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Fraud focus for Jefferson Safety Council

January 22, 2012
Weirton Daily Times

STEUBENVILLE - Members of the Jefferson County Safety Council were updated this week on the complexities of workers' compensation fraud investigations.

Rita Johnson, fraud analyst with the Logan Area Bureau of Workers' Compensation, said fraud is a statewide problem. In 2011, she said the Cambridge office logged 4,432 allegations of fraud. Of those allegations, she said they were able to close 2,425 cases, referring 245 of them to the prosecutor. Some 110 indictments resulted from BWC investigations, with 130 convictions. Their work resulted in $58 million in savings.

She said it's not easy to prove fraud.

"There's a higher standard to prove an injured worker knew what (he or she) was doing was wrong and that they intended to steal from the BWC," she said. "There's just a higher standard of proof."

Video can be used to document abuses, but she said in rural areas getting close enough to a suspect's house without being noticed is difficult at best.

"Documentation, that's what the prosecutor wants to see," she said, noting that even the smallest detail can be important.

"The more detail we get, the better off we are," she said.

Both video footage and still photos must have a time stamp on them.

If they can prove their case, however, Johnson said they can and do refer it to the prosecutor's office.

In drug cases, she said if an investigator suspects abuse or feels an individual is getting medications not related to their claim, "we can get it reviewed and medications terminated."

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