Archive

Archive for July, 2014

Florida man ordered to repay $8K in workers’ comp benefits

Ryan Strohm, of Cocoa Beach, Florida, pleaded guilty July 9 in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony.

BWC received an allegation that Strohm withdrew from his BWC-paid college courses, but submitted grades to BWC as if he had completed those courses. He received benefits while attending college to assist with his return to work goals. Investigators reviewed college transcripts and confirmed that Strohm submitted false college records and made false statements to BWC from June 2011 to June 2012. Investigators also conducted customer interviews, and confirmed that Strohm returned to work as a self-employed contractor from July 2011 to June 2012.

Strohm agreed to repay $8,472.08 in restitution. He was sentenced to three years of community control. He was also sentenced to seven months of incarceration, but that portion of the sentence was suspended.

Columbus man ordered to pay $7K for workers’ comp fraud

David Sturgill, of Columbus, pleaded guilty July 1 in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. ??????????????????????

 

BWC’s special investigation unit began investigating after receiving an allegation that Sturgill was working while receiving BWC benefits. Investigators found that Sturgill was working as an electrician.

 

Sturgill was sentenced to 180 days in jail, which was suspended for 36 months of community control and could be extended up to 60 months.  He was ordered to pay $5,000 in restitution and $2,000 in investigative costs.

 

The numbers are in: SID identified $60.1 million in savings last year

SID annual report FY 2014We are pleased to report that SID identified $60.1 million in savings over the past year, according to statistics outlined in BWC’s Special Investigations Department (SID) fiscal year (FY) 2014 annual report. The report, which was published today, reflects upon and reviews recent performance statistics, trends, and strategies for preventing and detecting fraud.

Since our department’s inception in 1993, we have closed nearly 61,000 cases and identified more than $1.5 billion in savings to the Ohio workers’ compensation system.

Among the more than 2,055 cases that were closed in FY 2014, 924 were closed-founded, meaning the original allegation was proven. The average savings identified among the 924 cases was more than $65,000. More than 250 of these cases were referred for prosecution, resulting in 149 indictments and 132 convictions. These 149 indictments were an 11 percent increase over last year.

During the last 12 months, SID staff continued their focus on technological advancements as well as emerging trends pertaining to fraud and abuse. Additionally, SID continued to use effective digital forensics and social media to root out otherwise undetected fraudulent activity, and to bring public attention to workers’ compensation fraud.

Comparatively, SID achieved the following in FY 2014:

  • Lowest number of cases open at year end in the last 15 years;
  • Lowest number of investigative lag days per closed case in the last seven years;
  • Highest savings identified in the last four years;
  • Highest savings identified per closed and per founded case in the last seven years;
  • Highest number of terabytes of data processed by our digital forensics unit;
  • Highest number of referrals in the last six years;
  • Third highest number of indictments in the last 15 years;
  • Highest percentage of founded cases referred for criminal prosecution in the last seven years.

Looking forward, FY 2014 marks the beginning of SID’s fourth strategic plan, which will serve as an operational guide for the next five years. The results of this level of planning are responsible for the success SID experienced in this past fiscal year.

Thank you for supporting our efforts to deter, detect and prosecute workers’ compensation fraud. Keep those tips coming!

Former Milford man ordered to repay more than $26K in workers’ comp benefits

??????????????????????Columbus – A former Milford (Clermont County) man was ordered to pay more than $26,000 in workers’ compensation restitution. David Delvecchio pleaded guilty April 29 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony, after the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID) discovered that he was collecting disability funds while employed.

“We are fully committed to stopping workers’ compensation fraud regardless of where it occurs,” said BWC Administrator/CEO Steve Buehrer. “With the efforts from our Special Investigations Department, we will continue to find those who are illegally drawing from the State Insurance Fund.”

After receiving an allegation from a claims specialist, investigators followed Delvecchio to Capital Machine Company in Indianapolis, Indiana, where he was employed from Feb. 4, 2013 to Aug. 2, 2013. Delvecchio was also employed as a seasonal safety patrol member for the Indianapolis Speedway from April 30, 2011 to Aug. 29, 2011.

Delvecchio was ordered to pay $26,580.77 in restitution to the BWC, court costs, and to continue mental health counseling. He was also sentenced to five years of basic supervision community control. Violation of his community control conditions will result in an 11 month prison term. 

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

BWC investigations result in 12 workers’ comp fraud convictions in June

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced that 12 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in June 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.

“Our investigators received more than 3,400 tips last year and take each one very seriously in order to protect the State Insurance Fund,” Buehrer said. “BWC staff is always on the lookout for the telltale signs of fraud, and welcome tips through our website, by phone and via social media.”

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

Brooklynn Mieczkowski (Columbus, Franklin County) pleaded guilty June 24 to one misdemeanor count of workers’ compensation fraud for performing activities outside of her medical restrictions. SID received an allegation that Mieczkowski was involved in physical activity outside of her medical restrictions, and was possibly working, while receiving workers’ compensation benefits. Investigators conducted surveillance, and observed Mieczkowski performing activities contrary to her medical restrictions. Additionally, Mieczkowski was a student at a local culinary school and she attended classes while receiving BWC benefits. Mieczkowski participated in meal preparation training, which involved standing for up to three hours at a time, and did not appear to have an injury while attending classes. However, she used a cane each time she attended a hearing at the Ohio Industrial Commission and at her doctor’s office. After viewing the surveillance video, Mieczkowski’s physician determined she had inaccurately reported her symptoms and the extent of her injuries, and dismissed her from his practice. Mieczkowski was ordered to pay $6,252 in restitution and $4,000 in investigative costs.

Maria Meszaros (Cleveland, Cuyahoga County) pleaded guilty June 5 in the Franklin County Court of Common Pleas to workers’ compensation fraud for working while receiving benefits.BWC received an allegation that Meszaros was the owner of the Tequila Sunrise 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. 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. The sentence will be suspended if she pays before that date.

Naif Said (Columbus, Franklin County) pleaded guilty to one misdemeanor count of workers’ compensation fraud June 5 for working while receiving benefits.SID received an internal allegation stating a cross match with the Ohio Department of Job and Family Services revealed Said had received wages during the same period he received temporary total benefits from the BWC.Said’s employment records from Covenant Home Health Care confirmed he worked as a home health care aide while concurrently receiving benefits.Said was sentenced to six months of incarceration, which was suspended for one year of community control.  Conditions are to pay restitution to BWC in the amount of $6,493.72, maintain employment and obtain no new convictions.

Russell Whitman (Mentor, Lake County) pleaded guilty June 12 to one felony count of workers’ compensation fraud for falsifying documents. SID began investigating Whitman, and his wife, Regina Whitman, after receiving an allegation. Both worked for a family-owned business in Lake County and were suspected of embezzling a large amount of money from the business. By reviewing hours of recorded jail phone calls between the Whitmans, the Special Investigations Unit (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 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.

Charles Oberdick (St. Clairsville, Belmont County) pleaded guilty to one count of workers’ compensation fraud June 17 in the Franklin County Court of Common Pleas for falsifying documents. 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. SID 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 days 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.

Shannon Rager (Logan, Hocking County) pleaded guilty June 26 in Franklin County Court of Common Pleas to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID received a tip that Rager was working while receiving BWC benefits. Surveillance was conducted on multiple days, and several witnesses confirmed that Rager was working as a tow truck driver and mechanic. The SIU’s investigation showed that Rager knowingly worked in these roles while receiving BWC benefits. Rager was sentenced to 12 months of community control. He was also ordered to pay $2,376 in restitution to the BWC.

Maynard Jackson Sr. (Fremont, Sandusky County) pleaded guilty June 18 in Franklin County Court of Common Pleas to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID received an allegation that he was working while collecting BWC benefits. The investigation found that he worked as a truck driver in Perrysburg while collecting more than $2,000 in non-working wage loss benefits between August and October 2008. He is scheduled to be sentenced on Aug. 6.

Kayla Fortman (Hicksville, Defiance County) pleaded guilty June 27 in the Lima Municipal Court to one misdemeanor count of falsification for filing a false claim. SIDreceived an allegation that Fortman filed a claim with the BWC indicating that she fell at work, although she posted on a social media site that she fell at a gas station.  The investigation found Fortman reported to her employer and treating physician that she fell in the company parking lot, when in fact she fell while getting out of her vehicle at the gas station across the street. Fortman was sentenced to 180 days in jail, which was suspended, and two years of probation.  She was ordered to pay $200 in court costs and to make restitution to BWC in the amount of $1,908.76.

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

Sources say the darndest things

We’ve seen movies with anonymous phone calls, tipping off the authorities to criminal activities, or even TV crime dramas with worried tipsters, who are reluctant to give their names to the police. In reality, scenes like this rarely happen. Callers to our fraud hotline willingly provide us with information without hesitation.

Typically, our sources are so infuriated by the subject’s criminal behavior that they are willing to risk having their identities known. They offer to assist with our investigation by capturing audio and video evidence, which could serve as admissible evidence in court.

To illustrate this, here are a few examples of the countless real statements sources have provided to our fraud hotline agents during their initial calls to us:

  • I have over 1,000 videotapes of the subject I secured from a permanent, continuous (24/7 year-round) stationary surveillance camera I installed three years ago overlooking his property;
  • I have audiotapes of the subject bragging to her sister about working more than 40 hours weekly while fraudulently receiving lost time benefits. I intercepted her cellular phone conversations. (The source then played several recordings through the phone.)
  • You are welcome to video the subject from my guest bedroom. It offers an unobstructed view of the subject’s residence and vehicles.
  • Do you want me to provide you with the plate numbers of the subject’s vehicles? I can easily get them for you and would be happy to do so.
  • Do you want me to follow and video the subject traveling to and from work? I have a good camcorder and I know how to use it.
  • Your agents will have a great view of the subject if they check into room number…of the…hotel. I know because I tested it yesterday. It is perfect.
  • I know you won’t need me to testify in court. However, I want you to know I am willing to testify against him or do whatever else you need to bring him to justice.
  • I don’t need any confidentiality. In fact, I want the subject to know who turned him in. I would like to tell him to his face that I reported him to BWC.

There is no question how far our sources willing to go. They get involved because they are hard-working citizens and believe that others should be, too.

Despite this willingness to share information, we instruct each source to protect their personal safety and if there are callers who worry about being subpoenaed to testify in court, we assure them this will not be the case.

Additionally, we ask them to avoid contact with the subject and to permit us to independently conduct a thorough and objective investigation. We advise sources that we will re-contact them regarding the investigative outcomes. We thank our sources for their interest in justice and willingness to join us in protecting the integrity of the workers’ compensation system in Ohio.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

Categories: News Articles

Overt or covert?

Summertime in the northern hemisphere means movie time in the USA. This is the season when new blockbusters are released. Some of these releases – especially the crime dramas – include scenes of undercover operatives conducting covert operations, or “espionage,” on the internOvert or covert picture 1 7-11-14ational stage, deploying undercover surveillance to capture stills and video of their target’s criminal behavior. But are they realistic?

Typically, these surveillances are predictably portrayed. The lead actor and his/her partner set up in a dark sedan parked directly across the street from the villain’s hide-out. Typically, this occurs at dusk. At night, we see coffee cups and a newspaper or two on the vehicle’s dashboard. In the next scene, it is dawn, and the heroes sit up, sleepily stretch and yawn. Three seconds later, it happens.

The target exits the building and proceeds down the sidewalk, carrying something of apparent evidentiary importance (e.g., a package or a briefcase) and glancing furtively over each shoulder…twice. A super sleuth quickly lowers the front passenger window, extends the camera’s long distance lens, then the camera body, and lastly, his entire head. He quickly focuses the device — we see the lens turning clockwise, then counterclockwise. Then, he commences firing away — we hear the rapid, emphatic (and interminable) click, click, click, click. A nod to the driver signifies to the audience that the evidence has been secured. The critical scene concludes with the driver squealing the undercover vehicle’s tires as she abruptly pulls away from the curb and into a U-turn, adroitly avoids a pedestrian, and accelerates to pursue the oblivious (but otherwise brilliant) fleet-footed fugitive.

The scene is so commonplace that we hardly question its realism. But shouldn’t we? Is this truly how successful undercover agents secure evidence, determine the facts and bring criminals to justice? No.

To counter this stereotype, we considered showing you stills of our agents conducting actual undercover surveillance. However, that would be foolish.

Instead, check out SID’s own blockbuster, Workers’ Comp Fraud: Raising Awareness, which highlights examples of surveillance video captured by our agents using their covert knowledge, skills and Overt or covert picture 3 7-11-14experience.Overt or covert picture 2 7-11-14

Successful undercover surveillance agents are not seen, heard or even sensed. That’s why they are effective. Their surveillance is covert.

Covert as in these images (see right).

BWC SID uses a variety of effective tools and techniques in our investigations, including undercover operations. In fact, a picture really does say a thousand words.

 

 

 

Categories: News Articles