In a six-month probe, NBC4 Lead Investigative Reporter Duane Pohlman uncovers quotas at Ohio’s Bureau of Workers Compensation (BWC) Special Investigations Department. Quotas for everything from the number of surveillances to, historically, indictments that former SID investigators claim have pressured agents to make cases, even when the people they’re investigating may be innocent.
HAVE A TIP? Submit A Tip To NBC4 Investigates
WATCHING A GRANDMOTHER
Seventy-year-old Kathy Trumm is a mother, grandmother and business owner, but for two and a half years, investigators at Ohio BWC Special Investigations Department (SID) were trying to prove she was also a criminal.
It became increasingly clear Trumm, who owns Korcar, which handles injured worker claims, was being targeted.
Trumm, along with neighbors and friends, witnessed at least five agents tailing Trumm at work and home.
“He parked on my street,” Trumm recalled, referring to one of the agents who was was watching her, adding, “He just snapped a picture of me.”
It happened frequently for years.
SPENDING $63,607.99 TO PROVE $2,632.20 IN “FRAUD”
As the glare of state agents continued, Trumm and her family and friends could not understand what would make this grandmother such a target for the men who were constantly showing up carrying their cameras and following her in their cars.
According to the BWC/SID Investigative Report obtained by NBC4, state agents were investigating Trumm for allegedly overcharging for mileage and time.
In the official final report’s Investigative Summary section issued on November 28, 2011, SID states Trumm had “billed the maximum travel time and mileage per day when she submitted a bill,” adding, “The bills show that TRUMM did not prorate her travel time or mileage.”
The same report concludes that “As a result of the… fraudulent billing, Trumm received $2,632.20.”
To prove that, state agents spent nearly 25 times the amount Trumm was allegedly defrauding the state to try and prove it. In an email from a Health Care Policy Analyst and Interim Legislative Liaison at BWC to legislative aid to Senator Tom Sawyer, the cost of the BWC/SID investigation was $63,607.99.
The Special Investigations Department forwarded the case to Ohio’s Attorney General’s office for criminal prosecution.
Trumm says she was forced to spend more than $10,000 to defend herself.
“I had backing,” a defiant Trumm proclaimed, “My claimants were there for me; doctors were there for me; attorneys were there for me.”
She was ready to go to court to defend herself against the charges and what she describes as direct attack on her reputation.
Trumm didn’t have to go to court.
On September 20, 2013, Assistant Attorney General Michael T. Fisher wrote a memorandum, concluding, “…the state lacks evidence Trumm acted intentionally and with purpose to defraud BWC.”
Fisher recommended Trumm reimburse BWC for being overpaid.
After tens of thousands of dollars in state surveillance and examination, Trumm says she has never had to pay back a dime of that alleged overpayment.
Why would state agents spend so much money, work so hard for so long to seek criminal charges against a grandmother who had done nothing criminal?
After a six-month examination, NBC4 uncovered a disturbing answer: Clear evidence that SID investigators are being pressured to target and force the prosecution of people, like Trumm, to meet quotas.
“Quotas,” former SID special investigator Doug Hunter said, in a matter of fact tone, adding, “We would have quotas in our performance evaluations every year.”
Hunter is a private eye in the Cincinnati area, but from 1999 until he was fired in 2010, Hunter was inside BWC. In his last five years, Hunter was one of BWC/SID’s top investigators, who achieved several awards for performance.
NBC4 obtained Hunter’s last performance evaluation as an SID investigator in 2009, which clearly spells out those quotas, listed as goals.
In a section (Page 4) of his review, a standard form in the review reveals the expectations for each agent for the year: 16 closed cases; five referrals for prosecution, and most surprisingly; three indictments.
When asked whether that was causing BWC investigators to play judge and jury, Hunter said, “Sure, because they have quotas to meet.”
In the 2009 review, Hunter got a check for “Below Target” in his review and appealed (Page 9) the evaluation, strongly objecting to quotas.
“By requiring an agent to meet this goal, the Ohio BWC has placed their fraud investigators in an ethical dilemma,” Hunter wrote, adding,“The agent must choose between meeting this goal in order to preserve… his/her employment or make a criminal referral on an injured worker who has not committed a crime.”
In an email on July 16, 2009 (page 11), Jennifer Saunders, current SID Director wrote, “I have determined that the goals established your supervisor as objective…” concluding Hunter’s evaluation was “…fair and justified.”
“NOT IN THE BEST INTEREST OF THE AGENCY”
In a call to Director Saunders, NBC4 requested an on-camera, on-the-record interview. Director Saunders referred NBC4 to BWC’s public information personnel, who refused to allow the request, abruptly stating in an email (bottom of page) “Jennifer Saunders will not be available for the interview you requested.”
When NBC4 followed up, asking why, a representative wrote in another email (top of page), “We’ll continue to provide information and public records you’d like to request, but do not see how this interview is in the best interest of the agency.”
Hunter says the quotas are not in the best interest of the people of Ohio.
In a series of questions, Hunter made it clear that those quotas lead to pressure to make cases:
Pohlman: “You’re saying that state agents are required to go out and not only find wrong doing but to be responsible for the criminal conviction of wrong doing, regardless?”
Hunter: “Regardless. And they have to because if they don’t get the amount of convictions and referrals that they need every year, then their performance evaluation will show.”
Pohlman: “Does this equate to an incentive to find wrong doing where there is none?”
Hunter: “Oh absolutely! Absolutely! I’ve seen investigators push purposefully to get criminal referrals with their analysts just to meet those goals.”
Hunter is not alone.
Becky Roach, a former SID analyst, who oversaw several agents and their cases says she often dealt with complaints about the quotas.
Pohlman: “How many times did you hear from agents that they were being pressured to make these quotas?”
Former BWC Special Investigations Analyst Becky Roach: “Constantly, it was monthly a monthly thing, how far, how many cases do you have that can be referred for indictment, how many indictments are you getting, how many convictions, what’s it look like, it was constant.”
Roach quit BWC and SID in 2009 after facing a series of pending disciplinary reviews says the consequences of those quotas are clear.
Pohlman: “Are innocent people being railroaded because of this activity?”
Roach: “Yes they are, yes they are. DUANE: Is that acceptable?”
Roach: “No, no.”
The quotas and pressure to meet them described by Roach and Hunter was verified by another agent who did not want to be identified in our investigations.
NBC4 Investigates took our findings to former Ohio Attorney General Jim Petro, who had a strong reaction.
“That’s kind of a shocking revelation!” Petro said, after we showed him the proof of the quotas and relayed the stories from former agents.
Petro says quotas have no place in official investigations.
“That kind of incentive in the workplace is not appropriate in law enforcement,” Petro explained, adding that he is even more concerned about the issue of withholding evidence.
“If there are instances where managers are saying to their investigators, withhold this evidence, don’t give it to anybody because it’s exculpatory and it makes it harder for us to make our case, than that’s a crime from my perspective, that’s a terrible act, and that is the kind of act that can result in a grave injustice,” Petro said.
The issues uncovered in NBC4, Petro says may call in to question countless cases where BWC/SID investigations already lead to judgments and convictions.
“I am concerned because I don’t want to see a justice system anywhere that tolerates that kind of activity that we know leads to wrongful conviction,” he said.
Since 1993, when SID was created, BWC states its investigations produced nearly 25 thousand cases of wrongdoing that allowed the collection of more than $1.5 billion and sent nearly 4,500 cases to prosecutors, netting 2,379 criminal convictions.
Petro made it clear that the stakes are huge if the quotas played a major role in those actions.
“The integrity of the system is now in question,” Petro said. “That is a serious problem.”
And, in a series of questions, Petro made it clear that the state now needs to investigate the investigators.
Petro: “Absolutely! If that’s happening, if those things are really happening in an agency of the state then that needs to be investigated.”
Petro: “I think it is a criminal investigation yes.”
After challenging quotas and other issues within BWC’s Special Investigations Deparment, Hunter, who had been disciplined three times, was officially removed as a special investigator on July 20, 2010.
In the termination letter, BWC Administrator Marsha Ryan stated “The Ohio Bureau of Workers’ Compensation (BWC) is hereby removing you from employment effective July 20, 2010.
In the letter, Ryan wrote Hunter had violated BWC policy, laying out his offenses as insubordination, failure to follow a written policy, neglect of duty and dishonesty.
Ryan also accused Hunter of failing to properly secure evidence.
Hunter disputes those findings, saying he was targeted.
Pohlman: “So you blew the whistle on the problem?”
Pohlman: “And you got fired?”
Hunter: “Right that’s pretty much how it goes there.”
NBC4 examined several performance evaluations for several SID investigators conducted last year.
While SID investigators no longer are evaluated based on the number of indictments, the quotas remain in every other category, including criminal referrals.
Pohlman: “Are they stacking the deck?”
Hunter: “Yes. They are stacking the deck. They’re stacking the deck for the grand jury and the prosecutor.”
Trumm, the grandmother who was the target of those investigators and managed to escape criminal prosecution, says she suffered huge losses after years of being a target.
“They need to be stopped,” Trumm said. “They need to be held accountable. And I keep asking who is responsible for them? Who’s responsible?”
Late Thursday, the BWC issued the following statement to NBC4:
It’s important to root out fraud to ensure continued care for Ohio’s injured workers, and BWC has a duty to ensure those paying and participating in the workers’ compensation system are not defrauding the system.
As with any position, investigators do have goals and performance expectations to measure productivity and effectiveness. The goals include the expectation that our investigators put together evidence for strong criminal referrals but do not include quota requirements. Under no circumstances would it be acceptable for any BWC staff to place these performance goals above good investigatory techniques.
We are not able to respond to specific allegations about any investigators working outside of BWC’s policy if you will not elaborate on the evidence you reference.