibited by law.

If the BWC finds out that an injured worker, receiving TTD, is working, the Fraud Unit will investigate and pursue prosecution. Ohio BWC fraud is a felony.

Interestingly, based on the following article posted on the Ohio BWC website, it seems that an injured worker on PTD, who seeks a lump sum settlement may become the subject of a BWC Fraud Unit investigation.

FROM THE BWC WEBSITE:
Richland County Man Sentenced For Workers’ Compensation Fraud

Roger Roseberry found guilty of filing a false claim

COLUMBUS – A Mansfield man was sentenced yesterday in the Richland County Common Pleas Court after pleading guilty to fraud following an investigation by the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID). A judge ordered Roger Roseberry to pay at least $500 per month to BWC and will face incarceration for six years if he fails to pay. He was also sentenced to five years of community control. Roseberry was collecting Permanent Disability from the BWC for an injury that included total loss of use of his right arm and both legs due to Reflex Sympathetic Dystrophy, also known as RSD. A BWC Attorney referred the settlement to the SID for review after Roseberry submitted an application for a lump sum settlement in the amount of $617,000. The SID’s investigation revealed Roseberry did have use of both his legs as well as his right arm.

“Injured worker fraud draws resources from workers who have legitimately been injured on the job, and unfairly raises premiums for employers who are working to maintain safe workplaces,” said SID Director Tom Wersell. “Careful monitoring of claims helps us identify and prosecute those who abuse the system.”

Special Agents conducted several days of surveillance and observed Roseberry operating a motor vehicle, driving long distances, walking, opening and closing doors, holding items and writing. The videos were later shown to Roseberry’s treating physicians who indicated the video contradicted the conditions allowed in his workers’ compensation claim. Upon completion of the investigation, the settlement was rejected by the BWC and Roseberry was referred for prosecution. Roseberry admitted to fraud related to collecting Permanent Total Disability benefits and his request for the lump sum settlement.

On March 30, 2009, Roger Roseberry pleaded guilty in Richland County Common Pleas Court to one count of workers’ compensation fraud, a third degree felony and one count of theft, a fourth degree felony. As part of the plea agreement, Roseberry has agreed to repay $23,536.92 in restitution and $7,000 in investigative costs.