Bait shop owner caught on video, working while receiving workers’ comp

Columbus – A Cleveland (Cuyahoga County) man was sentenced July 21 in the Franklin County Court of Common Pleas on one count of workers’ compensation fraud, a first-degree misdemeanor. Anthony A. Avancini pleaded guilty to the charge on the same day.

“A doctor’s note tipped off one of our claims service specialists, who reported potential fraud,” said BWC Administrator/CEO Steve Buehrer. “Our Special Investigations Department will not waiver in its efforts to seek justice in cases where claimants, employers and medical providers commit workers’ compensation fraud.”

SID received an allegation from a claims service specialist supervisor that a doctor’s note stated Avancini “owns a store, now works mostly at a sitting job.” Forms submitted to BWC were faxed from a bait and tackle business. Investigators captured surveillance footage showing that Avancini was involved in the day-to-day business and operation of Stink’s Bait and Tackle in Cleveland from September 2013 to June 2014 while receiving temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit.

In November 2014, the Industrial Commission of Ohio issued an order finding an overpayment of temporary total disability compensation in Avancini’s claim between September 2013 and June 2014 due to fraud.

Avancini was sentenced to 180 days in jail, which was suspended for two years of community control. He must maintain employment and pay $4,276.40 in restitution to BWC.

Surveillance footage from the case is available here. A picture of Avancini is available here.

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

Spotlight: Our college interns

BWC’s Special Investigations Department (SID) created its college relations program in 1995 to promote the study and practice of criminology, criminal justice, law enforcement and public administration. On college and university campuses throughout Ohio (and beyond), SID staff members exchange insights with students, faculty and staff members on how to combat crime.

Since the program began 20 years ago, SID has recruited, selected and trained more than 300 paid interns and unpaid externs. Many have gone on to become law enforcement officers, criminal investigators, special agents, digital forensic analysts, assistant special agents in charge and special agents in charge.

We currently employ nine SID interns, many of whom were interviewed for this article.

The SID college relations program has expanded to a variety of universities, including The Ohio State University, Ohio Dominican University, the University of Akron, Columbus State Community College, Cuyahoga Community College and Champlain University.

The current SID interns work in specialized units, such as the digital forensics, intelligence, security and special investigations units (SIUs).

“I liked sitting with each member and having them walk us through what they do and how they do it,” said intelligence unit intern Courtney Kozak.

These interns aren’t simply getting coffee or food for their co-workers either; they have many important duties for the SID. As an intern for both the Columbus SIU and the digital forensics unit, Carlos Gonzalez has great deal of responsibilities and duties.

“I have assisted with investigations to document fraudulent activities, gathered information for case support, documented research and acquisition, assisted with translation, analyzed internet-based software and collected intelligence using open-source tools to assist ongoing investigations,” said Columbus special investigations unit and digital forensics unit intern Carlos Gonzalez.

Many of the interns, such as Jennifer Thomas from the intelligence unit, have deemed their work to be a beneficial experience due to exposure to a variety of areas within the department, such as healthcare and digital forensics.

Security intern Brad Horstman appreciated getting the chance to visit the Ohio Department of Homeland Security headquarters as well as the Ohio State Highway Patrol Criminal Intelligence Center.

“It was a beneficial experience to get a firsthand look at how these different departments and centers operate,” Horstman said.

Most of our current interns are studying criminology and criminal justice, but there are exceptions. One, for example, is double majoring in accounting and finance.

Career goals and aspirations are diversified among these interviewed interns.

Taylor Scarberry, a college intern on a regional claimant SIU team, wants to work for a federal government agency. Kozak, on the other hand, hopes to eventually become a forensic accountant for a government agency. Horstman is keeping his options open.

The SID college relations program has been successful in hiring interns with a variety of backgrounds, majors and career goals who quickly become vital assets to BWC’s efforts to fight workers’ compensation fraud. We use feedback like this from our interns to continually improve our program.

If you’re enrolled at a college or university and interested in joining our team as an intern, contact our college relations program coordinator, Jeff Baker.

Categories: News Articles

Akron woman ordered to pay $11K for workers’ comp fraud

Jessica Price, of Akron (Summit County), pleaded guilty and was sentenced July 13 in the Franklin County Court of Common Pleas on one count of workers’ compensation fraud, a first-degree misdemeanor.

SID received an internal allegation from a claims service specialist that Price never answered her cell phone and returned calls from a home health care company. Investigators found that Price returned to work as a secretary while receiving temporary total disability and living maintenance benefits. Injured workers are not permitted to work while receiving temporary total disability benefits.

In November 2014, the Industrial Commission of Ohio issued an order that $8,156.19 in workers’ compensation benefits was overpaid to Price due to fraud.

Price was sentenced to six months of incarceration, which was suspended for five years of community control. As a condition of community control, she must pay $8,156.19 in restitution and $2,910.98 in investigative costs to BWC.

Clermont County man ordered to pay $7K in restitution for workers’ comp fraud

Columbus – A Milford (Clermont County) man was sentenced July 10 in the Franklin County Court of Common Pleas on one count of workers’ compensation fraud, a first-degree misdemeanor, and one count of forgery, a fifth-degree felony. Douglas Vastine previously pleaded guilty to these charges.

“Assisting injured workers as they transition back to work or seek new employment is vital to supporting their overall recovery,” said BWC Administrator/CEO Steve Buehrer. “However, we must also root out fraud like that perpetrated by Mr. Vastine to ensure benefits go only to those who qualify and protect the dollars Ohio employers pay into the State Insurance Fund.”

BWC received an allegation that Vastine was possibly falsifying job searches he submitted to BWC for disability benefits. Investigators found that Vastine did falsify job searches to qualify for living maintenance wage loss benefits between January and April 2013, and that many of the jobs and job locations he said he applied for did not exist, or the employers did not have any record of job applications from him. He received $6,337.30 in wage loss benefits he would have otherwise been ineligible to receive. Investigators also discovered that Vastine submitted $902.48 in false travel reimbursement forms to BWC for traveling to job searches that were proven false.

Vastine was sentenced to serve six months in jail for each count concurrently, which was suspended for two years of community control. Vastine must pay $7,239.78 in restitution to BWC, maintain employment and not have any new offenses.

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

Coming soon…SID’s annual report

Each year, we furnish an annual report of SID’s performance, strategic initiatives and fraud trends, and this year isn’t any different.

The SID team is currently reviewing operations, assessing performance outcomes and tallying the results achieved throughout fiscal year 2015, which concluded June 30. Since fiscal year 2001, this year-end process has culminated in the annual late July publication of our SID annual report.

Although we’re still finalizing the latest report, we’re pleased that it appears we will surpass our outstanding results from fiscal year 2014. View the entire 2014 annual report here.

SID diligently works behind the scenes. Our investigative staff makes sure that those with legitimate work-related injuries are receiving needed benefits and medical care, and that employers and medical providers are fulfilling workers’ compensation requirements. Those who do not follow the law are handled accordingly. In this upcoming report, we will draw attention to some of our successes in the past year, profile interesting and noteworthy fraud cases, and provide a preview of our new strategic practices and initiatives.

The report will also offer achievements of respective teams and task forces, as well as shine a spotlight upon their operational trends and strategies. This year’s report will include a summary of presentations facilitated by SID employees.

As we create and finalize the annual report, we continue to deter, detect and investigate fraudulent behavior. On July 1, we commenced the work that will be included in our fiscal year 2016 annual report.

Criminals do not take time off, and neither do we.

Categories: News Articles

Former Cuyahoga County man ordered to pay $9k for workers’ comp fraud

Columbus – A Duncan, Oklahoma, man has been ordered to repay $9,000 to the Ohio Bureau of Workers’ Compensation (BWC) after it was discovered he was working while receiving benefits for a workplace injury. Charles Jewell, formerly of Cuyahoga County, pleaded guilty June 29 to one count of workers’ compensation fraud, a felony of the fifth degree.

“Moving to another state and working there does not excuse one from following Ohio’s workers’ compensation laws,” said BWC Administrator/CEO Steve Buehrer. “Mr. Jewell committed a crime when he knowingly returned to work and concealed that employment from BWC. We’re pleased we received an anonymous tip in this case and encourage calls from anyone who suspects criminal behavior.”

BWC’s Special Investigations Department began investigating after receiving an anonymous allegation that Jewell was working as a taxi driver for a business he owned in Duncan, Oklahoma.

Investigators traveled to Oklahoma to interview witnesses and compiled evidence proving Jewell returned to work while concurrently receiving permanent total disability benefits from December 2009 to September 2014. He failed to notify BWC of his return to work, and took steps to conceal his employment from BWC.

Jewell was sentenced in the Franklin County Court of Common Pleas to a seven-month prison term, which was suspended for three years of community control. As a term of his community control and suspended prison sentence, he was ordered to pay $9,000 in restitution to BWC.

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

BWC investigations result in 10 workers’ comp fraud convictions in June

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that 10 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in June 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“Whether it’s an employer failing to pay workers’ comp premiums, a medical provider doling out prescriptions without evaluating patients, or claimants secretly working while improperly receiving disability benefits, BWC does not take workers’ compensation fraud lightly,” Buehrer said. “Funds that are recovered thanks to SID’s efforts are returned to the State Insurance Fund to care for injured workers who are truly injured, and to keep employer premiums as low as possible.”

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

Tina Trill, doing business as TEP Bedding Group Inc. (Orwell, Ashtabula County), pleaded guilty June 1 in the Ashtabula County Court of Common Pleas to one count of obstructing official business, a second-degree misdemeanor. BWC’s employer fraud team received an allegation from the agency’s collections department that the employer submitted a workers’ compensation premium payment that was dishonored by the bank, and the policy lapsed. The employer submitted outstanding payroll reports, but didn’t make any other attempts to bring the policy into compliance with the law. Trill paid $12,000 in restitution to BWC.

James Crist, of Middletown (Butler County), pleaded guilty and was sentenced June 2 in Middletown Municipal Court on one count of workers’ compensation fraud, a first-degree misdemeanor. A BWC employee alerted SID that Crist was difficult to contact during the day and that machinery was sometimes heard running in the background during telephone calls. Investigators found that Crist returned to work for his own business, Crist Construction LLC, while collecting temporary total disability benefits from November 2010 to August 2011. Claimants are not permitted to work while receiving this type of benefit. Crist paid $21,579 in restitution before entering his plea in court, and paid $4,155.07 to cover the fraud investigation costs on the same day he appeared in court. He was given a suspended sentence of 180 days in jail and was also fined $500.

Laurie Nesit, of Akron (Summit County), pleaded guilty June 8 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. BWC became aware through a data cross-match with the Ohio Department of Job and Family Services that Nesit received wages and temporary total disability benefits from BWC during the same time period. Claimants are not permitted to work while receiving this type of benefit. Investigators found that Nesit returned to work as an inspector for two businesses from April to May 2013, and from July 2013 to January 2014, while receiving temporary total disability benefits. In August 2014, an Industrial Commission hearing officer issued an order finding an overpayment of BWC benefits for those time periods. The hearing officer also issued a finding of fraud relative to the declared overpayment. Nesit was sentenced to serve 11 months in jail, which was suspended for five years of community control. She was ordered to pay $23,847 in restitution to BWC and ordered to maintain employment.

Melony Belcher, of Toledo (Lucas County), was granted into a criminal diversion program June 17 in the Lucas County Court of Common Pleas. SID received an allegation through BWC’s fraud hotline that Belcher may have returned to work while collecting workers’ compensation benefits from her self-insured employer. Investigators discovered that Belcher returned to work from February to April 2014 as a full-time elder assistant for a Monclova business while collecting temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit. In addition to the criminal diversion program, which she must remain in for two years, Belcher was ordered to repay $2,696.70 in restitution to the self-insured employer.

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

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

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