Fraudulent billing leads to occupational therapist’s conviction

Agency secures 6 fraud-related convictions in December   

A northeast Ohio occupational therapist was convicted last month for felony workers’ compensation fraud for billing the Ohio Bureau of Workers’ Compensation (BWC) for treatment services she did not provide to patients.

Susanna Kagalitskaya Freedman, of Euclid, pleaded guilty Dec. 17 in a Cuyahoga County court to a fifth-degree felony count of workers’ compensation fraud. The judge sentenced her to five years of probation and a $2,500 fine. Additionally, Freedman was permanently decertified to treat BWC patients for claim-related injuries.

“As an agency, we expect providers to give superior care and service to injured workers,” said BWC Administrator/CEO Stephanie McCloud. “This particular provider obviously did not meet the standard of care injured workers deserve and she cheated our system.”

Numerous red flags in Freedman’s billing practices and treatment notes sent to BWC prompted BWC’s Special Investigations Department (SID) to initiate an investigation starting in October 2017. Investigators discovered Freedman was falsifying documents, indicating services had been rendered when they had not. BWC would then pay for the substandard care based on the falsified information Freedman provided.

SID secured five other fraud-related convictions in December, bringing calendar year 2019’s total to 94.

Jeffrey Jakob of Toledo
Jakob pleaded guilty Dec. 31 in Toledo Municipal Court to one count of failure to comply, a second-degree misdemeanor, after BWC found he was operating his business, J.A. Jakob Marine Contracting, with lapsed coverage since March 2015. BWC agents made multiple attempts to assist Jakob in getting his coverage reinstated, but he failed to do so. The judge ordered him to one year of probation and to comply with a reinstatement payment plan with the Ohio Attorney General’s office. He must also remain current on installment payments to BWC.

Harold Brown of Bellefontaine
Brown pleaded guilty Dec. 23 to three second-degree misdemeanor charges of failure to comply for running his business, Brown’s Lawn & Tree Service, without workers’ compensation coverage. BWC investigators discovered his BWC policy had been lapsed since September 2010. Brown received 30 days in jail (suspended), a $250 fine, and was ordered to make regular payments to BWC and the Attorney General until a reinstatement payment plan was paid in full. The current amount due on Brown’s BWC policy is approximately $133,000.

Marie Olinger of Delta
On Dec. 17, a Franklin County judged ordered Olinger to three years of community control for working while receiving more than $2,800 in disability benefits from BWC. The investigation found Olinger had returned to work at the Dental Center of Northwest Ohio between January and March 2017 while receiving temporary total disability benefits.

Rodney Filibeck of Mansfield
Filibeck pleaded guilty Dec. 16 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. After receiving an anonymous tip, BWC investigators determined Filibeck was working construction jobs while receiving BWC disability benefits between September 2016 and June 2017. The judge handed down a 60-day jail sentence, suspended for 12 months of community control and ordered him to pay $2,519 in restitution to BWC.

Deangelo Speed of Shaker Heights
Speed pleaded guilty Dec. 2 in a Franklin County courtroom to a fifth-degree felony count of workers’ compensation fraud. BWC agents found Speed working as a truck driver while collecting BWC benefits from Oct. 20, 2015, through Jan. 27, 2017. The judge ordered Speed to pay BWC $7,599 in restitution and court costs by March 2, 2020. The judge also sentenced Speed to a six-month jail sentence, suspended for six months of probation.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Spreading joy is a tradition here at BWC

Each year our agency supports local charities.

In December 2019, we supported the following:

FireFighters 4 Kids Toy Drive (gifts); Franklin County Children Services Holiday Wish (cash donation); and the Beach House Family Shelter (supplies) located in Toledo, Ohio. #giveback

The gifts pictured left were delivered to the Columbus area FireFighters 4 Kids Toy Drive today.

 

 

 

An appreciative Columbus area firefighter pictured below coordinated receipt of the gifts by the local FireFighters 4 Kids Toy Drive.

 

 

 

 

 

 

 

 

 

 

 

On Thursday, December 19, the gifts pictured below were delivered to the Beach House Family Shelter located in Toledo, Ohio.

   

The gifts below will be donated to Richland County Children’s Services.

 

Thanks to our BWC executives and SID employees for these generous donations that will benefit local charities.
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Thank you!

Thanks for following, liking and sharing our International Fraud Awareness Week posts!

It’s great to be part of a large network of individuals and organizations with the same mission – to #StopFraud!

We appreciate the opportunity to share our story and learn what our counterparts are doing in their fight to stop all kinds of fraud.

While we hope you never come across workers’ comp fraud, if you do, we want you to know how to recognize it and where to find us.

 

BWC secures 14 fraud-related convictions in October

Fraudsters owe BWC more than $283,000 in restitution

The Ohio Bureau of Workers’ Compensation (BWC) secured 14 fraud-related convictions in October, with those convicted owing BWC a combined $283,146 in restitution.

Those convicted include injured workers found working while collecting disability benefits, family members collecting their deceased parent’s compensation benefits, and business owners whose coverage had lapsed.

“When people cheat BWC or fail to cover their own employees, they are cheating the injured workers who really need our help and the employers in our system that follow the law,” said BWC Administrator/CEO Stephanie McCloud.

In order of most recent court appearance, those convicted in October include:

Bruce Starkey of Cincinnati, Ohio
Starkey pleaded guilty Oct. 17 and was sentenced in Hamilton County Common Pleas Court Nov. 4 on one count of workers’ compensation fraud, a fifth-degree felony. Starkey received 100 hours of community service and was required to pay BWC full restitution for the $1,459 in permanent total disability benefits he took from his mother’s bank account after she passed. He failed to inform BWC of her passing and wrote 15 checks, forging his mother’s signature.

Cecil Piner of Xenia, Ohio
Piner pleaded guilty Oct. 31 in Franklin County Common Pleas Court on one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him driving a school bus while receiving $17,901 in disability benefits. He was sentenced to five years’ probation in lieu of 12 months in jail and ordered to pay court costs and full restitution.

Kyle Foreman of New Carlisle, Ohio
Foreman pleaded guilty Oct. 30 in Clark County Municipal Court on two counts of failure to comply, both second-degree misdemeanors. His coverage for Kyle S. Foreman Enterprises had lapsed since November 2017, and he failed to pay the premiums before taking his company into bankruptcy. He was ordered to pay a $100 fine and court costs for each count.

Michelle Smith of Cincinnati, Ohio
Smith, 57, pleaded guilty Oct. 23 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered she owned and ran two businesses, Expression Unique LLC and Later in Life Brides, while collecting BWC benefits for workers deemed permanently and totally disabled. A Franklin County judge ordered Smith to pay BWC $40,873 dollars in restitution and serve five years of non-reporting community control (probation). If she violates her probation, she must serve a year in prison.

Louis Tombazzi of Cleveland, Ohio
BWC found Tombazzi owed the agency approximately $75,000 in premiums after letting the policy lapse for his business, Garda Architectural Fabrication. He pleaded guilty Oct. 16 in Cleveland Municipal Court to one count of failure to comply, a second-degree misdemeanor, and was ordered to serve 90 days in jail (suspended), pay a $400 fine, and serve two years’ probation. He also was ordered to report monthly to the court his effort to reduce or pay off his BWC obligation.

Natalia Daniels of Concord Township, Ohio
Daniels pleaded guilty Oct. 16 to one count of workers’ compensation fraud, a first-degree misdemeanor, after receiving $3,600 in BWC disability benefits while working as a bus driver for a senior living facility and as a laborer for an insurance company. A judge ordered her to pay full restitution to BWC and serve 18 months of probation in lieu of a 180-day jail sentence.

Vicki Aloisio of West Chester, Ohio
Aloisio was convicted Oct. 11 on two counts of failure to comply, both second-degree midemeanors, for failing to carry BWC coverage on her business, Richard Aloisio Trucking Inc., despite numerous BWC attempts to assist her. Aloisio owes $28,000 in past-due premiums and penalties. Sentencing in a Butler County courtroom is scheduled for Dec. 6.

Ahmad Al-thamra of Akron, Ohio
Al-thamra pleaded guilty Oct. 10 in Akron Municipal Court to two counts of failure to comply, both second-degree misdemeanors, for failing to maintain workers’ compensation coverage on his business, The Family Corner Store. He was ordered to pay $300 in fines and ordered to pay court costs and obey all laws for one year.

Jason Gaschler of Cheswick, Pennsylvania
Gaschler pleaded guilty Oct. 10 of one count of theft, a first-degree misdemeanor, for operating a construction company, General License Contracting, in Pennsylvania while receiving $6,864 in BWC benefits. He was sentenced to one day in jail (time served) and made full restitution at the time of his hearing.

Jason Rissner of Rockford, Ohio
Rissner pleaded guilty Oct. 9 in Mercer County Common Pleas Court to one count of petty theft, a first-degree misdemeanor, after he was caught operating his own construction company while receiving $35,261 in temporary total disability benefits from his employer, O’Reilly Auto Parts. He was ordered to spend 180 days in jail, which would be suspended if he committed no more crimes within a year and pay full restitution to O’Reilly.

Brian Franklin of Sharonville, Ohio
Franklin avoided conviction on one charge of workers’ compensation fraud, a fifth-degree felony, after he agreed Oct. 8 in Franklin County to pay BWC $18,081 in restitution. BWC found Franklin working at a community center in 2018 while collecting BWC benefits.

Marshann Kinman of Cedar Grove, Ohio
Kinman pleaded guilty Oct. 8 to one count of workers’ compensation fraud, a fifth-degree felony, in Hamilton County Common Pleas Court. Kinman failed to let BWC know her mother had passed so she could take $6,321 in BWC widow death benefits intended for her mother. Kinman received two years of community service and was ordered to pay BWC full restitution.

Charles Ayler of Cincinnati, Ohio
Ayler pleaded guilty Oct. 3 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving BWC benefits. He was sentenced to 180 days in jail, which was suspended for two years of community service, the promise to avoid similar offenses, and to pay BWC full restitution of $6,090 and court costs of $150 by Dec. 31, 2020.

Ronald J. Dorfeld of Brunswick, Ohio
Dorfeld must pay BWC $78,957 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Oct. 1 in a Franklin County courtroom. BWC found Dorfield operating his own business, Xtreme Multimedia Marketing, while receiving disability compensation. A Franklin County judge sentenced Dorfeld to ninth months in jail, which was suspended for five years’ probation and full restitution.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Happy Anniversary to Us!

On Nov. 14, 2019, our BWC Special Investigations Department celebrated the second anniversary of its Fraud Hotline system.

We launched this system during Fraud Awareness Week 2017 as an important new customer service tool for external sources to report their suspicions of workers’ compensation fraud. What a successful launch and two years it has been!

We’ve received more than 3,300 calls since then, an average of nearly seven each work day!

If you suspect workers’ compensation fraud in Ohio, call us on it.

We look forward to hearing from you. Give us a call at 1-800-644-6292. We will conduct an investigation and determine the facts. Together, we are successfully combatting workers’ compensation fraud in Ohio – one most important call at a time.

Today, during International Fraud Awareness Week 2019, we thank you for your support!

A letter from Jim Wernecke – Director of BWC Special Investigations

As Director of the BWC Special Investigations Department (SID), I am honored to kick off Fraud Awareness Week. I invite you to view my video message, “Fraud Hurts Us All.

In the video I discuss how workers’ compensation fraud increases premiums for employers, which reduces the money employers can invest in their employees, community and future growth. I explain how BWC employees are improving workplace health and safety, getting injured workers back to work, and keeping premium rates low for employers. I describe how SID employees protect the State Insurance Fund by detecting, investigating, and deterring fraud.

Lastly, I invite viewers to report, via an online form, suspected workers’ compensation fraud.

I also invite you to check back daily as we share success stories in our efforts to combat workers’ comp. fraud. Some stories we will highlight are:

We would not have achieved these successes without the dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law. Since our inception in 1993, we have identified over $1.9 billion in savings, as well as:

  • Completed over 69,000 investigations
  • Referred 5,420 subjects for prosecution
  • Secured 2,941 criminal convictions

We are honored and eager to join our fraud-fighting colleagues around the country and abroad each November to participate in International Fraud Awareness Week.

The campaign, which runs through Saturday, was established by the Association of Certified Fraud Examiners to highlight the issue of fraud and minimize its impacts.

Most weeks, you’ll find us sharing our fraud news on #FraudFriday. But this week, we’ll have a new fraud feature each day! So keep an eye here on our blog and on our Facebook and Twitter pages!

Happy Fraud Awareness Week!

Fraud of the Day during Fraud Awareness Week

By Jeff Baker, BWC Special Investigations Department

When the Ohio Bureau of Workers’ Compensation (BWC) created its Special Investigations Department (SID) in 1993, investigative professionals in the new department knew they would need to do more than detect, identify and investigate suspected workers’ compensation fraud. To fully meet the department’s mandate and mission, SID professionals would need to also deter fraud.

We felt one of the most effective ways to deter fraud might be to raise public awareness of what we do by reaching out to the media about our latest cases. In the years since, SID has collaborated with BWC’s Communications Department to issue news releases on many of the nearly 3,000 subjects convicted and sentenced as a result of our work.

To reach an even wider audience, we created our first social media accounts in 2011 and launched our Fraud Awareness Series via ohiobwcfraud and twitter.com/ohiobwcfraud. Through our YouTube channel, we added videos showing undercover surveillance footage of subjects caught in act of committing their crimes.

The success of our Fraud Awareness Series can be measured by its reach beyond our initial audience. That is why we take note (ok, we admit we are thrilled) whenever one of our prosecution news releases is shared or re-Tweeted by a follower. Since 2014, we have seen this occur 39 times from just one follower — Larry Benson. Larry has used our news releases as the basis for 39 of his Fraud of the Day blogs published by LexisNexis. Larry sees news releases for countless other successful fraud investigations by government agencies within hundreds of jurisdictions (local, state, and federal), so we are always delighted when he takes note of ours. We also appreciate his Fraud of the day website permits users to select their favorite examples by fraud type and state. For example, here is a filtered link to the Fraud of the Day articles for Ohio, including the 39 (and counting) articles pertaining to BWC.

Conveniently, E-mail subscribers to Fraud of the Day blogs may “get their fraud fix” by “waking up five days a week to the most current fraud article delivered straight to their inbox.”

But no matter how you access the Fraud of the Day blogs, you will note Larry’s clever use of headlines and tags referencing the subject’s type of fraud. A few of our favorites include:

The owner of an excavation business without coverage Bulldozed December 23, 2015

The owner of a transport company without coverage The Freeway to Prison February 9, 2016

A swimming pool construction/maintenance contractor Swimming in Fraud December 20, 2016

Wholly falsified statement of reported wages earned Making Stuff Up April 25, 2017

A bowling coach Gutter Ball July 5, 2017

Felon skipped court date due to imprisonment Fraud in Absentia August 8, 2017

The owner of a cleaning business with lapsed coverage Dust Bunnies  September 12, 2017

The owner of a pool and spa company without coverage Grab on to the Life Raft  January 31, 2018

The owner of a high-volume garbage hauling business Garbage In, Garbage Out March 27, 2018

A bartender Where Everyone Knows Your Name July 12, 2018

An overprescribing doctor Fraud Dispenser September 20, 2018

A business owner who misclassified employees Misclassified November 13, 2018

A doctor billing for services not rendered Lacking January 31, 2019

Felon convicted on charges of breaking and entering, gross sexual imposition, burglary and other charges That’s Quite A Rap  May 7, 2019

Machine press operator and pizza shop employee Triple Dipper September 17, 2019

Of course, as humorous as these titles may be, we know that no fraud is a matter for laughter. We certainly take all crime seriously. That is why we have dedicated our careers to detecting, identifying, investigating, prosecuting, and deterring fraud. Like Larry, we, too, are willing to deploy clever or funny headlines in news releases, but that’s only to increase the likelihood that the media and general public will take note and read and heed the releases as the cautionary tales they are.

Widening our reach, getting our word out, deters fraud. In the spirit of International Fraud Awareness Week, we invite all of you to join us in combatting crime by continuing to follow this blog and Larry’s Fraud of the Day series this week and beyond.

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