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

A claims service specialist (CSS) in the Dayton service office received the 2016 Fraud Finder of the Year award Jan. 26 from BWC’s Special Investigations Department (SID).

The CSS received the award for alerting SID to a case in which an injured worker claimed to be wheelchair bound and unable to ambulate. Surveillance video in SID’s subsequent investigation, however, showed the claimant shopping, going to the movies and climbing steps at a football game, all without a wheelchair or assistance of any kind.

“Thanks to this CSS’s vigilance and timely referral, we were able to stop fraud in its tracks and save the BWC system tens of thousands of dollars, if not more,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects scarce resources needed to create safe workplaces in Ohio and to take care of those who are legitimately injured on the job.”

The CSS, who handles permanent total disability cases, said she was delighted to receive the award.

“I was surprised,” she said. “It makes you feel good to be recognized.”

SID received 2,700 allegations of fraud in 2016, with about a fourth of those coming from BWC personnel around the state — claims representatives and others who suspect illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system.

To show their appreciation, SID leaders conducted a thank-you tour from November through mid-February, presenting Fraud Finder Award certificates to CSSs 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 or visit bwc.ohio.gov.

Foul! Bowling coach crosses the line, commits work comp fraud

A Marion man who was injured on the job as an emergency medical technician in 2010 pleaded guilty to workers’ compensation fraud Tuesday after investigators discovered him working as a high school bowling coach.

After Jason Neagles, 43, pleaded guilty to the first-degree misdemeanor charge, a Franklin County judge ordered him to pay the Ohio Bureau of Workers’ Compensation (BWC) $1,587 for the cost of the agency’s investigation. He warned Neagles to pay BWC within 90 days or face 90 days in jail.

BWC’s Special Investigations Department found a database cross match with the Ohio Department of Job and Family Services indicating Neagles earned wages during periods he also collected temporary total disability benefits from BWC. The subsequent investigation proved Neagles worked as a bowling coach for Ridgedale High School in Marion.

BWC collected $14,697 in restitution prior to Neagles’ sentencing.

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

BWC secures 13 fraud convictions in January

Work comp cheats owe more than $66K

BWC is owed more than $66,000 in restitution from claimants and employers who were convicted and sentenced in January on fraud-related charges.

That total will likely grow, as three of the 13 claimants convicted last month still await sentencing.

“Workers’ comp cheats raise the costs for everyone else in the system,” said BWC Administrator/CEO Sarah Morrison. “The money we recoup from these cases will go where it rightfully belongs — caring for those who are legitimately injured on the job and creating safe workplaces across Ohio.”

Those convicted include:

Ruth Shelhart-Holleran of Hilliard, Ohio — Working and Receiving
BWC’s Special Investigations Department found Shelhart-Holleran was working while receiving BWC benefits after finding her name in a cross match with the Ohio Department of Job & Family Services. Shelhart-Holleran pleaded guilty Jan. 30 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. A judge set restitution at $8,366.

Edgardo Ocasio of Cleveland, Ohio — Working and Receiving
Acting on a tip, investigators found Ocasio working as a mechanic while receiving BWC benefits. Ocasio pleaded guilty Jan. 30 in Franklin County to one count of workers’ compensation fraud, a first-degree misdemeanor. He was ordered to pay $2,522 in restitution. Additionally, he was sentenced to a three-month suspended jail sentence and put on community control for three years.

Robert Beasley of Cleveland, Ohio — Working and Receiving
Beasley must pay $7,065 in restitution after pleading guilty Jan. 26 to a misdemeanor count of workers’ compensation fraud. A Franklin County judge also sentenced Beasley to three years of community control after suspending a 180-day jail sentence. Investigators found Beasley working as a cleaner while receiving BWC benefits.

Frederic Dasse of Canal Winchester, Ohio — Working and Receiving
Investigators found Dasse working two jobs while receiving BWC benefits. Dasse pleaded guilty Jan. 25 in Franklin County to one misdemeanor count of workers’ compensation fraud. A judge ordered Dasse to pay $5,472 in restitution to BWC by July 25 or face 180 days in jail.

Brenda Fletcher of Delaware, Ohio — Working and Receiving
Undercover investigators found Fletcher working as a bartender while receiving BWC benefits. Fletcher was found guilty Jan. 18 by a jury in Delaware County on one count each of workers’ compensation fraud and theft, both fourth-degree felonies. Fletcher is scheduled to be sentenced Feb. 27.

Roland Samons, dba Shafer Brothers Body Shop, of Ironton, Ohio — Lapsed Coverage
Samons pleaded guilty Jan. 18 in Lawrence County to one count of attempted workers’ compensation fraud, a first-degree misdemeanor, after failing to establish a payment plan for unpaid BWC premiums. He was sentenced to a six-month suspended jail sentence and placed on probation for three years. He was ordered to pay $5,687 in restitution.

Jason E. Chamberlin of Kingston, Ohio — Working and Receiving
Chamberlin pleaded guilty to a misdemeanor count of workers’ compensation fraud Jan. 12 in Franklin County. He must pay nearly $5,918 in restitution after investigators found him working as a prison guard while collecting injured workers’ benefits. He also must serve five years probation.

Andrea Menendez, dba Spring Clean Maids, of Warren, Ohio — Lapsed Coverage
Menendez pleaded guilty Jan. 12 in Warren Municipal Court to one count of failure to comply, a second-degree misdemeanor, for failing to pay premiums owed to BWC. She was sentenced to three years probation and ordered to pay court costs and to bring her company into BWC compliance. She paid $1,000 toward her past-due balance of $3,884.

Tony Harn of Columbus, Ohio — Falsified Wages
Investigators started looking at Harn after learning he had filed a suspicious wage earnings statement with BWC, a document needed to calculate his injured workers’ benefits. Harn pleaded guilty Jan. 9 in Franklin County to one count of workers’ compensation fraud and one count of theft, both misdemeanors of the first degree. A judge ordered Harn to pay $12,861 in restitution and sentenced him to 180 days in jail on each count. The judge then suspended the jail sentence and placed Harn on two years of community control.

William Seckler of Andover Village, Ohio — Working and Receiving
Investigators found Seckler working as a delivery driver for an Amish roofing company while receiving BWC benefits. Seckler must pay BWC $14,520 in restitution and $2,530 in investigative costs after pleading guilty to workers’ compensation fraud Jan. 3 in Franklin County. A judge also ordered Seckler to serve 180 days in jail, suspended, and four years of community control for his crime, a first-degree misdemeanor.

Limo driver takes work comp system for a ride, now owes BWC $80,000

robert-willie-jr-booking-photoA former school bus driver caught working as a limousine driver while receiving injured workers’ benefits must pay the Ohio Bureau of Workers’ Compensation $80,000 and serve five years probation.

“Thanks to responsible citizens who report fraud, we were able to stop a workers’ comp cheat and return BWC dollars to their rightful purpose — creating safer workplaces across Ohio and helping workers who are legitimately injured on the job,” said BWC Administrator/CEO Sarah Morrison.

Robert Willie, Jr., 57, of Columbus, pleaded guilty Tuesday in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. In addition to restitution and probation, a judge warned Willie that he would serve six months in jail if he violated the terms of his probation.

Willie started collecting BWC benefits in 2010 after getting injured while working as a school bus driver. Acting on an anonymous tip to the BWC Fraud Hotline, BWC’s Special Investigations Department reviewed bank and employment records and found Willie had worked off and on for much of the time between March 2010 and May 2015, all while collecting BWC benefits. Willie worked as a limousine driver and office clerk for a Columbus company.

A photo of Willie can be found here.

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

Lapsed coverage leads to court convictions for two Ohio employers

A southern Ohio body shop owner must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $6,000 for not carrying workers’ compensation coverage while running his business.

Ironton resident Roland Samons, owner of the Shafer Brothers Body Shop, pleaded guilty Jan. 18 to one count of attempted workers’ compensation fraud, a first-degree misdemeanor. A Lawrence County judge sentenced Samons to six months in jail before suspending the sentence and placing Samons on three years probation. Probation will terminate sooner once Samons pays BWC $5,686 in restitution.

BWC’s Special Investigations Department (SID) determined Samons failed to carry proper coverage from January 2010 through December 2014.

In another recent court case, the owner of a cleaning service company in northeast Ohio must pay BWC nearly $4,000 to bring her BWC policy into compliance after pleading guilty Jan. 12 to a second-degree misdemeanor count of failure to comply.

A Warren Municipal Court judge also sentenced Andrea Menendez, who with her husband owns Spring Clean Maids, to three years probation. At sentencing, Menendez provided documentation showing she had already paid $1,000 toward her BWC debt of $3,884.

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

Cross match in state agency databases leads to fraud convictions

A routine check on injured worker names through state agency databases led to convictions this week of two Ohio men on workers’ compensation fraud charges.

Investigators with the Ohio Bureau of Workers’ Compensation (BWC) ran the workers’ names by the Ohio Department of Job and Family Services and found records indicating they were employed while concurrently receiving temporary total disability benefits from BWC.

dasse-booking-photoFrederic Dasse, 44, of Canal Winchester, pleaded guilty Wednesday in a Franklin County court room to one misdemeanor count of workers’ compensation fraud.

A judge ordered Dasse to pay $5,472 in restitution to BWC by July 25 or face 180 days in jail.

beasley-booking-photoIn a separate and unrelated case, Robert Beasley, 56, of Cleveland, must pay BWC $7,065 in restitution after pleading guilty Thursday to a misdemeanor count of workers’ compensation fraud.

The judge also sentenced Beasley to three years of community control after suspending a 180-day jail sentence.

BWC’s Special Investigations Department discovered Dasse, a security guard when he was injured in 2013, was working two jobs while receiving BWC benefits. They found Beasley working as cleaner for a Cleveland-area company while receiving benefits.

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

Prison guard cheats workers’ comp system, must reimburse BWC

jason-chamberlin-booking-photoA Ross County prison guard must pay the Ohio Bureau of Workers’ Compensation nearly $6,000 in restitution after investigators found him working while collecting injured workers’ benefits.

Jason E. Chamberlin of Kingston, about 11 miles northeast of Chillicothe, pleaded guilty to a misdemeanor count of workers’ compensation fraud Jan. 12 in the Franklin County Court of Common Pleas.

BWC’s Special Investigations Department (SID) got a tip in 2015 that Chamberlin might be working after a representative from a managed care organization called him at home and was told he was at work. The investigation revealed Chamberlin knowingly returned to work at the Chillicothe Correctional Institution while receiving temporary total disability benefits. He failed to notify BWC that he returned to work and he continued to withdraw payments from his BWC debit card.

A judge sentenced Chamberlin to 180 days in jail, but suspended the jail term for five years probation. The probation could terminate sooner if Chamberlin pays full restitution, $5,918, in less time.