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Archive for September, 2016

Northeast Ohio business owner convicted of workers comp fraud

Brunswick man owes BWC $22,000, tried to deceive agency

The owner of a tree service company in Medina County who cancelled his policy with the Ohio Bureau of Workers’ Compensation in 2004 pleaded guilty to workers’ compensation fraud last week after investigators found he was still operating his business and owed the agency $22,000 in back premiums.

Robert D. Matusiak, owner of Rob’s Tree Service in Brunswick, Ohio, pleaded guilty Sept. 19 in Medina County Court of Common Pleas to one count of workers’ compensation fraud, a fourth-degree felony. The plea culminated an investigation that started in 2012 after BWC discovered Matusiak trying to circumvent the law and avoid his debt by applying for a new policy but with deceptive information.

“Ohio’s workers’ compensation system is designed to ensure injured workers get the care and benefits they need while also protecting employers from claims’ costs that could potentially cripple their business,” said BWC Administrator/CEO Sarah Morrison. “When employers try to skirt the law and avoid this responsibility, they put their employees and themselves at risk and place an unfair burden on the entire system.”

Matusiak opened and closed his original BWC policy in 2004, saying he no longer operated his business. BWC started receiving injury claims from his employees in the years that followed, however. Matusiak ignored BWC’s attempts to work with him to bring his policy into compliance. He then applied for new coverage but under a different address and under his wife’s name. Matusiak stated on the application that there were no other policies associated with the current operation, and he left several questions blank that are used to determine if a duplicate policy exists. The case was forwarded to BWC’s Special Investigations Department.

Through audits, interviews and other techniques, investigators determined Rob’s Tree Service had been in continuous operation from at least April 23, 2013 to Sept.30, 2015. After being confronted by agents, Matusiak again applied for BWC coverage but with deceptive information.

With some exceptions, Ohio law requires employers with at least one employee to carry workers’ compensation coverage. Many businesses won’t hire contractors, such as painters or tree-trimming companies, unless the contractors prove they have workers’ compensation coverage.

Matusiak’s sentencing is set for Nov. 3.

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

Teachable moment: Cleveland woman falsifies student status, must repay BWC $54,000

kori-white-booking-photoA Cleveland woman pleaded guilty Monday, Sept. 19, to workers’ compensation fraud after investigators found she deceived the Ohio Bureau of Workers’ Compensation (BWC) about her student status to collect nearly $54,000 in dependent death benefits over four years.

Kori White, 26, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas. Prior to her plea, White paid $10,000 toward her restitution to BWC, leaving her with a balance owed of $43,782.

“The sad part about this case is that money was supposed to support this young woman’s educational endeavors,” said BWC Administrator/CEO Sarah Morrison. “Now it’s a debt that represents poor choices and a missed opportunity.”

A judge sentenced White to community control for five years, under the conditions she obtain a job or undergo job training and make regular payments toward her BWC balance. She will have to serve 120 days in jail if she violates the terms of her community control.

BWC’s Special Investigation Department began investigating White after reviewing a group of dependent death benefit recipients. Investigators found she was submitting college enrollment forms to BWC to show she was enrolled in full-time classes at the University of Akron, Cuyahoga Community College or Lakeland Community College from January 2009 to December 2013. However, White did not attend classes or dropped them after the paperwork was submitted, both actions that made her ineligible for continued benefits.

 

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

BWC SID: Annual in-service training – Part 2 of 3

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In our constant quest for improvement, all members of the Bureau of Workers’ Compensation Special Investigations Department (SID) gathered on September 14, 2016 at our Mansfield service office to successfully complete annual in-service training.

sid-trg-picLed by SID Director Jim Wernecke, we shared investigative successes, learned how to use new technology we recently secured, and committed to operational strategies for even greater effectiveness.

We’ve found that one of the chief ways to find new or alternate methods of fraud detection and investigation is to consult counterpart agencies. Such collaboration allows SID to examine its own methods to see where improvements can be made, how tasks can be accomplished more efficiently, and what new strategies or technologies can be used in the course of an investigation.

sidpic2This is why Director Wernecke invited Ron Davitt, a talented Training Officer with the Ohio Peace Officer Training Academy (OPOTA), to be a keynote speaker. In two hours he enhanced our awareness and skills in conducting “De-Escalation and Mental Health” to increase our effectiveness in planning and conducting criminal investigations.

Director Wernecke presented Training Officer Davitt with a certificate of appreciation, noting that it is an honor for us to recognize, praise and thank him. We respect and appreciate all of our law enforcement colleagues for their dedication to serving and protecting the citizens of the state of Ohio.

You can read the first article about the September 14 event here and our most recent annual report here.

Categories: Uncategorized

State agencies share data to nab workers’ comp cheat

hopsonA Columbus man who worked two jobs while collecting injured workers’ benefits must pay the Ohio Bureau of Workers’ Compensation $6,000 in restitution and investigative costs and serve five years probation, a judge ruled Tuesday in the Franklin County Court of Common Pleas.

Dion S. Hopson, 43, pleaded guilty Sept. 20 to workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, which was suspended in exchange for five years community control. Hopson also was ordered to pay $5,000 in restitution to BWC and $1,000 in investigative costs. He must pay $100 per month to stay in good standing with community control, which will terminate once restitution has been paid.

BWC’s Special Investigations Department started looking at Hopson after a cross-match query with the Ohio Department of Job and Family Services revealed two employers were paying Hopson wages in 2014 and 2015. SID found Hopson was simultaneously receiving Temporary Total Disability benefits from BWC.

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

 

BWC SID: Annual in-service training – Part 1 of 3

September 23, 2016 2 comments

By Jeff Baker, Program Administrator, BWC Special Investigations Department

admin-morrison-sid-mtgIn our constant quest for improvement, all members of the Bureau of Workers’ Compensation Special Investigations Department (SID) gathered on September 14, 2016 at our Mansfield service office to successfully complete annual in-service training.

BWC Administrator/CEO Sarah Morrison welcomed the 125 attendees and opened the meeting. In her opening remarks, Administrator Morrison praised the department’s more than 20 years of success. She noted that strategies identified and implemented during the past twelve months, under the leadership of SID Director James Wernecke, have positioned the department to extend its tradition of excellence.

Following these remarks, Administrator Morrison, SID Director Wernecke, and SID Assistant Directors Jennifer Cunningham and Dan Fodor presented service pins to 22 SID employees. These recipients included two employees with 30 years of service to the State of Ohio: Shawn Miller, a fraud analyst with the southeast regional claimant special investigations unit (SIU); and Lisa Ray, SID training manager.

Pictured left to right: Sarah Morrison, James Wernecke, Lisa Ray, Shawn Miller, Jennifer Cunningham and Dan Fodor.

Subsequently, Director Wernecke thanked Administrator Morrison for her executive leadership, essential support for SID’s mission and compelling presence at the annual event. All of members of the Special Investigations Department joined Director Wernecke in thanking Administrator Morrison for inspiring us to realize our departmental mission to deter, detect, investigate and prosecute workers’ compensation fraud.

In the coming two weeks, we will offer more details from September 14 training event. Stay tuned for part two of the series, which acknowledges specialized training we received at the event.

In the meantime, you can read the past posts about our SID Director here and our most recent annual report here.

Ohio trucker guilty of workers’ comp fraud

booking-photo-5-26-16-christopA Stark County trucker pleaded guilty to workers’ compensation fraud Aug. 31 after investigators discovered he worked for two different companies while claiming to be disabled and unable to work.

Christopher James, 43, of Massillon, was off work following an injury and was receiving temporary total disability benefits. BWC’s Special Investigations Department began investigating James after receiving a tip from an anonymous source.

James was sentenced in the Stark County Court of Common Pleas following his plea to the fifth degree felony. He was ordered to serve three years of community control and to serve 200 hours of community service. James paid full restitution in the amount of $7,740.

BWC’s Special Investigations nets 8 convictions in August

fraud imageCOLUMBUS – The Ohio Bureau of Workers’ Compensation (BWC) netted eight convictions in August in criminal cases related to workers’ compensation fraud.

The eight Ohioans convicted include a Hamilton man who got an 18-month jail sentence for falsifying his wages to increase his disability rate, a Dayton-area man who filed a false injury claim and tried to extort $3,000 from his employer in return for dropping the claim, and a Toledo man who lied to his physician and used an alias to collect injured workers’ benefits.

“These convictions illustrate the nefarious lengths some will undertake to rip off the workers’ compensation system,” said BWC Administrator/CEO Sarah Morrison. “But they also highlight the skill and dedication of our staff and investigators to catch this activity and return BWC funds to their rightful purpose – preventing workplace injuries and caring for those who do get injured.”

As of Aug. 31, BWC’s Special Investigations Department (SID) had secured 69 convictions for the calendar year. August convictions include:

Matt E. Wilder of Hamilton – False Wages
SID initiated an investigation after a BWC compliance officer suspected Wilder may have filed false wage statement forms to increase his weekly injured workers’ benefits. The investigation found Wilder was legitimately injured, but he had filed false wages from another employer, which happened to be his father’s business.

Wilder pleaded guilty Aug. 30 in Montgomery County Common Pleas Court to one count of forgery (uttering), a fifth-degree felony, and one count of workers compensation fraud, a first-degree misdemeanor. Wilder was ordered to serve 12 months in state prison and an additional six months in jail in Butler County. He received credit for 115 days served. He also was ordered to pay BWC $271 in restitution and to serve three years of post-release control.

Thomas Shafer of Miamisburg – False Claim
SID found Shafer filed a false claim and was not injured as reported. SID also found he tried to get his employer to pay $3,000 to him in exchange for dropping the claim.

Shafer pleaded guilty Aug. 29 in Dayton Municipal Court to one count of disorderly conduct, a fourth-degree misdemeanor, and was sentenced to 10 days in jail. He was originally charged with falsification and workers’ compensation fraud.

Michael Scott of Lancaster – Working and Receiving
SID found Scott was working for a window company for four months in 2014 while collecting BWC benefits. A judge in Franklin County Common Pleas Court ordered Scott to pay BWC $1,836 in restitution and sentenced Scott to two years community control, which will terminate with full payment of restitution and court costs.

Martin Halka of Oregon (Lucas County) – Lapsed Coverage
Investigators observed Halka, owner of Bay Area Concrete, and his workers finishing a concrete job in 2014, six years after Halka’s BWC coverage had lapsed. Agents worked with Halka to become compliant with BWC coverage, but Halka failed to submit all the required payroll records. He did, however, pay approximately $8,000 in back premiums.

A judge found Halka guilty of one count of failure to comply, a second-degree misdemeanor, on Aug. 23 in Oregon Municipal Court. He fined Halka $250, plus $87 in court costs, and ordered Halka to serve one year probation and 15 days of house arrest with electronic monitoring.

Kash Marzetti of Columbus – Working and Receiving
SID found Marzetti knowingly and with fraudulent intent worked for his company, Marzetti Swimming Pool Services, Inc., while collecting injured workers’ benefits. Marzetti pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor, Aug. 22 in Franklin County Common Pleas Court. He had to pay BWC $5,642 in restitution and a $50 court fine as part of his sentence.

David Abitua of Toledo – Falsification
Abitua, 51, pleaded guilty Aug. 18 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony. SID found in 2014 that Abitua had lied to his physician, used a false social security number and an alias of Jose L. Vasquez to collect injured workers’ benefits from Nov. 2, 2009 until Oct. 6, 2012. A judge fined Abitua court costs and sentenced him to six months community control, plus one year in jail if he violates the terms of his probation.

Ambrose Adams of Lexington – Working and Receiving
SID found Adams had returned to work as a self-employed home improvement contractor for his business, Double A Home Maintenance and Repair, while concurrently receiving workplace injury benefits from BWC.

Adams pleaded guilty Aug. 16 in Franklin County Common Pleas Court to one misdemeanor count of workers’ compensation fraud. He was sentenced to 60 days in jail, suspended, and one year of probation. BWC recovered $11,965 in restitution prior to his plea.

Christopher James of Massillon – Working and Receiving
SID found James working as a truck driver while receiving BWC benefits. James pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, on Aug. 4 in the Stark County Court of Common Pleas.  He was sentenced to three years of community control.  James has already paid $7,705 in restitution to BWC.

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