Archive

Archive for July, 2011

Columbus Woman Caught Working Four Jobs While On Workers’ Comp

Annette McDaniel must repay more than $19,000 after the Ohio Bureau of Workers’ Compensation (BWC) found she was working four jobs at Columbus area businesses while receiving workers’ compensation benefits for a prior workplace injury.  McDaniel, also known as Annette Fair and Ronette Fair, pleaded guilty to workers’ compensation fraud and was sentenced in a Franklin County courtroom earlier this week.

“McDaniel thought she could get away with working several jobs and also collecting several types of benefits under a number of aliases,” said BWC Administrator/CEO Stephen Buehrer.  “Our Special Investigations Department is a step ahead of her and other fraudsters with access to automated detection tools that bring attention to irregularities they hope will go unnoticed.”

In August 2007, BWC’s Special Investigations Department opened an investigation after a database cross-match conducted with the Ohio Department of Job and Family Services raised red flags.  The database reported McDaniel worked for KC Men’s Clothing while she was collecting Temporary Total Disability and Living Maintenance Wage Loss benefits from BWC.   The investigation confirmed McDaniel not only worked for KC Men’s Clothing, but also for AmeriCoat, Value City Department Stores and Adecco USA during the periods she collected these benefits.

On July 18, McDaniel pleaded guilty to a felony count of workers’ compensation fraud and was sentenced to a suspended sentence of eight months incarceration suspended and five years of community control. As a condition of the community control, McDaniel was ordered to pay restitution in the amount of $17,064.25 as well as investigative costs in the amount of $2,500 and court 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/2011/072211.asp

BWC Investigations Result in 11 Workers’ Comp Fraud Convictions in June

Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Stephen Buehrer today announced 11 individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers’ compensation system during the month of June. 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.

“Our Special Investigations Department continues to do an outstanding job of catching up to these fraudsters and holding them accountable for their actions,” said Buehrer. “Our hope is that by highlighting these actions in the media and through our newly launched Special Investigations Facebook page, we can deter those who would defraud Ohio’s injured workers and businesses.”

Earlier this week, BWC launched a Special Investigations Facebook page that can be found at www.facebook.com/ohiobwcfraud. It includes news on recent investigatory action, a most-wanted section and a link to report fraud.

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

Sharlyn Adams (Cincinnati, Hamilton County) pleaded guilty to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. Investigators found that Adams had returned to work while receiving Temporary Total Disability benefits for performing the same type of work she was performing at the time of her industrial injury. While collecting disability, Adams was working for the Catholic Residential Services Nursing Home. Adams was sentenced to 180 days in jail suspended and she was placed on probation for five years. She was also ordered to pay restitution of $3,661.29 and an additional $1,000 for investigative costs.

John Bou-Sliman (Port Clinton, Ottawa County) pleaded guilty to one count of workers’ compensation fraud for failing to make premium payments and maintain coverage for his restaurant business, The Jolly Roger. His workers’ compensation policy lapsed in September 2007 after his premium check bounced. Bou-Sliman was informed of his lapsed status and when agents later served him with a second notice, he assured them he would take the necessary steps to make the payment and have his policy reinstated. He failed to make any new payments within the allocated time frame and the policy remained lapsed. On June 14, 2011, Bou-Sliman pleaded guilty as part of a plea deal. Sentencing has been scheduled for August 8, 2011.

William Burchfield (Lancaster, Fairfield County) was sentenced for workers’ compensation fraud for operating without coverage. Burchfield, owner of Elite Sewer and Septic, allowed his policy to lapse in 2007 and failed to have it reinstated even after attempts by BWC agents to assist him in returning to compliance. A judge found Burchfield guilty on June 27 and ordered him to pay restitution to BWC in the amount of $300 per month beginning July 28. The judge also ordered five years probation, a suspended jail sentence of 90 days, and ordered him to pay $100 in fines and $95 in court costs.

James Goloversic (Cincinnati, Hamilton County) pleaded guilty to workers’ compensation fraud and two counts of deception to obtain a dangerous drug for using multiple doctors and multiple pharmacies to obtain narcotics. An investigation found Goloversic was obtaining prescriptions from physicians who were not aware he was seeking narcotics from other physicians. Goloversic utilized multiple pharmacies in order to conceal his deception. Goloversic was sentenced June 28 to three years of community control and ordered to pay court costs. The court further ordered that Goloversic must consult only his treating physician if he wishes to seek any narcotic for pain. If he violates the conditions of his community control, he will serve three and a half years in prison.

James Hale (Kenton, Hardin County), owner of Jimmy’s Pizza, was sentenced for operating his business without a workers’ compensation policy. Hale failed to obtain a policy even after BWC agents advised him of his obligation to do so. On June 2, 2011, Hale pleaded guilty to one count of failure to comply, a second degree misdemeanor. He was ordered to pay restitution in the amount of $1,980.67, in addition to a $200 fine. Hale was also sentenced to 90 days jail suspended, one year probation, and was ordered to remain in compliance with all BWC laws and regulations.

April Hupp (Norwalk, Huron County) pleaded guilty to one count of workers’ compensation fraud for working while receiving benefits. SID received an allegation from an employer who received an anonymous tip that Hupp was operating a cleaning business and was babysitting. Investigators found Hupp was employed as a house cleaner and babysitter while receiving Temporary Total Disability benefits. She was ordered to pay restitution of $5,973.51, sentenced to 11 months in prison, suspended, and placed on three years of probation. She was also ordered to obtain employment and perform 40 hours of community service.

Bradford Pirigyi (Warren, Trumbull County) pleaded guilty to four counts of deception to obtain dangerous drugs, all felonies of the fifth degree. SID opened an investigation when Pirigyi filed a claim against an employer BWC was not able to locate and BWC received a request from a doctor for approval to conduct an MRI for an injury unrelated to a Pirigyi’s allowed claim. The doctor’s office indicated Pirigyi advised them that his claim was for a separate injury he sustained while employed with a construction company. Investigators found Pirigyi sought treatment at several different hospitals and doctor’s offices, and attempted to file workers’ compensation claims against businesses that did not exist in order to obtain prescription narcotics. Pirigyi asked for narcotic pain medication during some of the visits. Each claim and the bills related to those claims were denied by the BWC. Sentencing is not yet scheduled.

Jeffrey D. Volz (Buckeye Lake, Licking County) entered a guilty plea to one count of workers’ compensation fraud for working while receiving benefits. SID opened an investigation into Volz after receiving an allegation from TS Tech, Inc. that Volz was working while receiving Temporary Total Disability benefits. An investigation confirmed that Volz was employed by Teleperformance, Acloche and Work Force Network and knowingly concealed his return to work so that he would continue to receive those benefits. Volz appeared in court with a certified check in the amount of $5,623.98 to cover restitution. The judge sentenced Volz to a term of three months of suspended incarceration and he must pay $700 for investigative costs. The incarceration sentence will be imposed if does not pay within six months.

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/2011/071911.asp

BWC Launches Social Media Effort

The Ohio Bureau of Workers’ Compensation (BWC) has entered the world of social media, launching both Twitter and Facebook accounts, each with its own distinctive purpose.

“100 years ago, Ohioans adopted an innovative new system for protecting our employers and workforce,” said BWC Administrator/CEO Stephen Buehrer. “Today, we are using innovations like social media to invite our customers to engage us as we think forward to advancing workers’ compensation in Ohio for the next 100 years.”

OBWC Twitter LogoThe Twitter account (http://twitter.com/ohiobwc) will highlight agency activities, news and information, and distribute updates important to employers, injured workers, medical providers, safety professionals and Ohio’s entire workers’ comp community. As a nod to the 100th anniversary of workers compensation in Ohio, the first Tweet was a link to a commemorative video titled Looking Back, Thinking Forward. June 15 marked the 100 year anniversary of the 1911 signing of the Ohio Workmen’s Compensation Act, which made Ohio one of the first states in the nation to offer workers’ compensation insurance.

SID Twitter LogoThe Facebook page (www.facebook.com/ohiobwcfraud) will focus on the bureau’s fraud investigation efforts. The BWC Special Investigations Department will use the page in their efforts to deter, detect, investigate, and prosecute workers’ compensation fraud. It includes news on recent investigatory action, a most-wanted section and a link to report fraud.

BWC is a non general-revenue fund state agency that provides workers’ compensation insurance for 230,000 Ohio employers and covers approximately two-thirds of Ohio’s workforce. With approximately $2.1 billion in annual premium and assessment income, BWC is the largest state-fund system in the United States and one of the top 10 underwriters of workers’ compensation insurance in the nation.

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/2011/071811.asp

Zannoni Sentenced for Fraud Related to Improper Prescribing and Billing

Zannoni UC Screenshot

Dr. Jean Zannoni

Dr. Jean Zannoni of Parma (Cuyahoga County) has been sentenced to two years probation and ordered to pay more than $7,500 in fines and restitution after pleading guilty to theft, attempted workers’ compensation fraud and telecommunications fraud. The action occurred following an undercover investigation of an alleged “pill mill” by the Ohio Bureau of Workers’ Compensation.

“Through our investigation, we were able to determine Dr. Zannoni was not only fraudulently billing BWC, but providing narcotics without proper medical examination,” said BWC Administrator/CEO Stephen Buehrer. “This action should serve as a warning to those physicians who put money before the proper treatment of injured workers.”

BWC’s Special Investigations Division teamed up with the Strongsville Police Department and Westshore Enforcement Bureau in 2007 to investigate an alleged pill mill at Cleveland Family Practice, 4732 Pearl Road in Cleveland. BWC supplied two undercover agents for the investigation and both were provided narcotic medications without proper medical examinations and BWC was billed improperly for the office visit. Search warrants later executed at her office and residence turned up a copy of orders Zannoni provided to her staff that instructed them to bill all injured workers under the same code and charge BWC $75 no matter the circumstances of their visit.

The team also obtained copies of patient files, including those of BWC’s undercover agents.

Undercover video above shows Parma doctor prescribing narcotics to BWC agents who reported no pain

Zannoni’s records falsely indicated she delivered services to the agents that she never provided, and that she elevated pain levels and fabricated tests to justify her continual prescribing of pain medication. When an agent conveyed that she had no pain, Zannoni advised her she had to have pain in order to receive a prescription; however, she wrote the prescription anyway. After the same agent had an MRI that returned normal, Zannoni continued to write the narcotic prescriptions without a physical examination and bill improperly for the visit.

Investigators also found that Zannoni continued to prescribe narcotics to patients who were known doctor shoppers even after receiving warnings from pharmacies, parents, spouses, social service agencies and police departments. In at least one circumstance, Zannoni confronted one of these patients about receiving narcotics from another physician but continued to prescribe on the condition that he promise he would only receive his pain medications from her.

Zannoni originally entered a no contest plea to these charges in September, 2010, but withdrew her plea in October. She pleaded again in June and was given probation, and ordered to pay restitution to BWC in the amount of $5,067.34 and a fine of $2,500.

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/2011/070711.asp