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Archive for February, 2018

Central Ohio man convicted of work comp fraud

Employment scheme implicates girlfriend

A Lancaster man must pay the Ohio Bureau of Workers’ Compensation nearly $7,000 in restitution after pleading guilty to workers’ compensation fraud Monday for a scheme that could land his girlfriend in court as well.

Charles Malone, 43, worked for a heating and air conditioning company for six months in 2016 while simultaneously collecting injured worker benefits from BWC. To hide his employment, he duped his employer into issuing his paychecks to his girlfriend in her name.

“He gave his employer a plausible explanation, and they fell for it,” said Jim Wernecke, director of BWC’s special investigations department. “As for the girlfriend, she could also face charges for her role in helping Mr. Malone defraud our agency.”

A judge in the Franklin County Court of Common Pleas sentenced Malone to 180 days in jail, the maximum for a first-degree misdemeanor. He then suspended the jail sentence for five years of community control (probation) under the condition that Malone maintains employment and pays BWC $6,879 in restitution.

In other fraud news, a Cleveland-area man pleaded guilty on Monday to a first-degree misdemeanor charge of workers’ compensation fraud after BWC investigators discovered him operating his sports video business while collecting disability benefits.

A Franklin County judge ordered Kyle E. Goodwin, 47, of Westlake, to pay BWC $2,978 in restitution. He sentenced Goodwin to 180 days in jail (suspended) and 12 months of community control.

Acting on a tip, BWC investigators found Goodwin continued working for his business, OhioSportsNet LLC, in 2016 and 2017 after he claimed to be temporarily totally disabled. They found he earned $9,025 obtaining, editing and producing videos for various high school sports teams, sports clubs and high school athletes.

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

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BWC secures three convictions in January

Two for work comp fraud, one for lapsed coverage

A funeral home worker and two cleaning company owners owe the Ohio Bureau of Workers’ Compensation $30,000 after pleading guilty to workers’ compensation fraud or related charges in January, the bureau’s first convictions of the new year.

“It’s thanks to honest citizens who report suspected fraud that we’re able to investigate many of our cases and stop this criminal activity in its tracks,” said Jim Wernecke, director of BWC’s special investigations department (SID). “The money we recover from people trying to cheat our system will go where it rightfully belongs — taking care of injured workers and helping employers create safer workplaces across this state.”

Those convicted include:

Oran Lewis of Columbus, Working and Receiving — Acting on a tip, investigators surveilled Lewis and uncovered evidence proving he worked for two funeral homes as a funeral procession escort on multiple occasions while collecting injured worker benefits from BWC.

Lewis pleaded guilty on Jan. 24 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 180 days in jail, which was suspended for one year of community control (probation). He must pay $10,442 in restitution to BWC.

Amanda Joy Klapp of Hudson, Ohio, dba Amanda Joy Cleaning Company LLC, Under Reporting Payroll — BWC’s employer fraud team received an anonymous allegation that Klapp was operating her business without workers’ compensation coverage. Agents discovered that Klapp had employees when she opened her business in 2013, but she didn’t secure BWC coverage until 2015. She then intentionally under-reported her payroll to avoid paying a higher premium. When she stopped paying her premiums and her policy lapsed, she attempted to take out a new policy using her husband’s name to avoid paying the balance owed on her original policy.

Klapp pleaded guilty Jan. 9 to three counts of workers’ compensation fraud, all first-degree misdemeanors, in Stow Municipal Court in Summit County. A judge sentenced her to 180 days in jail with 150 days suspended and ordered her to serve 30 days of house arrest. The judge fined Klapp $500 on each count, then suspended half the total. The judge ordered Klapp to bring her workers’ compensation coverage into compliance within 30 days and to pay $14,000 in restitution to BWC.

Robert Settlemoir of Columbus, dba Pro Clean Carpet and Upholstery, Lapsed Coverage — Investigators found Pro Clean Carpet and Upholstery had been operating since 2011 without workers’ compensation coverage. BWC attempted to work with Settlemoir to bring his policy into compliance, but Settlemoir failed to take the necessary steps.

Settlemoir pleaded guilty on Jan. 25 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, suspended for two years of community control. Conditions of community control are that Settlemoir obtain employment and pay restitution of $5,482 to BWC.

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

Working while receiving?

By Jeff Baker, Program Administrator, BWC Special Investigations Department

Working while receiving benefits is one of the most common types of fraud our investigators uncover. In fiscal year 2017, 57 out of 133 criminal convictions were claimants working while receiving lost time benefits to which they were not entitled.

Working while receiving is one of the most obvious and flagrant abuses of the system. It is particularly regrettable since the claimants were, at one time, truly injured and entitled to workers’ compensation benefits.

We make every effort to ensure that each claimant knows the well-established rules. The fraud warning messages are clear, explicit and conspicuously placed on forms. For example, a fraud warning message (pictured below) appears on the BWC form to be signed by a claimant to request temporary total lost time benefits.

Fortunately, the vast majority of claimants return to work when they are able and notify BWC that they intend to do so. They understand and accept that their lost time benefits achieved their essential purpose – they provided compensation while the claimant temporarily could not work and was recuperating from an accident, illness or injury.

No matter how clever an individual may be, if he or she commits the crime of returning to work while receiving workers’ compensation benefits, the tell-tale signs remain. Rest assured, we are looking for, investigating, and prosecuting these cases. They will lose their lost time benefits and perhaps their freedom as well.