Archive

Archive for August, 2012

Thieves and liars

Thieves and liars. Those who cheat Workers’ Comp cheat all Ohioans. http://ow.ly/dhFD9

Advertisements
Categories: News Articles

Surveillance video ends Galion couple’s workers’ comp fraud scheme

A surveillance operation by the BWC culminated with the sentencing of a Galion (Crawford County) couple who managed to scam hundreds of thousands of dollars in undue benefits designated for Ohioans injured on the job. Randy and Robin Hammond pleaded guilty in a Franklin County courtroom and must pay more than repay $173,000.

“This troubling video shows the Hammonds’ clear and blatant misuse of the workers’ compensation system,” said BWC Administrator/CEO Steve Buehrer. “While no fraud case is small, this one has to be among the more brazen attempts to exaggerate an injury. I am pleased with the thorough work of our investigators and assistance from Attorney General DeWine in bringing this case to a close so we can put these funds to work assisting those who have truly been injured on the job.”

Robin Hammond was a nurse’s aide and claimed a workplace injury left her unable to use her arms and legs and without fine motor skills in her hands and feet. Based on her diagnosis, she was granted permanent total disability and BWC paid for special medical equipment, including an electric wheelchair and vehicle lift, a hospital bed and a Hoyer lift. However, BWC’s Special Investigations Department (SID) opened an investigation into Hammond after receiving allegation that she was not as injured as she claimed to be, and was engaged in physical activity.

SID conducted surveillance for approximately ten months, gathering hours of video evidence revealing she had full use of all four limbs. Robin Hammond was regularly observed entering her physician’s office in a wheelchair, then walking without assistance after leaving her appointments. The video also shows her husband, Randy, assisting her into a wheel chair on several occasions before entering the physician’s office and later walking and talking with her without any apparent injury.

Investigators interviewed Robin, and the couple soon after fled the state. She failed to show up or respond to repeated requests to attend their civil hearing. Attorney General Mike DeWine’s office issued a nationwide warrant for their arrest. They were located in Hurricane, Utah in February with the assistance of the SID’s Fugitive Task Force, Digital Forensics Unit, and the U.S. Marshals Service, and were extradited back to Ohio.

“This couple had many people convinced. Doctors, family members, and friends all believed Robin Hammond was severely disabled,” said Attorney General DeWine. “But evidence gathered by my office and the Bureau of Workers Compensation found that it was all an elaborate act, and we are thankful to the person who tipped off investigators.”

The case was heard at the Ohio Industrial Commission and all of Robin’s injury awards were found overpaid beginning in February 2007.

Both pleaded not guilty in March but changed their pleas and today admitted guilt. Robin Hammond pleaded guilty to one felony count of workers’ compensation fraud and was and sentenced to one year in prison with judicial release possible after six months. She was taken away in handcuffs. Randy Hammond pleaded guilty to one felony count of complicity and received five years of community control. The couple was ordered to repay BWC $173,332.09.

FY 2012 Annual Report

We published our fiscal year (FY) 2012 fraud results, ongoing trends and future strategies. View our  SID FY 2012 Annual Report.

The report highlights our achievements during the fiscal year, including performance against goals measured via key indicators. During FY 2012, SID identified $59,373,483 in savings. SID closed 2,046 cases and 976 – or 47.7 percent – were closed founded (the original allegation was proven). Of these founded 976 cases, 251 – or 25.7 percent – were referred for prosecution. SID obtained 152 indictments and 123 convictions. These 152 indictments were a 9 percent increase over last year. SID received 4,198 allegations and teams are currently investigating 1,106 open cases. The average founded closed case in FY 2012 identified $60,833 in savings to the Ohio workers’ compensation system. These results contribute to the agency’s priorities — improving operations and providing better service and care for customers.

The report reviews results since our department’s inception in 1993 – including that we have closed more than 56,000 cases and identified nearly $1.5 billion in savings to the Ohio workers’ compensation system. The report also identifies fraud trends and highlights strategies as specified in our department’s five-year strategic plan.

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

Categories: Annual Reports

BWC investigations result in five workers’ comp fraud convictions in July

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced five individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers’ compensation system during July. 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.

“There can be no place for deception in a system helping injured workers recover and return to work at the lowest possible cost to employers,” said Buehrer. “Attacking fraud protects Ohio’s workers’ comp system and keeps employers’ premiums directed appropriately to assisting injured workers.”

A summary of the cases that resulted in a guilty plea or conviction during July follows.

Doug Caldwell (Springboro, Warren County) pleaded guilty July 20 in the Warren County Court of Common Pleas Court to two counts of deception to obtain a dangerous drug, both fourth degree felonies.  SID’s intelligence unit identified a high amount of prescribed narcotics from multiple prescribing physicians being issued to the Caldwell.  Investigators found Caldwell was simultaneously visiting two physicians to obtain duplicate prescriptions for the same narcotic.  Neither physician was aware that Caldwell was obtaining similar narcotics from the other.  Caldwell had signed and agreed to a pain management contract under both physicians certifying that he would only obtain pain medication from one physician. Caldwell was placed on three years of probation and has agreed to treatment in lieu of a conviction through the Warren County probation department.  He will be sent to prison if he violates the agreement.  Caldwell was also sentenced to repay BWC $1,225.25 for the cost of the medication he obtained and the cost of the investigation.

Michael Johnson (Lima, Allen County) pleaded no contest July 25 in Lima Municipal Court to a misdemeanor count of falsification for filing a false claim. A BWC claims service specialist made a referral to the SID indicating there were conflicting stories by Johnson as to whether he was actually injured at work. Investigators obtained evidence showing Johnson had conflicting stories for both the employer and medical centers.  Eyewitnesses who worked with Johnson on the day of the injury indicated that they never witnessed his injury as he reported.  Johnson was already serving a jail term in Lima for cocaine and opiate abuse in violation of his probation.  He was sentenced to 30 additional days in jail and must pay court costs.

Christ Yanacos (Mentor, Lake County) pleaded guilty July 24 to one felony count of workers’ compensation fraud for working while receiving benefits.  SID’s intelligence unit identified Yanacos as possibly working as a result of a cross match with Public Utilities Commission of Ohio that showed he was the subject of a safety inspection in October 2010 while operating a commercial vehicle.  Investigators found Yanacos returned to employment as a part-time independent truck driver with MARS Trucking Inc. after he began receiving Permanent Total Disability benefits as a result of a workplace injury.  Yanacos was delivering cargo to local customers on behalf of MARS Trucking Inc. Yanacos was sentenced to 11 months incarceration, suspended for five years of community control.  The terms of community control include restitution in the amount of $109,244.71.

Patricia Perry (Cleveland Heights, Cuyahoga County) pleaded guilty July 17 to one felony count of workers’ compensation fraud for working while receiving benefits. SID received an allegation that Perry was working as a licensed provider with the Ohio Department of Developmental Disabilities (DODD).  The investigation found Perry was a licensed and certified provider with both the DODD and the Cuyahoga County Board of Developmental Disabilities.  Perry provided care and services to developmentally disabled individuals during the same time periods she claimed to be disabled and unable to work.  Perry admitted to working while receiving various disability benefits and verified that she concealed her employment activities.  Perry pleaded guilty in the Cuyahoga County Common Pleas Court.  She is scheduled to be sentenced on August 22.

Renee Washington (Cleveland, Cuyahoga County) pleaded guilty July 18 to one felony count of workers’ compensation fraud for working while receiving benefits. BWC’s Special Investigations Department (SID) began investigating after receiving a cross match from the Department of Job and Family Services indicating Washington was paid wages by A-1 Health Care and Concordia Care. Investigators found Washington continued employment as a part-time home health aide with A-1 Nursing Care while receiving Temporary Total Disability and Living Maintenance benefits.  Washington admitted to her work activity and cooperated with the investigation. The Ohio Industrial Commission issued a finding of fraud in February and Washington appeared in a Franklin County courtroom July 18.  She pleaded guilty to one felony count of workers’ compensation fraud and was sentenced to five years community control.  She also must pay $16,202.79 in restitution.

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

# # #

See it, report it, stop it!

Our updated fraud brochure includes red flags, case summaries and more!  Please share and use it as a resource on workers’ comp fraud.Image

 

 

 

 

 

 

BWC investigators uncover workers’ comp fraud in Columbus

COLUMBUS – Two Columbus residents owe thousands of dollars in workers’ compensation benefits they collected illegally following separate investigations by the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID).  Suzarrah Fisher and James Decker each recently pleaded guilty to fraud related to their attempts to cheat Ohio’s workers’ compensation system.

“Working in conflict with benefits and filing false claims are some of the most common tactics among individuals who are discovered committing fraud,” said BWC Administrator/CEO Steve Buehrer.  “Whatever the tactic, costs can add up quickly for employers that must pay for these claims based on deception.”

ImageSID began investigating Suzarrah Fisher after receiving an internal referral that she was receiving wages while collecting benefits for a prior workplace injury. The investigation revealed she worked for three employers over a two year period while receiving Temporary Total Disability and Living Maintenance benefits.  

Fisher pleaded guilty to one felony count of workers’ compensation fraud.  She was sentenced August 2 to 11 months in prison, suspended for 24 months of community control.  She was also ordered to pay restitution totaling $7,942.29 and $1,782.81 for investigative costs

ImageIn a separate case, James Decker, also of Columbus, was caught filing false claims in order to obtain narcotics.  SID received an allegation and opened an investigation that revealed he knowingly filed four false claims against employers he never worked for. He also filed a false claim using another person’s name. Decker admitted to filing the five false claims and using a false identity to obtain narcotics.

Decker pleaded guilty July 31 to one felony count of workers’ compensation fraud and was sentenced the same day to 10 months in prison, suspended for a five-year period of community control.  He was also ordered to pay restitution in the amount of $1,014.23 and investigative costs totaling $4,654.78.  Decker must make monthly payments of $100 per month as a condition of community control. 

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

Data cross match nets workers’ comp fraud conviction

COLUMBUS – A Cleveland (Cuyahoga County) woman pleaded guilty to fraud after her name appeared in a cross match of data shared by the Ohio Bureau of Workers’ Compensation (BWC) and the Ohio Department of Job and Family Services, indicating she was breaking the law.  Renee Washington has been ordered to repay more than $16,000 she was paid while working in violation of the benefits she was receiving after sustaining a workplace injury.

“Our investigators are able to learn a lot just digging into data we have within BWC, and data we receive through cross matches like this,” said BWC Administrator/CEO Steve Buehrer.  “As careful someone may be about hiding their work activities, there are a number of other possible ways we can identify the red flags of fraud.”

BWC’s Special Investigations Department (SID) began investigating after receiving a cross match from the Department of Job and Family Services indicating Washington was paid wages by A-1 Health Care and Concordia Care.

Investigators found Washington continued employment as a part-time home health aide with A-1 Nursing Care while receiving Temporary Total Disability and Living Maintenance benefits.  Washington admitted to her work activity and cooperated with the investigation.

The Ohio Industrial Commission issued a finding of fraud in February and Washington appeared in a Franklin County courtroom July 18.  She pleaded guilty to one felony count of workers’ compensation fraud and was sentenced to five years community control.  She also must pay $16,202.79 in restitution.

A photo of Renee Washington is available here.

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

 # # #

Media Contacts:       

 Michelle Gatchell                                                                Bill Teets
614-466-1367 or 614-633-6751                                  614-728-8045 or 614-425-0013

michelle.gatchell@bwc.state.oh.us                             william.teets@bwc.state.oh.us

30 W. Spring Street
Columbus, OH  43215
1-800-OHIO-BWC
ohiobwc.com