Workers’ Compensation Fraud

Defrauding workers’ comp in the state of Ohio is a serious offense and the Ohio Bureau of Workers’ (BWC) Compensation will aggressively pursue those who attempt to engage in such fraud.

If convicted, you could spend up to a year in prison and be forced to pay back the amount defrauded along with extensive fines.

Attorney for Worker’s Compensation Fraud in Dayton, OH

If you believe you are being investigated for workers’ compensation fraud in the Dayton area, it is crucial you seek legal counsel from an experienced and knowledgeable fraud attorney from Joslyn Law Firm. We assist clients in Dayton, Kettering, Huber Heights, Troy, Piqua, Springfield, Beavercreek and other surrounding areas.

Joslyn Law Firm will strive to protect your rights and achieve the best possible result for your situation. Call us today at (937) 356-3969 or fill out our online form and one of our attorneys will review your case for free.


Overview of Workers’ Compensation Fraud in Ohio


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What is Workers’ Compensation Fraud?

For starters, workers’ compensation is a type of insurance that provides employee compensation for injuries or disabilities that occurred while on the job, while workers’ compensation fraud is considered any lie or misrepresentation made by an employer, employee or provider for financial benefit. Under Ohio Revised Code 2913.48, an individual commits workers’ compensation fraud when he or she:

  • Receives compensation she or he is not entitled to
  • Makes false or misleading statements with the purpose to obtain services or goods under the Workers’ Compensation Act
  • Falsified or altered records or documents that are used to validate a compensation claim
  • Entered an agreement or conspiracy to defraud the BWC or self-insuring employee by making false claims for disability benefits
  • Made or caused a false statement to be made about employees when such information is used to determine the payment owed to the BWC for their coverage
  • Forged, altered or created a false workers’ comp certificate
  • Failed to obtain or maintain workers’ comp benefits with the intention to defraud the BWC

Workers’ comp fraud isn’t just committed by employees, but employers and healthcare providers as well. Listed below are signs an employer or health care provider is committing workers’ comp fraud:

  • Employer misclassifies employees as independent contractors/subcontractors.
  • Certificate of BWC coverage is not visible, contains an outdated coverage period or an incorrect name of the BWC Administrator.
  • Suspicion that a competitor could underbid contracts due to not paying workers’ compensation coverage.
  • Employer misreports the amount of payroll or shifts payroll to lower cost jobs to avoid paying its fair share.
  • Medical provider performs unnecessary treatments or test.
  • Medical provider bills for more expensive procedures than were actually performed.
  • Receiving a bill from an unlicensed medical provider.
  • Medical provider provides heavy prescriptions for narcotics but gives limited or no medical treatment.

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Penalties for Workers’ Compensation Fraud in Ohio

The BWC aggressively attacks those who commit workers’ comp fraud through its special investigation unit. Depending on how much was defrauded in your case, if convicted, you could be charged with the following:

  • If the amount involved is less than $1,000, you could be charged with a first-degree misdemeanor and face up to one year in jail.
  • If the amount involved is between $1,000 and $7,5000, you could be charged with a fifth-degree felony, face up to a year in prison and extensive fines.
  • If the amount involved is between $7,500 and $150,000, you could be charged with a fourth-degree felony, face up to a year in prison and extensive fines.
  • If the amount involved exceeds $150,000, you could be charged with a third-degree felony, face up to a year in prison and extensive fines.

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Ohio Workers Compensation Resources

The Ohio Workers' Compensation Act: Internal and Extraterritorial Jurisdiction - View full text of the Ohio Workers’ Compensation Act on the BWC’s website. The act covers Supreme Court cases that helped shape the laws regarding workers’ comp, claims in multiple states and coverage agreements. The Ohio Bureau of Workers’ Compensation is the provider of workers’ comp insurance in Ohio.

Ohio Bureau of Workers' Compensation – Visit the website of the BWC, the provider of workers’ comp insurance in Ohio. The site features information on fraud, safety, and faqs for workers and employers. The BWC is the largest state-run insurance system in the country with a mission to protect Ohio’s workers and employers.

Ohio Revised Code 2913.48- View full text of the Ohio Revised Code that governs laws regarding workers’ compensation fraud in Ohio. The section offers an in-depth explanation of topics such as penalties and what is considered workers’ comp fraud.

Find a Workers’ Compensation Fraud Lawyer in Dayton, OH

Having experienced legal counsel from Joslyn Law Firm can make all the difference in your workers’ compensation fraud case. We will fight to protect your rights and achieve the best possible outcome for your situation. Joslyn Law Firm assists clients in Dayton, Kettering, Huber Heights, Troy, Piqua, Springfield, Beavercreek, Fairborn and many others.

Call us today at (937) 356-3969 or fill out our online form and Joslyn Law Firm will review your case for free.


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