State agencies share data to nab workers’ comp cheat

hopsonA Columbus man who worked two jobs while collecting injured workers’ benefits must pay the Ohio Bureau of Workers’ Compensation $6,000 in restitution and investigative costs and serve five years probation, a judge ruled Tuesday in the Franklin County Court of Common Pleas.

Dion S. Hopson, 43, pleaded guilty Sept. 20 to workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, which was suspended in exchange for five years community control. Hopson also was ordered to pay $5,000 in restitution to BWC and $1,000 in investigative costs. He must pay $100 per month to stay in good standing with community control, which will terminate once restitution has been paid.

BWC’s Special Investigations Department started looking at Hopson after a cross-match query with the Ohio Department of Job and Family Services revealed two employers were paying Hopson wages in 2014 and 2015. SID found Hopson was simultaneously receiving Temporary Total Disability benefits from BWC.

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

 

BWC SID: Annual in-service training – Part 1 of 3

By Jeff Baker, Program Administrator, BWC Special Investigations Department

admin-morrison-sid-mtgIn our constant quest for improvement, all members of the Bureau of Workers’ Compensation Special Investigations Department (SID) gathered on September 14, 2016 at our Mansfield service office to successfully complete annual in-service training.

BWC Administrator/CEO Sarah Morrison welcomed the 125 attendees and opened the meeting. In her opening remarks, Administrator Morrison praised the department’s more than 20 years of success. She noted that strategies identified and implemented during the past twelve months, under the leadership of SID Director James Wernecke, have positioned the department to extend its tradition of excellence.

Following these remarks, Administrator Morrison, SID Director Wernecke, and SID Assistant Directors Jennifer Cunningham and Dan Fodor presented service pins to 22 SID employees. These recipients included two employees with 30 years of service to the State of Ohio: Shawn Miller, a fraud analyst with the southeast regional claimant special investigations unit (SIU); and Lisa Ray, SID training manager.

Pictured left to right: Sarah Morrison, James Wernecke, Lisa Ray, Shawn Miller, Jennifer Cunningham and Dan Fodor.

Subsequently, Director Wernecke thanked Administrator Morrison for her executive leadership, essential support for SID’s mission and compelling presence at the annual event. All of members of the Special Investigations Department joined Director Wernecke in thanking Administrator Morrison for inspiring us to realize our departmental mission to deter, detect, investigate and prosecute workers’ compensation fraud.

In the coming two weeks, we will offer more details from September 14 training event. Stay tuned for part two of the series, which acknowledges specialized training we received at the event.

In the meantime, you can read the past posts about our SID Director here and our most recent annual report here.

Ohio trucker guilty of workers’ comp fraud

booking-photo-5-26-16-christopA Stark County trucker pleaded guilty to workers’ compensation fraud Aug. 31 after investigators discovered he worked for two different companies while claiming to be disabled and unable to work.

Christopher James, 43, of Massillon, was off work following an injury and was receiving temporary total disability benefits. BWC’s Special Investigations Department began investigating James after receiving a tip from an anonymous source.

James was sentenced in the Stark County Court of Common Pleas following his plea to the fifth degree felony. He was ordered to serve three years of community control and to serve 200 hours of community service. James paid full restitution in the amount of $7,740.

BWC’s Special Investigations nets 8 convictions in August

fraud imageCOLUMBUS – The Ohio Bureau of Workers’ Compensation (BWC) netted eight convictions in August in criminal cases related to workers’ compensation fraud.

The eight Ohioans convicted include a Hamilton man who got an 18-month jail sentence for falsifying his wages to increase his disability rate, a Dayton-area man who filed a false injury claim and tried to extort $3,000 from his employer in return for dropping the claim, and a Toledo man who lied to his physician and used an alias to collect injured workers’ benefits.

“These convictions illustrate the nefarious lengths some will undertake to rip off the workers’ compensation system,” said BWC Administrator/CEO Sarah Morrison. “But they also highlight the skill and dedication of our staff and investigators to catch this activity and return BWC funds to their rightful purpose – preventing workplace injuries and caring for those who do get injured.”

As of Aug. 31, BWC’s Special Investigations Department (SID) had secured 69 convictions for the calendar year. August convictions include:

Matt E. Wilder of Hamilton – False Wages
SID initiated an investigation after a BWC compliance officer suspected Wilder may have filed false wage statement forms to increase his weekly injured workers’ benefits. The investigation found Wilder was legitimately injured, but he had filed false wages from another employer, which happened to be his father’s business.

Wilder pleaded guilty Aug. 30 in Montgomery County Common Pleas Court to one count of forgery (uttering), a fifth-degree felony, and one count of workers compensation fraud, a first-degree misdemeanor. Wilder was ordered to serve 12 months in state prison and an additional six months in jail in Butler County. He received credit for 115 days served. He also was ordered to pay BWC $271 in restitution and to serve three years of post-release control.

Thomas Shafer of Miamisburg – False Claim
SID found Shafer filed a false claim and was not injured as reported. SID also found he tried to get his employer to pay $3,000 to him in exchange for dropping the claim.

Shafer pleaded guilty Aug. 29 in Dayton Municipal Court to one count of disorderly conduct, a fourth-degree misdemeanor, and was sentenced to 10 days in jail. He was originally charged with falsification and workers’ compensation fraud.

Michael Scott of Lancaster – Working and Receiving
SID found Scott was working for a window company for four months in 2014 while collecting BWC benefits. A judge in Franklin County Common Pleas Court ordered Scott to pay BWC $1,836 in restitution and sentenced Scott to two years community control, which will terminate with full payment of restitution and court costs.

Martin Halka of Oregon (Lucas County) – Lapsed Coverage
Investigators observed Halka, owner of Bay Area Concrete, and his workers finishing a concrete job in 2014, six years after Halka’s BWC coverage had lapsed. Agents worked with Halka to become compliant with BWC coverage, but Halka failed to submit all the required payroll records. He did, however, pay approximately $8,000 in back premiums.

A judge found Halka guilty of one count of failure to comply, a second-degree misdemeanor, on Aug. 23 in Oregon Municipal Court. He fined Halka $250, plus $87 in court costs, and ordered Halka to serve one year probation and 15 days of house arrest with electronic monitoring.

Kash Marzetti of Columbus – Working and Receiving
SID found Marzetti knowingly and with fraudulent intent worked for his company, Marzetti Swimming Pool Services, Inc., while collecting injured workers’ benefits. Marzetti pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor, Aug. 22 in Franklin County Common Pleas Court. He had to pay BWC $5,642 in restitution and a $50 court fine as part of his sentence.

David Abitua of Toledo – Falsification
Abitua, 51, pleaded guilty Aug. 18 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony. SID found in 2014 that Abitua had lied to his physician, used a false social security number and an alias of Jose L. Vasquez to collect injured workers’ benefits from Nov. 2, 2009 until Oct. 6, 2012. A judge fined Abitua court costs and sentenced him to six months community control, plus one year in jail if he violates the terms of his probation.

Ambrose Adams of Lexington – Working and Receiving
SID found Adams had returned to work as a self-employed home improvement contractor for his business, Double A Home Maintenance and Repair, while concurrently receiving workplace injury benefits from BWC.

Adams pleaded guilty Aug. 16 in Franklin County Common Pleas Court to one misdemeanor count of workers’ compensation fraud. He was sentenced to 60 days in jail, suspended, and one year of probation. BWC recovered $11,965 in restitution prior to his plea.

Christopher James of Massillon – Working and Receiving
SID found James working as a truck driver while receiving BWC benefits. James pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, on Aug. 4 in the Stark County Court of Common Pleas.  He was sentenced to three years of community control.  James has already paid $7,705 in restitution to BWC.

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

Concrete contractor with lapsed coverage given probation and house arrest

A Toledo-area concrete contractor whose BWC policy lapsed in 2008 must serve one year probation and 15 days of house arrest with electronic monitoring for running his business without BWC coverage, a judge ruled Aug. 23 in Oregon Municipal Court in Lucas County.

Martin Halka, 45, pleaded no contest to one count of failure to comply with the law, a second-degree misdemeanor, but a judge found him guilty and ordered him to pay a $250 fine and $87 in court costs. Halka was initially charged with 10 counts of failure to comply, but prosecutors reduced the charges because he had paid $8,000 toward his BWC balance prior to his court appearance. His BWC coverage won’t be reinstated, however, until his payments are up to date.

BWC’s Special Investigations Department started looking at Halka in 2014 after its Employer Fraud Team observed Halka, owner of Bay Area Concrete, and his workers finishing a concrete job. Halka provided some payroll records to investigators, but failed to take all the necessary steps to become compliant with the law.

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

Paramedic pleads guilty to workers’ comp fraud

lynn-mccannA Knox County man pleaded guilty to a first-degree misdemeanor charge of workers’ compensation fraud Tuesday after his employer reported him to the Ohio Bureau of Workers’ Compensation last year on suspicion of the crime.

BWC’s Special Investigations Department found Lynn D. McCann II, 48, of Mount Vernon, working as a paramedic for five months in 2015 for OhioHealth Grant Medical Center in Columbus while also collecting BWC benefits for an injury he suffered doing a similar job for a private medical transportation company.

McCann repaid more than $14,000 to BWC prior to his sentencing Tuesday in the Franklin County Court of Common Pleas. A judge sentenced McCann to one day in jail, then suspended the sentence and gave him credit for time served.

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

Two Central Ohio men guilty in workers’ comp fraud cases

Kash M. Marzetti

A Columbus swimming pool contractor and a window worker from Lancaster pleaded guilty last week to misdemeanor counts of workers’ compensation fraud for continuing to work while collecting injured workers’ benefits.

Kash M. Marzetti, 43, had to pay BWC $5,642 in restitution and a $50 court fine as part of his sentence Aug. 22 in the Franklin County Court of Common Pleas.

BWC’s Special Investigations Department started looking at Marzetti after a claims service specialist suspected he might be working while collecting temporary total disability benefits. SID subsequently found Marzetti knowingly and with fraudulent intent worked for Marzetti Swimming Pool Services, Inc., doing the same and/or similar work that he was performing when he was injured.

Investigators found in 2011 that Marzetti provided swimming pool inspections, estimates for repairs and new builds, supervised and managed the construction and repair of swimming pools, installed swimming pool accessories and worked as a laborer while collecting injured workers’ benefits.

In the same court two days later, a judge ruled Michael Scott, 52, of Lancaster, must pay BWC $1,836 in restitution for working while receiving injured workers’ benefits. The judge also sentenced Scott to two years community control, which will terminate with full payment of restitution and court costs.

Acting on a tip, BWC’s Special Investigations Department reviewed records and interviewed witnesses in determining Scott worked for a window company for four months in 2014 while collecting BWC benefits.

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