Search Warrant Finds Altered Medical Records and Changes to PPD Percentages

OHIO. The owner of a business compiling medical reports for law firms representing injured workers received a four-year prison sentence for workers’ compensation fraud, following prosecution for unusual reporting practices.

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The man pleaded guilty to one count of workers’ comp fraud, a fourth-degree felony; two counts of tampering with records, a third-degree felony; and 10 counts of forgery, a fifth-degree felony. He was ordered to pay $139,558 in restitution and $56,340 in investigative costs to the BWC.

The Bureau of Workers’ Compensation (BWC) became suspicious of the man’s medical reports and, suspecting fraud, notified the Special Investigation Department (SID).

SID exercised a search warrant of the man’s business and found evidence he altered medical reports used by the BWC and the Ohio Industrial Commission (IC) to determine the percent of permanent partial (%PP) awards (also known as C-92 awards).

BWC’s %PP compensation is available to injured workers with permanent injuries to a body part caused by a work-related accident or an occupational disease. (workersxzcompxzkit)

Investigators found the man inflated percentages submitted by medical providers and/or embellished medical conditions within the final report in an attempt to raise percentage PP awards and ultimately increase his business.

Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-553-6604.

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