Archive

Archive for June, 2014

Cleveland business owner guilty of working while receiving workers’ comp benefits

Maria Meszaros of Cleveland pleaded guilty to workers’ compensation fraud after BWC discovered she was working at her bar while she was supposed to be recovering from a workplace injury. BWC received an allegation advising Maria Meszaros was the owner of the Tequila Sunrise, located at 4803 Turney Rd. in Garfield Heights, and was working there while receiving temporary total disability benefits. Through undercover operations and interviews, SID confirmed Meszaros returned to employment as a cook for her business while receiving those benefits.

Meszaros appeared in the Franklin County Common Pleas Court June 5 and the judge sentenced her to what he termed “pay or stay.” That means he ordered Meszaros to repay $2,000 in restitution to BWC, as well as court costs by March 31, 2015, or she will serve 180 days in jail. If she pays before that date, the days will be suspended.

Advertisements

Coming Soon…SID FY 2014 Annual Report

Like a good movie trailer that entices you to go to the movie theater, we would like to make you aware of our soon-to-be released SID fiscal year 2014 Annual Report.  Each year, we furnish an annual report of our performance, strategic initiatives and fraud trends we have identified.  In the coming weeks, we will be hard at work reviewing operations, assessing performance outcomes and tallying the results achieved during fiscal year 2014, which concludes on June 30. Since fiscal year 2001, this year-end process has culminated in the publication (during late July) of our SID annual report.

Like in the movie, The Wizard of Oz, we are like the man behind the curtain.  Our investigative staff works diligently to ensure those with legitimate work-related injuries receive benefits and medical care…and those who are not answer for their actions to the fullest extent of the law.  In the coming report, we will highlight some of our successes in the past year, profile some interesting fraud cases and provide a sneak peak of our new strategic initiatives.

Since SID performance results are generated by effective collaborations with our governmental and public law enforcement colleagues, the report will acknowledge those agencies with which we conducted joint investigations during fiscal year 2014.

The document will also offer achievements of respective teams and task forces, as well as shine a spotlight upon operational trends and strategies. Debuting in this year’s report will be a summary of presentations facilitated by SID employees. These include our sponsorship of an inaugural Electronic Surveillance Equipment Symposium, conducted for 300 members of governmental and public law enforcement agencies on April 17.

Most importantly, we’re pleased that the current level of performance suggests we will surpass our outstanding results from fiscal year 2013. View the entire 2013 annual report here.

Of course, criminals do not take sabbaticals. Neither do we. Even as we create and finalize the fiscal year 2014 report, we continue to detect, investigate, prosecute and deter fraud. On July 1, we commence the work that will warrant review in our fiscal year 2015 Annual Report.

Meanwhile, stay tuned for the late July release of the SID fiscal year 2014 Annual Report.

Belmont County man guilty of workers’ comp fraud

oberdickColumbus – A St. Clairsville (Belmont County) man pleaded guilty to fraud after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found he was submitting false paperwork in order to receive workplace injury benefits. Charles Oberdick pleaded guilty June 17 in Franklin County Court of Common Pleas to one count of workers’ compensation fraud.

“BWC’s goal is to get injured workers healthy and back on the job as soon as possible,” said BWC Administrator/CEO Steve Buehrer.  “Falsifying paperwork in order to continue benefits is not only contrary to that goal, it is a crime that unfairly draws employer premiums dollars from the State Insurance Fund.”

Oberdick was receiving non-working wage loss, which is payable to injured workers who are unable to find suitable employment   In order to qualify, the injured worker must demonstrate a good faith effort to secure employment within physical restrictions, and is required to submit job search forms indicating an active searching for employment. BWC’s Special Investigations Unit received an internal allegation from a claims service specialist that Oberdick was not performing job searches and was submitting falsified job search forms in order to continue receiving these benefits.

The investigation showed Oberdick knowingly misrepresented the majority of his job searches to BWC. Reviews of his job searches showed the majority of the employers he claimed to seek employment with did not have his resume on file. The investigation also showed Oberdick routinely listed the same business on multiple job search forms for different time periods, and listed contacts on Saturday, Sunday and holidays when the businesses were not open. As a result of the false job search forms, BWC paid benefits to Oberdick he was not entitled to receive.

Judge Holbrook sentenced Oberdick to a suspended sentence of 90 days incarceration under the conditions that he pay court costs and restitution in the amount of $2,458.86.

A photo of Oberdick is available here.

 To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov. Check out our latest cases at ohiobwcfraud.wordpress.com, follow Fraud Fridays on Twitter @OhioBWCFraud, or join in the conversation at facebook.com/ohiobwcfraud. View and share BWC’s workers’ comp fraud awareness video on our YouTube channel.

BWC investigations result in 14 workers’ comp fraud convictions in May

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced that 14 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in May 2014. These 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.

“BWC is committed to carefully managing the money employers pay in premiums to protect their workforce,” said Buehrer.  “Putting an end to fraud and prosecuting those who break the law helps protect those employer dollars and ensure they’re available to support Ohio’s injured workers in their time of need.”

The following case information represents a sampling of cases that resulted in guilty pleas or convictions during May:

Gerald Whitacre (Upper Sandusky, Wyandot County) pleaded guilty May 15 in Franklin County Court of Common Pleas to one felony count of workers’ compensation fraud for falsifying wage statements. After conducting an employer audit, a BWC employer service specialist reported a suspicion that Whitacre may have falsified wage statements from a trucking company in Upper Sandusky to obtain increased workers’ compensation benefits. Investigators found that Whitacre altered his pay stubs to lower dollar amounts and submitted them to BWC to qualify for working wage loss disability benefits. He underreported his payroll to BWC on 41 wage statements, and if he had accurately reported his earnings, he would not have been entitled to the benefits he received.

Whitacre was sentenced to 12 months of incarceration, suspended for five years of community control. Conditions of Whitacre’s community control include paying $22,468.81 in restitution to BWC, obtaining viable employment, paying court costs and not having any new convictions. If he violates the terms of community control, Whitacre will serve 12 months of incarceration.

Garry Frederick, dba Top Notch Diner (Cortland, Trumbull County) pleaded no contest May 7 to charges related to a dishonored check for his premiums payment. Frederick, owner of Topnotch Diner, was convicted in 2010 for attempting to pass a bad check to BWC for a premium payment of his company.  In March 2011, Frederick reinstated his coverage; however, it lapsed in September 2011 after Frederick submitted another check to BWC that was returned due to non-sufficient funds.  Frederick subsequently submitted two additional checks to the BWC that were returned due to non-sufficient funds. Topnotch Diner continued to operate without workers’ compensation coverage.  Agents met with Frederick on multiple occasions and attempted to have Frederick repay the dishonored payments.  However, Frederick failed to comply and make payment. Frederick was ordered to pay the fine and court costs for each of the three misdemeanor counts.  He entered a payment plan with Attorney General’s Office.

Sean Merritt (Cincinnati, Hamilton County) pleaded guilty May 27 in the Franklin County Court of Common Pleas to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID initiated an investigation after identifying that Merritt had employment wages reported to another state agency during a period he was receiving BWC disability benefits. The investigation found that Merritt returned to work at My Brother’s Keeper, Therapeutic Home for Youth, Inc. in Cincinnati as a caretaker from while collecting temporary total disability from a work related injury. Merritt was sentenced to pay $6,789.07 in restitution, which he had already paid prior to the court date.  The judge also sentenced Merritt to one day in jail, which was suspended for time served.

Tina Contini (Wapakoneta, Auglaize County) pleaded guilty May 6 in the Franklin County Court of Common Pleas to one misdemeanor count of worker’s compensation fraud for working while receiving benefits.  SIDidentified through a state agency cross match that wages were being reported for Contini while she was collecting temporary total disability benefits.  The investigation found Contini returned to work as a sales manager at MT Business Technologies, Inc., an office equipment company.  Contini was sentenced to 60 days, suspended for 24 months of community control.  The judge also ordered Contini to pay restitution of $4,496.34 to BWC, as well as court costs.  The court ordered non-reporting probation that will be terminated upon payment of restitution in full.

Tameka Hines (Dayton, Montgomery County) pleaded guilty May 8 in the Franklin County Court of Common Pleas to a misdemeanor count of attempted workers’ compensation fraud for working while receiving benefits.SIDreceived an allegation that Hines may be working.  The investigation found that Hines returned to work as an independent contractor for Hooper Holmes, performing physical examinations for life insurance policy applicants.  She worked between December 2012 and February 2013 while collecting temporary total disability from BWC. Hines has settled her claim and restitution of $4,949.11 has been recouped. The judge also fined Hines $250 and ordered her to pay court costs.

Randy Hartman (Rudolph, Wood County) pleaded guilty May 19 in the Franklin County Court of Common Pleas to one misdemeanor count of workers compensation fraud for submitting false wage statements.SIDreceived an internal allegation after a BWC representative noticed Hartman was not submitting paystubs with his wage statements in order to obtain disability benefits. The investigation found that Hartman submitted false wage loss statements to BWC to obtain living maintenance wage loss benefits.  Hartman was fired from his legitimate job but continued to submit 22 wage statements to BWC in order to conceal he was no longer employed with Downtown Sports Bar and Grill in Bowling Green.  Hartman was sentenced to 150 days in jail, suspended for two years of community control.  Hartman was ordered to pay restitution to BWC in the amount of $4,682.84 and obtain no new convictions.

Michael Madigan (Wintersville, Jefferson County) pleaded guilty May 8 in Franklin County Municipal Court to a misdemeanor count of workers’ compensation fraud, for working while receiving benefits.SID received an allegation that Madigan was operating a firearms business while receiving multiple types of benefits from the BWC.  Investigators reviewed the bank records of the firearms business. Activity in the account showed sales of firearms and some checks were written directly to Madigan. An audit report of the business indicated that Madigan was the primary person selling the firearms. The investigation conducted by the SIU confirmed that Madigan knowingly owned and operated the business, and earned income while he was receiving benefits from the BWC.

Madigan was ordered to pay $14,801.78 in restitution to the BWC, and court costs.

Rita Lynch (Strongsville, Cuyahoga County) pleaded guilty May 21 to a misdemeanor count of theft for working while receiving benefits. SID received an allegation that BWC’s Cleveland Service Office had received numerous telephone calls stating that a claimant, Rita Lynch, was listing BWC as her employer on credit applications. Lynch stated to agents that she had reported BWC as her source of income when applying for credit, but had not represented herself as an employee.  Prior to the interview of Lynch, agents discovered that Lynch worked as a Telemarketer for Dial America.  Lynch initially denied working but when confronted, acknowledged she returned to work while receiving Living Maintenance Benefits.  Records confirmed Lynch, who was working closely with rehabilitation case managers, provided a false return to work date to BWC and repeatedly failed to advise her case managers that she had already returned to work. Lynch was sentenced to 180 days in prison, gave her credit for 10 days she already served, and suspended the balance for a term of five years of community control. As a condition of her community control, Lynch is to repay the BWC $4,854 in restitution.

Ronald G. Larlham, dba RGS Automotive (Ravenna, Portage County) pleaded guilty May 12 in Ravenna Municipal Court to one misdemeanor count of workers’ compensation fraud for operating his business with lapsed coverage. BWC’s Compliance Department found that Ronald G. Larlham, was operating his Portage County business (RGS Automotive) while its BWC coverage had lapsed.  The case was referred to the Employer Fraud team after Larlham failed to work with the BWC Compliance Department to bring his policy back into compliance.  Agents made several attempts to work with Larlham in order to bring his business into compliance with state law; however Larlham failed to comply with BWC’s requests. Larlham was sentenced to 180 days in jail with 179 day suspended and credit for one day served and was ordered to pay restitution to the BWC for $3,503.14 which is to be monitored by the Adult Probation Department and paid through the Office of the Ohio Attorney General.

Valencia R. Daniels (Columbus, Franklin County) pleaded guilty May 8 to a misdemeanor count of workers’ compensation fraud for filing a false claim. SIDreceived an allegation that Daniels filed a false claim against Friendly Transportation Services alleging she was injured while working.  However, Friendly Transportation Services indicated Daniels was never an employee.  Friendly Transportation Services acknowledged that Daniels had applied for employment with their company but was never hired.  The investigation found Daniels was never hired by or employed by the company. Daniels’ BWC claim was ultimately denied by the Ohio Industrial Commission. Daniels was ordered to pay a $150 fine and court costs were waived.

Joseph Garcia, dba A Expert Rooter, Inc. (Cincinnati, Hamilton County) was convicted May 8 of disorderly conduct after he was found operating his business with lapsed coverage. SID received an allegation that Garcia continued to operate his business, A Expert Rooter Inc., although his workers’ compensation coverage had lapsed.  The case was referred to the Employer Fraud team after Garcia failed to work with the BWC Compliance Department to bring his policy back into compliance. Garcia failed to comply with the agents’ continued requests to bring his business back into compliance. He also issued a payment to BWC that was dishonored by the bank due to insufficient funds. Garcia was present in court for a bench trial and provided EFT agents with money orders totaling the current balance due on his policy. In addition, Garcia was advised he would need to bring the business policy back into compliance with State law.

Ricky Gantz (Elyria, Lorain County) pleaded guilty May 9 to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID received an allegation from indicating Gantz was playing in a Beatles tribute band while receiving Temporary Total Disability benefits. The investigation found Gantz continued sustained remunerative employment, as a musician, with John F. Gilbert III, DBA Abbey Road Band, between April 2012 and August 2013.  The Industrial Commission of Ohio found Gantz overpaid $13,277.24. On the day of the hearing, Gantz’s attorney provided the SIU with a check for the complete overpayment amount.Gantz was fined $120 and ordered to pay court costs.

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

Under the table: Summertime fraud

Summer officially begins tomorrow, and warmer weather draws people outdoors.

For most of us, summer means barbeques, gardening, vacations and freshly cut grass. Some of us don’t like those summer chores and would rather pay the young person down the street to weed the flowerbeds and clear the gutters before the next big summer downpour.

It’s a pretty simple transaction, really. The neighbor isn’t an “employee” in the official sense, and you hand him the cash when the job is done.

A problem arises, however, if instead of a high school sophomore trimming your trees and bushes, the work is done by an injured worker receiving workers’ compensation benefits.

If that’s the case, there’s a big problem. There are two acts of fraud taking place. The first lies with the worker who is working while receiving compensation benefits. If you’re on comp, you can’t work.

The second would apply to you, the person who hired the injured worker. If you knowingly employ a worker who is simultaneously receiving workers’ compensation benefits, you are also liable and you could also face charges of fraud and conspiracy to conceal wages. This is precisely why attorney Otha Jackson was convicted in federal district court of one felony count of mail fraud and one felony count of conspiracy to commit an offense against the United States. Our investigation proved that Jackson had knowingly hired an injured worker, Renee Jefferson, and conspired to conceal her wages. Jefferson was sentenced to serve 18 months in federal prison. Jackson was sentenced to serve 21 months in federal prison.

BWC’s Special Investigations Department (SID) is constantly on the lookout, especially during the summer months, for fraudulent companies operating in the great outdoors with claimants receiving workers’ comp and trying to hide their earnings by taking cash under the table. SID is able to track official wage reports, and we’re also aware of ways those who commit fraud try to work around them. Our investigators are also out in full force. We know the extended daylight hours that draw injured workers into public view act as a spotlight to shine attention upon their activities. Cameras capture evidence of their crimes.

Don’t let fraud get in the way of a summer that should be about sunshine, family and fun.

Categories: News Articles

Former Mentor man ordered to repay $13K in workers’ comp benefits

Russell O. WhitmanColumbus – A former Mentor (Lake County) man was ordered to pay more than $13,000 in workers’ compensation restitution. Russell Whitman pleaded guilty June 12 to workers’ compensation fraud, a fifth-degree felony, after an investigation by the Ohio Bureau of Workers’ Compensation (BWC) revealed he and his wife concocted an elaborate scheme to submit false documents to the agency, so he would continue to receive workers’ compensation benefits while incarcerated.

“A quick-thinking claims service specialist spotted a newspaper article about the incarcerated injured worker, and reported it to our Special Investigations Department,” said BWC Administrator/CEO Steve Buehrer. “We often rely on tips from the public and from our own staff to report instances of suspected fraud, which we investigate in order to protect Ohio employers and the State Insurance Fund.”

The Northeast Region 1 Special Investigations Unit (SIU) began investigating Whitman, and his wife, Regina Whitman, after receiving the allegation. Both worked for a family-owned business in Lake County and were suspected of embezzling a large amount of money from there. By reviewing hours of recorded jail phone calls between the Whitmans, the SIU confirmed that his wife, who was the payroll manager for the business, submitted false payroll reports to the BWC on behalf of her husband. Those records allowed Whitman to collect workers’ compensation benefits he was not entitled to receive.

Whitman was ordered to pay $13,696.27 in restitution to the BWC and was sentenced to serve six months in prison, which will run concurrently with his current five-year sentence at the Belmont Correctional Institution for the embezzlement of more than $285,000. His wife was previously sentenced.

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

 

“Fraud Red” Flag Day

For the winter holidays, it might be a Christmas tree. Thanksgiving has the turkey and Easter has its egg.  And as Americans celebrate Flag Day this June 14, they, as you may have guessed, will certainly put their flags on display.

The point is that the actions we deliberately choose to perform are often accompanied by signs that communicate those actions to others.

Unlike the patriotic reasons many choose to celebrate Flag Day, those who commit workers’ compensation fraud send up flags that indicate their activities.

These “red flags” often alert BWC’s Special Investigations Department’s (SID) investigators to suspicious behavior by claimants, employers, and even providers.  After choosing to commit fraud, something in their behavior begins to shift. Their day-to-day actions begin to change, leaving tell-tale signs for SID to follow.

A situation might arise when someone you know was truly injured at one time and are receiving compensation, but now you suspect them of working at the same time. Are there red flags in this instance? You bet.

Injured workers who may be working while fraudulently receiving BWC benefits could give themselves away by being seen leaving their home in the morning and not returning until late in the afternoon, parking a work truck at their residence, or having many visitors at their house during the day, suggesting they are running a home business.

Employer red flags could include discouraging employees from filing valid workers’ compensation claims and requiring newly-hired employees to complete 1099 forms to declare themselves independent contractors.

When it comes to reporting fraud, it is important that we remember that spotting red flags is only the beginning. SID investigative staff still needs to conduct an investigation based upon the facts to determine if a crime was actually committed. The identification of any of these indicators does not mean that fraud was committed.

You play an integral role as our eyes and ears in helping us weed out people committing workers’ compensation fraud. Your efforts will help those who are truly injured receive the benefits to which they’re entitled. To report workers’ compensation fraud, click here or call our Fraud Hotline at 1-800-644-6292. To discover more about fraud red flags for employers and health care providers, click here.

While fraudsters might fly a special red flag for all the wrong reasons, remember those good reasons to raise the red, white and blue this weekend.

Happy Flag Day!

Categories: News Articles