Archive

Archive for September, 2013

Former Athens man installed cable while on workers’ comp

Dominic Musarra booking photo

COLUMBUS – An Athens (Athens County) man owes the Ohio Bureau of Workers’ Compensation (BWC) more than $40,000 after he was discovered working while receiving workers’ comp benefits.  Dominic Musarra, who was working as a satellite cable installer in Point Pleasant, West Virginia, pleaded to theft and fraud.

“BWC works hard to make it clear that working while receiving certain workers’ comp benefits is not permissible,” said BWC Administrator/CEO Steve Buehrer. “It’s unfortunate Mr. Musarra didn’t make the connection that violating the work rules can have serious consequences.”

BWC’s Special Investigations Department (SID) opened an investigation after receiving an anonymous allegation that Musarra was working for McDish Satellite in Point Pleasant, while receiving Temporary Total  Disability benefits. Temporary Total Disability is for injured workers who are totally disabled from work for a short period of time due to a work-related injury or occupational disease. An injured worker cannot work while receiving these payments.

The investigation revealed Musarra was also working as a self-employed satellite technician in conflict with the benefits he was collecting due to a prior workplace injury.

Musarra was convicted of felony counts of grand theft and workers’ compensation fraud.

Musarra was sentenced to five years of community control and general supervision and control of the Adult Parole Authority. He was also ordered to pay $40,432.49 in restitution, in addition to court costs.  Musarra must pay $350 per month and pay the full restitution before the five years of supervision has been completed.  He issued a $5,000 check to BWC prior to the sentencing date.

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

Committing workers’ comp fraud doesn’t make cents

September 27, 2013 1 comment

We’re often asked why people commit fraud against the Ohio Bureau of Workers’ Compensation (BWC). Fortunately, we have answers. Well, of a sort, anyway. We have the justifications offered by suspects themselves. We document the flimsy rationalizations blustered by suspects during their confessions. We hear the statements made in court by newly-convicted felons just before they’re sentenced.

As career criminologists, we know that our suspects exhibit one common behavior: they miscalculate the “risk versus reward” of workers’ compensation fraud. In their greed, they focus on their motive, opportunity and means to commit a crime against the State Fund. They calculate the apparent “reward” of their crime. However, they rashly dismiss and/or wildly underestimate the relentless resolve and well-honed skillfulness of fraud analysts, special agents and criminal investigators with the BWC Special Investigations Department (SID) to do the following:

  • To detect fraud, even while suspects are still in the process of perpetrating their crimes;
  • To heed – research, analyze and investigate – each suspicion reported to BWC by all sources;
  • To conduct a thorough and objective investigation, securing evidence to determine the truth;
  • To testify, as needed, in an administrative hearing to ensure the suspect’s BWC order is enforced;
  • To refer the case for criminal prosecution by local, state and federal prosecutors;
  • To locate via our Fugitive Task Force all fleeing defendants and to have them extradited to stand trial in criminal court on our charges;
  • To testify in court – telling the truth, the whole truth and nothing but the truth – to secure a conviction by means of the defendant’s guilty plea, or a guilty verdict from either a judge or jury;
  • To submit detailed Victim Impact Statements to the court prior to the convicted felon’s sentencing;
  • To request the court sentence convicted defendants to a serve a period of incarceration and to pay BWC full restitution, including the cost of our BWC investigation, to pay fines and court costs;
  • To work with a probation officer to fully collect the court-ordered restitution from those convicted and sentenced; and
  • To request the court revoke the felon’s probation and impose incarceration, if the debt is not paid in full, according to the court’s order.

Ultimately, since 1994, these miscalculations have contributed to the SID’s identification of more than $1.5 billion in savings to the State of Ohio. Clearly, it just doesn’t make sense to commit workers’ compensation fraud against the State of Ohio.

Check out archived articles in OhioBWCFraud to learn more about helping us continue to protect the State of Ohio. Complete an online form or contact our toll-free fraud hotline, 1-800-OHIOBWC, to report any suspicion of Ohio worker’s compensation fraud.

Categories: Fraud Awareness

Woman convicted in 2011 for scheme to obtain narcotics serves time for probation violation

Tabitha TaylorTabitha Taylor, convicted for scheming with her boyfriend to obtain narcotics (see 2011 news release), recently served six days in jail for a second violation of her probation. In August, 2011, Taylor was sentenced 180 days of suspended incarceration and was placed on five years of community control. She was ordered to pay restitution of $12,064.07 ($8,064.07 restitution plus $4,000 investigative costs), for which she is jointly and severally liable with Jeffrey Davis, who previously pleaded guilty to one felony count of workers’ compensation fraud.

BWC’s 2010 investigation found that Davis initiated a scheme by assisting his girlfriend, Taylor, in filing a workers’ compensation claim against his business, Davis Trucking. The couple claimed Taylor sustained an injury on the job while working for Davis Trucking, although she had never been an employee. It was later revealed that her injury actually occurred as a result of a domestic dispute between Taylor and a prior boyfriend.

Davis eventually admitted that he was the mastermind behind the filing of the false claim, instructing Taylor on what to say to the doctors, how to act, and how to complete paperwork claiming a workplace injury. Taylor cooperated in the prosecution of Davis and explained that he persuaded her to file the claim as a means for obtaining free medical treatment for her injury and narcotics for them both.

A hearing was held in the Franklin County Court of Common Pleas on Sept. 20 after Taylor failed to follow the terms of her probation as ordered by the court. Franklin County filed a motion to revoke her probation because she had failed to repay BWC, pay court costs, maintain employment, or obtain a drug and alcohol assessment. Since that motion was filed, Taylor had made several payments to the BWC, found a job, and completed 12 drug and alcohol classes.

Steubenville salesman sentenced for workers’ comp fraud

???????????????????????????????COLUMBUS – A Steubenville (Jefferson County) man pleaded guilty to fraud after an investigation by the Ohio Bureau of Workers’ Compensation (BWC) showed he was working while receiving workers’ comp benefits. Randall Bridges, Jr. was sentenced in the Franklin County Court of Common Pleas and ordered to repay more than $6,000.

“Mr. Bridges took his sales job knowing he was prohibited from working while on workers’ comp,” said Steve Buehrer, BWC Administrator/CEO. “Our investigators are working daily to stamp this type of fraud out of Eastern Ohio, and all across the state.”

BWC’s Special Investigations Unit opened an investigation after receiving an anonymous allegation that Bridges was working as a sales person for Global Childcare Resources in Steubenville.

The investigation revealed that Bridges was employed as a sales person/independent contractor. He knowingly worked during periods he was receiving Temporary Total Disability benefits for a prior workplace injury. Temporary Total Disability is for injured workers who are totally disabled from work for a short period of time due to a work-related injury or occupational disease. An injured worker cannot work while receiving these payments.

Bridges pleaded guilty Sept. 17, 2013, to one misdemeanor count of workers’ compensation fraud. Judge Cain sentenced Bridges to 90 days in jail, suspended for two years of community control under the condition that he pay restitution in the amount of $6,151.45, maintain employment and have no new convictions.

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

Tuscarawas County man sentenced for working while receiving workers’ comp

September 23, 2013 1 comment

COLUMBUS – A New Philadelphia man pleaded guilty to theft and was sentenced in connection with working while receiving workers’ comp benefits. A judge in the Franklin County Court of Common Pleas ordered Cecil Ball to repay nearly $10,000.

“Mr. Ball was attempting to take advantage of a benefit that is reserved for injured workers who cannot work,” said Steve Buehrer, administrator/CEO for the Ohio Bureau of Workers’ Compensation (BWC). “Our investigators use a number of tools to track down fraud and in this case, a wage cross-match with the Ohio Department of Job and Family Services helped us put an end to this ruse.”

BWC’s Cambridge Special Investigations Unit (SIU) started investigating Ball after receiving information from the SIU Intelligence Unit that the wage cross-match revealed that Ball earned wages in 2010 and 2011 while receiving temporary total benefits. Investigators found that Ball worked as a truck driver for a transportation company.

Ball acknowledged that he drove a truck and earned wages while receiving temporary total disability compensation at the same time.

He was sentenced on Sept. 18 after pleading guilty to one felony count of theft. He received 180 days in jail, suspended for five years of community control. He was also ordered to pay restitution to BWC in the amount of $9,699.16. He must also maintain employment, have random urine screens and no new convictions.

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

Anatomy of a criminal – Who commits workers’ compensation fraud?

September 20, 2013 1 comment

Have you ever wondered what kind of person would commit workers’ compensation fraud against the Ohio Bureau of Workers’ Compensation (BWC)? We are often asked this question. Usually the questioner implies a belief that our answer should include a data-based “profile” of the so-called “typical” white-collar fraudster. Admittedly, we have analyzed millions of data records pertaining to fraud committed against our State Fund. Sure, we have all the means necessary to identify suspect key characteristics and discern patterns of criminal behavior. However, what our experience proves to us is something altogether different. Namely, we know with certainty that those who commit workers’ compensation fraud vary dramatically by age, location, culture, nationality, ethnicity, level of education, income bracket, criminal history, etc. They come in all forms with a multitude of backgrounds. Motivated by greed, the perpetrators who attempt to victimize the State of Ohio fit no one’s stereotype of a criminal.

This is true in part because workers’ compensation – in any workers’ compensation system in all countries, states or other jurisdictions – involves so many different “actors” or parties to a claim.

You need only browse through the cases summarized on our OhioBWCFraud Facebook page to see criminals who have committed workers’ compensation fraud, including:

  • Employees who hide the fact that they have returned to work in order to continue to be paid lost time benefits or who use deception to illegally receive prescription medicine. For examples, see any of the following August convictions of Angel Ocasio, Randy Bartosh, Bob Morgan, Stephen Byrne, or Lawrence Blakeley.
  • Business owners who knowingly employ lost time benefit recipients and fail to report their wages or who underreport payroll and misclassify employees in order to pay less than the true premium amounts owed (see Sarah Barajas, dba Bane Specialty Services); and
  • Health-care providers who bill for medical treatments they have not rendered, upcode bills to charge us for more expensive treatment than they actually furnished, or unnecessarily prescribe narcotics to innocent claimants until these patients are addicted (see the Sept. 9, 2013 case summary pertaining to Joseph J. Yurigan, D.C.).

Ultimately, the variability in our suspects, while it may challenge our detection skills, simply serves to remind us of the importance of our mission to relentlessly deter, detect, investigate and prosecute crimes perpetrated by anyone against the State Fund.

Thank you for your interest in learning more about those criminals who seek to cheat a system that so effectively serves hundreds of thousands of deserving, law-abiding citizens in the State of Ohio. As our BWC Administrator/CEO Steve Buehrer recently noted: “Investigating and putting a stop to fraud helps protect the benefits of injured workers and keep employers’ premiums down. Those who break the rules are interfering with our ability to serve Ohio’s employers and truly injured workers.”

Check out archived articles in OhioBWCFraud to learn more about how you may help us protect the State of Ohio.

Categories: Fraud Awareness

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

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 in August. 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.

“Investigating and putting a stop fraud helps protect the benefits of injured workers and keep employers’ premiums down,” said Buehrer. “Those who break the rules are interfering with our ability to serve Ohio’s employers and truly injured workers.”

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

Angel Ocasio (Cleveland, Cuyahoga County) pleaded guilty Aug. 14 to one count of workers’ compensation fraud for working while receiving benefits. In July 2010 SID received an anonymous allegation indicating Ocasio operated his own car repair and tow company while receiving BWC benefits. Investigators found Ocasio returned to work as a self employed tow truck driver and auto mechanic from May 2010 through October 2011 while receiving temporary total disability benefits. Ocasio was sentenced to nine months in prison, suspended for two years of community control. As a condition of community control, he must repay BWC $15,679.

Randy Bartosh (Coraopolis, Pennsylvania) pleaded guilty Aug. 15 in Franklin County to one count of workers’ compensation fraud and one count of theft for working while receiving benefits. SID began investigating the former Columbiana (Columbiana/Mahoning Counties) man after a confidential source contacted the fraud hotline advising he was engaging physical activity inconsistent with his complaints to doctors in his workers’ compensation claim. Investigators conducted internet searches, undercover operations and obtained bank records discovering that Bartosh owned a tattoo shop called 213’s Tattoo U in Coraopolis, Pennsylvania while receiving temporary total disability benefits. Bartosh tattooed customers, and managed business and marketing operations. The Ohio Industrial Commission found Bartosh was overpaid and ordered him to return $4,541.70, which has since been repaid to BWC. A judge ordered him to pay a $100 fine.

Bob Morgan (Holland, Lucas County) pleaded guilty to one count of workers’ compensation fraud Aug. 6 for working while receiving benefits. SID received information that Morgan was a martial arts instructor, and had been teaching mixed martial arts at Donnelly’s USA Martial Arts in Holland and American Kenpo in Toledo. There were instructional videos and a news cast showing Morgan engaged in physical martial arts instruction while collecting disability for a neck and low back injury from September 2008 to July 2009. In a statement to the court, Morgan admitted that he committed fraud. He was sentenced to a suspended six month term incarceration at the Correctional center of Northwest Ohio, and 30 days of electronic monitoring. As part of his probation, he was ordered to complete 100 hours of community service, to seek and maintain gainful verifiable employment, and to pay restitution in the amount of $3,157.70. Morgan paid $300 toward his debt after sentencing.

Stephen Byrne (Brooksville, Kentucky) pleaded guilty Aug. 15 in the Hamilton County Court of Common Pleas to one count of theft for working while receiving benefits. SID initiated an investigation after receiving and allegation that Byrne was working while he was receiving BWC benefits. The investigation found Byrne worked at Millennium Towing & Recovery and rental properties during the periods in which he applied for and was awarded wage loss and temporary total benefits from his self-insured employer, the City of Cincinnati. Byrne was sentenced to one year of community control, 100 hours of community service, ordered to pay restitution and maintain employment. Byrne has made full restitution of $14,774.15 to the City of Cincinnati.

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

Confidentially speaking – Reporting suspected fraud as an anonymous source

Have you ever heard or seen something related to workers’ compensation that seems suspicious? If so, you are not alone. Thousands of citizens have suspected fraud and reported these suspicions to BWC. In fact, since 1993, SID has received and reviewed more than 100,000 fraud allegations. Many of these allegations were reported by anonymous sources, just like you.

All of these sources had at least three things in common:See it, report it, stop it!_Page_1

  • They suspected fraud. Perhaps, they read an article posted to our Facebook page. The article may have described examples of common fraud schemes, cases we’ve investigated, and suspects that were brought to justice. Something in a case example may have “clicked” and prompted them to realize they had knowledge of a person or business who is doing something similar. They may have also visited ohiobwc.com and learned more about the red flags of claimant, provider, and employer fraud.
  • They figured out how to report their suspicions to us. Some used an article posted to our Facebook page to learn that they could easily report fraud at ohiobwc.com. They were likely reassured when they learned that to report workers’ compensation fraud to BWC, they needed only to suspect that fraud may have been committed. Further, they realized our trained and experienced special agents conduct the investigation and testify in court, while they remain anonymous.
  • They determined to do the right thing. They took immediate advantage of the online form or our toll-free fraud hotline, 1-800-OHIOBWC, to report their suspicions.

Ultimately, these sources are the reason why we have identified more than $1.5 billion in savings to the State of Ohio… and counting.

Thank you for being our eyes and ears!

Video of Toledo man demolishing homes puts an end to his workers’ comp

COLUMBUS – A Toledo (Lucas County) man must return nearly $4,000 to the Ohio Bureau of Workers’ Compensation (BWC) after investigators caught him on camera demolishing homes when he was supposed to be off work recovering from a workplace injury. John Perkins was sentenced Sept. 6 in the Franklin County Court of Common Pleas.

“Mr. Perkins wasn’t honest about his employment while receiving workers’ comp benefits,” said BWC Administrator/CEO Steve Buehrer. “We’re pleased our investigators were able to capture this video to uncover his fraudulent activity, and the money he improperly received will be returned to the State Insurance Fund.”

BWC’s Special Investigations Department (SID) opened an investigation after receiving an allegation that Perkins was tearing down mobile home trailers while collecting temporary total disability. SID obtained video evidence and confirmed that Perkins was working for John Rogers of Rogers Services demolishing old mobile home trailers. The evidence showed Perkins tore down trailers, ran a reciprocating saw, used a sledgehammer, loaded materials into a dumpster and took scrap materials to scrap yards while working for Rogers Services.

Perkins pleaded guilty in to one misdemeanor count of workers’ compensation fraud and was sentenced to 90 days in jail, suspended for three years of community control. He must also pay restitution to BWC in the amount of $3,762, maintain employment or employment training, and have no new convictions. Perkins had forty-two days of jail time credit.

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

Kentucky man repays Cincinnati $14,000 for working while receiving workers’ comp

CINCINNATI – A Brooksville, Ky. man pleaded guilty to theft and has been sentenced in connection with working while receiving workers’ comp benefits from the city of Cincinnati. The Ohio Bureau of Workers’ Compensation (BWC) assisted Cincinnati, a self-insured employer, with its investigation of Stephen Byrne, who appeared in the Hamilton County Court of Common Pleas Aug. 15.

“We’re pleased we were able to help the city of Cincinnati bring Byrne to justice, and help recover the money he improperly received,” said Steve Buehrer, BWC Administrator/CEO. “Many self-insured employers are not aware our investigators can assist them in uncovering fraud, so we encourage them to utilize our services when fraud is suspected.”

BWC’s Special Investigations Department began an investigation after receiving an allegation that Byrne was working for a towing and recovery business while receiving workers’ comp benefits. Investigators found that Byrne did indeed perform shop cleanup work for the business, as well as rehab work on rental properties during the time he applied for and was awarded working wage loss and temporary total benefits from the city of Cincinnati.

Temporary total disability is for claimants who are totally disabled from work for a short period of time due to a work-related injury or occupational disease. Working wage loss is paid to injured workers who return to employment that’s different from their former positions, including different job duties, a different employer, less hours and less pay resulting from physical restrictions.

Byrne pleaded guilty to one count of theft, a first-degree misdemeanor, and was sentenced to a year of community control and 100 hours of community service. He was also ordered to pay restitution and maintain employment. Byrne paid the full restitution amount of $14,774.15 to the city of Cincinnati.

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

Chiropractor sentenced for health care fraud and tax evasion

September 9, 2013 4 comments

Joseph J. Yurigan, D.C., a chiropractor who formerly practiced in Weirton and Wheeling West Virginia and treated Ohio injured workers, was sentenced yesterday for health care fraud and tax evasion.

SID received a fraud allegation in 2008 concerning Yurigan, and conducted an undercover operation in each of the two chiropractic offices he owned and operated.  The investigation revealed Dr. Yurigan was routinely and consistently billing for services that he never provided to the undercover operatives.    

The Federal Bureau of Investigations, the West Virginia Department of Insurance Commission, United States Treasury Department and the United States Attorney’s Office became involved in the investigation and executed a search warrant in October, 2009.

Evidence obtained from the search warrant and information collected from numerous interviews confirmed Yurigan was billing multiple insurance providers for services that he never provided. 

Yurigan pleaded guilty and yesterday was ordered to make restitution totaling $836,065.93. 

He was also sentenced to 18 months in a federal institution. Yurigan will report to the designated institution on October 7 to serve his sentence.

Celebrating 20 Years: Eyes on the Future

September 6, 2013 1 comment

In honor of our 20th anniversary of the BWC’s Special Investigations Department (SID), we welcome you to the third of a three-part series of blog posts outlining the history of the department, its current offerings and its future goals. We welcome your thoughts and comments!

In addition to a highly-trained staff, the key to the SID’s success is the continued planning by the director and SID team supervisors. Progress is guided by five-year strategic plans. To date, SID has completed three of these strategic plans, the most recent plan having concluded in fiscal year 2013.  Over the next several months, SID professionals will meet and draft a new strategic plan to guide the department through the next five years.

One of the chief ways to find new or alternate methods of fraud detection and investigation is to consult counterpart agencies in other states and even private fraud investigation firms through periodic benchmarking surveys. Such interstate cooperation allows SID to examine its own methods to see where improvements can be made, how tasks can be accomplished more efficiently, and what new strategies or technologies can be used in the course of an investigation.

SID will continue to improve its use of social media, such as Facebook and Twitter to aid investigations.  Using social media is an example of how SID constantly responds to technological advances and changes.  Check out recent coverage from the Toledo Blade on how social media aids our investigations.

One of the highest priorities for SID is the never-ending search for ways to improve.  We believe that past achievement is not a guarantee for future success, and that contentment is often the quickest road to experiencing failure.

Thank you for following our three-part series about SID’s 20th anniversary! You can read the past posts about our history here and our current efforts here.

Categories: SID Information