Former Reynoldsburg resident pays over $12K in restitution to BWC

Latisha Holloway, 42, pleaded guilty to one count of workers’ compensation fraud and has been ordered to pay $2,119.73, the remaining amount of her $12,585.19 restitution.

Holloway became the subject of a Bureau of Workers’ Compensation (BWC) investigation after receiving an allegation that she made statements to examining doctors that she may be working. The investigation collected and reviewed the evidence and confirmed Holloway was working for multiple employers while receiving BWC disability benefits.

On March 21, 2023, Holloway pleaded guilty to one count of workers’ compensation fraud, a felony of the fifth degree. After already receiving a recoupment of $10,465.46 in March 2022, the Judge ordered Holloway to pay the remaining $2,119.73 to BWC.

Lawn Care Business Owner Found Guilty of Theft

A Kentucky man pleaded guilty to one count of theft, a fifth-degree felony, for collecting over $11,000 in disability benefits from the Ohio Bureau of Workers’ Compensation (BWC) while operating his lawn care business.

Michael Strother, 36, was the subject of a BWC Special Investigations Department (SID) investigation after an allegation he owned and operated his business, Eastern Style Lawn Care LLC while receiving BWC benefits.
The investigation found Strother was working for nine months and hid his work activity from BWC to continue collecting BWC temporary total disability benefits.
The investigation into Strother consisted of multiple surveillances, including videos of Strother performing lawn care services without any apparent injury. On December 19, 2022, Strother pleaded guilty to one count of theft, a fifth-degree felony. Strother was ordered to pay restitution of $11,237.77 to BWC and sentenced to 12 months of community control, nonreporting.
If Strother violates the terms of his probation, he is subject to a suspended sentence of 12 months in jail.

Click here for a video of the investigation highlights.

Business owner ordered to pay over $25K in restitution to BWC

On Nov. 10, 2022, Josh Bailey pleaded guilty to one count of workers’ compensation fraud and ordered to pay a total restitution of $25,460.87 to the Bureau of Workers’ Compensation (BWC).

BWC’s Special Investigations Unit (SIU) opened an investigation into Bailey after finding an address and phone number linking him to a business named J and J Roofing. During the review, SIU found three active business registrations listed for Bailey. Through surveillance and interviews, SIU confirmed Bailey operated and engaged in physical work activities for his business, Bailey’s Home Repair, while receiving Temporary Total Disability benefits from BWC.

On Nov. 10, 2022, Josh Bailey pleaded guilty to one count of workers’ compensation fraud, a misdemeanor of the first degree. After paying $10,000 toward his restitution. Judge Kim Brown found Bailey guilty and proceeded to sentencing. Judge Brown ordered Davis to pay the remaining balance of restitution totaling $15,460.87 to BWC and sentenced him to six months of community control.

Franklin County woman ordered to pay over $17K in restitution to BWC

On Nov 1, 2022, Frances Davis pleaded guilty to one count of attempt to commit workers’ compensation fraud, a fifth-degree felony, and pay $17,144.79 in restitution.

BWC’s Special Investigations Department (SID) opened an investigation into Davis after their Intelligence Unit identified she potentially earned wages when she was also receiving disability benefits from BWC. The investigation confirmed Davis worked for seven different employers over the course of two years. While collecting BWC benefits, she held positions such as manager, assistant manager, packer, and machine operator.

A Franklin County judge found Frances Davis guilty and sentenced her to pay the restitution as well as five years of community control.

Man with three jobs pleads guilty to workers’ compensation fraud and pays over $4k in restitution

On Sept. 26, 2022, Kerby Harrison pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, and was ordered to pay $4,462.02 in restitution.

BWC’s Special Investigations Department (SID) opened an investigation into Harrison after their Intelligence Unit identified he potentially concealed his work activity from BWC. SID found he maintained employment with three different employers while simultaneously collecting BWC disability benefits for nearly two and a half years.

Harrison pleaded guilty to one count of workers’ compensation fraud on Sept. 26. Harrison was sentenced to pay restitution in the amount of $4,462.02 to the BWC. Harrison was also ordered to five years of community control and 12 months prison if community control is violated.

BWC’s Special Investigations Department Achieves Another Great Fiscal Year

In its 29th year, the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID) achieved impressive results in fiscal year (FY) 2022.

This past fiscal year, SID closed 1,431 cases, had 69 convictions, and identified $90 million in savings to our system – the second highest annual savings since FY 2007. Protecting the state insurance fund, ensuring the workforce is receiving the best care possible, and employers pay their share to help keep premiums low, has been a driving force for the SID specialists. There have been many notable achievements this fiscal year by the team at BWC. Here are a few of the stories in the FY22 annual report.

Curtis Wilson – Stolen Check
Curtis Wilson of Columbus pleaded guilty to one count of receiving stolen property and was ordered to serve community control for five years and to pay restitution to the Ohio Bureau of Workers’ Compensation (BWC) in the amount of $18,369.33.

In December 2020, BWC issued a dividend check to an employer. Soon after the check was sent, the employer contacted BWC and advised they did not receive nor cash the dividend check. An investigation by the Special Investigations Department’s employer fraud team revealed the warrant was cashed via ATM deposit into the account of Curtis Wilson.

Through the investigation, it was determined Wilson did not have any relationship to the employer and was not entitled to the BWC dividend funds. On June 8, 2022, in the Franklin County Court of Common Pleas, Wilson pleaded guilty to one count of receiving stolen property, a fifth-degree felony. A Franklin County judge accepted his guilty plea and proceeded to sentencing. The judge ordered Wilson to serve five years of community control and to pay BWC $18,369.33 in restitution.

Kanubhai C Patel, MD – Billing for Services Not Rendered and Upcoding
On May 13, 2022, Kanubhai Patel, MD, pleaded guilty in the in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. Dr. Patel was ordered to pay the BWC $1,893.44 in restitution and $10,000 for investigative costs. Dr. Patel paid the full $11,893.44 amount and the court deemed the matter closed.

BWC’s Special Investigations Department’s health care provider team opened an investigation based upon an allegation from a managed care organization (MCO) regarding the billing practices of Dr. Patel from his medical office, Behavioral and Psychiatric Consultants (BPC). The investigation found Dr. Patel billed BWC for services not rendered. Dr. Patel’s scheme involved billing for counseling codes that he did not perform along with a high-level evaluation and management (E/M) services that did not meet requirements to bill for the higher-level E/M services during the same visit. Dr. Patel fabricated office notes and inflated treatment times to support his billing.

As part of a plea agreement, Dr. Patel signed a permanent decertification from BWC’s Health Partnership Program (HPP).

Caden Knight – Death and Violations of Specific Safety Requirements (VSSR) Benefits Fraud
On Nov. 30, 2021, Caden Knight pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, and was sentenced to serve 12 months of incarceration (suspended) and five years of non-reporting probation and ordered to pay $81,793.60 in restitution to the BWC.

Caden Knight, the son of a deceased BWC claimant, was collecting BWC death and VSSR benefits contingent upon his enrollment at an educational institution.

A proactive review of the BWC death benefit claims identified Caden Knight had submitted documentation to BWC reporting he was enrolled as a full-time student at three universities. This enrollment documentation was required for Knight to collect death and VSSR benefits from BWC. The SIU established that before each semester began, Knight submitted photographs of his anticipated school schedule for the upcoming semester to qualify for the BWC death and VSSR benefits.

SIU’s investigation determined Knight never participated in a full-time educational program. The educational transcripts and records from the universities showed Knight repeatedly enrolled in required courses, submitted the courses to BWC, and then subsequently dropped his courses. In an interview conducted by the SIU, Knight admitted that he was aware that his deception caused BWC to issue death and VSSR benefits to which he was not entitled.

Worker with three jobs while also collecting BWC disability benefits pleads guilty to workers’ comp fraud and ordered to return $12k

Roy Love pleaded guilty to one count of workers’ compensation fraud, a fourth-degree felony. Love was ordered to pay restitution in the amount of $12,128 to the Bureau of Workers’ Compensation (BWC) and sentenced to four years of community control.

BWC’s Special Investigations Unit established Roy was employed with three different employers while collecting BWC disability benefits. The investigation found Love worked and received benefits between January 2019 and August 2020.

On August 25, 2022, Roy Love pleaded guilty to one count of workers’ compensation fraud, a fourth-degree felony. Love was sentenced to four years of community control and 11 months prison if community control is violated. Love was given credit for 6 days of jail time along with restitution in the amount of $12,128.49 to the BWC.

Marion County Office Manager to pay back over $4K to BWC

Pamela MacMichael, 54, of Caledonia, Ohio was ordered to pay restitution of $4,452.11 to the Bureau of Workers’ Compensation (BWC) and serve 36 months of community control, nonreporting.

BWC’s Special Investigations Department opened an investigation after its Intelligence Unit identified that Pamela MacMichael potentially earned wages during periods she had received BWC disability benefits. The investigation proved MacMichael knowingly and with fraudulent intent returned to work as an office manager while simultaneously collecting BWC benefits to which she was not entitled.

On June 2, 2022, MacMichael plead guilty to one count of workers’ compensation fraud, a misdemeanor of the first degree. A Franklin County judge found MacMichael guilty and proceeded to sentencing. The judge ordered MacMichael to pay restitution of $4,452.11 to BWC and sentenced her to 36 months of community control, nonreporting.

Licking County business owner to pay back BWC $100k

Thomas Tomson was found guilty on one count of workers’ compensation fraud, a third-degree felony, and one count of workers’ compensation fraud, a fourth-degree felony, and must pay back $100,000 to the Bureau of Workers’ Compensation (BWC). BWC’s Special Investigations Department opened an investigation after its Intelligence Unit identified Thomas Tomson may own a company while in receipt of permanent total disability (PTD) benefits.

The investigation found Tomson started a new business, Bulldog Services, where he worked and received income from this business while in receipt of PTD benefits. Bulldog Services was later sold and operated under the name of Kirk’s Business with which Tomson continued to work. Both businesses provided the same services as the employer of record for Tomson’s BWC claims, T.H.E. Contracting, which was also owned by Tomson.

On February 22, 2022, a jury trial in Licking County began and on February 24, 2022, the jury found Thomas Tomson guilty on one count of workers’ compensation fraud, a third-degree felony, and one count of workers’ compensation fraud, a fourth-degree felony.

On April 11, 2022, Licking County Judge David Branstool sentenced Tomson to two years of probation and ordered Tomson to pay $100,000 in restitution to the Ohio Bureau of Workers’ Compensation.

Security guard to pay back over $6K to BWC

A Lucasville security guard, Rick Tackett, was sentenced to one month of nonreporting probation and ordered to pay restitution to the Bureau of Workers’ Compensation (BWC) in the amount of $6,167.89 after pleading guilty to one count of workers’ compensation fraud, a first-degree misdemeanor, on Feb. 9, 2022. BWC’s Special Investigations Unit (SIU) opened an investigation after its Intelligence Unit identified Rick Tackett potentially earned wages during periods he had received BWC disability benefits.

The investigation found Tackett knowingly and with fraudulent intent worked as a security guard for a hospital in southern Ohio while also receiving BWC disability benefits. Tackett paid the ordered restitution prior to his plea.

In other news:

Karen Fears
Working and Receiving
Euclid, Ohio

On Feb. 1, 2022, Karen Fears pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Fears was ordered credit for 12 days jail time served and to pay restitution to BWC in the amount of $5,843.60. Fears paid the restitution in full.

The Special Investigations Department opened an investigation after its Intelligence Unit identified Fears potentially earned wages during periods she had received BWC disability benefits. The investigation found Fears knowingly and with fraudulent intent worked while simultaneously collecting BWC disability benefits to which she was not entitled.

Della Wade
Working and Receiving
Cleveland, Ohio

On Feb. 2, 2022, Della Wade pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Wade was sentenced to 90 days of jail, suspended for the payment of restitution in the amount of $6,726.51. Wade paid the restitution in full.
The Special Investigations Department opened an investigation after its Intelligence Unit identified Wade potentially earned wages during periods she received BWC disability benefits. The Northeast Region SIU’s investigation found Wade was working for a restaurant company while concurrently collecting BWC disability benefits. The investigation identified that Wade worked and received benefits between May and November 2019.

October Convictions Totaling Over $13K in Restitutions

In October, the special investigations department secured three convictions with restitutions totaling $13,185.48. This brings the total convictions for 2021 to 46. Jasmine Byrd, and Charles Finks were convicted of workers’ compensation fraud after working while receiving workers’ compensation benefits.

Jasmine Byrd

Toledo, Ohio (Lucas County)

The Special Investigations Department found Byrd was working at a local Northwest Ohio employer between July and November 2018 while receiving over $6,000 in temporary total disability benefits.

On Oct. 13, 2021, Jasmine Byrd pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Judge Holbrook accepted the plea and sentenced Byrd to 180 days in jail, suspended for five years of community control. Byrd was ordered to pay $6,099.30 in restitution to BWC.

Charles Finks

Groveport, Ohio (Franklin County)

The Special Investigations Department opened an investigation after its Intelligence Unit identified Charles Finks potentially earned wages during periods he had received BWC disability benefits. The investigation found that Finks was working as a welding layout fitter between December 2018 and January 2019 while receiving over $3,900 in temporary total benefits he was not entitled to.

Charles Finks pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor on Oct. 19, 2021. Prior to entering his plea, Finks paid $3,964.72 in restitution to the clerk’s office. Judge Holbrook accepted the plea and sentenced Finks to one day in jail, one day of jail time credit, and waived fines and costs.

It’s International Fraud Awareness Week

November 14-20 is International Fraud Awareness Week. The Special Investigations Department (SID) of the BWC is hard at work every day to make sure the State Insurance Fund is protected from fraud committed by injured workers, employers, or health care providers.

Workers’ Compensation fraud occurs when someone knowingly makes a false representation to obtain or deny workers’ compensation benefits or to avoid responsibility under the law. It can also occur when an employer fails to obtain or maintain coverage or misrepresents the amount of payroll or classification of its employees. Healthcare providers commit fraud when they intentionally receive payments to which they’re not entitled. In Fiscal Year 2021, we received 2,421 allegations of fraud.

We value the public’s assistance in helping us identify instances of potential fraud. To make it easier for people to file reports, SID worked with the BWC Information Technology division to create a simplified online fraud referral form.

The form, which you can access on our website, now only requires the subject’s first name (or initial) and last name. We continue to welcome all information a source may furnish us. Including an injured worker’s full name, date of birth (or age), address, or city and state of residence, ensures we will immediately know whom to investigate.

The simplified form uploads the allegation into our case management database and immediately assigns the referral to the appropriate SID team for review and research. It also provides tipsters an immediate confirmation, including the fraud allegation number for future reference or follow-up.

In addition to online, suspected fraud can also be reported by calling 1-800-644-6292 or emailing Allegations.W.1@bwc.state.oh.us. 

Office manager sentenced to pay back over $30K

Crystal Posey was found guilty of one count of workers’ compensation fraud and must pay back $30,278.61 to the Bureau of Workers’ Compensation (BWC). BWC’s Special Investigations Unit (SIU) found Crystal Posey began working as an office manager for a chiropractic clinic in 2015 and was still employed at the end of the investigation. Evidence collected proved Posey knowingly, and with fraudulent intent, worked while simultaneously collecting BWC disability benefits to which she was not entitled.

Posey pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony. Posey was sentenced to eight months incarceration, suspended, and placed on non-reporting probation for five years. Should Posey violate the terms of her probation, she will be subject to a suspended sentence of eight months in jail.

“Our Special Investigations Department continues to do a fantastic job,” Administrator/CEO Stephanie McCloud said. “By shutting down fraud, this team helps ensure the funds are there for Ohio’s injured workers and employers.”

In other news:

Jason Strzala, dba Goodfellas Plumbing and Drain Inc                               

The Special Investigations Department received a referral from the BWC Employer Compliance Department after Jason Strzala, owner of Goodfellas Plumbing and Drain, failed to cooperate with the compliance officer and continued to operate without BWC coverage. The Employer Fraud Team made further attempts to assist Strzala with reinstating the policy; however, he failed to take the steps necessary to reinstate coverage on the policy.

On September 1, 2021, Strzala pleaded no contest and was found guilty in Parma Municipal Court on two (2) counts of failure to comply, both second-degree misdemeanors. Strzala was sentenced to 60 days in jail, suspended.

Jennifer Soich-Zecher

The Special Investigations Department received an anonymous call to report Jennifer Soich-Zecher working while concurrently receiving BWC benefits.

The Northeast Region SIU’s investigation found Soich-Zecher was employed as a cashier and customer service associate with Walmart and Dollar Tree while collecting BWC disability benefits. The investigation identified that Soich-Zecher worked and received benefits between February and August 2019 and confirmed that she knowingly and with fraudulent intent was working while collecting BWC disability benefits to which she was not entitled.

On September 9, 2021, Jennifer Soich-Zecher pleaded guilty in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. Soich-Zecher was sentenced to five years community control, 180 days jail (suspended) and ordered to pay restitution in the amount of $2,191.45.

Davida Taylor

The Special Investigations Department opened an investigation after it identified Davida Taylor potentially earned wages during time periods she had received BWC disability benefits.

The Northeast Region SIU’s investigation found Taylor maintained employment as a Clinical Technician/Patient Care Nurse Assistant with the Cleveland Clinic while concurrently collecting BWC disability benefits. The investigation identified that Taylor worked and received benefits between March and August 2019.

Davida Taylor pleaded guilty in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. Taylor was sentenced to non-reporting probation for four years and ordered to pay restitution of $12,206.16 to the BWC. If Taylor violates the terms of her probation, she is subject to a suspended sentence of nine months in jail.

Former doctor sentenced to pay back over $500K

Former New Albany doctor, Khaled Amr, admitted to staging a break-in at his Columbus practice for a fraudulent insurance claim and running a pill mill. Amr was sentenced to spend five years on probation and ordered to forfeit more than a half-million dollars.

Amr was arrested in 2019 at his home, where he was found hiding in a closet. According to court records, Amr was operating a pill mill out of his practice, Columbus Pain Specialists, for more than seven years. Amr was selling Oxycodone in exchange for financial kickbacks and staged a break-in at his practice to make a fraudulent insurance claim, resulting in more than $1 million being paid to him.

He will be ordered to surrender his medical license and DEA license as part of the terms of his probation. He also was ordered to pay a $5,000 fine and forfeit more than $524,000 that were proceeds of his criminal behavior.

In other news

On August 9, 2021, Lisa Buckner pled guilty to one count of workers’ compensation fraud, a misdemeanor of the first degree. Buckner returned to work at Fayette County Community Action, however, she had not reported this employment to the Bureau of Workers’ Compensation (BWC) and continued to receive disability benefits.

The investigation confirmed that Buckner knowingly and with fraudulent intent was working while simultaneously collecting BWC disability benefits to which she was not entitled. Restitution of $5,119.82 had previously been paid in full through a lump sum settlement. A Fayette County judge accepted Buckner’s guilty plea, ordered one day in jail, gave her one day jail time credit, and closed the case for time served.

Robert Swartz, dba Bamboo Relaxing Massage

The Special Investigations Department received an allegation from the Ohio Investigative Unit regarding Robert Swartz, owner of Bamboo Relaxing Massage. Swartz came under scrutiny by a task force investigating illegal activities at massage parlors. BWC investigators joined the Ohio Investigative Unit and other federal, state and local agencies in a joint investigation. It was discovered Swartz was operating his business without BWC coverage.

On July 15, 2021, Robert Swartz pleaded guilty in Cuyahoga County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony. On the workers’ comp fraud charge, Swartz was sentenced to five years of community control and restitution ordered in the amount of $1,156.56 to BWC.

As part of the task force investigation, Swartz also pleaded guilty to engaging in pattern of corrupt activity, promoting prostitution, grand theft, and practicing medicine without a license.

Cynthia Whitner

The Special Investigations Department opened an investigation after it’s Intelligence Unit identified Cynthia Whitner had potentially earned wages during periods she received BWC disability benefits. The investigation found Whitner knowingly and with fraudulent intent was hired and worked for I-Force while simultaneously collecting BWC disability benefits to which she was not entitled.

On July 14, 2021, Whitner pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Whitner was found guilty and, at the defendant’s request, deferred sentencing until September 23.

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

Real estate agent owes BWC over $151K after fraud conviction

A Columbus-area real estate agent and broker pleaded guilty to one count of workers’ compensation fraud, a felony of the fourth degree.

David L. Garner, 66, worked from 2009 through 2018 as both a real estate agent selling homes, and as a real estate broker providing broker price opinions while receiving the Bureau of Workers Compensation (BWC) disability benefits. Evidence obtained during the investigation revealed Garner intentionally misrepresented and withheld this activity from BWC to collect disability benefits he otherwise would not have been entitled to.

On June 6, a Franklin County judge found Garner guilty and proceeded to sentencing. The judge placed Garner on community control for 3 years and ordered him to pay BWC $151,705.15. If Garner violates the terms of his community control, he is subject to a suspended sentence of 18 months in prison.

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

Workers’ comp fraud lands cheaters costly penalties

Convicts include Central Ohio doc ordered to pay $71K to BWC

Four Ohioans convicted or sentenced for workers’ compensation fraud in April include a Central Ohio physician who unlawfully distributed controlled substances and overbilled the Ohio Bureau of Workers’ Compensation (BWC).

On April 15, U.S. Judge Michael Wilson of the Southern District of Ohio ordered Kedar Deshpande, MD, to pay $117,122 in restitution, including $70,957 to BWC. The judge also sentenced Deshpande to three years of supervised release, 12 months of which is to be served under home detention, for felony counts of unlawful distribution of controlled substances and false statements relating to health care matters.

“Our Special Investigations Department found Dr. Deshpande upcoded patient office visits by falsely representing the level of examination he performed on our injured workers so he could receive inflated reimbursement from BWC,” said BWC Interim Administrator/CEO John Logue. “Congratulations to our investigators for their work on this important case and for bringing three other fraud cases to a close last month.”

Deshpande is the former owner and operator of the now-closed Orthopaedic & Spine Center, which had three locations in Central Ohio. A multi-jurisdictional task force of state and federal authorities found Deshpande pre-signed blank prescriptions for unqualified and non-licensed staff to complete and dispense to patients in his absence. The staff would fill-in the prescriptions with Schedule II controlled substances before dispensing to patients. The staff would mostly dispense the pre-signed prescriptions when Deshpande was on vacation, arrived late to the office, or was otherwise not at the clinic.

Other April fraud cases include:

William Knox of Athens, Ohio

Knox pleaded guilty April 7 in the Franklin County Common Pleas Court to one count of workers’ compensation fraud and one count of forgery, both fourth-degree felonies. Knox was sentenced to community control for five years and ordered to pay BWC restitution of $131,752.

BWC investigators found Knox inflated his weekly income from his employer of record so he could be paid at a higher weekly rate of compensation from BWC.

Tanya Houston of Shaker Heights, Ohio

A Franklin County judge ordered Houston to pay $23,489 to BWC and serve five years of probation in lieu of a one-year prison sentence after she pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on April 7. BWC discovered Houston working while collecting injured-worker benefits.

Frank Phillips of Hamilton, Ohio

Phillips pleaded guilty April 26 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. He was ordered to pay BWC $12,588 in restitution and serve five years on community control.

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

Convicted of fraud, nurse ordered to pay BWC $23K in restitution

Felony conviction for Shaker Heights woman

A Cleveland-area nurse was ordered to pay the Ohio Bureau of Workers’ Compensation (BWC) more than $23,000 in restitution April 7 after BWC discovered her working while collecting injured-worker benefits.

A Franklin County judge ordered Tanya Houston, 46, of Shaker Heights to pay $23,489 to BWC and serve five years of probation in lieu of a one-year prison sentence after she pleaded guilty to a fifth-degree felony count of workers’ compensation fraud.

“We’re here to provide compensation for people who can’t work because of an on-the-job injury, not supplement the income of fraudsters cheating our system,” said BWC Interim Administrator John Logue.

According to BWC’s Special Investigations Department, Houston was working as a therapeutic program nurse when she injured herself in June 2019. As she collected disability benefits from BWC for the injury, she continued to work for a second employer without informing BWC, the employer where her injury occurred, or her physician and other treatment providers.

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

BWC secures 7 fraud-related convictions in February

A doctor who ran a pill mill in Dayton and the owner of a massage parlor in Medina were among seven Ohioans convicted or sentenced in February on workers’ compensation fraud or related charges.

Morris Brown, M.D., 73, was sentenced Feb. 8 to two years in prison after investigators with the Ohio Bureau of Workers’ Compensation (BWC) and other state and federal authorities discovered his involvement in an opioid ring. Brown was convicted in February last year, according to a news release from the U.S. Department of Justice.

“I’m proud of our Special Investigations Department for its role in bringing this criminal activity to an end,” said BWC Interim Administrator/CEO John Logue.

Others convicted or sentenced in February include:

• Yulian Fu, Lucky Jade LLC, Medina, Ohio

Yulian Fu pleaded guilty Feb. 11 to one count of workers’ compensation fraud, a fifth-degree felony, after his business came under scrutiny by a task force investigating illegal activities at     massage parlors. BWC investigators – joining The Ohio Investigative Unit and other federal, state and local agencies – discovered Fu was operating his business without BWC coverage. Multiple defendants, charges, and convictions were involved in this case. On the workers’ comp fraud charge, Fu was sentenced to three years discretionary post release control.

• Frederick Romito Jr., Youngstown, Ohio

Frederick Romito Jr. pleaded guilty Feb. 22 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a home remodeler while collecting BWC disability benefits. Romito was sentenced to five years of community control with an 11-month suspended prison sentence. He was ordered to pay $17,467 in restitution to BWC.

• Rhonda Rauch, dba The Yard Butler and Landscape Services, Lancaster, Ohio

Rhonda Rauch, owner of The Yard Butler Lawn and Landscape Services LLC, pleaded guilty Feb. 16 to one count of workers’ compensation fraud, a fifth-degree felony. BWC found Rauch had presented six forged/altered BWC Certificates of Coverage to Fairfield County Library in order to secure various bids for landscaping and snow removal services. Rauch was sentenced to five years of community control and ordered to pay restitution of $4,448 to BWC.

•  Bridget Casas, Cleveland, Ohio

Bridget Casas pleaded guilty Feb. 9 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found her working as a caregiver while receiving temporary disability benefits from BWC. Prior to her guilty plea, Casas paid BWC $9,606 in restitution. She was sentenced to two days in jail and granted credit for time served.

•  Manish Walia, dba Imaginarium Foods, Lima, Ohio

Manish Walia, co-owner of Imaginarium Foods, pleaded guilty Feb. 3 in Lima Municipal Court to one count of failure to comply, a second-degree misdemeanor. Walia was sentenced to a $250 fine and court costs. Walia had requested a BWC policy after a worker had filed a claim against his company, a Dunkin Donuts/Baskin Robins location. BWC discovered he had been operating the business without workers’ compensation coverage.

• Donnie Schilling, dba Cleveland Tire and Wheel, Cleveland, Ohio

Donnie Schilling was convicted Feb. 1 for the second time in eight years for workers’ compensation fraud after BWC found him operating his business without coverage. Schilling pleaded guilty to one count of worker’s compensation fraud, a fifth-degree felony. A judge placed him on community control for one year to ensure he pays his outstanding debt to BWC. Schilling pleaded guilty to a similar charge in 2013.

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

Happy Anniversary to our Fraud Hotline system!

International Fraud Awareness Week 2020

By Jeff Baker, Program Administrator, Central Operations, BWC Special Investigations Department

Our Special Investigations Department (SID) is celebrating the third anniversary of our Fraud Hotline system this month.

We launched this system on Nov. 14, 2017, during Fraud Awareness Week, and what a successful launch and three years it has been! We’ve received more than 3,900 calls since then from sources suspecting workers’ compensation fraud by injured workers, businesses, and health care providers. That’s an average of more than five each workday.

“Clearly, this important tool is working and we’re glad to have it,” said SID Director Jim Wernecke. “Fraud raises the cost of workers’ compensation for all of us, so the sooner we can stop it, the better.”

If you suspect workers’ compensation fraud in Ohio, give us a call at 1-800-644-6292 or complete a simplified online fraud referral form on our website, We will conduct an investigation and determine the facts.

Together, we are successfully combatting workers’ compensation fraud in Ohio.

Today, and always, we thank you for your support!

Special Investigations unveils new, improved referral form

By Jennifer Cunningham, Assistant Director, Field Operations, BWC Special Investigations Department

We value the public’s assistance in helping us identify instances of potential fraud. To make it easier for people to file reports, our Special Investigations Department (SID) worked with the BWC Information Technology division to create a simplified online fraud referral form.

The form, which you still access by visiting our website, now only requires the subject’s first name (or initial) and last name. Of course, we continue to welcome and will use any and all information a source may furnish us. For example, including an injured worker subject’s full name, date of birth (or age), address, or city and state of residence, ensures we will immediately know whom to investigate.

The simplified form uploads the allegation into our case management database and immediately assigns the referral to the appropriate SID team for review and research. It also provides tipsters an immediate confirmation, including the fraud allegation number for future reference or follow-up.

Whether the subject is an injured worker, provider, employer, or someone else, the new form routes the allegation to the appropriate SID personnel. For example, if you select Injured Worker as the subject, the allegation will automatically go to one of the three SID injured worker teams based on the ZIP code or county of residence for the injured worker.

In addition to online, fraud can also be reported by calling 1-800-644-6292 or emailing allegations.W.1@bwc.state.oh.us.

As always, SID thanks you for your assistance in reporting and stopping workers’ compensation fraud.

Former police officer convicted for workers’ comp fraud

North Canton man owes BWC $89,000

A retired police officer for the city of Canton pleaded guilty to workers’ compensation fraud Thursday after the Ohio Bureau of Workers’ Compensation (BWC) discovered him working two jobs while claiming to be permanently disabled.

James H. Blaine of North Canton must pay BWC $66,481 in restitution and $23,000 in investigative costs after pleading guilty to the fourth-degree felony charge through a bill of information hearing in the Stark County Court of Common Pleas. A judge also ordered Blaine to serve three years of probation, obtain a full-time job, and provide 100 hours of community service.

“If you’re working two jobs, you’re clearly not permanently disabled,” said BWC Administrator/CEO Stephanie McCloud. “Kudos to our investigators for detecting this fraud and putting a stop to it.”

BWC’s Special Investigations Department discovered Blaine working as a security guard for a private company in late 2017 and operating his own landscaping business while collecting permanent total disability benefits for an injury he suffered while working for a salt company. His fraudulent activity is unrelated to his former job as a police officer in Canton, where he retired in 1997, according to city records.

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

Fayette County man owes $141,000 after second fraud conviction

Ohio BWC releases latest fraud convictions

A Washington Courthouse man pleaded guilty to felony workers’ compensation fraud Oct. 5 for working while receiving more than $141,500 in benefits from the Ohio Bureau of Workers’ Compensation (BWC).

Jeffrey Janson, 70, pleaded guilty to the fourth-degree felony in Franklin County Common Pleas Court. A judge sentenced him to six months in jail, suspended for three years of probation, and ordered Janson to pay restitution of $141,578 to BWC. Janson was previously convicted of felony workers’ compensation fraud in July 2010.

“Most people learn a lesson after a conviction for workers’ compensation fraud,” said BWC Administrator/CEO Stephanie McCloud. “Obviously that’s not the case with Mr. Janson, who tempted fate again and was caught a second time by our investigators.”

BWC’s Special Investigations Department discovered Janson working as a semi-truck driver while receiving benefits for a workplace injury. Further review of his bank records proved he was, in fact, working for four additional employers during the same time period.

In other news, BWC secured five fraud-related convictions in September, bringing its 2020 calendar year total to 57.

On Sept. 23, Jessica Holston, of Dayton, pleaded guilty to misdemeanor theft in Franklin County Common Pleas Court for collecting more than $3,200 in disability benefits from BWC while working as a home health aide for Wellcare Home Health from March 13, 2017 to May 30, 2017. A judge sentenced Holston to 180 days in jail, suspended for three years of probation, and ordered her to pay $3,242 in restitution to BWC.

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

Tennessee man’s false injury claim costs him $33K

 Ohio BWC releases latest fraud convictions

A Tennessee man pleaded guilty to felony workers’ compensation fraud Sept. 9 after collecting more than $33,000 from the Ohio Bureau of Workers’ Compensation for a work injury he falsely claimed occurred in Ohio.

Roger Frankenberg, 60, of Sevierville, Tennessee, pleaded guilty to the fifth-degree felony in Franklin County Common Pleas Court. A judge sentenced him to 11 months in jail, suspended for five years of probation, and ordered Frankenberg to pay BWC $33,210 in restitution.

“As many fraudsters discover, ripping off this agency clearly doesn’t pay, thanks to the good work of our Special Investigations Department,” said BWC Administrator/CEO Stephanie McCloud. “Not only does Mr. Frankenberg owe us $33,000, he has a felony record.”

 Acting on a tip, BWC discovered Frankenberg had returned to work for his self-owned company, Custom Renovations and Beyond Inc., while receiving BWC disability benefits from December 2015 until December 2016.

 Further investigation determined Frankenberg sustained his injury in Pennsylvania, not Ohio. But because he didn’t have insurance coverage in Pennsylvania, he fabricated a BWC claim so he could have his medical bills covered and collect indemnity payments.

In a separate case on Sept. 9, a Columbus woman pleaded guilty to workers’ compensation fraud after BWC found she had returned to work but didn’t tell the agency so she could continue to receive disability benefits.

Deborah Chenault pleaded guilty to one misdemeanor count of workers’ compensation fraud and was ordered to pay BWC $6,000 in restitution. A three-month jail term was suspended for five years of probation.

In other news, BWC secured three fraud-related convictions in August, bringing its 2020 calendar year total to 51.

• Danny Mitchell of Clarksburg, West Virginia, dba Mitchell Drilling Inc., pleaded no contest Aug. 18 in Tuscarawas County to one minor misdemeanor count of failure to comply and was found guilty after BWC found him operating his business in Ohio without BWC coverage. A judge waived fines and court costs. Mitchell Drilling paid BWC its outstanding premiums and is no longer operating in Ohio.

 

• Nina Washington of Dayton must pay BWC $4,616 in restitution after pleading guilty Aug. 17 to a misdemeanor count of workers’ compensation fraud. A Franklin County judge also sentenced Washington to five years of probation for collecting disability benefits after she returned to work. Washington paid $500 toward her restitution the morning of her sentencing.

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

Video surveillance exposes Sidney couple’s scheme to defraud BWC

Agency closes 11 cases in June, July   

The Ohio Bureau of Workers’ Compensation (BWC) closed 11 cases involving workers’ compensation fraud and related charges in June and July, bringing total convictions for BWC to 47 for calendar year 2020.

“Workers’ compensation fraud can happen anywhere in Ohio,” said BWC Administrator/CEO Stephanie McCloud. “That’s why we have dedicated investigators in every corner of the state to uncover folks — whether they’re employers, injured workers or medical providers — who try to cheat the system.”

Among the June cases is a Sidney, Ohio, couple sentenced on felony charges related to workers’ compensation fraud after a BWC investigation found the husband mowing lawns, using a snow blower, and chopping wood while claiming to be permanently and totally disabled from work.

A Shelby County judge sentenced David Juillerat on June 8 to five years of probation in lieu of jail time and a fine of $1,000 for his conviction on a reduced charge of attempted tampering with records, a fourth-degree felony. Juillerat’s wife, Wendy Juillerat, was sentenced three days earlier on a similar charge, attempted complicity to tampering with records, also a fourth-degree felony. A judge sentenced her to five years of probation in lieu of jail time and to pay court costs.

David Juillerat applied to BWC in 2018 for permanent total disability benefits, claiming a work injury left him unable to drive a car or walk without the assistance of a walker. Acting on a tip that he might be faking his injury, agents with BWC’s Special Investigations Department surveilled David for several weeks in 2019. They filmed him on multiple occasions entering and leaving medical offices with a walker. Away from a medical office, however, agents filmed him walking, shopping, working on his car, chopping wood, and other activities, all without the use of a cane or walker.

As for Wendy Juillerat, agents say she admitted to helping her husband complete his application for permanent total disability and accompanied him to numerous doctor’s appointments in which she would exaggerate his physical limitations in order for the disability to be granted.

Based on BWC’s investigation, David Juillerat’s application for disability benefits was denied in late 2019, saving BWC an estimated $233,668 in benefits over the projected life of the claim.

Other cases in June and July include:

 

Joseph Ferguson of Toledo

Ferguson pleaded guilty July 24 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor, after a BWC investigation revealed he was working as a web development supervisor while receiving benefits from BWC from October 2017 to January 2018. The judge sentenced Ferguson to five years of community control and ordered him to pay restitution of $6,473 to BWC. If he violates the terms of his community control, he will serve 60 days in jail.

 

Ruth Asamoah of Columbus

On July 13, Asamoah pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. BWC investigators found Asamoah worked for eight employers, performing the same or similar jobs she was doing when she was injured. A Franklin County judge ordered her to pay $15,020 in restitution and sentenced her to an 11-month jail sentence, suspended for five years of probation.

 

Marguerite Cervantes of Perrysburg

Cervantes pleaded guilty July 2 to one count of workers’ compensation fraud, a fifth-degree felony, in the Franklin County Court of Common Pleas. A BWC investigation revealed Cervantes had returned to work as a clinical nurse from April to October 2016 while collecting temporary total disability benefits. The judge sentenced her to an 11-month suspended jail sentence, five years of probation, and ordered her to pay restitution of $16,885.

 

Angela Berardelli of North Canton

A BWC investigation revealed Berardelli was working at a restaurant while receiving BWC benefits from January 2016 to June 2017. On June 30, Berardelli pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. She received a sentence of 90 days in jail suspended for 12 months of community control. The judge ordered Berardelli to pay restitution of $10,194 to BWC. She made a payment of $6,500 at the time of plea.

Patricia Black of Cincinnati

Black pleaded guilty June 16 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony. An investigation by BWC found Black working as an office cleaner while receiving BWC benefits from January 2018 to October 2018. Black was ordered to pay $18,407 in restitution and sentenced to 12 months in prison, suspended for three years of non-reporting community control.

To report suspected workers’ compensation fraud, call 1-800-644-6292 (Option 4, Option 0, Option 1) or visit bwc.ohio.gov.

Dayton claims representative is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

A claims service specialist (CSS) in our Dayton Service Office is our 2019 Fraud Finder of the Year award winner.

We can’t name the employee because we don’t publicly identify our fraud tipsters, but this longtime BWC veteran tipped us off about a claimant collecting disability benefits after going to prison for shooting a SWAT officer.

“Thanks to this employee’s actions, we were able to save the BWC system more than $2 million,” said Jim Wernecke, director of our Special Investigations Department (SID), referring to the estimated cost over the life of the claim.

With characteristic humility, the CSS, who referred five other allegations to SID during fiscal year 2019, said, “I was just doing my job.”

About a fourth of the nearly 3,000 fraud allegations we received in fiscal year 2019 came from BWC personnel around the state. These included claims representatives, employer representatives, and others who suspected illicit behavior on the part of injured workers, employers, health-care providers or others connected to Ohio’s workers’ compensation system. Our investigations led to an estimated $5.9 million in savings to the BWC system.

“We encourage all BWC employees and the general public to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4, option 1) or visit www.bwc.ohio.gov.

Ohio business owners owe more than $800K following fraud-related convictions

William H. Foster III

Three Northeast Ohio men owe the Ohio Bureau of Workers’ Compensation (BWC) more than $800,000 after investigators discovered they were operating their businesses without workers’ compensation coverage.

“These business owners learned the hard way they cannot operate their business without workers’ compensation coverage, and now they owe us hundreds of thousands of dollars,” said BWC Administrator/CEO Stephanie McCloud. “I’m pleased our investigators stopped these employers from continuing to break the law and cheat our system.”

William H. Foster III, owner of American Construction Group LTD, pleaded guilty Feb. 11 in a Summit County courtroom to a second-degree misdemeanor of obstructing official business after failing to work with BWC to reinstate his policy. A judge sentenced Foster to credit for time served in jail and to follow the payment agreement he made with the BWC and the Ohio Attorney General’s Office to reinstate his policy. Foster owes BWC more than $360,000 in past premiums and penalties.

Paul “Bob” Collier Jr.

In Stark County, Paul “Bob” Collier Jr. and Miklos Fioretto pleaded guilty on Jan. 17 and Feb. 5, respectively, to a fourth-degree felony charge of workers’ compensation fraud for failing to maintain coverage on their East Sparta, Ohio, business. Investigators discovered that Fioretto and Collier changed the name of their pallet manufacturing business to avoid paying past premiums and penalties associated with the business.

Both men were sentenced to three years of community service. A condition of probation is to pay BWC restitution of $458,125.

In other news: A Columbus woman was ordered to pay BWC $6,941 in restitution on Tuesday after pleading guilty to a first-degree misdemeanor charge of workers’ compensation fraud.

BWC investigators discovered Jamia Smith, 39, working for a staffing firm while concealing that information from BWC to continue collecting disability benefits. A judge also sentenced Smith to three years of probation in lieu of six months in jail.

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

Woman convicted for cashing dead mother’s workers’ comp benefits

Alabama fraudster owes BWC $18,000

An Alabama woman was convicted of workers’ compensation fraud last month after investigators discovered she was cashing her deceased mother’s workers’ comp checks more than a year after her mother died.

Patricia Barney pleaded guilty Jan. 23 in a Franklin County courtroom to a fifth-degree felony charge of workers’ compensation fraud. A judge sentenced Barney to five years of probation and ordered her to pay the Ohio Bureau of Workers’ Compensation (BWC) $18,000 in restitution.

“Ms. Barney was clearly not the intended recipient of these benefits, and I’m pleased we brought her fraudulent activity to an end,” said BWC Administrator/CEO Stephanie McCloud.

BWC’s Special Investigations Department found Barney, who was an authorized user on a bank account where her mother’s BWC benefit payments were being directly deposited, continued to use funds on the account after her mother passed away in January 2017. She did so until May 2018 without notifying BWC.

Other convictions in January include:

Shawn Ferrer of Canton, Ohio
Ferrer pleaded guilty Jan. 28 in Franklin County Court to one count of workers’ compensation fraud, a first-degree misdemeanor, for working while receiving disability checks. A judge ordered Ferrer to pay $1,599 in restitution to BWC and sentenced to 90 days in jail and six months of probation.

Glenn Cummings and Jack Cummings, dba Cummings Moving & Storage of Dayton, Ohio Glenn and Jack Cummings owed BWC more $9,600 in premiums and penalties after they were convicted of operating their business without workers’ compensation coverage since September 2017.

Jack Cummings pleaded guilty Jan. 21 Dayton Municipal Court to one minor misdemeanor count of failure to comply and was sentenced to pay a $50 fine and court costs. Glenn Cummings pleaded guilty Jan. 23 to one minor misdemeanor count of failure to comply and was sentenced to pay a $25 fine and court costs. BWC reinstated their policy Jan. 21 after the Cummings paid their premiums and established a reinstatement payment plan.

Barton Carmichael, dba Haul Away Containers Inc, Bigdumpster.com LLC, and Wastetran LTD of Akron, Ohio
Carmichael pleaded guilty Jan. 21 in Franklin County to one amended charge of theft, a first-degree misdemeanor, for operating his businesses without workers’ compensation coverage. A judge ordered Carmichael to pay $14,329 to BWC in restitution. His 180-day jail sentence was suspended.

Todd Bennett, dba Rent-A-Vision, McConnelsville, Ohio
Bennett pleaded guilty Jan. 6 in Morgan County Court to two counts of failure to comply, both second-degree misdemeanors, for operating his business without workers’ compensation. A judge ordered Bennett to pay $50 in fines plus court costs for each count.

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

How employers can prevent workers’ compensation fraud

By Dan Fodor, Assistant Director, BWC Special Investigations Department

Workers’ compensation fraud can be costly, so it’s important to know how to protect your organization. Here are five ways you can prevent fraud.

1. Make employees aware of workers’ compensation fraud. Employees should know that workers’ compensation fraud has a price. Individuals who are caught may face a felony criminal record.

2. Promote a zero-tolerance fraud policy. Promoting a zero-tolerance policy encourages employees to be active in reporting and preventing fraud. Ensure that employees are aware of how and where they can report suspected fraud at any time.

3. Know the red flags. As an employer, it is important to know the indicators of potential fraud while reviewing incident reports. Some of these red flags include:

• • Late reporting of the incident without a reasonable explanation.
  • Inconsistent descriptions of initial report of injury.
  • The individual is hard to reach.
  • Individuals who perform seasonal work that is about to end when they file a claim.

4. Create safe working conditions. Prioritizing the safety of your employees is an effective method in preventing fraud. Train your employees to identify possible safety hazards at work and how to report them.

5. Use your resources. If you suspect an individual of fraud, contact BWC’s Special Investigations Department and let them investigate. Special investigations professionals pursue cases of claims fraud, medical provider fraud or employer fraud. Also, if you suspect other organizations may be operating without workers’ comp coverage, you should contact BWC.

If you suspect workers’ compensation fraud, submit a Fraud Allegation Form or call 1-800-644-6292, and follow the options.

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.

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 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:

• Southwest Ohio business owner gets prison time, hefty fine for work comp fraud: Business owner defrauded BWC of $425K
• Akron pain doc guilty of workers’ comp fraud: False billing cited in felony case
• Prison, hefty restitution ordered for Cleveland fraudster: Contractor collected $246K in disability from BWC, Social Security
• Pataskala man owes BWC $41,000 after felony conviction
• Logan County man sentenced for workers’ comp fraud

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.

Northeast Ohio business owners owe BWC nearly $1.3 million following fraud convictions

Two northeast Ohio businessmen must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $1.3 million in restitution following their recent convictions on multiple fraud charges in separate, unrelated cases.

“We look forward to recouping these dollars and directing them where they belong — taking care of injured workers, creating safe workplaces, and giving employers excellent coverage and service,” said BWC Administrator/CEO Stephanie McCloud.

Sentenced Monday in a Cuyahoga County courtroom, Robert E. Fitz must pay BWC $961,956 in monthly installments and serve five years of probation for his Sept. 30 conviction on a fourth-degree felony charge of workers’ compensation fraud.

Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, had refused to cooperate with BWC to bring his lapsed policy into compliance, leaving the agency to pick up the costs on 43 injury claims since 2003, five in the last five years.

On Oct. 21 in Stark County, a judge ordered an Alliance man to pay BWC $300,230 in restitution after BWC found him defrauding the agency in multiple ways, including working at two businesses he owned while collecting workers’ compensation for work injuries he claimed left him permanently and totally disabled.

Roger L. Kale, Jr., 51, also must serve five years of probation and perform 100 hours of community service. BWC’s Special Investigations Department also found the following:

• To establish his compensation rate for his 2009 workplace injury, Kale reported wages for himself that were higher than what he reported on his BWC payroll reports for all of his employees combined.
• Kale operated A-1 Brosch Tree Service without workers’ compensation coverage required by Ohio law.
• Kale under-reported his payroll and misclassified his employees to lower the cost of his BWC premiums.
• Kale presented clients an altered BWC certificate of coverage to make it appear his business had coverage when it did not. One client reported Kale to BWC.

Video obtained from the Ohio State Highway Patrol shows Kale operating a tow truck while claiming to be permanently disabled.

Kale pleaded guilty to one count of tampering with records, a fourth-degree felony; three counts of workers’ compensation fraud, all fourth-degree felonies, and two first-degree misdemeanor charges of workers’ compensation fraud.

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

Cincinnati caterer convicted of workers’ comp fraud

Woman ran catering business while collecting disability benefits

 

A Cincinnati woman claiming to be permanently disabled from work owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $41,000 after her felony conviction Oct. 24 for workers’ compensation fraud.

Michelle D. Smith, 57, pleaded guilty to the fifth-degree felony in the Franklin County Common Pleas Court 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.

“Our Special Investigations Department found records indicating Ms. Smith worked 35 hours per week at her businesses,” said BWC Administrator/CEO Stephanie McCloud. “I don’t think that meets anyone’s definition of ‘permanently and totally disabled,’ let alone BWC’s.”

Smith, who was injured on a job in 2000, declined through her attorney to be interviewed by BWC investigators about her case. Investigators gleaned much of their evidence from customer interviews and a catering contract Smith had with the city of Cincinnati.

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.

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

Nearly $1 million owed BWC in employer fraud case

Cleveland-area business owner convicted of fraud Monday

A northeast Ohio business owner owes the Ohio Bureau of Workers’ Compensation nearly $1 million in restitution following his conviction Monday in Cleveland on workers’ compensation fraud charges.

Robert E. Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud after refusing to cooperate with BWC to bring his lapsed policy into compliance.

“Mr. Fitz owes at least $965,000 in unpaid premiums and for the costs of injured worker claims that occurred while his policy was lapsed,” said BWC Administrator/CEO Stephanie McCloud. “If he had just followed the law and paid his premiums, he wouldn’t be in this trouble today.”

At his conviction hearing in the Cuyahoga County Court of Common Pleas, Fitz agreed to work with BWC and the Ohio Attorney General’s Office to provide his company’s financial reports and enter a reinstatement payment plan prior to his sentencing date of Nov. 4.

According to BWC’s Special Investigation Department, Fitz’s BWC policy has been lapsed since Sept. 1, 2003. Since then, BWC has picked up the costs on 43 injury claims, including five since 2014.

In other fraud news, a northeast Ohio man must pay BWC nearly $79,000 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Tuesday in a Franklin County courtroom.

Ronald J. Dorfeld of Brunswick, Ohio, must pay BWC $78,957 and serve five years of probation in lieu of a nine-month jail sentence for working while collecting BWC disability benefits.

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

Special investigations department concludes FY 2019 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY 2019, which closed June 30.

The report details another impressive year of our department’s efforts to deter, detect, investigate, and prosecute workers’ compensation fraud.

Here are some highlights in what was our 26th year as a department:

• We closed 1,732 fraud cases, 7% more than in 2018.
• We secured 101 convictions of claimants, employers, and health care providers who defrauded our agency.
• For every dollar we spent on our efforts, we saved the state fund nearly $5.
• We reduced our investigation time per case by 2.9 days on average, to 189 investigative days, our lowest number on this measure since 2005.
• All told, we saved the state fund $65.1 million in 2019, an 8 % increase over 2018’s numbers.

We couldn’t have achieved this success without the 119 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.

In 2019, our investigative teams continued to work closely with the law enforcement community at the local, state, and federal levels. We collaborated on several investigations, including cases involving physicians running pill mills in Ohio and surrounding states. In addition, our teams joined other state and federal investigators participating in the Document and Benefit Fraud Task Force, the Ohio Medicaid Prescription Program Integrity Group, and the Pill Mill Coordination team for the Ohio Attorney General’s Medicaid Fraud Control Unit.

As we commence our 27th year in FY 2020, we remain united in our commitment to protecting the State Insurance Fund for injured workers and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

Former deputy sheriff owes BWC $235K for workers’ comp fraud

Zanesville man earns felon status after Monday’s conviction

A Zanesville man and former county deputy sheriff must reimburse the Ohio Bureau of Workers’ Compensation nearly $235,000 in restitution following his felony conviction for workers’ compensation fraud Monday in a Franklin County courtroom.

A judge ordered Gregory A. Fitzer, 56, to pay BWC $211,536 in restitution and $23,187 in investigative costs after Fitzer pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud. She also ordered the former Muskingum County deputy sheriff to serve four years of probation in lieu of a year in jail.

“Our investigators found Mr. Fitzer knowingly and with fraudulent intent deceived our agency and his physicians in order to receive disability benefits,” said BWC Administrator/CEO Stephanie McCloud.

Acting on a tip, BWC’s Special Investigations Department discovered Fitzer worked as a process server and investigator for several law firms in and around Zanesville from January 2007 to March 2016 while collecting disability benefits from BWC. The investigation, which included surveillance, multiple interviews and a review of bank and employment records, also found he worked as a truck driver and laborer for a local retailer.

In other fraud news:

BWC secured eight fraud-related convictions in August, bringing 2019’s total to 63. They include a Central Ohio nurse practitioner convicted on health care fraud charges.

BWC assisted in the investigation that led to the Aug. 30 sentencing of nurse practitioner Amy Wood-Kirk of Grove City and fiancé Ryan Edney on one count of conspiracy to commit health care fraud. Amy Wood-Kirk prescribed large quantities of medications, including prescriptions for compounded pain cremes, outside acceptable medical standards for the personal profit of herself and Edney.

The U.S. District Court for the Southern District of Ohio sentenced Wood-Kirk to five years of probation and ordered her and Edney to repay Medicaid, TriCare, and Medical Mutual of Ohio $751,809 in restitution. Wood-Kirk was also sentenced to 180 days home confinement.

In order of most recent court appearance, other August convictions include:

Jim Hesler, dba Robert’s Roofing, Batavia, Ohio
Hesler was found guilty Aug. 23 in Clermont County Common Pleas Court on two counts of workers’ compensation fraud, both fifth-degree felonies. BWC investigated Hessler after learning he had not been reporting his payroll to the agency and several injury claims had been filed.

Investigators found his business was still in operation. Sentencing is scheduled for Oct. 8, at which time a judge may determine the amount of restitution owed BWC.

Eric Johnson, Akron, Ohio
Johnson pleaded guilty Aug. 22 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving disability benefits. Prior to entering the plea, Johnson deposited full restitution of $1,062 at the clerk of court’s office.

Gregory White, dba White’s Auto Care LLC, Lorain, Ohio
White pleaded no contest Aug. 22 to one count of failure to comply, a second-degree misdemeanor, for not reinstating his BWC policy while operating his business. A second count was dismissed as White had brought his BWC account current prior to court. White was ordered to pay court costs of $167.

Everett Ferryman, Marysville, Ohio
Ferryman pleaded guilty Aug. 21 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered him working as a truck driver and receiving cash “under the table” while receiving BWC disability benefits. The court sentenced him to a term of probation not to exceed five years but could terminate sooner upon payment of $22,851 in restitution. The court also imposed a suspended sentence of 12 months in prison.

Tammy Hill, Jackson, Ohio
Hill pleaded guilty Aug. 12 in Jackson County Municipal Court to theft by deception, a first-degree misdemeanor, after BWC found her cashing BWC benefit checks belonging to an injured worker. A judge ordered Hill to serve up to five years of probation, complete 500 hours of community service, 180 days in jail (suspended), and pay a $100 fine and court costs within 12 months.

Paul Gall, dba Sun Masters, Brooklyn Heights, Ohio
BWC found Gall had been operating his business, Sun Masters LLC, without BWC coverage since March 2014. In lieu of conviction, Gall entered a payment plan with the Ohio Attorney General’s office after making a down payment of $12,000 toward his $44,000 balance.

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

Ohio trucker, others convicted of workers’ comp fraud

Marysville man kept truckin’ while collecting disability benefits

A Marysville truck driver was convicted of workers’ compensation fraud Wednesday after the Ohio Bureau of Workers’ Compensation discovered he continued to work while collecting BWC benefits for a workplace injury he suffered more than a decade ago.

Everett Ferryman, 46, pleaded guilty in a Franklin County courtroom to a fifth-degree felony count of workers’ compensation fraud. The judge ordered Ferryman to pay BWC $22,851 in restitution and serve probation for five years or until restitution was paid, whichever came first. She also imposed a suspended sentence of a year in prison.

“The law is clear — our benefits are for workers who are truly injured,” said BWC Administrator/CEO Stephanie McCloud. “They’re not a support system for people trying to cheat BWC and Ohio employers.”

Acting on a tip in 2017, BWC’s Special Investigations Department found Ferryman working as a truck driver while collecting BWC benefits from at least March 27, 2017, to Oct. 31, 2017. He was injured as a truck driver in May 2008 and had received temporary disability benefits from BWC periodically since then.

In other news

In recent news, BWC’s Special Investigations Department secured five fraud-related convictions in July, bringing total convictions for calendar year 2019 to 54. Those convicted include:

James Coon of Akron, dba James Coon Construction
Coon pleaded guilty to involuntary manslaughter July 24 after one of his workers fell to his death in late 2017. He also pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud.

BWC found Coon lacked workers’ comp coverage when his employee died and that he repeatedly lied about his business over the years to minimize his premiums or avoid paying them altogether. Sentencing is scheduled for Sept. 6.

Jacci Richards of Toledo/dba Acorns to Oaks
Richards pleaded no contest but was found guilty July 16 to a second-degree misdemeanor charge of failure to comply after BWC found her operating a now-closed day care center without workers’ compensation coverage. A judge ordered her to pay $99 in court costs.

R. Gregory Lawrence of Euclid, dba Lakeshore Coffee House Inc.
BWC found Lawrence was operating Lakeshore Coffee House Inc. with lapsed BWC coverage. Lawrence pleaded guilty July 11 in Euclid Municipal Court to two counts of disorderly conduct, both minor misdemeanors. Lawrence was fined $200. Prior to the court date, Lawrence paid the balance he owed BWC and brought his policy into compliance.

Scott Laird of Cambridge
Laird pleaded guilty July 10 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while collecting BWC benefits. A judge ordered Laird to pay BWC $3,113 in restitution and sentenced him to two years of probation in lieu of 90 days in jail.

Cynthia Gribble of New Philadelphia
Gribble pleaded guilty July 1 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found her working as a home health care aide while collecting BWC benefits. A judge ordered her to pay BWC $7,328 in restitution and serve six months of probation in lieu of 90 days in jail.

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

Akron business owner convicted of manslaughter, workers’ comp fraud

Company has history of worker injuries, noncompliance with BWC

The owner of an Akron construction company pleaded guilty to involuntary manslaughter July 24 after one of his workers fell to his death in late 2017.

James D. Coon, the owner of James Coon Construction, also pleaded guilty in a Summit County courtroom to a fourth-degree felony charge of workers’ compensation fraud. Investigators with the Ohio Bureau of Workers’ Compensation (BWC) found Coon lacked BWC coverage when his employee died and that he repeatedly lied about his business to minimize his premiums or avoid paying them altogether.

“This tragic case underscores the critical importance for workplace safety protocols and workers’ compensation insurance,” said BWC Administrator Stephanie McCloud. “Our investigation found Mr. Coon willfully and deliberately disregarded his responsibilities under the law, and now several lives are devastated by it.”

Gerardo “Jerry” Juarez Sr., a 39-year-old married father of five, died Nov. 4, 2017, at the scene of his fall. It was his second day on the job. The federal Occupational Safety and Health Administration notified BWC of the accident four days later.

According to BWC’s special investigations department, Juarez was working on a sloped roof of a 3-story apartment complex without a fall protection device when he slipped and fell 25 feet to his death. Among the investigation’s findings:

• Two other Coon employees were injured in falls prior to Juarez’s death, also during a time when Coon lacked BWC coverage.
• Coon told BWC he no longer operated his business. But in March 2018 — five months after Juarez’s death — agents observed six Coon employees at a worksite tearing shingles from a roof. They had no safety equipment.
• Coon consistently reported to BWC over the years of having no employees. A BWC audit found nearly $286,000 in payroll to employees from July 1, 2009 through July 1, 2018.

Coon owes BWC $303,152 to date for unpaid premiums and claims costs for workers injured during a policy lapse. His conviction for involuntary manslaughter, a third-degree felony, is punishable by a maximum five years in prison and a fine of up to $10,000. Sentencing is set for August 21.

BWC safety services and grants: BWC offers free safety consultations and grant dollars to assist employers with the purchase of equipment that improves workplace safety. For more, visit bwc.ohio.gov and click on the Safety & Training link.

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

BWC reports 4 fraud-related convictions in June

Four Ohioans were convicted for workers’ compensation fraud or related charges in June, including a Springfield man who must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $13,000 after investigators found him working two jobs while collecting disability benefits.

Clark A. Howard pleaded guilty June 18 to a fifth-degree felony count of workers’ compensation fraud after BWC investigators discovered him working for a pizza shop in London, Ohio, and as a machine press operator for another business. A Franklin County judge ordered Howard to pay BWC $13,518 in restitution.

“We’re here to support injured workers as they try to get back to work and back to life, not supplement the income of able-bodied people cheating our system,” said BWC Administrator/CEO Stephanie McCloud.

The judge also sentenced Howard to 30 months of community control (probation) in lieu of a year in jail.

Other June convictions include:

Ben Patterson of Xenia, Ohio, dba C&B Landscaping
Patterson pleaded guilty June 25 to one count of failure to comply, a second-degree misdemeanor, for operating his landscaping company without BWC coverage since 2009. Investigators worked with Patterson to reinstate coverage, but Patterson failed to establish a payment plan.

Patterson paid all outstanding BWC premiums, related fees and interest on June 24, the day before his court hearing. A Xenia Municipal Court judge fined him $150 and court costs and sentenced him to 90 days in jail, suspended upon the condition he not have a similar offense for five years.

Patricia Simon of Columbus, Ohio
Simon pleaded guilty June 18 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC determined she intentionally submitted a false statement to support her claim for workers’ compensation benefits. A Franklin County judge ordered her to pay a $250 fine and $128 to BWC for investigative costs.

Lori Hines of Waynesfield, Ohio, dba Marshall’s Hydraulic Services
Hines pleaded guilty June 7 to one count of failure to comply, a second-degree misdemeanor, after BWC found Marshall’s Hydraulic Services operating without BWC coverage since January 2017.

An Auglaize County Municipal Court judge sentenced Hines to a year of non-reporting probation, a 90-day suspended jail term and a $100 fine. Hines subsequently paid her BWC balance in full and the company’s coverage was reinstated.

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

Toledo contractor owes BWC $57K following fraud conviction

Lapsed policy, refusal to cooperate costs Holland man

By Tony Gottschlich, BWC Public Information Officer

A Toledo-area contractor owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $57,000 in restitution after pleading guilty to workers’ compensation fraud in a Toledo courtroom last month.

Eric L. Hughes, 53, of Holland, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud May 19 after failing to renew his BWC policy despite repeated attempts by the agency to bring him into compliance. A Lucas County judge ordered Holland to pay BWC $56,959 in restitution and serve three years of community control (probation).

“Ducking his legal obligation to protect his workers clearly didn’t pay for Mr. Hughes,” said BWC Administrator/CEO Stephanie McCloud. “He could have resolved this issue fairly easily when we first contacted him in 2017, and we would have given him a payment plan to boot. Now he’s got a $57,000 debt and a felony record.”

According to BWC’s special investigations department, Hughes worked as a handyman and general contractor on residential and commercial buildings, usually with just one employee. But after securing a sizable contract to replace a roof on a fire-damaged building in 2017, he hired a crew of eight to 10 workers and started the job while his BWC policy was still lapsed. The company that hired Hughes later fired him after learning of the lapse.

A BWC audit in 2018 determined Hughes owed the agency nearly $57,000 in past premiums, based largely off his payroll for the time he worked on the roofing job.

In other news, a Springfield man must pay BWC $13,518 in restitution after agency investigators found him working in a machine shop and at a restaurant while collecting BWC benefits.

Clark Howard, 35, pleaded guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud in a Franklin County courtroom.

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

BWC secures six convictions in May

Five Ohio workers and one business owner were convicted in May on workers’ compensation fraud and related charges.

The six convictions raise BWC’s total convictions for the 2019 calendar year to 38.

“When people cheat the BWC system, they are cheating the employers and hard-working Ohioans across this state who play by the rules,” said BWC Administrator/CEO Stephanie McCloud. “Congratulations to our special investigations department for stopping this fraudulent behavior.”

In order of most recent case, those convicted include:

James Nichols of Cleveland, Ohio
BWC investigators found Nichols working as a janitor and office manager while collecting BWC benefits. Nichols pleaded guilty May 13 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 150 days in jail, suspended for two years of community control. He was ordered to pay BWC $3,525 in restitution. He made a $1,000 payment at sentencing.

Deborah Rosenlieb of Cuyahoga Falls, Ohio
Rosenlieb pleaded guilty May 9 in Summit County Common Pleas Court to workers’ compensation fraud, a fourth-degree felony, after investigators found her collecting her late father’s BWC benefits for two years. A judge ordered her to pay BWC $29,418 in restitution and serve two years of community service.

Jesse Lemaster, dba Lemaster Tree Care, Springfield, Ohio
Lemaster pleaded guilty May 8 to two counts of failure to comply, both second-degree misdemeanors, for operating his business without a valid BWC policy. He was sentenced to 30 days in jail on each charge, which was suspended pending a July 10 hearing, at which time he is to prove to the court he has valid workers’ compensation coverage.

Natasha Mitchum of Youngstown, Ohio
Mitchum pleaded guilty May 2 in Franklin County Common Pleas Court to workers’ compensation fraud, a first-degree misdemeanor, after BWC found her working as a call center employee/customer service representative while receiving disability benefits. She was sentenced to 180 days in jail, suspended for three years of community control, and ordered to pay BWC $1,863 in restitution.

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

BWC secures 7 fraud convictions in April

Fraudsters ordered to pay BWC nearly $107,000 in restitution

The Ohio Bureau of Workers’ Compensation secured seven fraud convictions in April, all workers who were discovered working for a living while collecting disability benefits from the agency.

Those convicted were ordered to pay BWC a combined total of $106,995 in restitution.

“We look forward to recouping those dollars so they can serve a legitimate purpose – taking care of injured workers,” said BWC Administrator/CEO Stephanie McCloud.

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

Clinton Walker of Cincinnati, Ohio
Walker pleaded guilty April 25 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. He was ordered to pay BWC $9,831 in restitution and $3,600 in investigative costs. He provided a cashier’s check to BWC at his hearing for the full amount.

Ernest Thomas of Boardman, Ohio
Thomas pleaded guilty April 23 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, which was suspended for six months of probation, and ordered to pay a $500 fine and court costs. Thomas paid restitution and investigative costs totaling $10,605 to BWC at the time of his plea.

Antonio Daniels of Streetsboro, Ohio
Daniels pleaded guilty April 17 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working as an industrial assembler while collecting BWC benefits. A Franklin County judge ordered Daniels to pay BWC $6,409 in restitution and serve five years of probation in lieu of 30 days in jail.

Kristin Stuhldreher of Youngstown, Ohio
Stuhldreher pleaded guilty April 16 to a fifth-degree felony count of workers’ compensation fraud after investigators found her working as a restaurant manager while collecting BWC disability benefits. A judge ordered her to pay BWC $18,239 in restitution and serve five years of probation.

Amanda Treadway of Reynoldsburg, Ohio
Treadway was ordered to pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC discovered Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.

Antoine Harris of Cincinnati, Ohio
Harris was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3 after BWC found him working as a truck driver while collecting disability benefits. Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.

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

Ohio woman keeps BWC benefits alive after father dies

Owes BWC more than $29,000 after fraud conviction

A northeastern Ohio woman pleaded guilty May 9 to workers’ compensation fraud after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found her collecting her father’s benefits for more than two years after he died.

Deborah Rosenlieb of Cuyahoga Falls pleaded guilty to the fourth-degree felony in the Summit County Common Pleas Court, where a judge ordered her to pay BWC $29,418 in restitution. The judge also ordered Rosenlieb to serve two years of community service.

“Ms. Rosenlieb’s father was receiving death benefits on behalf of his late wife, but when her father died in January 2016 she didn’t let us know,” said BWC Administrator/CEO Stephanie McCloud. “She knew she wasn’t entitled to these benefits, but she used them for personal expenses until we learned of her scheme in April 2018.”

In other news:

A Cleveland man must pay BWC $3,525 in restitution after pleading guilty Monday to a misdemeanor count of workers’ compensation fraud after BWC found him working as a maintenance technician and office manager while collecting disability benefits.

James Nichols, 57, also must serve two years of probation and pay court costs. He paid $1,000 toward his restitution prior to entering his guilty plea in the Franklin County Common Pleas Court.

A Youngstown woman pleaded guilty May 2 to a misdemeanor count of workers’ compensation fraud after BWC found her working for a call center while collecting disability benefits.

A Franklin County judge ordered Natasha Mitchum, 42, to pay BWC $1,863 in restitution and serve three years of probation.

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

Fraud hurts us all

Fraud hurts us all, says Jim Wernecke, head of BWC’s special investigations department, in this video.

 

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

Order up! Restaurant manager earns fraud conviction

A Youngstown woman must pay the Ohio Bureau of Workers’ Compensation more than $18,000 in restitution after the agency found her working as a Steak ‘n Shake manager while collecting BWC disability benefits, a judge ruled April 16.

Kristin Stuhldreher, 54, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. In addition to $18,239 in restitution, Stuhldreher also must serve five years of probation.

“Our investigators found Ms. Stuhldreher worked for seven months in 2017 while concealing her employment from us so she could continue to receive BWC benefits,” said BWC Administrator/CEO Stephanie McCloud. “Clearly, she wasn’t disabled from work, and I’m grateful to our investigators for bringing this fraudulent scheme to an end.”

According to BWC’s Special Investigations Department, Stuhldreher collected workers’ compensation benefits after suffering an injury in late 2010 while working for another employer. She required surgery for that injury years later while working for Steak ‘n Shake. She took time off for the surgery, but didn’t tell BWC when she returned to work.

In other news:

A northeast Ohio man pleaded guilty April 17 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working as an industrial assembler while collecting BWC benefits.

A Franklin County judge ordered Antonio Daniels of Streetsboro to pay BWC $6,409 in restitution and serve five years of probation in lieu of 30 days in jail.

A northeast Ohio woman was sentenced April 8 to five years of probation after BWC found her working as a self-employed photographer while receiving disability benefits from her employer.

A Trumbull County judge ordered Kimberly Floyd of Warren, owner of Floyd’s Photography and KLG Sports Photography, to also pay $325 in court fees. Floyd pleaded guilty Feb. 4 to a fifth-degree felony count of workers’ compensation fraud.

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

Ducking workers’ comp coverage costs Mansfield freight hauler $144K

The owner of a Mansfield freight hauling and trucking company must pay $144,400 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) following his sentence Monday for his conviction on four felony charges related to workers’ compensation fraud.

A Richland County judge also ordered Robert Tate, owner of Elite TNT Enterprises, to serve two years of probation for his conviction Feb. 20 on two counts of workers’ comp fraud, fourth-degree felonies, and two counts of tampering with records, third-degree felonies. Tate must bring his BWC policy into compliance with state law and pay the agency $137,447 in unpaid policy premiums and $6,953 for the costs of its investigation.

“We reached out to Mr. Tate several times to follow the law and protect his employees with workers’ compensation coverage, but he chose to ignore us and it cost him,” said BWC Administrator/CEO Stephanie McCloud.

BWC’s special investigations department discovered in 2017 that Tate was operating his business without BWC coverage. After several attempts to work with Tate, agents subpoenaed bank records and audited his business, finding Tate under-reported his payroll over several payroll periods in an attempt to lower the amount he owed the agency. They also found he falsified new applications for BWC coverage by failing to list previous policies with the agency and he under-reported the number of workers he employed.

In other news:

• A Reynoldsburg woman must pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC investigators discovered Amanda Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.
• A Cincinnati man found working as a truck driver while collecting BWC disability benefits was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3. Antoine Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.
• A Cleveland Heights woman found working as a restaurant hostess while collecting BWC disability benefits pleaded guilty to a misdemeanor count of workers’ compensation fraud March 28 in Franklin County Municipal Court. A judge ordered Morgan Hines to pay BWC $4,089 in restitution, $88 in court costs and a $250 fine. The judge also sentenced her to two years of probation.

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

Employer compliance supervisor is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An employer compliance supervisor in the Cincinnati Service Office received the 2018 Fraud Finder of the Year award Feb. 21 from BWC’s special investigations department (SID).

The supervisor received the award for alerting SID to a case in which an employer failed to report payroll and failed to respond to multiple attempts to schedule a premium audit. An investigation by the SID employer fraud team revealed the employer was operating without coverage. The referral resulted in the identification and recovery of $316,103 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud in its tracks and save the BWC system hundreds of thousands of dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources needed to create safe workplaces in Ohio and to care for those who are legitimately injured on the job.”

The BWC employee, who supervises field staff members assigned to the BWC employer compliance department, said he was honored to receive the award.

“I am truly honored to be recognized for simply doing my job and trying to do my part, while seemingly small, to safeguard the State Insurance Fund,” the employee said. He offered the following advice to any BWC employee who suspects fraud: “Trust your gut.”

SID received 3,150 allegations of fraud in 2018. About a fifth of those came from BWC personnel around the state. These included claims representatives, employer representatives and others who suspected illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system. During 2018, SID closed 381 cases referred by 169 BWC employees. The investigations resulted in 192 “founded cases” (the original allegation was proven true) and identified $3.1 million in savings to the BWC system

To show their appreciation, SID leaders conducted a thank-you tour and red-flag training from November through February, presenting Fraud Finder Award certificates to BWC employees in service offices across Ohio.

“We encourage all BWC employees and the general public to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4, option 1) or visit www.bwc.ohio.gov.

Logan County man sentenced for workers’ comp fraud

On the day he was sentenced to prison for breaking and entering, gross sexual imposition, burglary and other charges, a Bellefontaine man was also ordered to pay nearly $6,400 in restitution to his employer and the Ohio Bureau of Workers’ Compensation (BWC) for collecting disability benefits while secretly working another job.

Joseph A. Wilson, 32, was sentenced to six years in prison March 8 on multiple charges, including reduced charges related to workers’ compensation fraud — petty theft, a first-degree misdemeanor, and failure to appear in court, a fourth-degree felony. A judge in the Logan County Court of Common Pleas ordered Wilson to reimburse his employer (Rent-A-Center) $2,904 and pay BWC $3,469 for the cost of its investigation.

“Workers’ compensation fraud is a crime we take seriously,” said BWC Administrator/CEO Stephanie McCloud. “Fraud steals resources needed by workers who are truly injured, and it raises the cost of our entire system. Kudos to our special investigations department for bringing this case to a close.”

BWC investigators confirmed an anonymous tip they received in late 2017 that Wilson was working on a horse farm while collecting disability benefits from Rent-A-Center. Wilson was arrested in November on warrants for five counts of gross sexual imposition, two counts of workers’ compensation fraud, two counts of failure to appear, and single counts of receiving stolen property, theft, breaking and entering and criminal damaging.

In other news:

The owner of Home Bakery in Coldwater, Ohio, pleaded guilty March 8 to three counts of failure to comply after BWC discovered him operating his business without a workers’ comp policy for three years. A Celina judge ordered Carl R. Brunswick to pay a $50 fine for each count and serve 10 days in jail for each count. The judge suspended the jail time on the condition Brunswick not have any similar violations in the next five years. Brunswick is on a repayment plan with the state to pay his past BWC premiums.

A Dayton woman convicted last month of passing a bad check to BWC must serve five years of probation and complete 40 hours of community service. Carissa Couch of Couch Family Construction pleaded guilty to the fifth-degree felony on Feb. 27 in the Montgomery County Court of Common Pleas. The plea followed multiple attempts by BWC to work with Couch to bring her policy into compliance after her check to the agency for $3,333 bounced at the bank.

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

Prison, hefty restitution ordered for Cleveland fraudster

Contractor collected $246K in disability from BWC, Social Security

A Cleveland-area man was sentenced to seven months in prison Wednesday and ordered to repay nearly $246,000 in disability benefits he fraudulently received from the Ohio Bureau of Workers’ Compensation (BWC) and the Social Security Administration.

Louis C. Cooper, 57, of North Royalton, previously pleaded guilty to wire fraud and theft of government property after investigators discovered him concealing his work as a general contractor. He was sentenced Wednesday in the U.S. District Court for the Northern District of Ohio in Cleveland.

“Acting on an anonymous tip, our investigators discovered Mr. Cooper earned at least $185,000 over the last eight years as a general contractor while telling BWC and Social Security he was too injured to work,” said BWC Administrator/CEO Stephanie McCloud. “Our benefits are for workers who truly need them, not for fraudsters to pad their income. I commend our special investigations department and the Social Security Administration for bringing Mr. Cooper’s criminal activity to an end.”

Cooper was injured on the job in 1996. Investigators from BWC and Social Security found he had developed a scheme dating back to at least 2010 to conceal his income as a general contractor by asking his clients to not pay him directly. While reporting to both agencies numerous times that he was too injured to work, Cooper collected nearly $168,000 from BWC and nearly $78,000 from Social Security.

According to court documents, Cooper must surrender to the U.S. Marshals Service on April 18 for transfer to a federal prison. He must serve three years of probation following his release. This case was prosecuted by the U.S. Attorney’s Office for the Northern District of Ohio.

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

Receptionist owes BWC $19K after fraud conviction

Agency secures six convictions in January

A Bellefontaine woman who worked as a receptionist while claiming to be disabled from work owes the Ohio Bureau of Workers’ Compensation nearly $19,000 following her conviction last month on a felony workers’ compensation fraud charge.

A Franklin County judge on Jan. 16 ordered Dawn M. Hattery, 50, to reimburse BWC $17,937 and pay $1,000 in investigation costs for working while collecting BWC benefits from January to November 2017. The judge also sentenced her to five years of probation after she pleaded guilty to the fifth-degree felony.

“Ms. Hattery not only broke the law deceiving this agency, she earned a criminal record that will follow her for years to come,” said BWC Administrator/CEO Stephanie McCloud. “Our role is to compensate workers while they’re recovering from injury, not pad the income of people trying to cheat the system.”

In other convictions last month:

Marc E. Pope, 50, of Cleveland, paid BWC $23,793 in restitution Jan. 30 before his guilty plea on two first-degree misdemeanor counts of workers’ compensation fraud in the Franklin County Court of Common Pleas. BWC found Pope working multiple jobs while collecting disability benefits from the agency.

Kenneth Miller, owner of Grant Street Pallet Inc. in Lisbon, Ohio, pleaded no contest Jan. 29 to a second-degree misdemeanor count of failure to comply after entering a reinstatement payment plan with BWC. A judge sentenced Miller to 10 days in jail and fined him $750, then suspended both.

Larry West, owner of the Bluebird Restaurant in Norwood, paid all past-due installments and premiums on his BWC policy before pleading guilty Jan. 25 to a reduced charge of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to one day in jail, then credited with time served.

Douglas J. Krouskoupf of Zanesville pleaded guilty Jan. 9 to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge sentenced Krouskoupf to 180 days in jail, which he suspended on the condition Krouskoupf pay BWC $7,924 in restitution.

Stephan L. Evans Sr, dba AB Shelby’s Auto Tractor and Trailer Repair in Akron, pleaded guilty Jan. 7 to one count of failure to comply, a second-degree misdemeanor, after BWC found him operating his business without workers’ compensation coverage. An Akron Municipal Court judge sentenced Evans to one year of obeying the law and ordered him to pay $324 in court costs.

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

Construction worker hammered with fraud conviction

Cleveland man reimburses BWC $24,000

A Cleveland construction worker who worked multiple jobs while collecting disability benefits from the Ohio Bureau of Workers’ Compensation reimbursed the agency nearly $24,000 on Jan. 30 before pleading guilty to workers’ compensation fraud.

Marc. E. Pope, 50, paid BWC $23,793 in restitution before his guilty plea on two first-degree misdemeanor counts of workers’ compensation fraud in the Franklin County Court of Common Pleas.

“We found Mr. Pope working as a laborer for several businesses while claiming to be disabled from work,” said BWC Administrator/CEO Stephanie McCloud. “When someone scams the system, they are really hurting injured workers who rely on us to help them recover from their injury and return to work.”

In other fraud-related news:

A Cincinnati-area restaurant owner who would not cooperate with BWC to reinstate his policy finally did so after a Hamilton County grand jury indicted him on a fourth-degree felony count of workers’ compensation fraud.

Larry West, owner of the Bluebird Restaurant in Norwood, paid all past-due installments and premiums on his BWC policy before pleading guilty Jan. 25 to a reduced charge of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to one day in jail, then credited with time served.

The owner of a pallet company in eastern Ohio was sentenced to two years of probation Jan. 29 for failing to carry workers’ compensation insurance on his business.

Kenneth Miller, owner of Grant Street Pallet Inc. in Lisbon, Ohio, pleaded no contest to a second-degree misdemeanor count of failure to comply after entering a reinstatement payment plan with BWC. A judge sentenced Miller to 10 days in jail and fined him $750, then suspended both.

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

Trucker kept truckin’ while collecting injured-worker benefits

Zanesville man convicted of workers’ comp fraud

A Zanesville truck driver must pay nearly $8,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after agency investigators found him working for a living while collecting BWC disability benefits.

Douglas J. Krouskoupf, 53, pleaded guilty Jan. 9 to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge sentenced Krouskoupf to 180 days in jail, which he suspended on the condition Krouskoupf pay BWC $7,924 in restitution.

“We found Mr. Krouskoupf working for his brother’s sandblasting business on multiple occasions and that he was also driving a semi-truck while collecting BWC benefits,” said Jim Wernecke, director of BWC’s special investigations department. “Our benefits are for people who suffer a workplace injury and can’t do their job. Mr. Krouskoupf clearly doesn’t fit into that category.”

In other news, BWC netted seven fraud or fraud-related convictions in December, bringing calendar year 2018’s total to 94. In order of most recent case, December convictions include:

Jason Dudas, Mentor, Ohio
Dudas pleaded guilty Dec. 13 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working as a handyman while receiving BWC benefits. A judge ordered Dudas to pay $5,073 in restitution and serve three years of non-reporting probation.

John House, Chris Kraft and Lynn Howard, dba Old Crow Bar, Middletown, Ohio
House, Kraft and Howard, owners of the Old Crow Bar, each pleaded guilty Dec. 3 to disorderly conduct, a fourth-degree misdemeanor, after BWC discovered they weren’t carrying workers’ compensation coverage on their business. A judge sentenced House to 10 days in jail (suspended) and fined him $200 and $90 in court costs. Kraft and Howard were both sentenced to one day in jail (suspended) and fined $100 and $90 in court costs.

Brian Lang, dba Outdoor Inspirations, Holland, Ohio
Lang pleaded guilty to a third-degree misdemeanor charge of attempted failure to comply with the law Dec. 3 after BWC discovered him running a business without workers’ compensation coverage to protect his employees. A judge scheduled sentencing for Jan. 28 after Lang paid $5,304 toward the balance he owes BWC.

Beth Turner, dba Flashions Ltd, Springfield, Ohio
Turner pleaded guilty Dec. 3 to failure to comply, a minor misdemeanor, after BWC found her operating her business without workers’ compensation coverage. Turner was fined $100 and court costs.

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

Auld Lang Syne…

Standout fraud cases in 2018

By Melissa Vince, BWC Public Relations Manager

Soon we’ll all be counting down and singing that classic New Year’s song to say farewell to 2018 and hello to 2019. Or maybe you’re like me and you’ll wake up at 12:05 a.m. to realize you missed another countdown.

In the spirit of Auld Lang Syne, which roughly translates as “for old times’ sake,” we thought we’d look back at some of our more notable cases in 2018. Since January, we shared 48 blogs covering claimant, provider and employer workers’ compensation fraud cases. The following cases stand out in our memory:

• This man pleaded guilty to defrauding BWC for the fourth time since 2003.
• This man’s voicemail greeting exposed his $684,000 work comp/Social Security fraud scheme.
• This murder suspect and tree trimmer created a phony certificate of coverage to land jobs without actually paying for workers’ compensation insurance.
• This pain doc falsely billed BWC to the tune of $33,000.
• This owner of a taxi service didn’t want to pay for workers comp and racked up $55,000 in overdue premiums.
• This man tried cashing a BWC rebate check he stole from a day care center but was outsmarted by a Check Smart employee.
• This owner of a now defunct professional employer organization was ordered to repay $425,000 for his scheme to short BWC on the premiums he received from employers and pocket the difference.

Thanks for your support this year. We were proud to celebrate our 25^th year of investigating, detecting and deterring fraud in Ohio. Now it’s on to 26!

And thanks for following the BWC Fraud Blog. We hope you’ll stay tuned here in 2019 for more on the latest news and information on workers’ comp fraud in Ohio. Don’t forget to also follow our Facebook page.

Cheers! Okay, everyone now: Should auld acquaintance be forgot….

Home Depot shopping trip blows fraudster’s cover

Mentor man caught working as handyman while collecting BWC benefits

 

A northeast Ohio landscaper must pay the Ohio Bureau of Workers’ Compensation (BWC) a little more than $5,000 in restitution after the agency’s investigators found him working while collecting injured-worker benefits.

Jason Dudas, 39, of Mentor, pleaded guilty Dec. 13 to one count of workers’ compensation fraud, a first-degree misdemeanor, in the Franklin County Court of Common Pleas. A judge ordered Dudas to pay BWC $5,073 in restitution and serve three years of non-reporting probation.

“We got a tip that Mr. Dudas might be working after someone spotted him getting into a truck loaded with construction supplies at a Home Depot store,” said Jim Wernecke, director of BWC’s special investigations department. “We checked it out and found Mr. Dudas working as a handyman while collecting BWC benefits. This behavior isn’t just illegal, it’s expensive and unfair because it drives up the costs of our workers’ comp system for everyone.”

In other business, a Toledo-area business owner pleaded guilty to attempted failure to comply with the law Dec. 3 after BWC discovered him running a business without workers’ compensation coverage to protect his employees.

Brian Lang, owner of Outdoor Inspirations of Holland, Ohio, pleaded guilty to the third-degree misdemeanor charge in Sylvania Municipal Court after paying $5,304 toward the balance he owes BWC. A judge scheduled sentencing for Jan. 28.

“Our investigation revealed Mr. Lang had several employees and therefore he absolutely should be carrying workers’ compensation insurance,” said Wernecke. “We put him on notice to become compliant with the law, but he failed to do that and that’s why he found himself in court Dec. 3.”

Outdoor Inspirations is a specialty landscaping and tree service company, according to its website. The company’s workers’ comp policy remains lapsed.

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

Southwest Ohio business owner gets prison time, hefty fine for work comp fraud

Business owner defrauded BWC of $425K

The owner of a former payroll services company in southwest Ohio was sentenced to six months in federal prison and fined $10,000 today for defrauding the Ohio Bureau of Workers’ Compensation (BWC) out of more than $425,000.

John R. Cacaro, 59, owner of the now-defunct Employers Choice Plus LLC, also must serve one year of house arrest and three years of supervised release under a sentence handed down by U.S. District Judge Michael H. Watson in the U.S. District Court for southern Ohio.

“Multiple businesses entrusted Mr. Cacaro with processing their payroll and remitting insurance premiums to our agency and he broke that trust,” said Jim Wernecke, director of BWC’s special investigations department. “Justice was served today and I can’t thank our partners in this investigation enough, the IRS Criminal Investigation unit and the U.S. Attorney for the Southern District of Ohio.”

Cacaro was convicted in June on wire fraud and money laundering charges after BWC and IRS investigators discovered a scheme he concocted to short BWC on the insurance premiums he received from employers and pocket the difference.

“John Cacaro made a conscious decision to keep over $425,000 in workers’ compensation premiums so he could live a lavish lifestyle that included the purchase of a second residence in Naples, Florida, and a motor home,” said IRS Special Agent in Charge Ryan L. Korner. “Now he is a convicted felon headed to prison.”

At his sentencing today, Cacaro submitted a cashier’s check to the court for $425,247 in restitution to BWC. He noted that he has voluntarily closed Employers Choice Plus and he will likely have gainful employment through his car transportation business when he leaves prison.

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

Drug-trafficking nurse practitioner, other work comp cheats convicted in November

Eight Ohioans convicted on workers’ compensation fraud or related charges in November include a Springfield nurse practitioner who pleaded guilty to felony drug trafficking and a Cleveland-area man who collected $245,000 in disability benefits while working construction jobs since 2009.

Douglas Shrewsbury pleaded guilty Nov. 16 to several drug charges in the Clark County Court of Common Pleas after multiple authorities found him running a pain clinic without a proper license. The charges included aggravated trafficking in drugs, a first-degree felony, aggravated possession of drugs, a second-degree felony, and Medicaid fraud, a fourth-degree felony.

“Mr. Shrewsbury wrote 56 prescriptions for schedule II narcotics to injured workers in our system without an overseeing physician, which is beyond his scope and illegal,” said Jim Wernecke, director of the Ohio Bureau of Workers’ Compensation special investigations department.

Other agencies involved in the investigation included lead agency the Ohio Board of Pharmacy, the Springfield Police Department, Ohio Board of Nursing, State Medical Board of Ohio, Attorney General’s Medicaid Fraud Control Unit, Ohio Bureau of Criminal Identification and Investigation, and the Clark County Prosecutor’s Office.

Shrewsbury’s sentencing is scheduled for Dec. 27.  

In the Cleveland-area case, Louis Cooper of North Royalton pleaded guilty Nov. 19 in a federal courtroom to one count of theft of government property and wire fraud. He was released on a $20,000 unsecured bond and must surrender his passport and participate in a pre-sentence investigation prior to his March 5 sentencing.

Acting on a tip, BWC investigators found Cooper working as a self-employed general contractor, installing flooring and drywall and remodeling bathrooms. Due to concealing his work activity, Cooper fraudulently secured approximately $245,000 in benefits from the Social Security Administration and BWC, of which $167,000 came from BWC.

In order of most recent court appearance, other BWC subjects convicted in November include:

Dean Richards of Lancaster
Richards pleaded guilty Nov. 29 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC agents found him working as a construction subcontractor while receiving permanent disability benefits from BWC. He was sentenced to 23 days in jail, credited for time served, and ordered to pay BWC $6,614 in restitution.

James T. Wilson Jr, dba Performance Companies, of New Albany
Wilson pleaded guilty Nov. 19 in a Columbus courtroom to a second-degree misdemeanor count of failure to comply after BWC investigators found him operating Performance Companies LLC/Enviro Recycling Group without workers’ compensation coverage. Sentencing will occur after BWC finishes auditing his business records.

Dwayne Dotson of Cleveland
Dotson pleaded guilty Nov. 14 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a self-employed general contractor while receiving disability benefits. He was given three years of probation and ordered to pay BWC $14,453 in restitution.

Yue Liang, dba New Sheng Hung, of Cleveland
Liang pleaded guilty Nov. 13 to a first-degree misdemeanor charge of workers’ compensation fraud after he lapsed on a repayment plan related to his 2014 conviction on a similar charge. The food warehouse and market owner agreed to pay BWC $5,500 toward the balance owed to the agency and an additional $2,000 in restitution. He was sentenced to one year of community control and ordered to bring his policy into compliance.

Douglas Rheaume of New Franklin
Rheaume pleaded guilty Nov. 13 to a fifth-degree felony count of workers’ compensation fraud after BWC found the former sheriff’s deputy operating a baseball training facility and working as an insurance agent while collecting BWC benefits. A judge sentenced Rheaume to a suspended nine-month prison term and ordered him to serve two years of probation. Additionally, he was ordered to pay $56,000 in restitution to BWC.

Stephanie Terry, dba Universal Fleet & Tire Service, of Cincinnati
Terry pleaded guilty Nov. 5 to one count of obstructing official business, a second-degree misdemeanor, after BWC found her operating her business with employees and lapsed BWC coverage. Two of her employees had filed injury claims while the coverage was lapsed. Terry paid $27,947 to BWC for the balance she owed the agency.

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

Two Ohio business owners convicted for failing to carry workers’ comp coverage

Second conviction for both employers

A Columbus-area business owner with a criminal history against the Ohio Bureau of Workers’ Compensation pleaded guilty Monday to failing to carry workers’ compensation coverage on his asphalt paving business.

James T. Wilson Jr., 52, of New Albany, pleaded guilty in a Columbus courtroom to a second-degree misdemeanor count of failure to comply after BWC investigators found him operating Performance Companies LLC/Enviro Recycling Group without workers’ compensation coverage. The plea came nine years after Wilson’s first case with BWC, when he pleaded guilty to a fourth-degree felony theft charge and was ordered to pay BWC more than $180,000 in restitution.

“We attempted to work with Mr. Wilson to bring his business into compliance with Ohio law, but ultimately we had to go with this course of action,” said Jim Wernecke, director of BWC’s special investigations department. “I can’t say this enough to employers in our system: If you’re struggling with your BWC premiums, reach out to our agency and work with us. Don’t risk a criminal conviction.”

Wilson’s sentencing will be scheduled for a later date after BWC has finished auditing his business records.

In other news, the owner of a food warehouse and market in Cleveland pleaded guilty Nov. 13 to a first-degree misdemeanor charge of workers’ compensation fraud after he lapsed on a repayment plan related to his 2014 conviction on a similar charge.

Yue Liang, owner of New Sheng Hung, agreed to pay BWC $5,500 toward the balance owed to the agency and an additional $2,000 in restitution. He was sentenced to one year of community control and ordered to bring his policy into compliance.

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

IFAW: That’s a wrap

It’s time to wrap another impressive International Fraud Awareness Week.

We specialize in workers’ comp fraud but enjoy hearing about what our counterparts are doing in their fight to stop all kinds of fraud. We also appreciate the opportunity to share our story with you.

We’ve shared a lot about ourselves, including what we do, why we do it, a little about how we do it, how Ohioans can help and much more.

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

If you do still have questions, don’t worry, we’re here all year long.

Our fraud hotline is, well, hot! Thanks for making us aware of fraud all year long!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received more than 2,300 calls since we launched our new Fraud Hotline system on November 14, 2017, during International Fraud Awareness Week 2017.

The nearly 200 calls a month, means we have received 9 each work day, or more than one every working hour!

In our November 14, 2017 blog, we noted that calling the BWC Fraud Hotline is the most interactive and direct way for you to report an allegation of fraud. Our hotline puts you in direct contact with an agent in our Special Investigations Department, one ready and willing to listen to, document, and promptly act upon, your concerns.

We look forward to hearing from you, so give us a call at 1-800-644-6292 if you suspect fraud. We will conduct the 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 2018, we thank you for your support!

‘Records told the story’ in fraud case: Northeast Ohio business overbills agency; owner found guilty of workers’ comp fraud

By Jennifer Cunningham, Assistant Director, BWC Special Investigations Department

The bills coming from a Northeast Ohio health care facility to the Ohio Bureau of Workers’ Compensation (BWC) looked suspicious.

Too many, it seemed, were for treatment to a company co-owner and others closely connected to the business. Our agency had paid more than $110,000 for claims on one of those cases alone and $27,000 for treatment provided to co-owner Jeffrey L. Guerin. So, in late winter of 2013, our special investigations department decided to take a closer look at PT Plus LLC of Willoughby Hills, a provider of physical therapy and massage therapy about 20 miles northeast of Cleveland.

After a preliminary investigation by our Health Care Provider Team, we used an undercover agent posing as an injured worker to get an inside look at the practice. In roughly 23 visits over three months our agent observed — and records later proved — PT Plus billed BWC for services that weren’t rendered to patients. In one case, our agent witnessed an injured worker refuse treatment, but PT Plus billed BWC anyhow, using spurious treatment notes to support the claim.

Our agents subsequently interviewed three former PT Plus employees, all of whom alleged co-owner Guerin committed health care fraud out of the business. Specifically, they claimed Guerin billed BWC and other third-party payers for treatment not rendered to patients. They said Guerin managed the day-to-day operations of the business and had total control over the billing process. They said he altered the units of service recorded on fee sheets and the patient’s in/out time recorded on treatment notes to correspond with the amount of treatment billed to BWC.

As we were investigating, PT Plus went out of business around July 2014. Our agents learned the business records and patient charts were stored at Guerin’s business partner’s residence. We conducted a search warrant and interviewed the co-owner, who denied any involvement in the company’s day-to-day operations and billing responsibilities. That was Guerin’s role, he said.

Our agents interviewed Guerin, who admitted sole responsibility for billing and overseeing his company’s daily operations. He told our agents that beginning in 2009 he had auditors review his businesses records to look for discrepancies. He said they found that he had actually under-billed BWC about 60 percent of the time, thus shorting his business money. For the audits that revealed overbilling, it didn’t amount to much money, he said. Taken collectively, it was all a wash and that’s why he didn’t inform BWC or any other third-party payer, he explained. But that’s not what our agents found.

During the interview, Guerin retrieved the audit worksheets from his basement and surrendered them to the agents. The agents conducted a cursory review and discovered the majority of the 2014 audit worksheets recorded overbilling. “He offered bizarre justifications and excuses for the records,” one agent told me. “He was cooperative, but we could tell he wasn’t truthful. I think he felt he could explain his way out of it, but the records told the story.

Back at the office, the health care provider team conducted its own audit. The methodology entailed comparing the type, amount (Units of Service) and length (In/Out Times) of treatment that the therapists recorded on the billing and treatment records with the bills Guerin sent to BWC. The audit revealed more than 170 instances where Guerin altered data so he could bill and receive reimbursement for more treatment than was rendered.

On May 18, 2018, Guerin pleaded guilty to one count of workers’ compensation fraud, a first- degree misdemeanor, in Franklin County Municipal Court. He paid BWC restitution in the amount of $7,154 on the same day.

Let’s talk workers’ comp fraud

By Melissa Vince, BWC Public Relations Manager

Fraud (/frôd/), noun
Definition: Wrongful or criminal deception intended to result in financial or personal gain.

In other words, cheating to get one over on others. There are countless ways people try to commit fraud. Check fraud, identify theft, pyramid schemes, credit card fraud and so on.

What do we do in the Ohio Bureau of Workers’ Compensation Special Investigations Department? We pursue workers’ compensation fraud.

BWC insures Ohio employers for workplace injuries and cares for employees who are hurt on the job. The vast majority of Ohio workers, employers, medical providers and others are interested in nothing other than getting injured workers healed and back on the job. There are a few though who have other ideas.

We define workers’ compensation fraud as knowingly making a false representation of a material fact to obtain or to deny workers’ compensation benefits or to avoid responsibility under the law. Workers’ compensation fraud increases premiums for employers, which reduces the money employers can invest in their employees, community and future growth.

There are a number of ways fraudsters can seek to manipulate the system, for example:

• When an employer misrepresents the amount of payroll or classification of its employees.
• When a medical provider intentionally receives payments to which he or she is not entitled.
• When a worker fakes an injury, or returns to work while receiving benefits.

And there are many more detailed on our website, bwc.ohio.gov.

What’s our goal? #StopFraud in Ohio’s workers’ compensation system. You’ll see in this infographic highlighting a few stats from the last year that we work hard every day to achieve that goal.

Anyone committing fraud, or thinking of trying to get one over on us should remember this word:

ex·pose (/ikˈspōz/), verb
Definition: make (something) visible, typically by uncovering it.

Check Smart clerk outsmarts phony owner of BWC rebate check

BWC investigators report 9 convictions in October

An Akron sex offender added forgery to his criminal record last month after a clerk at a Check Smart thwarted his attempt to cash a $5,500 rebate check from the Ohio Bureau of Workers’ Compensation (BWC) that belonged to a church-owned day care center.

“We have to give credit to the clerk, she made our job easy,” said Jim Wernecke, director of BWC’s special investigations department (SID). “She could tell the man added his name to the check and he wasn’t the rightful owner. But instead of simply turning him away, she took his picture, photocopied his driver’s license and had him fill out an application. Then she confiscated the check and refused to cash it.”

A Summit County judge sentenced Keith A. Galloway, 45, to one year in prison Oct. 24 after Galloway pleaded guilty to forgery, a fifth-degree felony. The judge ordered the term be served concurrently with Galloway’s three-year sentence on unrelated drug charges and for failing to register his address with the Summit County Sheriff’s Office.

Galloway attempted to cash the rebate check in July 2017. The check was part of BWC’s $1 billion rebate to Ohio employers that year.

In other news, SID secured eight other workers’ comp fraud or fraud-related convictions in October, bringing calendar year 2018’s total to 72. In order of most recent court case, those convicted include:

Jason Moffitt of Columbus
Moffitt pleaded guilty Oct. 31 to one count of workers compensation fraud, a first-degree misdemeanor, after investigators found he had falsified records to increase his BWC cash benefits. He was sentenced to three months incarceration, which was suspended for two years of community control on the condition he pay BWC $5,325 in restitution.

Philip Ayers, dba Ayers Transportation Services, of Cincinnati
Ayers pleaded guilty Oct. 24 in Hamilton County to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him operating his business with lapsed coverage and non-compliant claims filed against his policy. A judge sentenced Ayers to two years of probation and ordered him to maintain full-time employment and cooperate fully with BWC and the Ohio Attorney General’s office on his payment plan to BWC. Ayers owes BWC more than $159,000.

Kurt Ballish, dba Kurt Ballish Construction & Custom Decks, of Chardon
Ballish pleaded guilty Oct. 22 to two misdemeanor counts of failure to comply, the same charges he pleaded guilty to in 2016. A judge in Chardon Municipal Court sentenced Ballish to one year of probation in lieu of 90 days in jail and ordered Ballish to pay fines and court costs totaling $642 by Nov. 30. Ballish owes BWC nearly $19,000.

Frank Krailler, dba Transmission Specialists of Montgomery, of Cincinnati
Krailler pleaded guilty Oct. 22 in Hamilton County to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC discovered him operating his business without workers’ comp coverage. As part of his plea deal, Krailler paid $4,000 in restitution.

Gyorgy Benedek of Columbus
Benedek, owner of Maintenance Free Building Services Inc., pleaded guilty Oct. 18 in Franklin County to a reduced charge of failure to comply after submitting a check to BWC for $43,069 in restitution.

Penny Sibila of Canton
Sibila must pay BWC $26,719 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Oct. 18 in a Franklin County courtroom. Acting on a tip, BWC investigators found Sibila working as a property manager for an apartment complex while collecting BWC benefits for an injury she suffered in 2014. In addition to restitution, a judge sentenced Sibila to two years of non-reporting probation in lieu of a seven-month jail sentence.

Thomas Banig of Cleveland
Banig pleaded guilty Oct. 17 to one count of workers’ compensation fraud, a first-degree misdemeanor, after he filed a false claim in 2014 against an employer he had not worked for since 2003. A judge sentenced Banig to 180 days incarceration, suspended for one year of community control.

Rami Khayat, dba Triple Auto Sales, of Cleveland
Khayat pleaded guilty Oct. 1 to one count of failure to comply, a second-degree misdemeanor, after BWC found he was operating his business without BWC coverage. A judge ordered Khayat to pay BWC $965 in restitution.

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

Foregoing workers’ comp coverage costs Ohio businesses

The Ohio Bureau of Workers’ Compensation (BWC) secured court convictions in October against three Ohio business owners — including a Cleveland-area man for the second time since 2016 — who failed to protect their workers with proper BWC coverage.

“We made every attempt to bring these employers into compliance with Ohio law, but they wouldn’t cooperate and we were forced to bring charges against them,” said Jim Wernecke, director of BWC’s special investigations department (SID). “I can’t stress this to employers enough: If you’re struggling with your BWC premiums, work with us. Avoiding us will only make your situation worse.”

Among those convicted were Kurt A. Ballish of Chardon, Ohio, owner of Kurt Ballish Construction & Custom Decks. He pleaded guilty Oct. 22 to two misdemeanor counts of Failure to Comply, the same charges he pleaded guilty to in 2016.

A judge in Chardon Municipal Court ordered Ballish, who owes BWC nearly $19,000, to become compliant with Ohio’s workers’ compensation law or go to jail. He sentenced Ballish to one year of probation in lieu of 90 days in jail and ordered Ballish to pay fines and court costs totaling $642 by Nov. 30.

In Cincinnati, the owner of a now-closed transportation services company must pay BWC more than $159,000 in restitution following his guilty plea to a reduced charge of workers’ compensation fraud.

Philip Ayers, owner of Ayers Transportation Services, pleaded guilty Oct. 24 in a Hamilton County courtroom to the first-degree misdemeanor charge. A judge sentenced Ayers to two years of probation and ordered him to maintain full-time employment and cooperate fully with BWC and the Ohio Attorney General’s office on his payment plan to BWC.

In another employer case, the owner of Triple R Auto Sales in Cleveland pleaded guilty to one count of Failure to Comply Oct. 1 after BWC discovered the business had been in operation for 11 years without workers’ comp coverage.

A judge in Cleveland Municipal Court ordered Rami Khayat to pay BWC $965 in restitution. An injured-worker claim filed against Khayat’s business triggered BWC’s investigation.

In other news, a Columbus tow-truck driver who falsified records to increase his BWC cash benefits pleaded guilty Wednesday to a first-degree misdemeanor count of workers’ compensation fraud.

A Franklin County judge sentenced Jason E. Moffitt to two years of community control in lieu of a three-month jail sentence. The judge also ordered Moffitt to pay BWC $5,325 in restitution.

BWC investigators say Moffit intentionally inflated his income on an earnings statement and signed another person’s name to it. The letter was used to establish Moffitt’s BWC compensation payments.

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

Lapsed policy costs Columbus cleaner $43,000

BWC wraps three fraud-related cases over the last week

The owner of a Columbus cleaning company who continued to run his business after his workers’ compensation insurance lapsed in 2010 paid more than $43,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) at his court hearing Oct. 18.

Gyorgy Benedek, owner of Maintenance Free Building Services Inc., pleaded guilty to a reduced charge of Failure to Comply after submitting a check to BWC for $43,069 in the Franklin County Court of Common Pleas. The plea followed a BWC investigation that revealed Benedek provided falsified BWC certificates of coverage to land a cleaning contract with another company.

“We got a tip from a company doing business with Mr. Benedek that his BWC certificates looked suspicious, so we checked it out,” said Jim Wernecke, director of BWC’s special investigations department. “We found multiple problems with the certificates indicating Mr. Benedek was attempting to skirt his legal obligation to protect his employees and carry proper insurance.”

Among BWC’s findings:

• Benedek provided three BWC certificates showing the signature of former BWC Administrator/CEO Marsha P. Ryan when it should have been the signature of her successor, Stephen Buehrer.
• The certificates were dated during a period Benedek’s policy was lapsed.
• Benedek reported zero payroll between 2009 and 2015, but a BWC audit found he had more than 30 employees during that time and unreported payroll of more than $650,000.

In two other recent cases, a Canton woman must pay BWC $26,719 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation on Oct. 18, and a Cincinnati-area business owner avoided a felony fraud conviction by paying $4,000 in restitution to BWC at his court hearing Oct. 22.

Acting on a tip, BWC investigators found Penny L. Sibila of Canton working as a property manager for an apartment complex from May 11, 2015 to July 27, 2016, while collecting BWC benefits for an injury she suffered in 2014.

Investigators observed Sibila performing several office functions and learned she collected commissions for landing new tenants. They also found she used the alias “Linda” to conceal her return to work from BWC.

In addition to restitution, a Franklin County judge sentenced Sibila to two years of non-reporting probation in lieu of a seven-month jail sentence.

 

In Hamilton County on Monday (Oct. 22), Frank Krailler of Loveland pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him operating his business, Transmission Specialists of Montgomery, without BWC coverage.

Krailler paid BWC $4,000 in restitution at his hearing in a Hamilton County court room, but an outstanding balance remains.

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

BWC reports 7 fraud-related convictions in September

Six Ohioans and a Florida resident owing the Ohio Bureau of Workers’ Compensation (BWC) more than $450,000 in back premiums and restitution were convicted on fraud or fraud-related charges in September.

Those convicted include a Jackson Twp. business owner who misclassified his employees and underreported his payroll to shave $350,000 off his BWC premiums. Others include a basketball coach, a taxi service owner and a valet attendant.

“Whether it’s employers trying to avoid paying their fair share or claimants trying to hide their work activity, cheating the system is not tolerated,” said Jennifer Cunningham, assistant director of BWC’s special investigations department. “We exist to find and prosecute these cheaters to reduce costs to employers and ensure honest claimants receive the benefits they need.”

September’s cases bring total convictions since January to 61, as of Sept. 30. Those convicted, in order of most recent court case, include:

Christine Estrict, Working and Receiving, Cleveland, Ohio
Estrict, aka Christina Estrict, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud on Sept. 26 in the Franklin County Court of Common Pleas after BWC found her working as a youth basketball coach and referee while collecting BWC benefits. A judge sentenced her to 180 days in jail, then suspended the sentence for five years of probation. He ordered her to pay BWC $4,156 in restitution.

Glenn J. Miller III, Working and Receiving, Augustine, Florida
Miller pleaded guilty Sept. 26 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a truck driver while collecting BWC benefits. A judge sentenced him to six months incarceration, suspended for three years of community control with the condition to pay restitution of $16,000 to BWC.

James M Horton, dba All Around Transportation, Lapsed Coverage, Hamilton, Ohio
Horton, of Clarksville, pleaded guilty to a second-degree misdemeanor count of Failure to Comply Sept. 25 in Hamilton Municipal Court after BWC discovered his policy lapsed in July 2016. Horton, who owes BWC more than $55,000 in back premiums, faces up to 90 days in jail and a $750 fine at his sentencing Dec. 5 if he fails to enter a repayment plan by then.

Anthony Caputo, Working and Receiving, Strongsville, Ohio
Caputo pleaded guilty Sept. 17 in Franklin County to a first-degree misdemeanor count of workers’ comp fraud after investigators found him working as a valet attendant at a Cleveland-area hospital while collecting BWC benefits. A judge fined him $500 in lieu of a 10-day jail sentence. Caputo paid BWC $4,021 in restitution prior to his plea.

Linda Cline, Working and Receiving, Springfield, Ohio
Cline pleaded guilty in a Franklin County courtroom to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found her working while collecting BWC benefits. A judge ordered Cline to serve six months of community control and to pay $1,500 in investigative costs. Cline paid BWC $6,759 in restitution prior to her plea.

Craig Snee, dba Earth ‘n Wood, Underreporting and Misclassification of Payroll, North Canton, Ohio
A Stark County jury found Snee guilty Sept. 12 of a fourth-degree felony count of workers’ compensation fraud after BWC found he had misclassified his employees and underreported his payroll to save $350,000 in BWC premiums. Sentencing is scheduled for Oct. 17.

Clarice Ward, Working and Receiving, Euclid, Ohio
Ward pleaded guilty Sept. 4 to a fifth-degree felony count of workers’ compensation fraud after investigators found her working while collecting BWC benefits. A Cuyahoga County judge sentenced her to six months in prison, suspended for five years of community control, and ordered her to pay BWC $26,578 in restitution.

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

Taxi service owes BWC $55K in back premiums

Owner pleads guilty to ‘failure to comply’ with workers’ comp law

The owner of a taxi service in southwest Ohio who owes the Ohio Bureau of Workers’ Compensation more than $55,000 in back premiums has until December to enter a repayment plan with the agency or he could face jail time and fines.

James M. Horton of Clarksville, owner of All Around Transportation in Hamilton, pleaded guilty to a second-degree misdemeanor count of Failure to Comply Sept. 25 in Hamilton Municipal Court. He faces up to 90 days in jail and a $750 fine at his sentencing Dec. 5 if he fails to enter a repayment plan by then.

“We understand the pressures of running a business, and that’s why we work with employers to bring them into compliance before involving the criminal justice system,” said Jim Wernecke, director of BWC’s special investigation department. “Unfortunately, Mr. Horton didn’t follow through on his side, and as a result of a subsequent investigation criminal charges were filed.”

Horton’s BWC policy lapsed in July 2016.

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

BWC calls foul on Cleveland youth basketball coach

Coach convicted of workers’ comp fraud Wednesday

A basketball coach in Cleveland must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $4,000 after the agency’s investigators found her working while collecting injured-worker benefits.

Christine Estrict, aka Christina Estrict, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Wednesday in the Franklin County Court of Common Pleas. A judge sentenced her to 180 days in jail, then suspended the sentence for five years of probation. He ordered her to pay BWC $4,156 in restitution.

“We received an anonymous tip in 2016 that Ms. Estrict was working as a paid referee while receiving BWC benefits, which is against state law,” said Jim Wernecke, director of BWC’s special investigations department. “Our investigation found her working as a basketball coach in Beachwood City Schools and also as a coach and athletic director for a charter school.”

In other news, a former Ohioan now living in Florida pleaded guilty Wednesday to a fifth-degree felony count of workers’ compensation fraud after BWC found him working as a truck driver in 2015 while collecting BWC benefits.

A Franklin County judge ruled Glenn J. Miller III, 44, must serve three years of probation and pay BWC $16,000 in restitution.

Also this week, a Dayton-area business owner who owed BWC more than $190,000 in back premiums this year avoided jail time Monday when a judge fined him $250 for failing to comply with Ohio law requiring him to carry workers’ compensation coverage.

A Kettering Municipal Court judge suspended his 30-day jail sentence for Randall Mount, the owner of Ram Restoration in Centerville, and sentenced Mount to two years non-reporting probation instead. Mount and BWC informed the court that Mount is in a repayment plan with BWC and the agency had reinstated his coverage Aug. 13.

Mount’s business remediates water, fire and mold damage and performs other construction work, according to its website.

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

Cleveland-area valet attendant convicted of workers’ comp fraud

BWC also reports four fraud convictions in August

A Cleveland-area man collecting disability benefits from the Ohio Bureau of Workers’ Compensation pleaded guilty to workers’ compensation fraud Monday after investigators found him working as a valet attendant at Southwest General Hospital in Middleburg Heights.

Anthony Caputo, 67, paid BWC $4,021 in restitution prior to his plea in the Franklin County Court of Common Pleas, where a judge fined him $500 in lieu of a 10-day jail sentence for the first-degree misdemeanor.

“Acting on a tip in 2017, our investigators found Mr. Caputo had worked for no less than four employers while receiving BWC benefits,” said Jim Wernecke, director of BWC’s special investigations department. “In fact, we found he went back to work just a few weeks after his on-the-job injury at a restaurant in August 2016.”

In another fraud case, a Springfield woman pleaded guilty to workers’ compensation fraud Sept. 13 after investigators found her working as a consultant to a South Charleston employer while collecting BWC benefits.

Linda Cline paid BWC $6,759 in restitution prior to pleading guilty to the first-degree misdemeanor in the Franklin County common pleas court. A judge sentenced her to six months of probation.

In other news, BWC secured fraud convictions against three Ohioans and one Texan in August, bringing the calendar year’s total to 54 as of Aug. 31. Those convicted include:

• Walter Patterson of Olmsted Twp. – Patterson pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in Franklin County. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.
• Jason Smith of Pataskala – Smith pleaded guilty Aug. 14 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 12 months incarceration, suspended for three years of community control. He was ordered to pay restitution of $41,413 to his former employer, TS Tech Corporation.
• Grant Myers of Huron – Myers pleaded guilty Aug. 8 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 30 days incarceration, suspended. He paid BWC $11,566 in restitution.
•  Stacy Driskell of Cedar Park, Texas – Driskell pleaded guilty Aug. 3 to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found her working for a mortgage lending law firm in Texas while collecting BWC benefits. A judge fined Driskell $300 plus court costs. Prior to the plea, Driskell paid full restitution of $3,056 to BWC.

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

2,000 Fraud Hotline calls in 10 months!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received 2,000 calls since we launched our new Fraud Hotline system ten months ago during International Fraud Awareness Week 2017. The 200 calls a month, means we have received nearly 10 each work day, or more than one every working hour!

In our November 14, 2017 blog, we noted that calling the BWC Fraud Hotline is the most interactive and direct way for you to report an allegation of fraud. Our hotline puts you in direct contact with an agent in our Special Investigations Department, one ready and willing to listen to your concerns.

Our hotline agents have years of investigative knowledge, skills and experience securing the essential information from sources. Whether the fraud hotline agent is Connor, Jake, Jeff, Karen, Karie or Loryn, or any of our 25 fraud analysts assigned to our special investigations unit statewide, callers know within seconds that they have reached a committed, respectful professional.

These same agents also receive and process fraud referral forms submitted by sources who report their suspicions via a Report Fraud link on bwc.ohio.gov. Just last month, for example, the convictions of Jason C. Smith and Walter M. Patterson were the result of fraud referral forms submitted to our hotline.

If you’re concerned about the alleged fraudster discovering your identity, rest assured. Your identity may remain either anonymous or confidential, depending on your preference. In addition, you don’t need to prove any facts or even have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continues to occur. We’ll take care of the rest.

We look forward to hearing from you, so give us a call at 1-800-644-6292 if you suspect fraud. We will conduct the investigation and determine the facts. Together, we are successfully combatting workers’ compensation fraud in Ohio – one call and referral form at a time.

Thank you for your support!

Cleveland-area bartender served felony conviction for workers’ comp fraud

Euclid woman owes BWC more than $25K in restitution

A Cleveland-area bartender must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $25,000 after pleading guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud.

BWC learned in late 2016 that Euclid resident Clarice L. Ward was not attending her physical therapy appointments for her workplace injury and that the BWC-contracted company managing her care couldn’t reach her. As BWC investigated her case, the agency received an anonymous tip that Ward was working at Final Score Bar in Willowick, Ohio, while collecting BWC disability benefits.

“Ms. Ward would not cooperate with our investigators, so we interviewed her former employer and obtained evidence proving her fraudulent activity,” said Jim Wernecke, director of BWC’s special investigations department.

Ward, 40, pleaded guilty Tuesday in the Cuyahoga County Court of Common Pleas, where the judge sentenced her to six months in prison, suspended for five years of community control, and ordered her to pay BWC $26,578 in restitution.

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

Workers’ comp fraud scheme burns cook for $46K

Northeast Ohio man guilty of 5^th degree felony

 

A northeast Ohio man who worked as a cook for nearly three years while collecting disability benefits from the state owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $46,000 following his fraud conviction last week.

Walter M. Patterson, 58, of Olmsted Twp., pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.

“It’s a mistaken perception among some people that workers’ compensation fraud is not that big a deal, that BWC ‘can afford it,’” said Jim Wernecke, director of BWC’s special investigations department. “As this case demonstrates, we take fraud very seriously and intend to recoup every ill-gotten dollar fraudsters take from this agency so those funds can serve injured workers who truly need them.”

Acting on a tip, BWC investigators found Patterson working as a cook at the Valley Tavern in Valley View, Ohio, and learned that he had previously worked as a cook at the County Line Bar in Brecksville.

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

Special investigations department finishes FY2018 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY2018, which closed June 30. The report details another impressive year of our department’s efforts to deter, detect, investigate and prosecute workers’ compensation fraud.

Here are some highlights in what was our 25th year as a department:

• We closed 1,622 fraud cases, 448 more than in 2017.
• We secured 101 convictions of claimants, employers and health care providers who defrauded our agency.
• For every dollar we spent on our efforts, we saved the state fund nearly five ($4.81), or $1.33 more than last year.
• We reduced our investigation time per case by 23 days on average, our lowest number on this measure since 2005.
• All told, we saved the state fund $60.1 million in 2018, a 44 percent jump over 2017’s numbers.

We couldn’t have achieved this success without the 121 dedicated staff members who serve our department with great skill, resourcefulness and determination to bring justice to those who cheat our system. We also owe a great deal of credit to advances in technology and a key operational change we made last year to increase our efficiency and productivity.

Drones and Workplace Safety
The drone program we implemented in 2017 for our safety investigators proved itself a worthy investment in 2018. Our safety investigators relied on the tool at 10 workplace safety violation sites last year, including two that would have been especially difficult and dangerous, if not impossible, to properly investigate without it. The most challenging case involved flying the drone into an elevator shaft. Another involved an old factory site where the factory was being torn down. Thanks to our drones, our safety investigators could remain at a safe distance while navigating the drones to survey the sites and take accident scene pictures.

We have three drone pilots certified with the Federal Aviation Administration and three more waiting in the wings, so to speak. And while they find the drones fun and exciting, their enthusiasm is tempered in knowing that each operation is tied to tragedy and unfortunate events. Their drive is to ensure they gather accurate data and conduct unbiased investigations.

Hotline
In November we rolled out a new method for collecting fraud allegations. Until then, outside callers would report allegations to BWC personnel that staffed our customer contact centers. Now the callers reach our investigators directly, which allows our team to ask follow-up questions and obtain more precise information to jumpstart the investigation. It also reduced or eliminated the wait times for callers, which led to fewer dropped calls. The bottom line is the new hotline system led to a more comprehensive and detailed fraud allegation packet that we could send to our field teams.

Looking ahead
As we commence our 26th year in FY 2019, we remain united in our commitment to protecting the state insurance fund and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

Central Ohio handyman guilty of workers’ comp fraud

Pataskala man owes BWC $41,000 after felony conviction

A maintenance man for a mobile home park must reimburse his former employer more than $41,000 after pleading guilty Tuesday to a felony count of workers’ compensation fraud.

Acting on a tip, investigators with the Ohio Bureau of Workers’ Compensation discovered Jason C. Smith, 35, of Pataskala, working for a mobile home park and for private individuals for nearly two years while collecting $41,413 in disability benefits from his employer, TS Tech USA Corporation in Reynoldsburg.

“You can’t claim you’re disabled and collect benefits from BWC or your employer when you’re also working under the radar and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “Workers’ comp benefits are for people who truly can’t work because they were injured on the job, not people who want to cheat the system and pad their income.”

Smith pleaded guilty to a fifth-degree felony count of workers’ compensation fraud. A Franklin County judge ordered him to pay TS Tech restitution and sentenced him to a year in jail, which he suspended in exchange for three years’ probation.

In other fraud news: A northern Ohio man was ordered to reimburse BWC $11,566 after investigators found him running a drywall business while receiving disability benefits from the agency.

Drywall installer Grant Myers, 57, of Huron, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Aug. 8 in the Franklin County Court of Common Pleas. A judge suspended a 30-day jail sentence after Myers paid BWC restitution.

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

Dayton home remodeler sentenced for workers’ comp fraud

Ohio BWC secures three fraud convictions in July

The owner of a residential construction business in Dayton who under reported his payroll by millions of dollars to lower his workers’ comp premiums is among three Ohioans convicted last month for workers’ compensation fraud, the Ohio Bureau of Workers’ Compensation (BWC) reported Friday.

Honorato Camacho, owner of Field Construction LLC, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on July 12. Acting on a tip, BWC investigators found Camacho had deliberately under reported his payroll by more than $3.5 million from 2013 to 2015.

“Mr. Camacho’s scheme saved him more than $300,000 in premiums, but look what it cost him in the end — he still owes us for the premiums and now he has a felony criminal record on top of it,” said Jim Wernecke, director of BWC’s special investigations department.

Judge Mary Wiseman in the Montgomery County Court of Common Pleas ordered Camacho to pay BWC $255,434 in restitution, the balance owed after repayments he made prior to sentencing. She also sentenced Camacho to five years’ community control.

In other July convictions:

Arthur J. Brinkerhoff of Newcomerstown, Ohio, pleaded guilty July 25 in Franklin County to one misdemeanor count of workers’ compensation fraud after a tipster alleged he was working as a truck driver while receiving BWC benefits. Brinkerhoff was sentenced to one day in jail with credit for time served. He paid BWC $2,034 in court-ordered restitution.

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

Ohio BWC secures 7 convictions in June

More than a quarter million dollars owed in restitution

Six current and one former Ohioan who owe more than $269,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) were convicted in June on charges related to workers’ compensation fraud.

Those convicted included six employers and one injured worker who was working in Colorado while collecting disability benefits from BWC. Three employers account for the bulk of the restitution owed.

“If these employers had just played by the rules and reached out to us for help when they were struggling, we could have had a better outcome for all involved,” said Jim Wernecke, director of BWC’s special investigations department. “Instead, they went in a different direction and now they have a criminal record in addition to their unpaid BWC premiums.”

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

Randall Mount, dba Ram Restoration, Lapsed Coverage, Dayton, Ohio
Mount pleaded no contest June 25 to one count of failure to comply, a second-degree misdemeanor, after BWC found him operating without coverage since January 2016. BWC worked with Mount to bring his policy current, but Mount failed to follow through.

Sentencing is scheduled for Aug. 13. The judge advised Mount that he should come to sentencing prepared to show actual steps taken toward reinstatement and compliance with the law. Mount owes more than $190,000 in premiums and claims costs billed to his policy while his coverage was lapsed.

Karrie Hoskisson, Working and Receiving, Colorado Springs, Colorado
Hoskisson, 44, formerly of Canal Winchester, pleaded guilty to a first-degree misdemeanor theft charge June 21 after BWC found her living and working in Colorado Springs, Colorado, as a night watchman while receiving BWC benefits.

The former dog groomer was sentenced to 36 days in jail. A Franklin County judge gave her credit for time served because she was jailed in Colorado after her arrest in May and again in Columbus following her extradition to Ohio.

John Triskett, dba The Gyro Spot, Under Reporting Payroll, Parma, Ohio
Triskett pleaded guilty June 19 to one count of Attempted Workers’ Compensation Fraud, a second-degree misdemeanor, after BWC found his business lacked workers’ comp coverage. A judge sentenced Triskett to 30 days in jail (suspended), six months of probation and ordered Triskett to pay a $100 fine and $1,140 in restitution to BWC.

Jason Brown, dba Bolts Carriers LLC, Lapsed Coverage, Bellefontaine, Ohio
Brown pleaded no contest June 12 in the Bellefontaine Municipal Court to two counts of failure to comply, both second-degree misdemeanors. Brown was sentenced to 20 days jail and fined $450 for each charge. The judge suspended the sentence conditionally, giving Brown until Dec. 12 to prove to the court that his BWC policy had been reinstated.

The policy for Bolts Carriers LLC had been lapsed since September 2015. Prior to sentencing, Brown paid approximately $1,900 toward his balance of more than $55,000.

Howard McIntosh, dba Custom Canvas, Lapsed Coverage, Lakeview, Ohio
McIntosh pleaded no contest June 12 in the Bellefontaine Municipal Court to three counts of failure to comply, all second-degree misdemeanors. McIntosh was sentenced to 30 days jail and fined $450 for each charge. The judge suspended the  sentence conditionally, giving McIntosh until Sept. 1 to prove to the court his BWC policy had been reinstated. One week prior to his court appearance, McIntosh remitted a $1,000 payment toward his BWC balance of more than $23,000.

Stephen Frair, dba Frair Ltd, Lapsed Coverage, Columbus, Ohio
Frair pleaded guilty June 5 in Franklin County Municipal Court to two counts of failure to comply, both second-degree misdemeanors, after letting his policy lapse in July 2015. Frair told BWC he closed his business Nov. 1, 2017. A judge fined him $165.

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

Truck-driving fraudster owes Ohio BWC more than $78,000

Judge orders restitution, 5 years probation

A judge on June 28 ordered a Zanesville-area truck driver to pay $78,321 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after investigators found the driver had gone back to work without telling BWC so he could continue to collect disability benefits.

The Franklin County judge also sentenced Walter Lee, 54, of Frazeysburg to five years of probation and a 14-day suspended jail term. Lee pleaded guilty on April 24 to a fifth-degree felony count of workers’ compensation fraud.

“Our investigators discovered through state records that Mr. Lee had returned to work as a truck driver on May 3, 2013, but he deliberately concealed that information from BWC,” said Jim Wernecke, director of BWC’s special investigations department.

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

Dog groomer, two businesses plead to workers comp fraud-related charges

A former central Ohio dog groomer pleaded guilty to a theft charge June 21 after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found her living and working in Colorado Springs, Colorado, while receiving BWC benefits.

Karrie Hoskisson, 44, formerly of Canal Winchester, pleaded guilty to a first-degree misdemeanor theft count and was sentenced to 36 days in jail. A Franklin County judge gave her credit for time served because she was jailed in Colorado after her arrest in May and again in Columbus following her extradition.

“Ms. Hoskisson failed to follow through with us following her not guilty plea to theft and workers’ compensation fraud charges in 2016, so we had her arrested by the U.S. Marshal’s Office and extradited to Ohio,” said Jim Wernecke, director of BWC’s special investigations department.

Wernecke said marshals arrested Hoskisson on May 16 when she appeared for a medical exam related to her 2004 work injury. He said Hoskisson collected $15,000 in BWC benefits during the time she was also working as a night watchman in Colorado.

Two business owners convicted

In other news, the owner of a Dayton-area business that owes BWC more than $190,000 must prove to a judge that he’s taken steps to bring his policy back into compliance when he’s sentenced on a related criminal charge Aug. 13.

Randall Mount, the owner of Ram Restoration in Centerville, pleaded no contest Monday in Kettering Municipal Court to a second-degree misdemeanor count that he failed to comply with Ohio law requiring him to carry workers’ compensation coverage for his business. Mount’s business remediates water, fire and mold damage and performs other construction work, according to its website.

Back premiums and claims costs have accrued since Mount’s policy lapsed in January 2016. BWC worked with Mount for five months to bring his policy into compliance, but Mount ultimately failed to do so.

In another employer case, the owner of a Columbus automotive repair shop pleaded guilty June 5 to two second-degree misdemeanor counts of Failure to Comply after letting his policy lapse in July 2015.

Steve Frair told BWC he closed his Essex Avenue business Nov. 1, 2017. A judge in the Franklin County Municipal Court fined Frair $165. Frair owes BWC $626 in back premiums and penalties.

Three Ohio businesses plead in work comp fraud cases

Two owners owe a combined $78K in back premiums

Two business owners from Bellefontaine, Ohio, that owe approximately $78,000 in back premiums to the Ohio Bureau of Workers’ Compensation can avoid fines and jail time if they bring their BWC policies back into compliance later this year, a municipal judge ruled June 12.

“Letting your workers’ compensation coverage lapse is a serious matter that puts employees and businesses at risk for potentially staggering medical costs and related expenses,” said Jim Wernecke, director of BWC’s special investigations department. “We tried to work with these owners, but they ultimately didn’t do what they needed to do to avoid criminal charges.”

Jason Brown, the owner of the trucking company Bolts Carriers LLC in Bellefontaine, pleaded no contest to two second-degree misdemeanor counts of Failure to Comply after BWC found he defaulted on a reinstatement payment plan in September 2015. Prior to sentencing, Brown paid approximately $1,900 toward his balance of more than $55,000. He has until Dec. 12 to bring his policy into compliance or he could face 20 days jail and a $450 fine on each of the two charges.

In a separate case, the owner of a boat canvas shop in Bellefontaine whose policy lapsed 18 years ago has until Sept. 1 to bring the company’s policy into compliance. One week prior to sentencing, Desee McIntosh of Custom Canvas remitted a $1,000 payment toward his balance of more than $23,000. He pleaded no contest to three second-degree misdemeanor counts of Failure to Comply. He faces 30 days in jail and $450 in fines for each count.

In other news, the owner of The Gyro Spot Bar & Grill in Parma, Ohio, pleaded guilty Tuesday to one count of Attempted Workers’ Compensation Fraud, a second-degree misdemeanor, after BWC found his business lacked workers’ comp coverage.

As BWC agents worked with owner John Triskett to bring his business into compliance, they found he intentionally under-reported his payroll and used other inaccurate information to keep his policy payments significantly less than the amount he actually owed.

A judge sentenced Triskett to 30 days in jail (suspended), six months of probation and ordered Triskett to pay a $100 fine and $1,140 in restitution to BWC.

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

Eight Ohioans plead to work comp fraud-related charges in May

The eight Ohioans who pleaded guilty and no contest in May to fraud-related charges against the Ohio Bureau of Workers’ Compensation (BWC) include a homicide suspect, a Cincinnati bus driver who collected disability benefits while working two other jobs, and a health care provider who billed BWC for work his company didn’t perform.

“Our convictions in May illustrate a range of fraud types that we see at BWC, some more serious than others,” said Jim Wernecke, director of BWC’s special investigations department. “But regardless of severity, we approach each case with equal determination to find the truth, prosecute the guilty and reclaim funds that support injured workers and create safer workplaces in our state.”

The cases, in order of most recent court date, include:

Samantha Coleman, Cincinnati — Working and Receiving
Coleman was working as a bus driver for the Southwest Ohio Regional Transit Authority (SORTA) when she was injured on the job in November 2015. While collecting disability benefits from SORTA, she continued to work her other two jobs as a tax preparer and security guard.

Coleman pleaded guilty May 30 in Hamilton County to one count of worker’s compensation fraud and one count of theft, both fifth-degree felonies. She was placed in the county’s diversion program because she had no prior record. Over the next year, she must reimburse SORTA $7,088, complete 120 hours of community service and participate in a counseling program.  If she successfully completes these requirements the case will be dismissed and she will not receive a conviction.

Bryan Gentry, Canal Fulton — Tampering with Records
Gentry pleaded guilty to a third-degree felony count of Tampering with Records after SID determined he created a phony BWC certificate of coverage to secure a tree-trimming job in Stark County. The judge sentenced him to a year in prison, to be served concurrently with a three-year term for assault and receiving stolen property.

Gentry, who’s imprisoned in Richland Correctional Institution in Mansfield, is also a suspect in the 2017 killing of a Stark County man who was romantically involved with Gentry’s girlfriend.

Gabriella Benkovits, Lakewood — Working and Receiving
Benkovits pleaded guilty May 22 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found her working as a bartender while collecting disability income. She must pay BWC $7,595 in restitution and serve two years of probation.

Jeffrey Guerin, Willoughby Hills — Services Not Rendered
Guerin pleaded guilty in a Franklin County court to a first-degree misdemeanor count of workers’ compensation fraud. BWC found him billing the agency for work his now-defunct company, PT Plus in Willoughby Hills, did not perform. Guerin paid $7,154 in restitution to BWC and agreed to leave the BWC network of providers.

Carolyn Tibbetts, Toledo — Lapsed Coverage
Tibbets, the owner of Little Explorers Toledo Learning Center, pleaded no contest May 17 to three charges of failure to comply after investigators found her operating her child care center without BWC coverage. Tibbets worked with BWC to bring her businesses into compliance, but she failed to continue payments on a balance of more than $12,000. The charges are second-degree misdemeanors.

A judge referred her case to Lucas County’s probation department to be considered for its Alternatives Program. No further court action will be taken against Tibbetts if she’s accepted into the program.

Marshall Winn IV, Niles — Working and Receiving
Winn, a truck driver from northeast Ohio, pleaded guilty May 14 to a fifth-degree felony count of workers’ compensation fraud after investigators found him working while collecting disability benefits. A Franklin County judge sentenced him to five years of probation in lieu of nine months in prison and ordered him to pay BWC $12,450 in restitution and court costs.

Judith Barlock, Parma — Lapsed Coverage
Barlock, the owner of Chase Professional Transport, failed to bring her company back into compliance after BWC discovered her policy had lapsed. She pleaded guilty May 2 to one count of failure to comply, a second-degree misdemeanor. A judge sentenced her to 90 days in jail (60 days suspended) and five years of probation. The court deferred the balance of jail time and $750 of her fine until a June 20 probation review. The amount of restitution owed BWC will be determined at that review.

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

Ohio murder suspect defrauds state work comp bureau

Northeast Ohio tree trimmer falsified coverage certificate

One month after his alleged role in murdering his girlfriend’s other lover in February 2017, Bryan T. Gentry created a phony proof-of-coverage certificate from the Ohio Bureau of Workers’ Compensation (BWC) to land a tree-trimming job and avoid paying for actual coverage.

The Stark County man’s handiwork earned him a one-year prison sentence May 24 when a Summit County judge found him guilty of tampering with records, a third-degree felony. On the same day, the judge also found Gentry, 27, of Canal Fulton, guilty for the second-degree felonious assault of an Akron man last year, a crime apparently unrelated to his BWC case or to one involving a deadly love triangle.

“It seems our case might be the least of Mr. Gentry’s legal troubles right now, but we can’t let unrelated crimes stop us from doing our job,” said Jim Wernecke, director of BWC’s special investigations department. “Our job is to deter, detect and prevent worker’s comp fraud. We don’t let anyone slide.”

The judge gave Gentry three years in prison for the assault charge, to be served concurrently with his sentence for tampering and still another prison sentence he earned in December for receiving stolen property. Police tracked Gentry down last year after finding his mail in a stolen truck.

In the BWC case, Wernecke said a customer of Gentry’s tree service contacted the agency last summer after he suspected Gentry’s BWC certificate wasn’t legitimate. Two clues tipped off the customer, an insurance salesman: The certificate lacked a policy number, and Gentry noted a policy period of one day, “3/10/2017 through 3/10/2017.” BWC’s practice is to note a full policy year, such as 07/01/2016 through 06/30/2017.

BWC agents determined Gentry doctored a relative’s certificate to look like his own so he and his six workers could get the job. Agents interviewed Gentry on Jan. 31 at the Lorain Correctional Institution in Grafton, Ohio, where he lied and denied forging the certificate, but was “soft-spoken and very well-mannered” while doing it, they said.

Two days later, Gentry’s life got more complicated. Acting on a tip from Gentry’s girlfriend, Stark County authorities recovered the body of 25-year-old man from the backyard of his Massillon home. They found him in a plastic tote, encased in concrete and buried six feet below ground.

For more on that case, see these articles in the Massillon Independent and People magazine.

Gentry has since been relocated to the Richland Correctional Institution in Mansfield.

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

Case update: Ohio doctor sentenced to 5-year prison term

Dr. Timothy Manuel, a Highland County physician who improperly prescribed opioids to injured workers, was sentenced Thursday to five years in prison and ordered to pay $12,060 in restitution to BWC.

Manuel, 59, was the subject of a joint investigation by BWC and the Ohio Board of Pharmacy that found he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care in southwestern Ohio. He also billed BWC for medical services that weren’t provided.

Manuel was taken into custody following his sentencing in the Highland County Court of Common Pleas. Read more on the case in this Hillsboro Times Gazette article.

Youngstown auditor is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An external auditor in the Youngstown Claims Office received the 2017 Fraud Finder of the Year award May 22 from BWC’s special investigations department (SID).

The auditor, who does not want to be identified given the sensitive nature of his job, received the award for alerting SID to a case in which an employer failed to report payroll and failed to respond to multiple attempts to schedule a premium audit. An investigation by the SID Employer Fraud Team revealed that most of the employer’s Ohio employees were reported to ODJFS, but not to BWC. The referral resulted in the identification and recovery of $804,352 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud and save the BWC system nearly a million dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources we need to take care of injured workers, create safe workplaces and provide the best service possible to employers at affordable rates.”

The auditor, who handles employer policy underwriting and premium audits, said he appreciates the recognition and is glad he could help.

“This is why we do what we do,” he said. “After spotting a red flag in this case, I dug a little deeper and found more red flags. Persistence paid off, and it’s a good thing, because this kind of behavior drives up our costs and hurts all the honest players in our system.”

SID received 2,320 allegations of fraud in 2017, with about a fourth of those coming from BWC personnel around the state — claims representatives, employer representatives and others who suspect illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system. During 2017, SID closed 311 cases referred by 158 BWC employees. The SID investigations found fraud in 146 of the 311 cases and generated $2,724,426 in identified savings.

To show their appreciation, SID leaders conducted a thank-you tour and red flag training from March through May, presenting Fraud Finder Award certificates to BWC employees in customer service offices across Ohio.

“We encourage all BWC employees to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4) or visit www.bwc.ohio.gov.

Cleveland bartender’s Facebook post exposes work comp fraud

Restaurant worker owes BWC nearly $7,600

A Cleveland bartender must repay the Ohio Bureau of Workers’ Compensation $7,595 after pleading guilty Tuesday to workers’ compensation fraud.

In addition to restitution, Gabriella Benkovits, 26, of Lakewood, must serve two years of probation for the first-degree misdemeanor, a judge in the Franklin County Court of Common Pleas ruled.

“The company managing Ms. Benkovits’ medical claim for her 2012 work injury alerted us that they found a Facebook post indicating she was working as a bartender in Westlake,” said Jim Wernecke, director of SID’s special investigations department. “Our investigation revealed she worked at three different establishments from July 2015 to February 2016 while collecting disability benefits she wasn’t entitled to.”

Wernecke said Benkovits deliberately concealed her employment from BWC, her physicians and other parties officially involved in her injury case.

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

1,000 Fraud Hotline calls in 6 months!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received 1,000 calls since we launched our new Fraud Hotline system six months ago during International Fraud Awareness Week 2017. That’s 167 calls a month, a little more than seven a day, or one nearly every working hour!

In our November 14, 2017 blog, we noted that calling the BWC Fraud Hotline is the most interactive and direct way for you to report an allegation of fraud. Our hotline puts you in direct contact with an agent in our Special Investigations Department, one ready and willing to listen to your concerns. (Under our old system, you reached a representative in BWC’s Customer Contact Center.)

Our hotline agents have years of investigative knowledge, skills and experience securing the essential information from sources. Whether the fraud hotline agent is Connor, Jake, Jeff, Karen, Karie or Loryn, or any of our 25 fraud analysts assigned to our special investigations unit statewide, callers know within seconds that they have reached a committed, respectful professional.

You, the general public, are essential in helping us fight fraud, waste, and abuse in workers’ comp. We are celebrating our 25^th year since the creation of our Special Investigations Department in 1993 and thousands of our closed, founded cases started with a call to our Fraud Hotline.

Just last month, for example, the convictions of Rodney Alberino, James Harris and Donna Steele were each the result of just such a call.

If you’re concerned about the alleged fraudster discovering your identity, rest assured. Your identity may remain either anonymous or confidential, depending on your preference. In addition, you don’t need to prove any facts or even have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continues to occur. We’ll take care of the rest.

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

Thank you for your support!

Truck driver guilty of workers’ comp fraud

A truck driver from northeast Ohio must pay more than $12,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after the agency’s investigators found him working again while collecting disability benefits.

Marshall Winn IV of Niles in Trumbull County pleaded guilty Wednesday to a fifth-degree felony count of workers’ compensation fraud in Franklin County Common Pleas Court. A judge sentenced him to five years of probation in lieu of nine months in prison and ordered him to pay BWC $12,450 and court costs.

“Mr. Winn was injured in 2014 and claimed he was disabled from work, but we found evidence that he started working again in January 2015 and that he was running his own trucking business,” said Jim Wernecke, director of BWC’s special investigations department.

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

Trucker and 10 others convicted in April for cheating BWC

Agency owed more than $500,000 in restitution

An Ohio truck driver who worked for more than two years while collecting disability benefits could be ordered to pay more than $78,000 in restitution at his sentencing for workers’ compensation fraud June 14.

Walter Lee, of Frazeysburg in Muskingum County, pleaded guilty to the fifth-degree felony April 25 in Franklin County Common Pleas Court. The judge ordered a pre-sentence investigation due to the large amount of restitution — $78,321 — owed to the Ohio Bureau of Workers’ Compensation (BWC).

“Our investigators discovered Mr. Lee knowingly returned to work as a truck driver while collecting disability benefits from our agency,” said Jim Wernecke, director of BWC’s special investigations department. “We’re glad he can work again, but he can’t tell us he’s disabled and collect our benefits while doing it. Those funds are for injured workers who truly need them.”

Lee was injured on the job in 2002. BWC’s investigation found him working from May 3, 2013 to Oct. 2, 2015 while collecting agency benefits.

Lee’s case was one of 11 convictions BWC secured in April along with $515,713 in restitution ordered. Other cases include:

Timothy Manuel, M.D. (Wilmington, Ohio), Drug Trafficking
Manuel pleaded guilty April 27 to four counts of aggravated trafficking in drugs and a fourth-degree felony count of workers’ compensation fraud.

Manuel, who now lives in Missouri, was indicted last year after an investigation by BWC and the Ohio Board of Pharmacy found that he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care. He also collected $12,068 from BWC for services he did not perform.

His sentencing is scheduled for May 24 in Highland County Common Pleas Court.

Rodney Alberino (Parma Heights, Ohio), Working and Receiving
Alberino was ordered to pay BWC $193,574 in restitution after pleading guilty April 26 to one count of workers’ compensation fraud, a fourth-degree felony. He was also ordered to serve two years of probation. BWC investigators discovered that Alberino had been working a variety of jobs for nearly seven years while collecting disability benefits.

Randall Abel (North Canton, Ohio), Working and Receiving
Abel pleaded guilty to a first-degree misdemeanor theft charge April 25 after BWC found him working as a self-employed automotive repairman while collecting disability benefits. Abel paid $6,475 in restitution to his former employer and was sentenced in the Stark County Common Pleas Court to two years of probation.

James Harris (Cleveland, Ohio), Working and Receiving
Harris pleaded guilty April 25 in Franklin County Common Pleas Court to one count of workers compensation fraud, a fifth-degree felony, after investigators found him working for a property management company while receiving BWC benefits. He was sentenced to three years of probation and ordered to pay BWC $10,498 in restitution.

Tina Valley (Akron, Ohio), False Claim
Valley pleaded guilty April 16 in Akron Municipal Court to workers’ compensation fraud, a first-degree misdemeanor, after filing a false injury claim. She claimed she was injured from a slip and a fall while working at a local fast food restaurant. Surveillance video from the business showed she never actually slipped and fell.

A judge gave Valley a six-month suspended jail sentence and ordered her to perform three days of community service and pay court costs and fines totaling $527.

Thomas Cannell (Northfield, Ohio), Working and Receiving
Cannell pleaded guilty April 11 in United States District Court to one count of theft of government property and one count of wire fraud after BWC and
federal investigators discovered he had been working for decades while collecting disability income from BWC and the Social Security Administration.

Cannell was ordered to pay restitution of $684,048 ($479,288 to Social Security and $204,761 to Ohio BWC).  A sentencing date has not yet been set.

Vincent Dombrow (Findlay, Ohio), Working and Receiving
Dombrow pleaded guilty April 9 in Franklin County Common Pleas Court to obstructing official business, a second-degree misdemeanor, after investigators found he had returned to work while collecting BWC benefits. A judge sentenced him to 90 days in jail, which was suspended after Dombrow paid restitution of $3,941.

Kenneth Gilmore (Cleveland, Ohio), False Claim
Gilmore pleaded guilty April 2 in Lorain County Common Pleas Court to multiple felony counts related to his attempts to fraudulently obtain prescription pain killers. A judge sentenced him to 30 months in jail and ordered he pay $6,075 in restitution BWC.

Investigators found Gilmore had submitted three false claims of work injuries at Cleveland-area hospitals between December 2013 and June 2014. He admitted to BWC that he filed the claims to obtain narcotics. 

Donna Steele (New Lebanon, Ohio), Working and Receiving
Steele pleaded guilty April 4 in Franklin Municipal Court to workers’ compensation fraud, a first-degree misdemeanor, after BWC found her running a babysitting business in her home while collecting disability benefits. She paid BWC $10,611 in restitution, plus a fine of $250 and court costs.

Kalyan Ravula, dba United Car Lot (Columbus, Ohio), No Coverage
Ravula pleaded guilty April 3 to one count of failure to comply, a second-degree misdemeanor, and was fined $100 after BWC found him operating a business without workers’ compensation coverage.

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

Cleveland fraudster owes BWC nearly $200,000

Former trucker worked variety of jobs while collecting disability benefits

 

A Cleveland-area man owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $200,000 after the agency found him working for nearly seven years while collecting disability benefits.

Rodney W. Alberino, 44, of Parma Heights, pleaded guilty to a fourth-degree felony count of workers’ compensation fraud April 26 in the Cuyahoga County Common Pleas Court. He must pay BWC $193,574 in restitution and serve two years of probation.

“We got a tip that Mr. Alberino had been operating a lawn care business and working with his neighbor rehabbing houses while collecting disability benefits,” said Jim Wernecke, director of BWC’s special investigations department. “Our investigators talked to witnesses, gathered records and shot surveillance video. They found Mr. Alberino performing a number of work activities, including snow removal, landscaping, property maintenance, painting, and siding installation.”

Alberino was working as a truck driver when he was injured on the job in January 2010. He collected BWC benefits until Dec. 28, 2016.

In other fraud news:

A southwest Ohio physician who pleaded guilty April 27 to four counts of aggravated trafficking in drugs also collected $12,068 from BWC for services he did not perform.

In addition to the drug charges, Dr. Timothy Manuel, 59, pleaded guilty in Highland County Common Pleas Court to a fourth-degree felony count of workers’ compensation fraud. Sentencing is scheduled for May 24.

Manuel, who now lives in Missouri, was indicted last year after an investigation by BWC and the Ohio Board of Pharmacy found that he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care.

Randall Abel, 33, of North Canton, pleaded guilty to a first-degree misdemeanor theft charge April 25 after BWC found him working as a self-employed automotive repairman while collecting disability benefits.

Acting on a tip, investigators found Abel owning and operating RJ’s Performance Diesel while receiving disability benefits from his former employer, a local construction company.

Abel paid $6,475 in restitution to his former employer and was sentenced in the Stark County Common Pleas Court to two years of probation.

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

Cleveland man finds work doesn’t pay

Work comp fraudster owes BWC $10k+ after conviction

A Cleveland man who worked for nearly a year while collecting injured-worker benefits must pay $10,498 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after pleading guilty to workers’ compensation fraud Wednesday.

James Harris, 44, also must serve three years of probation for the fifth-degree felony, according to his sentence in the Franklin County Court of Common Pleas.

“We got an anonymous tip that Mr. Harris was working as a laborer for a property management company, so we checked it out,” said Jim Wernecke, director of BWC’s special investigations department. “After reviewing employment records and interviewing property owners, we determined Mr. Harris was engaged in regular, ongoing work and getting paid for it. You can’t do that and claim you’re disabled from work.”

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

Ohio BWC secures five fraud-related convictions in March

The Ohio Bureau of Workers’ Compensation secured five fraud-related convictions in March and restitution orders totaling more than $41,000.

Those convicted include a remodeling contractor, a babysitter and the owner of a Dayton drive-thru business, as well as a landscaper and a graphic artist. The following cases bring BWC’s total convictions this year to 12 as of March 31.

“Employers must have workers’ comp insurance to support injured workers in their time of need,” said Jim Wernecke, director of BWC’s special investigations department. “With these cases closed, we can put their premium dollars back to work caring for injured workers and promoting safety in every Ohio workplace.”

Scott Jones of Perrysburg, Ohio (Wood County), Working and Receiving
Jones was found guilty on March 21 of a first-degree misdemeanor count of workers’ compensation fraud after investigators found him remodeling bathrooms, convenience stores and performing other construction work while collecting BWC benefits.

A Franklin County judge ordered Jones to pay BWC $3,957 in restitution by Oct. 30 this year or face 45 days in jail. Jones paid $1,000 toward the restitution when he appeared in court.

 Sharrounda Fuller, Columbus, Ohio (Franklin County), Working and Receiving
Investigators discovered Fuller operating a day care out of her home while collecting workers’ compensation benefits from her self-insured employer. She pleaded guilty March 20 to a fifth-degree felony count of workers’ compensation fraud. She must pay $11,514 in restitution to her former employer, a home health care company, and serve five years of probation, according to her sentence in the Franklin County Court of Common Pleas.

Christine Niffa, dba Christy’s Drive Thru, Dayton, Ohio (Montgomery County), Lapsed Coverage
BWC discovered that Christy’s Drive Thru in Dayton had been operating with lapsed workers’ comp coverage since March 2013. After charges were filed, Niffa appeared in court March 8 and pleaded guilty to disorderly conduct, a minor misdemeanor. She paid BWC the balance due and her policy was reinstated.

Charles Parry

Charles Parry, Plain City, Ohio (Union County), Working and Receiving
BWC investigators found Parry operating a landscaping business for 10 months while receiving temporary total disability benefits. Parry pleaded guilty March 8 to one count of theft, a first-degree misdemeanor. He paid restitution of $6,527 to BWC and was sentenced to one day in jail, suspended for time served.

John Bezusko, Tacoma, Washington, Working and Receiving
Injured on the job in 1991, Bezusko pleaded guilty to workers’ compensation fraud March 5 after investigators found him working in Colorado while collecting BWC benefits. Bezusko must pay $19,530 in restitution to BWC and serve five years probation for the first-degree misdemeanor, according to his sentence in a Franklin County courtroom.

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

Northeast Ohio man charged in $684K work comp/Social Security fraud scheme

Voicemail greeting exposes scheme

 

Thomas H. Cannell’s friendly voicemail greeting blew his cover, and now the fireplace salesman from northeast Ohio faces potential prison time and a bill for more than $684,000 for defrauding the Ohio Bureau of Workers’ Compensation (BWC) and the Social Security Administration for decades.

The 62-year-old Cannell, a resident of Northfield Village in Summit County, was charged with theft of government funds and wire fraud Wednesday in the United States District Court in Cleveland after BWC discovered him concealing work income since 1993 while collecting $204,761 in permanent total disability benefits from BWC and $479,288 in Supplemental Security Income from Social Security.

“One of our claims specialists returned a phone call from Mr. Cannell in 2015 and heard the voicemail greeting, ‘Hello, you have reached Tom at Your Fireplace Shop,’” said Jim Wernecke, director of BWC’s special investigations department. “We took it from there.”

Wernecke said Cannell concocted a scheme to avoid being paid directly by the Summit County business owner. He said the owner had no knowledge of anything illegal going on and cooperated fully with BWC and Social Security investigators.

Sentencing for Cannell has not yet been scheduled. According to the U.S. Attorney for the Northern District of Ohio’s office, the court will first review Cannell’s prior criminal record, if any, his role in the offense and other characteristics of the violation. In all federal cases, the sentence will not exceed the statutory maximum. In most cases, it will be less.

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

For Cleveland man, there’s something about workers’ comp fraud

Habitual offender, already in prison, convicted for fifth time on fraud-related charges

Kenneth L. Gilmore doesn’t give up easily, even if the price means prison, probation and steep financial penalties.

After three previous convictions for crimes against the Ohio Bureau of Workers’ Compensation, the 54-year-old Cleveland man found himself in court again on April 2, where he pleaded guilty to workers’ compensation fraud and other felonies in connection with deceiving hospitals to obtain prescription painkillers.

“Mr. Gilmore filed a legitimate injury claim with us in 2001, but since then he’s filed several fake claims to obtain narcotics and have us pay for it,” said Jim Wernecke, director of BWC’s special investigation department.

Taking a break from the Lorain Correctional Institution, where he’s serving a 27-month sentence on similar charges in a federal case, Gilmore pleaded guilty last week in the Lorain County Court of Common Pleas to 10 felonies. They include three counts of forgery, a fifth-degree felony (F5), three counts of tampering with records (F3), two counts of deception to obtain dangerous drugs (F2), one count of workers’ compensation fraud (F5) and one count of theft (F5). He was sentenced to 30 months in jail, to be served concurrently with his federal sentence, and ordered to pay BWC $6,075 in restitution.

Gilmore’s previous BWC-related convictions occurred in 2003, 2008 and 2010. The most recent case stems from 2013 and 2014, when he filed false applications for injured-worker benefits at a hospital emergency department in Lorain and at another in Twinsburg in Summit County. The companies he listed as his employers later confirmed Gilmore never worked for them. Gilmore confessed as much when interviewed by BWC agents.

In the federal case, Gilmore posed as an injured U.S. Marshal in 2017 at a Cleveland hospital to obtain narcotics. He was convicted of one count of impersonating a peace officer and five counts of obtaining dangerous drugs by deception.

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

Day care owner guilty of work comp fraud

BWC helps self-insured employer secure case

A Columbus day care owner and nursing assistant pleaded guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud after her former employer reported her to the Ohio Bureau of Workers’ Compensation (BWC) for the crime.

Sharrounda Fuller, 42, must pay $11,514 in restitution to her former employer, a home health care company, and serve five years of probation, according to her sentence in the Franklin County Court of Common Pleas.

“The employer is self-insured, so it was paying Ms. Fuller’s benefits out-of-pocket when it learned she had opened a day care center out of her home” said Jim Wernecke, director of BWC’s special investigations department. “After the company asked for our assistance in pursuing criminal charges, we discovered she also had worked for three other home health care businesses while collecting disability benefits.”

Wernecke said that while self-insured companies manage their own workers’ compensation programs, BWC will investigate alleged fraud cases on their behalf, because “workers’ comp fraud impacts all of us.”

“Workers’ comp benefits are for people who legitimately can’t work because they were injured on the job,” he said. “When people cheat the system, it just drives up the costs for all the honest stakeholders in the system.”

In other news, a northwest Ohio man who remodeled bathrooms, convenience stores and performed other construction work while collecting BWC benefits was found guilty Wednesday of a first-degree misdemeanor count of workers’ compensation fraud.

A Franklin County judge ordered Scott J. Jones of Perrysburg to pay BWC $3,957 in restitution by Oct. 30 this year or face 45 days in jail. Jones paid $1,000 toward the restitution Wednesday morning.

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

Ohio Safety Congress & Expo for 2018: Another complete success

By Jeff Baker, Program Administrator, BWC Special Investigations Department

As part of our Special Investigations Department (SID) mission to effectively and proactively prevent losses to the workers’ compensation system and to deter, detect, investigate and prosecute workers’ compensation fraud, we recognize the importance of educating and informing our stakeholders about how they may join us to combat fraud.

That’s why we annually schedule and conduct dozens of fraud presentations to groups of internal and external stakeholders throughout the state.

On March 7 and 8, at the Ohio Safety Congress & Expo 2018, Shawn Fox, a SID special agent in charge, facilitated a workers’ compensation fraud presentation and Josh Grappy, a forensic computer specialist with the SID digital forensics unit, conducted a session on commercial uses, regulations and best practices for drones.

This annual event was another complete success. To a packed house, we shared techniques used to combat workers’ compensation fraud and to investigate safety violations. In the photo above SID Special Agent in Charge Shawn Fox walks attendees of a BWC Safety Congress & Expo through the steps he and his staff take when investigating a fraud allegation.

SID employees consistently promote fraud prevention strategies to stakeholders by means of social media, articles in periodicals, and presentations, such as participation in the annual Ohio Safety Congress & Expo, safety councils, MCOs and community-based organizations. These efforts educate, inform and build understanding of the BWC’s overall mission “to protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates.”

Since July 1, 2017, SID has conducted 51 fraud presentations describing and demonstrating how we accomplish our mission. Our SID employees share examples of successful cases and furnish all attendees with the means to detect and report suspected fraud.

We welcome requests for fraud presentations from all interested organizations. To schedule a fraud presentation, simply e-mail your request to Jeffrey.B.1@bwc.state.oh.us and we will promptly contact you to discuss your group’s event.

We hope you’ll contact us and look forward to meeting you soon!

For more details pertaining to our fraud prevention efforts, view our Annual Report here.

Graphic artist guilty of work comp fraud

Former Ohioan found working in Colorado

A former Ohioan injured on the job in 1991 pleaded guilty to workers’ compensation fraud March 5 after investigators found him working in Colorado while collecting injured workers’ benefits from the Ohio Bureau of Workers’ Compensation (BWC).

John W. Bezusko, 50, must pay $19,530 in restitution to BWC and serve five years probation for the first-degree misdemeanor, according to his sentence March 5 in a Franklin County courtroom.

“We reviewed bank records, emails and other evidence showing Mr. Bezusko worked as a graphic designer for his home-based business while living in Grand Junction, Colorado,” said Jim Wernecke, director of BWC’s special investigations department (SID).

Also last week, a judge ordered Eric Payne of Hamilton, Ohio, to pay BWC $4,065 in restitution and serve two years probation after Payne pleaded guilty March 6 to a fifth-degree felony count of workers’ compensation fraud. The judge also warned Payne that if he violates his probation, he must serve 11 months in prison.

SID investigators found Payne working as a building inspector and a temporary laborer for a mobile home park while collecting more than $8,000 from BWC in 2015.

In other news, SID secured two fraud convictions in February.

Charles Malone, of Lancaster, pleaded guilty Feb. 12 to a first-degree misdemeanor count of workers’ compensation fraud after he was discovered working for a heating and air conditioning company while simultaneously collecting benefits. A Franklin County judge sentenced Malone to 180 days in jail, suspended for five years of community control (probation), under the condition that he maintains employment and pays $6,879 in restitution.

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

Central Ohio man convicted of work comp fraud

Employment scheme implicates girlfriend

A Lancaster man must pay the Ohio Bureau of Workers’ Compensation nearly $7,000 in restitution after pleading guilty to workers’ compensation fraud Monday for a scheme that could land his girlfriend in court as well.

Charles Malone, 43, worked for a heating and air conditioning company for six months in 2016 while simultaneously collecting injured worker benefits from BWC. To hide his employment, he duped his employer into issuing his paychecks to his girlfriend in her name.

“He gave his employer a plausible explanation, and they fell for it,” said Jim Wernecke, director of BWC’s special investigations department. “As for the girlfriend, she could also face charges for her role in helping Mr. Malone defraud our agency.”

A judge in the Franklin County Court of Common Pleas sentenced Malone to 180 days in jail, the maximum for a first-degree misdemeanor. He then suspended the jail sentence for five years of community control (probation) under the condition that Malone maintains employment and pays BWC $6,879 in restitution.

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

BWC secures three convictions in January

Two for work comp fraud, one for lapsed coverage

A funeral home worker and two cleaning company owners owe the Ohio Bureau of Workers’ Compensation $30,000 after pleading guilty to workers’ compensation fraud or related charges in January, the bureau’s first convictions of the new year.

“It’s thanks to honest citizens who report suspected fraud that we’re able to investigate many of our cases and stop this criminal activity in its tracks,” said Jim Wernecke, director of BWC’s special investigations department (SID). “The money we recover from people trying to cheat our system will go where it rightfully belongs — taking care of injured workers and helping employers create safer workplaces across this state.”

Those convicted include:

Oran Lewis of Columbus, Working and Receiving — Acting on a tip, investigators surveilled Lewis and uncovered evidence proving he worked for two funeral homes as a funeral procession escort on multiple occasions while collecting injured worker benefits from BWC.

Lewis pleaded guilty on Jan. 24 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 180 days in jail, which was suspended for one year of community control (probation). He must pay $10,442 in restitution to BWC.

Amanda Joy Klapp of Hudson, Ohio, dba Amanda Joy Cleaning Company LLC, Under Reporting Payroll — BWC’s employer fraud team received an anonymous allegation that Klapp was operating her business without workers’ compensation coverage. Agents discovered that Klapp had employees when she opened her business in 2013, but she didn’t secure BWC coverage until 2015. She then intentionally under-reported her payroll to avoid paying a higher premium. When she stopped paying her premiums and her policy lapsed, she attempted to take out a new policy using her husband’s name to avoid paying the balance owed on her original policy.

Klapp pleaded guilty Jan. 9 to three counts of workers’ compensation fraud, all first-degree misdemeanors, in Stow Municipal Court in Summit County. A judge sentenced her to 180 days in jail with 150 days suspended and ordered her to serve 30 days of house arrest. The judge fined Klapp $500 on each count, then suspended half the total. The judge ordered Klapp to bring her workers’ compensation coverage into compliance within 30 days and to pay $14,000 in restitution to BWC.

Robert Settlemoir of Columbus, dba Pro Clean Carpet and Upholstery, Lapsed Coverage — Investigators found Pro Clean Carpet and Upholstery had been operating since 2011 without workers’ compensation coverage. BWC attempted to work with Settlemoir to bring his policy into compliance, but Settlemoir failed to take the necessary steps.

Settlemoir pleaded guilty on Jan. 25 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, suspended for two years of community control. Conditions of community control are that Settlemoir obtain employment and pay restitution of $5,482 to BWC.

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