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Archive for December, 2013

Construction business owner ordered to pay $55K in workers’ comp premiums

December 27, 2013 1 comment

COLUMBUS – A Cincinnati (Hamilton County) business owner was sentenced earlier this month to pay nearly $55,000 in unpaid premiums owed to the Ohio Bureau of Workers’ Compensation (BWC). Todd Bittner pleaded guilty in October to two counts of workers’ compensation fraud, both fifth-degree felonies, as part of a plea deal.

“Bittner Construction had lapsed coverage, and this wasn’t the first time,” said BWC Administrator/CEO Steve Buehrer. “BWC attempted to work with Mr. Bittner, but he failed to pay the premiums or enter into a payment plan. The bottom line is that all employers need to pay for workers’ compensation coverage. We’re pleased that these overdue premiums will finally be collected.”

BWC’s Employer Fraud Team (EFT) received a referral from the agency’s Employer Compliance Department indicating that Bittner Construction continued to operate with lapsed coverage since September 2007. It’s the second case of lapsed coverage the EFT had for this business; in the first case, the company became compliant, so the case was closed. EFT agents attempted to work with Bittner, who confirmed that he was responsible for handling the company’s workers’ compensation duties. He submitted outstanding payroll reports to the EFT, but didn’t pay the related premiums or enter into a payment plan.

On Dec. 10, Bittner was sentenced to four years of community control and was ordered to pay the BWC $54,934 in restitution, plus court costs and a $1,000 fine. He must also perform 500 hours of community service. He will serve two years in prison if he fails to meet any of his court-ordered requirements.

Back in July, Bittner was indicted by the Hamilton County Grand Jury on 12 fifth-degree felony counts of workers’ compensation fraud. In October, he pleaded guilty to two fifth-degree felony counts as part of a plea deal; the other 10 counts were dismissed.

To report suspected workers’ compensation fraud, call 1-800-644-6292, visit www.bwc.ohio.gov, or visit www.facebook.com/ohiobwcfraud.

Fraud red flags: Recognizing fraud wherever it exists

fraud picWorkers’ compensation fraud takes many forms and we rely on all law-abiding citizens to provide tips when they notice suspicious behavior.

However, we understand the untrained person may notice warning signs, but not recognize them as fraud red flags. To assist, we created a one-page brochure for printed distribution to safety councils throughout the state – and to you. This resource lists signs of potential fraud committed by claimants, health-care providers and employers. Of course, detection of any of those signs does not necessarily mean that fraud exists. Our investigators carefully collect and analyze the facts to determine whether fraud was committed.

We hope our ongoing efforts to educate and provide awareness about workers’ compensation fraud further your understanding of our mission to protect the State Insurance Fund.

You are our eyes and ears! Thank you for your help in stamping out fraud. Please, use these fraud red flags and keep your tips coming. To report workers’ comp fraud in Ohio, click here or call our fraud hotline at 1-800-644-6292.

Categories: Fraud Awareness

Putnam County man sold guns while on workers’ comp

COLUMBUS – A Vaughnsville (Putnam County) man has repaid more than $26,000 to the Ohio Bureau of Workers’ Compensation (BWC) after investigators caught him on camera selling firearms out of his home while receiving workers’ comp benefits. Charles Newland pleaded guilty to fraud Dec. 9 in the Franklin County Court of Common Pleas.

“Mr. Newland was operating this business while he was supposed to be off work recovering from a workplace injury,” said BWC Administrator/CEO Steve Buehrer. “That is a clear conflict and we are pleased our investigators were able to capture the video evidence to put an end to it and bring thousands of dollars back to the State Insurance Fund.”

BWC’s Special Investigations Department opened a case on Newland after receiving an allegation that he may be operating a firearm and archery business near his home while collecting disability for a prior workplace injury. Investigators who visited Newland and posed as customers confirmed he was operating Buckeye Archery next to his home. He was selling the firearms, archery, and hunting equipment and supplies while collecting temporary total, living maintenance, and living maintenance wage loss benefits. Injured workers are not permitted to return to work while collecting these benefits.

Newland pleaded to one misdemeanor count workers’ compensation fraud.  He had already paid restitution of $18,367.90, in addition to investigative costs of $7,845.50, for a total of $26,213.40.  The judge found Newland guilty and ordered him to pay a $100 fine and court costs.

To report suspected workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit www.facebook.com/ohiobwcfraud. View and share BWC’s workers’ comp fraud awareness video on our YouTube channel.

BWC investigations result in eight workers’ comp fraud convictions in November

December 16, 2013 1 comment

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

“The actions of these individuals are all illegal and our Special Investigations Department is doing an outstanding job of conducting investigations to return dollars to the State Insurance Fund,” said Buehrer.

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

Mark Owens (Warren, Trumbull County) pleaded guilty Nov. 18 in the Franklin County Court of Common Pleas to a misdemeanor count of theft for working while receiving benefits. SID opened the case against Owens after performing a cross match with the Ohio Department of Job and Family Services that indicated he was possibly working while receiving temporary total disability benefits.  Agents obtained employment records and found that Owens returned to work on a regular basis for a temporary agency as a general laborer from January 2011 through March 2012. Owens was sentenced to 38 days in jail, given credit for the eight days he already served, and the remaining time was suspended for three years of community control.  As a condition of community control, Owens was ordered to pay $6,121.59 in restitution to BWC.  He paid $800 at sentencing to begin his repayment.

Timothy Hunter (Columbus, Franklin County) pleaded guilty Nov. 20 to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID performed a cross match with the Ohio Department of Job and Family Services that indicated Hunter had received wages from The Kroger Company during the same period he received temporary total benefits from BWC. The investigation found Hunter knowingly worked for The Kroger Company during the same period he received benefits and failed to notify BWC or his physician of his employment. Hunter was sentenced to 30 days in jail suspended for six months of community control. He must also pay restitution in the amount of $2,088.

Michael Bassinger, dba Freight Lease Inc., (Elida, Allen County) was convicted of one count of failure to comply for operating his business without the required workers’ compensation insurance coverage. SID opened the case after BWC’s Employer Compliance Department tried multiple attempts to assist Bassinger with bringing his policy into compliance. Investigators interviewed Bassinger, who stated he knew he was in violation of state law and wished to get back into compliance.  Bassinger submitted payroll reports and made a few sporadic payments, but never entered into a payment plan that would allow reinstatement of his policy. The case was referred to the Lima Municipal Court. Bassinger testified that he agreed to a payment plan with the Ohio Attorney General’s Office to reinstate his policy. He presented a copy a treasurer’s check in the amount of $50,000 to be used as a down payment, followed by $2,500 monthly payments. Bassinger was convicted of a misdemeanor count of failure to comply, fined $150 plus court costs, and ordered to comply with his established payment plan. Judge Workman advised Bassinger that he would lose his freedom if he did not comply with the sentencing.

John Monday AKA John Turner (Cincinnati, Hamilton County) pleaded guilty in the Franklin County Court of Common Pleas Nov. 5 after he was found working as a janitor while receiving benefits, a job he got using a fake ID.  SID learned that Monday, under his alias of John Turner, sought afterhours treatment for pain from a physician at the Spine Institute, where he worked as a janitor. He told this physician that he already had a physician who treated him for injuries related to a previous workers’ comp claim. Monday then stated his intention to change physicians and supplied his medical records to the physician who treated him afterhours.  Monday later realized the records were under his real name, John Monday, and asked the office not to file the most recent visit with BWC because he was not supposed to be working.  SID later learned that Monday worked as a janitor at the Cincinnati Spine Institute since 1990 while receiving permanent total disability and disabled workers’ relief fund benefits.  Monday used an Ohio driver’s license and a state Identification card under the name John Turner in order to obtain employment at the Spine Institute while on workers’ comp. Monday was found guilty of one felony count of workers’ compensation fraud and the judge proceeded immediately to sentencing. Monday was ordered to pay restitution of $105,169.23, in addition to court costs and $3,692.84 for investigative costs.  He was also placed on community control for five years under the conditions that he has no new convictions, and establishes an income within 60 days. If Monday violates the terms of his community control, he will serve 18 months in prison.

Elvin Hamilton (Dayton, Montgomery County) pleaded guilty to one felony count of workers’ compensation fraud on Nov. 22 in Franklin County Common Pleas Court for working while receiving benefits.  SID initiated an investigation after receiving an allegation from a BWC claims service specialist that Hamilton may have a photography business.  The investigation found Hamilton was operating Hamilton Photography taking pictures for companies, athletic organizations, government entities and private individuals while he concurrently received temporary total benefits between July 2010 and March 2013.  Agents conducted surveillance and undercover operations resulting in video evidence of Hamilton’s activities. The judge placed Hamilton on community control for 5 years, conditions are that he obtain/maintain employment and have no new convictions.  Hamilton was ordered to pay restitution of $63,196.35 to the BWC and transferred his supervision to Greene County.  If Hamilton violates the terms of his community control, he will serve 6 months at a State prison. Video footage of Elvin Hamilton is available here.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit bwc.ohio.gov, or visit www.facebook.com/ohiobwcfraud. View and share BWC’s workers’ comp fraud awareness video on our YouTube channel.

SID spreads holiday joy with toy drive

The Special Investigations Department (SID) has been busy again this holiday season collecting toys to donate to toy drives in the Columbus area. Spreading joy to children in need has become a tradition in SID and is now in its eighth year.IMG_0125

“The Holiday season presents opportunities to help those less fortunate in our community,” says Director of Special Investigations Rick Gregory. “Once again, members of our department donated cash, toys and their personal time to support another toy drive. Our employees know the power of giving and enthusiastically donate to ensure children in our area have a happy holiday when otherwise they would not.”

Join the generosity!

For those in the Columbus area, you still have an opportunity to contribute toys. Join us at the NBC4 Firefighters 4 Kids Toy Drive on Saturday, December 14 from 8 a.m. to 3 p.m. All Columbus fire stations will also accept toy donations until December 24. Visit the Firefighters For Kids website for more details.

The Marine Toys for Tots program has collection sites located throughout Columbus. Visit the Toys For Tots website for donation locations.

In addition, SID is donating $500 to Franklin County Children’s Services (FCCS) Holiday Wish program for gifts to children under the care of FCCS who might not otherwise receive any. Visit the website to grant a child’s holiday wish or to learn more about the program.

Categories: SID Information

Lima business owner owes more than $68,000 in unpaid premiums

BWC investigators recently closed a case involving Michael Bassinger, owner of Freight Lease, Inc. in Lima (Allen County), who was found operating his business without the required workers’ compensation insurance coverage since 2009.  Bassinger must now repay BWC more than $68,000 he owes in unpaid premiums.

The Special Investigations Department opened the case after BWC’s Employer Compliance Department tried multiple attempts to assist Bassinger with bringing his policy into compliance. Investigators interviewed Bassinger, who stated he knew he was in violation of state law and wished to get back into compliance.  Bassinger submitted payroll reports and made a few sporadic payments, but never entered into a payment plan that would allow reinstatement of his policy.

The case was referred to the Lima Municipal Court. Bassinger testified that he agreed to a payment plan with the Ohio Attorney General’s Office to reinstate his policy. He presented a copy a treasurer’s check in the amount of $50,000 to be used as a down payment, followed by $2,500 monthly payments. Bassinger was convicted of a misdemeanor count of failure to comply, fined $150 plus court costs, and ordered to comply with his established payment plan. Judge Workman advised Bassinger that he would lose his freedom if he did not comply with the sentencing.

A source’s one stop shop: BWC Contact Center

ImageSince 1996, professionals in the BWC Contact Center’s “fraud hotline” have effectively processed more than 30,000 allegations of workers’ compensation fraud. While this statement is comprised of simple words, the work required is far from simplistic.

To meet the expectations of fraud hotline customers, our BWC Contact Center colleagues:

  • Conduct immediate interviews with sources contacting the BWC fraud hotline to furnish new allegations;
  • Conduct follow-up interviews with sources and witnesses re-contacting the fraud hotline to either furnish additional information or to secure an investigative update;
  • Process allegations submitted to BWC by means of an online allegation referral form accessed and completed by sources via the BWC’s “Reporting fraud” web page;
  • Complete preliminary research pertaining to each subject before re-assigning the new allegations to the Fraud Management System work list of the respective special investigations unit.

The front end work performed by BWC Contact Center colleagues is instrumental to the success of our investigations. Their interviews with sources and preliminary research of BWC information are critical steps. Their considerable efforts have resulted in more than 2,500 cases closed founded (the original allegation was proven) and $163.8 million in savings identified to the Ohio State Fund.

You are our eyes and ears! Members of the BWC Contact Center fraud hotline understand, appreciate and thank you for your help in stamping out fraud. Please, keep those tips coming. To report workers’ comp fraud to one of our BWC Contact Center professionals, click here or call our fraud hotline at 1-800-644-6292.

Categories: SID Information