Archive

Archive for May, 2012

Mount Gilead business owner sentenced for failing to maintain workers’ comp coverage

A Mount Gilead (Morrow County) business owner has been sentenced for failure to comply with the law after amassing more than $90,000 in premiums and penalties owed on his workers’ compensation insurance policy.  Phil Kraus, owner of KC Berkshire, a janitorial service, pleaded guilty last week following an investigation by the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID).

“Protecting one’s workforce from injury and illness ought to rank among any employer’s highest priorities,” said BWC Administrator/CEO Steve Buehrer.  “Fortunately, Ohio law allows employees of businesses with lapsed policies to receive care should they be injured, but BWC must recover these costs in order to maintain a fair system that keeps all employers’ premiums as low and stable as possible.”

SID’s Employer Fraud Team began investigating Kraus after he failed to enter into a payment plan after falling behind on his premiums. Kraus was previously investigated by SID for issues pertaining to under-reporting his business’ payroll, which is used to calculate premium.  SID closed that case after Kraus amended the payroll reports and agreed to enter into a reinstatement payment plan to pay overdue premiums. 

After several attempts to make contact with Kraus, BWC’s collections department referred the matter back to the SID as Kraus was continuing to operate his business without coverage and without establishing a payment plan.  Attempts to reach Kraus regarding the lapsed policy were unsuccessful, and SID referred the case for prosecution. 

Kraus pleaded no contest May 7 to two counts of Failure to Comply with Law and two counts of Attempted Failure to Comply with Law. He was sentenced to 18 months of community control, and ordered to pay $91,555 in restitution. He must also pay court costs and a $50 fee for each count.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

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

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced seven individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers’ compensation system during April. The court actions are the result of investigations conducted by BWC’s special investigations department (SID). The department works to deter, detect, investigate and prosecute workers’ compensation fraud.

“As demonstrated in the first case, BWC’s Employer Compliance Department makes every attempt to work with employers who fall behind on their workers’ compensation premiums, but sometimes those efforts are simply ignored and result in criminal charges,” said Buehrer. “Other acts of forgery and concealing employment demonstrated in this month’s cases to obtain undeserved injured worker benefits are also violations of the law that cannot be tolerated.”

A sampling of cases that resulted in a guilty plea or conviction during April follows.

Janell Howell (dba Jump Start Child Development Center Inc.) (Youngstown, Mahoning County) was found guilty of two counts of failure to comply for operating without the required workers’ compensation insurance coverage. SID opened an investigation after Howell did not cooperate with repeated attempts by BWC’s Employer Compliance Department to bring Jump Start Child Development Center up-to-date on its policy. Howell completed required payroll reports but failed to establish a payment plan or make payment. She was found guilty in Youngstown Municipal Court and her attorney initially advised she would not be establishing a payment plan as she was losing her Ohio Department of Job and Family Services license to run the center.  She stated that another person would take over the business.  Investigators advised that the debt would carry over to the new owner under the BWC’s successorship rule and Howell subsequently agreed to make the payment.  Howell was ordered to pay $300 per month for the next five years while on probation, and pay court costs and probation fees.  If the full amount owed of $18,547.17 is paid during her probation, her probation will be terminated at the time the debt is paid.  If Howell fails to make any payment, she will return to court and may serve up to 90 days in jail.

Myron Rose (Cambridge, Guernsey County), pleaded guilty to working while receiving benefits. SID received a fraud allegation in May 2010 after Rose was pictured in an advertisement as a salesman for Fairdale Auto Sales in the Zanesville Times Recorder newspaper.  The investigation found Rose knowingly worked for Fairdale Auto Sales during the period he was receiving non-working wage loss compensation.  The work activity was verified through payroll documentation from the employer which indicated that Rose started working for Fairdale Auto Sales in March 2010. On April 24, 2012, Myron Rose pled guilty to 1 count of Workers’ Compensation Fraud, a felony of the fifth degree.  Rose was sentenced to 365 days incarceration suspended for five (5) years community control; payment of court and probation costs; $7,794.37 in restitution payable to the BWC; and for Rose to maintain viable employment.

Adam Long (Bloomville, Seneca County) pleaded guilty to one count of workers’ compensation fraud for working while receiving benefits. An investigation revealed that Long began working for Keirns Concessions at the same time he was collecting temporary total disability benefits from BWC for an injury that occurred while working for another employer.  Investigators found he was performing maintenance on the concession trailers and on the concession company’s property.  He was also found cooking for the company and working with the customers serving food and collecting money.  Investigators captured Long on video performing these work duties.   The judge ordered Long to pay restitution in the amount of $4,740.36.  He was also sentenced to 180 days in jail, suspended and one year of probation. He must serve jail time if he does not pay the full amount back at the end of one year. 

William Vargas Jr. (Youngstown, Mahoning County) pleaded guilty to workers’ compensation fraud for altering wage statements in order to receive benefits for periods in which he did not work. SID received an allegation from a claims service specialist who managed Vargas’ workers’ compensation claim. The BWC employee noticed irregularities in paystub information being submitted by Vargas for his employment with Niles Manufacturing and Signs by Tomorrow. The employee specifically noted that the “year-to-date” earnings listed on the paystubs did not change from week to week.  SID found that Vargas purposely altered paystubs and wage statements so that he could receive Living Maintenance Wage Loss benefits for periods in which he did not work, and therefore did not incur a wage loss. Investigators also found that Vargas worked for GLI Pool Products during the time period he concurrently received living maintenance benefits. He was not permitted to work while receiving living maintenance benefits. William Vargas pleaded guilty April 26 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 30 days in jail, suspended for two years of community control. As a condition of community control, he is required to repay $6,107.46 in restitution.

Raymond Adams (Fairport Harbor, Lake County) pleaded guilty in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud for working while receiving benefits. SID received a cross match of data with Ohio Department of Jobs and Family Services indicating  Adams was receiving wages from Spat’s Café while receiving temporary total compensation for a workplace injury.  Through surveillance, employment records and interviews, SID found Adams was employed while receiving these benefits.  Adams was ordered to repay $2,613.45 in restitution and $500 investigative costs.  He was also sentenced to 90 days (80 days suspended for one year of community control and credited 10 days for time already spent in jail). 

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

https://www.ohiobwc.com/home/current/releases/2012/051512.asp

Cambridge car salesman sentenced for workers’ comp fraud

COLUMBUS – A Cambridge (Guernsey County) man has been sentenced for working as an automobile salesman while receiving benefits from a workplace injury.  Myron Rose pleaded guilty to workers’ compensation fraud and must repay nearly $8,000 following an Ohio Bureau of Workers’ Compensation (BWC) investigation initiated after Rose appeared in a newspaper ad for a local car dealership.

“The type of compensation Mr. Rose was receiving is available to injured workers who tell us they are searching but have been unable to secure employment within their physical restrictions,” said BWC Administrator/CEO Steve Buehrer.  “It can provide useful assistance during a difficult time following a workplace injury but is not available to those who have found employment.”

BWC’s Special Investigations Department (SID) received an allegation indicating that a picture of Rose was in a Zanesville Times Recorder newspaper advertisement as a salesman for Fairdale Auto Sales. Rose at the time was receiving Non-Working Wage Loss benefits for a prior workplace injury, payable when an injured worker is unable to find suitable employment.  SID’s investigation showed Rose knowingly worked for Fairdale Auto Sales during the period he was receiving this compensation. 

Rose was indicted in November 2011 and pleaded guilty April 24 to one felony count of Workers’ Compensation Fraud. A Franklin County judge ordered Rose to pay $7,794.37, in addition to court and probation costs. He was also sentenced to one year of incarceration, suspended for five years of community control and must maintain viable employment.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

https://www.ohiobwc.com/home/current/releases/2012/051412.asp

Watch Watchdog10’s Kurt Ludlow’s Special on SID

Watchdog10’s Kurt Ludlow: Group Catches Worker’s Comp Cheaters In The Act http://ow.ly/aQtkL

Categories: News Articles

Gallia County woman sentenced for workers’ comp fraud

ImageCOLUMBUS – A Vinton (Gallia County) woman pleaded guilty to workers’ compensation fraud and forgery this week after she was found forging documents in order to receive undue injured worker benefits. Maria Patterson must repay more than $7,000 as a result of her attempt to extend the benefits she was receiving for a prior workplace injury beyond her eligibility.

“Physicians are an important part of the process of evaluating the condition of injured workers and whether they are able to return to work,” said Steve Buehrer, Administrator/CEO of the Ohio Bureau of Workers’ Compensation (BWC). “Forging a provider’s name to extend benefits is not only illegal, it denies them their role in guiding a medical treatment plan designed to get injured workers back on this job.”

BWC’s Special Investigations Department (SID) opened an investigation after receiving an allegation from a BWC employee who suspected that Patterson submitted three falsified C-84 forms. These forms are used by injured workers and their physicians to initiate or extend payment of temporary total disability benefits. The investigation revealed Patterson did in fact falsify three forms by signing her doctor’s name and misrepresenting her dates of disability. As a consequence, she was paid benefits she would not otherwise have been eligible to receive.

Patterson pleaded guilty May 8 to one felony count of workers’ compensation fraud and one felony count of forgery. Franklin County Judge Guy Reece sentenced Patterson to 180 days incarceration on each count and ordered her to pay $7,450.63 in restitution. Patterson is currently serving a nine year sentence for unrelated charges of burglary, two counts of theft, tampering with evidence and breaking and entering.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

https://www.ohiobwc.com/home/current/releases/2012/051012.asp

Youngstown man sentenced for workers’ comp fraud

COLUMBUS – A Youngstown (Mahoning County) man who pleaded guilty to workers’ compensation fraud has been ordered to repay more than $6,000 or face jail time.  William Vargas was receiving Living Maintenance Wage Loss benefits due to a workplace injury but was found to be altering wage statements in order to receive benefits for periods in which he did not work. Living Maintenance is paid to an injured worker while they are participating in a vocational rehabilitation plan.

Image“Living Maintenance can be a useful part of a vocational rehabilitation plan to assist injured workers in returning to work and maintaining their jobs,” said Steve Buehrer, Administrator/CEO of the Ohio Bureau of Workers’ Compensation (BWC).  “However, accurate reporting of income is important and altering records to skew benefits in your favor is not only misrepresenting the facts, it constitutes fraud.”

BWC’s Special Investigations Department (SID) received an allegation from a claims service specialist who managed Vargas’ workers’ compensation claim. The BWC employee noticed irregularities in paystub information being submitted by Vargas for his employment with Niles Manufacturing and Signs by Tomorrow. The employee specifically noted that the “year-to-date” earnings listed on the paystubs did not change from week to week.

SID found that Vargas purposely altered paystubs and wage statements so that he could receive Living Maintenance Wage Loss benefits for periods in which he did not work, and therefore did not incur a wage loss. Investigators also found that Vargas worked for GLI Pool Products during the time period he concurrently received living maintenance benefits. He was not permitted to work while receiving living maintenance benefits.

William Vargas pleaded guilty April 26 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 30 days in jail, suspended for two years of community control. As a condition of community control, he is required to repay $6,107.46 in restitution.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.