Here in the state of Ohio, the Bureau of Workers' Compensation has made big effort to put an end to fraud. Like many other crimes, its nearly impossible to stop it completely, however, the Bureau has agents who investigate the claims and track down the people and businesses trying to scam the system.
Shawn Fox is one of many on the front lines in the fight against fraud. He investigations allegations of employee fraud against the state's system.
"Our agents typically review a work list of allegations that come in either from employers in the State of Ohio, doctors or the general public," Fox said.
Thousands of tips come in every year. In 2012, the Bureau closed more than 2000 cases, a quarter of those were recommended for prosecution, including the case of James Speegle.
The Toledo native claimed he couldn't work after an injury on the job. But state agents go a big surprise when they tracked him down in Warsaw, Indiana.
"Our agents drove three hours daily to take days of video of this guy loading his mower on the back of a trailer and taking lumber into a house to do some carpentry work," Fox said.
In the end, Speegle pleaded guilty to on misdemeanor count of workers' comp fraud. He was sentenced to 180 days in jail. He won't spend time behind bars as long as he pays a fine.
"By us attacking people abusing the system, we are making a solid foundation for the financial bas for the people that really deserve it," Fox said.
That's a goal shared by fellow agent, Craig Matthews. He is the special agent in charge of employer fraud. Its a crime committed by business owners, not employees.
"We're going after the employers that are not paying into the system, or who do not have coverage at all," Matthews said.
Ohio businesses with at least one employee are required to have workers' compensation coverage. But, not everyone follows that rule.
"A lot of people will maintain a policy and report 0 payroll stating they don't have any employees when in fact they do," Matthews said.
Matthews and Fox say the only way to stop fraud is to investigate every lead and sometimes that means going under cover.
"When you get a good case like Speegle, for example, there was probably 20 hours of video that we edited down to turn in as evidence," an unidentified agent said.
From binoculars and tiny cameras to an unmarked surveillance vehicle, the Bureau goes to great lengths to capture evidence.
"We have ports out the back and on the sides. It helps keep it dark in here and allows us to shoot video," the agent said.
Preventing fraud keeps premiums low for businesses and keeps employees safe. That's why the state is committed to continue to crack down on the those trying to cheat the system.
As taxpayers fraud can also affect you. If premiums go up businesses may have to raise prices to make up the difference. Also public employers must have coverage as well, and they are paying the premiums with taxpayer dollars. A fraud case there may affect your bottom line.
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