Cleveland man ordered to serve jail time, pay $11K for workers’ comp fraud

Columbus – A Cleveland (Cuyahoga County) man was sentenced June 18 in the Franklin County Court of Common Pleas in connection with working while receiving workers’ compensation benefits. Cymande McFarland previously pleaded guilty last month to one charge of theft, a fifth-degree felony.

“BWC is committed to finding and eliminating fraud, one of a number of ways BWC is working to keep employer premiums costs as low as possible,” said BWC Administrator/CEO Steve Buehrer. “Combating fraud also supports BWC’s most important mission of caring for Ohioans as they recover from workplace injuries.”

A data cross-match with the Ohio Department of Job and Family Services in March 2014 alerted BWC that McFarland was possibly violating the terms of his temporary total disability benefits by returning to employment as a factory worker from April 2013 to April 2014. Claimants are not permitted to work while receiving this type of benefit.

McFarland was ordered to serve 11 months in prison effective immediately and to pay $11,881.14 in restitution to the BWC.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov. Check out our latest cases at ohiobwcfraud.wordpress.com, and see what workers’ compensation fraud looks like in our fraud awareness video on YouTube.

Ohio State Highway Patrol veteran to lead BWC fraud unit

James WerneckeCOLUMBUS – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced the appointment of a 25-year Ohio State Highway Patrol veteran as director of BWC’s Special Investigations Department. James Wernecke began his duties yesterday, overseeing 123 employees who work to deter, detect and investigate workers’ compensation fraud. The department pursues cases of claimant, medical provider and employer fraud by identifying savings, disallowing claims and referring criminal matters for prosecution.

“With more than 25 years of law enforcement experience, Jim is a public safety and criminal investigation expert who is exceptionally qualified to lead our fraud prevention efforts,” said Buehrer. “We look forward to having Jim join our outstanding team of skilled, professional investigators and take the lead in identifying wrongdoing to protect the State Insurance Fund, keep employer premiums as low as possible and provide the best care possible to Ohioans injured on the job.”

A Tuscawaras County native, Wernecke began his career as a trooper in Massillon in 1990 and later served as an investigator in Massillon and Bucyrus, and commander at the Mansfield Patrol Post. He was appointed in 2012 commander of the Ohio Investigative Unit, which is charged with enforcing the state’s liquor laws and is the only state law enforcement agency specifically tasked with investigating food stamp fraud crimes. Agents also investigate tobacco violations.

Wernecke served as an investigative team leader with the Ohio Inspector General’s Task Force and was also assistant commander of the Special Operations Office of Investigative Services from 2006 to 2012.

Wernecke completed advanced law enforcement and investigative training at a number of law enforcement agencies in and outside of Ohio, including the United States Army War College, the West Virginia and Delaware State Police, the New York State Police Academy, Ohio University and the Ohio State University. He also attended the Northwestern University for Public Safety and North Central State College.

From January 2011 to present, BWC’s Special Investigations Department obtained 601 convictions, identifying a total of $260 million in savings for the State Insurance Fund.

Akron woman sentenced for workers’ comp fraud, ordered to pay $23K in restitution

Laurie Nesit, of Akron (Summit County), pleaded guilty June 8 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony.

BWC became aware through a data cross-match with the Ohio Department of Job and Family Services that Nesit received wages while also receiving temporary total disability benefits from BWC. Claimants are not permitted to work while receiving this type of benefit.

Investigators found that Nesit returned to work as an inspector for two businesses from April to May 2013, and from July 2013 to January 2014 while receiving the benefits. In August 2014, an Industrial Commission hearing officer issued an order finding an overpayment of BWC benefits for those time periods. The hearing officer also issued a finding of fraud relative to the declared overpayment.

Nesit was sentenced to serve 11 months in jail, which was suspended for five years of community control. She was ordered to pay $23,847 in restitution to BWC and ordered to maintain employment.

BWC investigations result in 11 workers’ comp fraud convictions in May

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that 11 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in May 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“Two cases this month highlight the value of the work of the intelligence unit within our Special Investigations Department, which exchanges data with other state agencies to root out fraudulent activity,” Buehrer said. “They also uncover potential false claims, diversion of prescription drugs, medical billing fraud and unpaid workers’ compensation premiums.”

The following is a sampling of cases that resulted in guilty pleas or convictions during May:

Tim Wyse, Felicia Braggs-Wyse and Sarah Washtak doing business as Wyse Enterprise Inc. (Toledo, Lucas County), pleaded guilty recently in the Lucas County Court of Common Pleas in connection with lapsed workers’ compensation coverage, dishonored payments and altering a BWC coverage certificate. Co-owner Tim Wyse, of Toledo (Lucas County), pleaded guilty April 27 to two counts of workers’ compensation fraud, both fifth-degree felonies. Co-owner Braggs-Wyse, of Toledo (Lucas County), pleaded guilty the same day to passing bad checks, a first-degree misdemeanor. Business secretary Washtak, of Maumee (Lucas County), pleaded guilty May 11 to workers’ compensation fraud, a first-degree misdemeanor. Investigators received two allegations about the business. The collections department reported that a check written for a premium payment was returned for non-sufficient funds, which caused the employer’s policy to lapse. Agents provided Wyse with instructions on how to reinstate the company’s workers’ compensation policy, but Wyse failed to take steps toward becoming compliant. An allegation that the employer passed a false BWC certificate of coverage was also received. Braggs-Wyse said she generated the dishonored check, and Washtak admitted to falsifying and providing the workers’ compensation coverage certificate. Wyse was ordered to pay $13,277.59 in restitution and sentenced to three years of community control. Braggs-Wyse was ordered to pay $13,277.59 in restitution and is scheduled for sentencing on June 18. Washtak was not ordered to pay restitution and is scheduled for sentencing on June 25.

David Story doing business as Story Equipment & Repair (Wayne, Wood County) was convicted and sentenced May 8 in the Bowling Green Municipal Court on one count of failure to comply, a second-degree misdemeanor. BWC fraud investigators received a referral about Story’s business, Story Equipment & Repair in Wayne, in 2012 from the agency’s employer compliance department. Story entered into a payment plan for premiums owed, and that investigation was closed. In 2014, SID used data to identify lapsed employers and discovered that Story defaulted on his payment plan, failed to report payroll for his business and did not pay related premiums to BWC. Investigators found that the payroll information he withheld resulted in an additional $6,969.62 in premiums due. Story was sentenced to five years of probation and was ordered to pay $125 in court costs. He was also ordered to pay a $750 fine and sentenced to 90 days of incarceration, which were both suspended as long as he continues making payments.

Douglas Vastine (Milford, Clermont County) pleaded guilty May 20 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor, and one count of forgery, a fifth-degree felony. BWC received an allegation that Vastine may be falsifying his job searches submitted to the BWC for disability benefits. Investigators found that he falsified job searches to qualify for living maintenance wage loss benefits between January and April 2013. Vastine received more than $6,000 in benefits he would otherwise been ineligible to receive. Investigators also found Vastine submitted false travel reimbursement forms to BWC, resulting in approximately $900 of improper payments. Vastine is scheduled to be sentenced July 10.

Vincent Biasella (formerly of Clinton, Summit County) was convicted May 15 in the Franklin County Court of Common Pleas for working while receiving workers’ compensation benefits. Biasella, who currently resides in Cape Coral, Florida, previously pleaded guilty in March to one count of workers’ compensation fraud, a fourth-degree felony. A data cross-match with the Ohio Department of Job and Family Services indicated that Biasella was employed while receiving compensation for a 2009 workplace injury. An investigation conducted by SID confirmed Biasella was employed by a yacht club and a boat club in Florida between February 2011 and June 2013 while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Biasella was sentenced to five years of community control and ordered to pay BWC $93,683.57 in restitution. He could face up to 18 months in prison, if he fails to abide by the terms of the probation.

Rick Hamed, doing business as MZM Transport, Inc. (Cleveland, Cuyahoga County) pleaded guilty May 12 in the Cuyahoga County Court of Common Pleas to one count of passing bad checks and one count of workers’ compensation fraud, both first-degree misdemeanors. SID received an allegation from BWC’s employer compliance department after MZM Transport Inc. failed to reinstate its workers’ compensation coverage, or repay BWC for a payment returned due to non-sufficient funds. SID’s employer fraud team contacted Hamed and discussed the issue. Agents provided Hamed with the necessary forms to reinstate his workers’ compensation coverage, but he failed to file payroll reports and pay premiums for three reporting periods between 2012 and 2013. Hamed also failed to repay the dishonored payment. Hamed is scheduled to be sentenced June 18.

Cymande McFarland (Cleveland, Cuyahoga County) pleaded guilty May 6 in the Franklin County Court of Common Pleas to one count of theft, a fifth-degree felony. SID’s intelligence unit identified through a data cross match with ODJFS that McFarland was possibly working while receiving BWC disability benefits. Investigators found that McFarland worked at a factory and receiving BWC benefits between April 2013 and April 2014. McFarland is scheduled to be sentenced on June 18.

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

Check out our latest cases at ohiobwcfraud.wordpress.com and view BWC’s workers’ comp fraud awareness video on YouTube.

Butler County man repays $25K for workers’ comp fraud

James Crist, of Middletown (Butler County), pleaded guilty and was sentenced June 2 in Middletown Municipal Court on one count of workers’ compensation fraud, a first-degree misdemeanor.

A BWC employee alerted SID that Crist was difficult to contact during the day and that machinery was sometimes heard running in the background during telephone calls. Investigators found that Crist returned to work for his own business, Crist Construction LLC, while collecting temporary total disability benefits from November 2010 to August 2011. Claimants are not permitted to work while receiving this type of benefit.

Crist paid $21,579 in restitution before entering his plea in court, and paid $4,155.07 to cover the fraud investigation costs on the same day he appeared in court. He was given a suspended sentence of 180 days in jail and was also fined $500.

Spencerville man convicted for workers’ comp fraud, ordered to repay more than $20K

Columbus – A Spencerville (Allen County) man was convicted June 1 in the Franklin County Court of Common Pleas for working while receiving workers’ compensation benefits. Douglas Roop previously pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony.

“Fraud investigations are an essential part of our work to ensure Ohio workers are insured for workplace injuries, and employer dollars aren’t going toward fraudulent claims,” said BWC Administrator/CEO Steve Buehrer. “We are pleased to see this case, which began with a search warrant more than a year ago, wrap up and more than $20,000 returned to the State Insurance Fund.”

On March 26, 2014, the Lima Special Investigations Unit executed a search warrant at Roop’s place of employment after receiving an allegation that Roop may have been working while receiving benefits. Investigators obtained evidence proving that Roop worked at his brother-in-law’s two Lima businesses while collecting permanent total disability from June 2012 to September 2013.

The judge ordered Roop to pay court costs and restitution totaling $22,930.67, plus investigative costs of $5,000. If Roop violates the terms of his community control, he will receive a prison term of 12 months.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov. Check out our latest cases at ohiobwcfraud.wordpress.com, and see what workers’ compensation fraud looks like in our fraud awareness video on YouTube.

Blacklick woman ordered to repay $8K in workers’ comp restitution

Memunatu Sheriff, of Blacklick (Franklin County), pleaded guilty and was sentenced May 19 in the Franklin County Court of Common Pleas on one count of attempted workers’ compensation fraud, a first-degree misdemeanor.

SID’s intelligence unit found that Sheriff earned wages from two employers while receiving temporary total disability benefits, a type of benefit reserved for claimants that cannot work while recovering from a workplace injury. The findings stemmed from a database cross match query from the Ohio Department of Job and Family Services. Investigators found that Sheriff worked for approximately seven months while receiving temporary total disability benefits.

Sheriff was ordered to pay $8,891 in restitution to BWC by Aug. 3. She paid the full restitution amount before entering her plea.

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