Archive

Archive for December, 2014

Thank you for your help in 2014!

It’s been an exciting year.

BWC’s Special Investigations Department conducted more than 60 fraud presentations to groups of internal and external stakeholders throughout the state. These include BWC employees, public and private employers, third-party administrators, medical providers and members of associations, such as chambers of commerce, safety councils and bar associations.

In April, SID and the Ohio State Highway Patrol hosted in Columbus hundreds of law enforcement professionals from around Ohio and the U.S. for the first Electronic Surveillance and Equipment Symposium.

We also shared a number of claimant, provider and employer workers’ compensation fraud cases with you this year. Here are a few of them:

  • Brooklynn Mieczkowski of Columbus, who inaccurately reported her symptoms and the extent of her injuries to improperly collect workplace injury benefits;
  • Glenn Jones of Cleveland, whose workplace security camera caught him faking a workplace injury;
  • Nelsonville chiropractor Michael L. Brown, whose patients were not at his office on days that he billed BWC for treating them, including dates his office was closed, and who fabricated the amount of treatment he provided to patients to receive a higher payment for services;
  • Lawanna Porter of Shaker Heights, who operated Palladium Healthcare, a home healthcare agency with more than 100 employees, but failed to report those employees to various state agencies.

We thank you for your support in 2014.

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

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

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Categories: News Articles

Lake County man pays $2,500 in workers’ comp restitution

Ronald Maiden, of Eastlake (Lake County), pleaded guilty Dec. 9 in Cuyahoga County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor.

BWC received an internal allegation from the agency’s intelligence unit that a cross-match of data from the Ohio Department of Job and Family Services found that wages were reported for Maiden. BWC’s fraud investigators examined employment and bank records, and confirmed that Maiden was employed as a car salesperson/manager while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit.

Maiden paid $2,599.05 in restitution to BWC on Dec. 9, and was fined $250 plus court costs.

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

Revised June 16, 2016 to remove an expunged case.

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that nine individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in November 2014. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“Investigating fraud is a vital part of the workers’ compensation business,” Buehrer said. “Identifying fraud puts dollars back into the State Insurance Fund and supports our efforts to keep premiums as low as possible.”

The following is a sampling of cases that resulted in guilty pleas or convictions during November:

Leslie Hammond (Newark, Licking County) was sentenced Nov. 21 in Franklin County Court of Common Pleas in connection with working while receiving disability benefits. In October, he pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony. BWC received an allegation that Hammond was working while receiving benefits. Investigators conducted multiple interviews and reviewed bank records, which showed that Hammond worked as a subcontractor while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Hammond was sentenced to serve one year in jail, but that was suspended for five years of community control. As a condition of community control, Hammond must pay $71,310.82 in restitution to BWC; if this requirement is not met, he will serve the jail time.

Dianne Smoot (Columbus, Franklin County) was sentenced Nov. 6 to pay $14,598.24 in restitution to BWC after pleading guilty the same day in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. A data cross-match with the Ohio Department of Job and Family Services revealed that Smoot received wages during the time she received disability benefits from BWC. Investigators found that Smoot worked as a home health aide for a program sponsored by the Central Ohio Area Agency on Aging while receiving the benefits. In addition to restitution, Smoot was sentenced to six months of incarceration, which was suspended for five years of community control. Terms of community control include paying the restitution and maintaining employment.

Russell Milam (Columbus, Franklin County) pleaded guilty Nov. 12 in Franklin County Court of Common Pleas to workers’ compensation fraud, a fifth-degree felony. BWC received two separate allegations that Milam was working while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Investigators reviewed payroll records, which showed that Milam worked as a subcontractor for a gutter company in 2010 while receiving temporary total disability. Milam was ordered to pay $3,288.24 in restitution. He was placed on community control with basic supervision for two years. Milam was also given 12 months at the Ohio Department of Rehabilitation and Correction, which was suspended as long as community control is not violated. He also had 13 days of jail time credit.

Samuel Jarrell (Marion, Marion County) pleaded guilty Nov. 12 in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. BWC received an allegation that Jarrell was working while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Investigators reviewed bank records and conducted both interviews and surveillance to prove that Jarrell was working at his family truck and auto repair business while receiving temporary total disability. Jarrell was ordered to pay $6,136 in restitution, and was also sentenced to 90 days of incarceration, which was suspended for a year of community control. Terms of his community control include paying the restitution.

Anthony Sebree (Amelia, Clermont County) pleaded guilty Nov. 14 in Clermont County Municipal Court to falsification, a first-degree misdemeanor, and was sentenced to two years of court-monitored probation. BWC received an allegation that Sebree may have filed a false claim. Investigators found that Sebree filed a claim with BWC, indicating that he was injured while working at a company in Batavia. The business provided records that showed Sebree was not employed by the company when the alleged injury occurred. Sebree confessed to investigators that he lied when he filed the claim with BWC.

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 and view BWC’s new workers’ comp fraud awareness video on YouTube.

Newark man ordered to repay $71K in workers’ comp benefits

Leslie Hammond, of Newark (Licking County), was sentenced Nov. 21 in Franklin County Court of Common Pleas in connection with working while receiving disability benefits. In October, he pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony.

BWC received an allegation that Hammond was working while receiving benefits. Investigators conducted multiple interviews and reviewed bank records, which showed that Hammond worked as a subcontractor while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit.

Hammond was sentenced to serve one year in jail, but that was suspended for five years of community control. As a condition of community control, Hammond must pay $71,310.82 in restitution to BWC; if this requirement is not met, he will serve the jail time.

Spreading holiday joy with toy drive

BWC’s Special Investigations Department (SID) has been busy again this holiday season, collecting toys to donate to toy drives around Ohio. Spreading joy to children in need has become a tradition in SID.

“I’m proud of our department’s efforts each year for the past several years to make the holidays a little brighter for children in need,” said SID Interim Director Jennifer Saunders. “We have an impressive team of dedicated professionals who not only do outstanding work all year, but really shine when they come together each December make a difference in their communities.”

We encourage you to join the generosity, and find a way to make a difference in your community this holiday season.

Thank you for reading our blog, and happy holidays!

Categories: SID Information

Meet Karen, our fraud hotline dispatcher

We really like Karen, our fraud hotline dispatcher.

Why? She thoroughly interviewed a source and effectively documented suspected fraud, which resulted in the identification of $374,175 in savings. To thank her, a member of our Special Investigations Department recently presented a certificate of appreciation to Karen for her dedication and success as a dispatcher with the fraud hotline, which is operated by BWC’s customer contact center.

A fraud analyst and a special agent for our department note that one of their recent investigations would not have occurred without Karen’s initial interview of a source.

Karen, thanks for all that you do! To report workers’ comp fraud to Karen, click here or call her at the BWC fraud hotline at 1-800-644-6292.

Categories: SID Information