Schwartz filed a workers' compensation claim on Nov. 30, 2000, alleging he sustained fractures in both wrists when he fell off a ladder while working for Schwartz Construction, a company owned by his son. BWC allowed the claim and began paying medical and TTD benefits. Schwartz collected temporary total disability (TTD) benefits from BWC after returning to the work force.
Schwartz's fraud was discovered when a BWC claims services specialist (CSS) placed a call to the claimant and received an answering machine message from Schwartz Construction. The CSS referred the case to BWC's special investigations unit (SIU).
An investigation was initiated on Jan. 2, 2001. Through surveillance, SIU agents found Schwartz had returned to work, operating his own collectables shop, while still collecting workers' compensation. The address for the collectables shop matched the one listed as the location of injury in the claim. Further investigation found Schwartz was not an employee of Schwartz Construction. As a result, the claim was disallowed.
Injured workers who receive TTD benefits are temporarily disabled due to an occupational injury. TTD benefits are to be terminated when the injured worker is physically able to return to work.
"BWC is committed to cracking down on fraud and preventing theft of taxpayer dollars," said BWC Administrator/CEO James Conrad. "Workers' compensation fraud is a hurdle that we must surpass in our efforts to make Ohio's workers' compensation system the most efficient and effective in the nation."
In fiscal year 2002, BWC's SIU uncovered $98.8 million in savings from fraudulent activity. It referred 312 subjects for criminal prosecution. The average take in a fraudulent workers' compensation case is $35,000.
