Archive

Archive for February, 2016

Columbus pest control business owner guilty of workers’ comp fraud

David Wallace of Columbus (Franklin County) appeared in court this week and was ordered to repay the Ohio Bureau of Workers’ Compensation (BWC) $10,000 in restitution for running a pest control company while receiving benefits for a workplace injury.

BWC’s Special Investigations Department initiated an investigation after receiving an allegation that Wallace was running a pest control business while receiving disability benefits. The investigation found evidence proving Wallace was the owner/operator of Discount Pest Control, and was actively working as the sole employee while intentionally concealing his activities from BWC in order to continue receiving benefits.

 

Wallace appeared in the Franklin County Court of Common Pleas on Feb. 23 and pleaded no contest to a first-degree misdemeanor count of workers’ compensation fraud. Judge Holbrook  found him guilty and in addition to ordering $10,000 in restitution, sentenced Wallace to 180 days in jail, suspended for 60 months of Community Control.

A forged relationship: The victimization of a claimant

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In a September 23, 2011 blog, “Dishonored memories: Deceased claimants with dishonest relatives,” we described how dishonest relatives may express their grief over the death of a loved one quite differently than law-abiding citizens. We noted that criminals may choose to dishonor the memory of deceased relatives by committing workers’ compensation fraud in the personal, confidential records of a deceased claimant.

These criminals falsely report to us that their deceased relatives continue to live. They pretend to be the claimants themselves, sometimes even adopting the voice of an opposite gender’s voice and/or an elderly person in an attempt to deceive us. These charlatans scheme to intercept any check addressed to a deceased claimant, forge their signature, and pretend to be the claimant (aka “uttering”) in order to cash the check to which they know they are not entitled. In situations where lost-time benefits are paid electronically, family members may inappropriately access and use monies to which they are not entitled, by concealing the claimant’s death.

Of course, such deceptive acts, born out of greed, are not limited to the relatives of our claimants. Forgery and uttering crimes are also committed by non-relatives, such as neighbors or other acquaintances. And some claimants are victimized before death, such as when the criminal uses a power of attorney to grab benefits intended for a claimant who has been deceived, often while incapacitated or otherwise dependent.

A Case In Point

blog pic 1Consuelo “Connie” Griffin and David Lusk (Cincinnati, Hamilton County) both pleaded guilty Jan. 14 in the Hamilton County Court of Common Pleas to counts of theft after they were discovered cashing BWC benefit checks for a claimant who had died.

SID opened an investigation after receiving an allegation from BWC’s claims department, which was unable to contact a claimant receiving permanent total disability for a workplace injury. The claims department reported that claimant’s phone was disconnected.

The investigation found that while the claimant passed away in June 2014, the BWC checks that were mailed to his home continued to be cashed. Griffin and Lusk lived in the same apartment complex as the deceased and when he was hospitalized, Griffin signed a power of attorney document giving her control over his finances. Griffin also had the claimant’s mail forwarded to her address and the pair moved into his apartment when he was hospitalized. Griffin confessed to signing Harrell’s name on the checks and cashing them. Griffin also took money out of his bank account while he was ill and wrote checks from his account to herself for cash. His account was soon closed because Griffin and Lusk spent all the money and failed to pay any of his nursing home expenses.

blog pic 2Lusk pleaded guilty to count of theft and one count of theft from the elderly, both fifth-degree felonies. Griffin also pleaded guilty to two counts of theft, both fifth-degree felonies. The court sentenced them to 10 months in jail, suspended, and ordered them to repay restitution of $5,072.62. They also received three years of probation.

For other case examples or more information about the SID, see our Special Investigations Department Fiscal Year 2015 Annual Report.

To report suspected fraud via a fraud referral form click here or call the BWC fraud hotline at 1-800-644-6292.

Cincinnati home health aide repays $12K for workers’ comp fraud

Talesha Sherman Booking PhotoA Cincinnati (Hamilton County) woman has repaid more than $12,000 in workers’ comp benefits she received fraudulently. Talesha Sherman was sentenced in the Franklin County Court of Common Pleas on Feb. 11

The BWC Special Investigations Department began investigating after identifying that Sherman may have been earning wages while simultaneously collecting disability for a workplace injury.  The investigation revealed that Sherman had returned to work as a home health aide while on temporary total disability.

Sherman pleaded guilty to one first-degree misdemeanor count of workers’ compensation fraud and paid restitution totaling $12,981.40 prior to her plea. The judge also sentenced her to 90 days in jail, suspended for one year of community control.

Cleveland man repays $42K, pleads guilty to workers’ comp fraud

A Cleveland (Cuyahoga County) man repaid more than $42,000 to the Ohio Bureau of Workers’ Compensation (BWC) before entering a guilty plea to workers’ compensation fraud earlier this month.

BWC’s Special Investigations Department (SID) opened an investigation into David Milcinovic after a cross-match with Ohio Department of Job and Family Services indicated the Polish National Alliance reported wages for him during a period of time he was receiving workers’ compensation benefits. The investigation confirmed Milcinovic continued employment as the Vice President of Union of Poles and Board Member of the Polish National Association while he was receiving temporary total disability benefits for a workplace injury.

Milcinovic pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud on Feb. 9 in the Franklin County Municipal Court. Milcinovic had already prepaid the entire restitution in the amount of $42,911.73 to the Bureau of Workers’ Compensation. He was ordered to pay a fine of $250, plus court costs.

Columbus woman ran cleaning business while on workers’ comp

Olivia Robinson Booking PhotoOlivia Robinson of Columbus (Franklin County) has been ordered to repay the Ohio Bureau of Workers’ Compensation (BWC) more than $26,000 in workers’ compensation benefits. She received the benefits fraudulently while working at a banquet center and concurrently operating her own cleaning business.

BWC’s Special Investigations Department (SID) received an allegation that Robinson owned a cleaning company and was cleaning offices and residential homes while she was receiving workers’ comp for a workplace injury. The investigation confirmed she was owner of All Points Cleaning and had been cleaning offices for regular and repeat customers over a period of several years. Investigators also found Robinson was concurrently employed with Bridgewater Banquet Center, and that she intentionally misrepresented and withheld her employment with both companies in order to continue collecting BWC benefits.

Robinson pleaded guilty to a first-degree felony count of attempted workers’ compensation fraud on Feb. 16 in the Franklin County Municipal Court. She was ordered to pay $26,737.47 in restitution to BWC. She was also sentenced to eight months in the Ohio Department of Rehabilitation and Correction, suspended on the condition that she successfully completes five years of community control.

BWC investigations result in four workers’ comp fraud convictions in January

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that four individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in January 2016. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“A recent case in which two individuals stole the identity of a deceased claimant shows that some people will go to great lengths to scam the system,” said Buehrer. “They are a clear reminder why we continue our efforts to protect the dollars employers pay to support Ohio’s injured workers in their time of need.”

 The following are cases that resulted in guilty pleas or convictions during January:

Consuelo “Connie” Griffin and David Lusk (Cincinnati, Hamilton County) both pleaded guilty Jan. 14 in the Hamilton County Court of Common Pleas to counts of theft after they were discovered cashing BWC benefit checks for an injured worker who had died. SID opened an investigation after receiving an allegation from BWC’s claims department, which was unable to contact an injured worker receiving permanent total disability for a workplace injury. The claims department reported that worker’s phone was disconnected. The investigation found that while the injured worker passed away in June 2014, the BWC checks that were mailed to his home continued to be cashed. Griffin and Lusk lived in the same apartment complex as the deceased and when he was hospitalized, Griffin signed a power of attorney document giving her control over his finances. Griffin also had the injured worker’s mail forwarded to her address and the pair moved into his apartment when he was hospitalized. Griffin confessed to signing Harrell’s name on the checks and cashing them. Griffin also took money out of his bank account while he was ill and wrote checks from his account to herself for cash. His account was soon closed because Griffin and Lusk spent all the money and failed to pay any of his nursing home expenses. Lusk pleaded guilty to count of theft and one count of theft from the elderly, both fifth-degree felonies. Griffin also pleaded guilty to two counts of theft, both fifth-degree felonies. The court sentenced them to 10 months in jail, suspended, and ordered them to repay restitution of $5,072.62. They also received three years of probation.

Michelle Green (Columbus, Franklin County) pleaded guilty Jan. 13 in the Franklin County Court of Common Pleas to attempted workers’ compensation fraud, a first degree misdemeanor, for working while receiving benefits. SID’s Intelligence Unit received data from the Ohio Department of Job and Family Services (ODJFS) that indicated Green had received wages while receiving BWC benefits. The investigation confirmed Green was employed with Good Hands Home Health Care Service in Columbus. Evidence obtained during the course of the investigation also showed that she intentionally misrepresented and withheld her employment in order to continue collecting benefits. She was ordered to pay restitution in the amount of $1,899.99 and $100 in court costs.

Randy Gates, dba Gator’s Auto Repair and Towing (Caledonia, Marion County) pleaded no contest on Jan. 21 in the Marion Municipal Court to a second-degree misdemeanor count of failure to comply for operating his business without workers’ compensation insurance coverage. BWC’s Employer Fraud Team (EFT) identified that Gates continued to operate his business, Gator’s Auto Repair and Towing, without valid BWC coverage after two previous investigations for the same issue. He had been previously referred for prosecution in 2005 for failure to comply for operating a business without the required BWC coverage. The EFT attempted to work with this employer to become compliant with state law but Gates refused to submit completed outstanding payroll reports in an effort to calculate accurate premiums owed. The employer also failed to attempt to pay his balance with the BWC. On January 21, 2016, Gates entered a plea of no contest to failure to comply, a second-degree misdemeanor. Gates received a 180-day jail sentence which was suspended, and was ordered to pay fines and court costs. Gates currently has an estimated balance due of approximately $36,000 and is working with the BWC to submit outstanding payroll reports for calculation of exact premium due.

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 workers’ comp fraud awareness video on YouTube.

Refusal to pay workers’ comp premiums lands owner of Marion County auto repair business in court

The owner of an auto repair shop in Caledonia (Marion County) has been sentenced for refusing to pay his workers’ comp premiums. Randy Gates, owner of Gator’s Auto Repair and Towing, was sentenced Jan. 21 in the Marion Municipal Court.

BWC’s Employer Fraud Team (EFT) discovered that Gates continued to operate his business without valid BWC coverage after conducting two previous investigations on the same issue. He had been previously prosecuted in 2005 for failure to comply for operating his business without the required BWC coverage.

The EFT attempted to work with Gates to become compliant with state law but he refused to submit completed outstanding payroll reports necessary to calculate accurate premiums owed.  He also failed to take any steps towards paying his outstanding balance.

Gates entered a plea of no contest to a misdemeanor count of failure to comply. He received a suspended sentence of 180 days in jail and was ordered to pay fines and court costs.  BWC is again attempting to work with Gates to submit his outstanding payroll reports so an accurate balance can be calculated.