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Archive for May, 2011

BWC Investigations Result in 10 Workers’ Comp Fraud Convictions in April

Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Stephen Buehrer today announced 10 individuals were convicted or pleaded guilty to charges related to defrauding Ohio’s workers’ compensation system during the month of April. The court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID), which works to deter, detect, investigate, and prosecute workers’ compensation fraud.

“BWC continues to mount an aggressive attack on fraud in order to protect Ohio’s workers’ comp system and keep employers’ premiums down,” said Buehrer. “While there unfortunately never seems to be a shortage of cases to investigate, our agents remain persistent in their efforts to track down fraud and put an end to it.”

Following is a sampling of cases that resulted in a guilty plea or conviction during the month of April.

Joseph D. Reed (Castalia, Sandusky County) pleaded guilty to two counts of failure to obtain/maintain workers’ compensation coverage, both fourth degree felonies. A claim was filed against the policy of Reed’s company, Reed’s Supply, after he failed to submit payroll reports but continued to operate with lapsed coverage. During the investigation, payroll reports were obtained and used to calculate premiums and penalties owed in the amount of $33,261.94. On April 26, Reed was sentenced to five years of community control and ordered pay the costs of prosecution, complete 50 hours of community service and make restitution through a payment plan with BWC.

James Slones (Millersport, Fairfield County) pleaded guilty to one count of attempted forgery for falsifying his BWC certificate of coverage in order to make it appear to a potential client that he had the workers’ compensation insurance coverage required to perform remodeling work on their home. BWC began an investigation of Slones, owner of Buckeye Valley Services, after receiving a tip that he altered his BWC certificate. A client of Slone’s was required to submit proof to a lender that the selected contractor (Slones) had valid BWC coverage to complete home remodeling work. SID discovered Slones did alter a BWC certificate belonging to another business. That business owner confirmed he previously provided a copy of his BWC certificate to Slones, who changed the business name and provided it to his client. The lender would not have approved the loan for the remodeling job if it was discovered Slones did not have valid BWC coverage. A judge sentenced Slones April 21 to 45 days of jail suspended and ordered him to pay court costs.

Charles Thoerner (Cincinnati, Hamilton County) pleaded guilty to one count of attempted workers’ compensation fraud, a felony of the fifth degree, for operating with lapsed coverage. Thoerner, owner of Montgomery Flooring, allowed his policy to lapse and during that time accumulated nearly $20,000 in claims resulting from workplace injuries. SID met with Thoerner at his business and advised him that the policy was lapsed. He subsequently failed to submit the missing payroll reports and was served with a subpoena for the information. In October 2009, Thoerner submitted the payroll records but failed to remit payment or request a payment plan. Sentencing is scheduled for May 25, 2011.

Michael Carver (Lucasville, Scioto County) pleaded guilty to one count of workers’ compensation fraud, for working while receiving benefits. Carver became the subject of an investigation in 2008 when an anonymous tip alleged he was working as a pizza delivery driver while concurrently collecting Permanent Total Disability (PTD) benefits from BWC. An investigation found Carver was employed actively as a pizza delivery driver and the Ohio Industrial Commission subsequently terminated his PTD benefits. Carver entered his plea on April 6 and sentencing was scheduled for May 19. Carver will be ordered to pay $58,066.57 in restitution pursuant to the plea agreement.

Daizonia Benton (Cincinnati, Hamilton County) pleaded guilty to one count of workers’ compensation fraud for working while receiving benefits. In January 2009, SID began investigating an allegation that Benton had wages reported while concurrently receiving Temporary Total Disability (TTD) benefits. Investigators discovered that Benton worked at Core Behavioral Health Center/Centerpoint Health, Inc. in Cincinnati in violation of rules that prohibit working while receiving these benefits. A judge will sentence Benton May 26. Benton will be ordered to pay $9,511.20 in restitution and $1,000 in investigative costs pursuant to a plea agreement.

Tammy Peck (Hamilton, Butler County) pleaded guilty April 28 to one count of workers’ compensation fraud, a misdemeanor of the first degree, for working while collecting workers’ compensation benefits. An investigation revealed Peck worked as a bartender at Classic Rock Café and Dotties Bar & Grille while she was collecting Temporary Total Disability. Her job duties included serving drinks, stocking the bar, washing glasses, running the vacuum, and cleaning the bathroom. Peck paid $1,000 in restitution prior to sentencing. A judge then ordered her to pay the balance of $4,406.62 by April 28, 2014, including $2,000 to cover investigative costs.

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Surveillance Video Captures Cleveland Man Committing Workers’ Comp Fraud

Paneto SurveillanceA Cleveland man has been sentenced after an undercover investigation captured video showing his work remodeling homes during a time in which he was receiving workers’ compensation benefits and claimed to be incapable of working. Luiz Paneto pleaded guilty to a fourth degree felony of workers’ compensation fraud in March and was ordered Friday to repay more than $43,000 he fraudulently received from the Ohio Bureau of Workers’ Compensation (BWC).

“Workers’ comp fraud comes in many forms, and we will utilize all of our resourcesto detect, investigate and deter deception wherever it exists,” said BWC Administrator/CEO Stephen Buehrer. “Filing false or exaggerated claims are forms of fraud that are especially disturbing, given there are so many who would like to return to work but have very real injuries that keep them from their livelihoods.”

Paneto was working in construction for a general contractor when he sustained a workplace injury in 2001. He received Temporary Total Disability and Living Maintenance benefits from that time until he was granted Permanent Total Disability in 2007.

Paneto Undercover StillBWC’s Special Investigations Department (SID) received an anonymous complaint in 2009 stating that Paneto was working for a home remodeling company as a laborer and home remodeler. SID conducted surveillance and Paneto was seen walking, lifting heavy construction materials, driving his truck, and performing work as a home remodeler at numerous houses.

Paneto was interviewed at a job site in April, 2010 and admitted to working in violation of his receipt of BWC benefits. He admitted he was doing the same work he had done prior to his injury, and stated he knew he was prohibited from working while receiving Permanent Total Disability benefits. Paneto later attended a BWC hearing on his case wearing a large ankle brace and using the cane to walk.

Luiz Paneto was sentenced on April 29 in the Cuyahoga County Common Pleas Court to five years of community control and ordered to pay restitution of $24,122.47 and another $19,517.67 for investigative costs.

To report fraud online, please visit: http://bit.ly/reportfraud.
To speak with a fraud hotline agent, please call: 1-800-OHIOBWC.

http://www.ohiobwc.com/home/current/releases/2011/050211.asp