The word “fraud” carries a heavy connotation with it and making a fraud referral to the Bureau of Workers’ Compensation can feel a bit overwhelming. What should you do if you suspect that a fraudulent claim has been filed against you? The Bureau of Workers’ Compensation has an entire division devoted to analyzing and investigating fraud concerns. The Special Investigations Department was created in 1994 with the sole purpose of reviewing potential fraud in the workers’ compensation system.   

According to the Bureau’s Special Investigations Department Annual Report from 2025, they received 2,164 fraud allegations and ultimately closed 1,395 cases with 56 resulting in convictions for an identified savings of $91 million dollars.

It is important to understand the activities that are most associated with potential workers’ compensation claim fraud:

• Collecting disability benefits while receiving compensation 
• Receiving cash payment for work performed “under the table”
• Claiming to be injured while at work when the injury happened elsewhere
• Exaggeration of disability complaints to extend disability
• Falsifying documents related to a claim application

Employers are often notified of potential fraud either from co-workers who witnessed or heard about the suspected incident or through personal observation, such as seeing a post on social media.  Should you suspect one or more of the above activities you should contact the BWC Fraud unit to report a concern.

You can do this either through the Bureau of Workers’ Compensation’s website or by contacting the BWC Fraud department directly at 1.800.644.6292.  For more information, contact our Sedgwick program manager, Dave Deyo at 614-318-5516 or email david.deyo@sedgwick.com 

Workplace injuries can carry both financial and emotional weight for employers and employees alike. While ensuring injured workers receive proper care remains the top priority, managing the associated costs is also essential to maintaining a healthy workers’ compensation program.

In Ohio, employers have three key strategies available to help contain costs: Settlements, Disability Relief, and Subrogation/No-Fault Motor Vehicle Accidents (MVA). Sedgwick continues to lead the industry in leveraging these tools effectively.

Our approach combines advanced analytics and proactive cost containment strategies to help Ohio employers reduce claim expenses and lower premiums. From the moment a claim is filed, our team is equipped to implement solutions that drive meaningful savings.
Sedgwick’s dedicated cost containment team focuses exclusively on delivering impactful results through these three avenues. Our efforts have led to significant savings not only for individual employers but also for those participating in group retrospective rating programs.

Settlement Agreements
A settlement involves a mutual agreement between the employer, the injured worker, and the Ohio Bureau of Workers’ Compensation (BWC) to resolve a claim with a lump sum payment. This can result in full or partial closure of the claim, helping employers manage long-term exposure.

Disability Relief
This program supports employers who hire or retain individuals with pre-existing medical conditions. If a disability contributes to an injury or delays recovery, employers may be eligible for reimbursement on related claims, reducing their financial burden.

Subrogation / No-Fault MVA
When a workplace injury stems from a motor vehicle accident involving a third party, the Ohio BWC may assign the claim’s cost to the surplus fund—relieving the employer of direct financial responsibility.

Sedgwick is proud to collaborate with our clients in optimizing their workers’ compensation programs. Our early, proactive approach to cost containment remains a cornerstone of our commitment to achieving the best possible outcomes for both employers and injured workers.

For questions or support, please contact Peyton Rosier at Sedgwick via peyton.rosier@sedgwick.com.

The Ohio Bureau of Workers’ Compensation (BWC) provides workers’ compensation coverage based on estimated payroll. Therefore, at the end of the policy year, BWC asks employers to report their actual payroll for the prior policy year and pay any shortage (or receive a refund for any overage) in premium. This process is called a true-up. If the true-up is not completed timely, the following may occur:

• Employer will not be eligible for prior year rebates and incentives
• Employer will be removed from current year programs
• Employer will become ineligible for programs the following year and will continue to remain ineligible for all future years until all past true-ups are completed.

How to report payroll and complete the true-up
Although employers may contact BWC at (800) OHIO-BWC (800.644.6292) and complete their true-up report over the phone, BWC anticipates high call volumes and long wait times. They strongly encourage employers to complete their true-up report online through their BWC e-account at www.bwc.ohio.gov. If you do not have an e-account, simply select the Create E-Account Link to begin. You will need your BWC policy number and/or Federal Tax Identification Number.  

Deadline: Private employers - True-up report must be completed and payment received no later than August 31, 2025. 

Please note: There is no longer a grace period. True-up and payment (if owed) must be POSTED by the deadline date.

If you have any questions, contact our Sedgwick program manager, Dave Deyo, at david.deyo@sedgwick.com.