Archive

Archive for August, 2018

Workers’ comp fraud scheme burns cook for $46K

Northeast Ohio man guilty of 5th degree felony

 

A northeast Ohio man who worked as a cook for nearly three years while collecting disability benefits from the state owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $46,000 following his fraud conviction last week.

Walter M. Patterson, 58, of Olmsted Twp., pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.

“It’s a mistaken perception among some people that workers’ compensation fraud is not that big a deal, that BWC ‘can afford it,’” said Jim Wernecke, director of BWC’s special investigations department. “As this case demonstrates, we take fraud very seriously and intend to recoup every ill-gotten dollar fraudsters take from this agency so those funds can serve injured workers who truly need them.”

Acting on a tip, BWC investigators found Patterson working as a cook at the Valley Tavern in Valley View, Ohio, and learned that he had previously worked as a cook at the County Line Bar in Brecksville.

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

Special investigations department finishes FY2018 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY2018, which closed June 30. The report details another impressive year of our department’s efforts to deter, detect, investigate and prosecute workers’ compensation fraud.

Here are some highlights in what was our 25th year as a department:

  • We closed 1,622 fraud cases, 448 more than in 2017.
  • We secured 101 convictions of claimants, employers and health care providers who defrauded our agency.
  • For every dollar we spent on our efforts, we saved the state fund nearly five ($4.81), or $1.33 more than last year.
  • We reduced our investigation time per case by 23 days on average, our lowest number on this measure since 2005.
  • All told, we saved the state fund $60.1 million in 2018, a 44 percent jump over 2017’s numbers.

We couldn’t have achieved this success without the 121 dedicated staff members who serve our department with great skill, resourcefulness and determination to bring justice to those who cheat our system. We also owe a great deal of credit to advances in technology and a key operational change we made last year to increase our efficiency and productivity.

Drones and Workplace Safety
The drone program we implemented in 2017 for our safety investigators proved itself a worthy investment in 2018. Our safety investigators relied on the tool at 10 workplace safety violation sites last year, including two that would have been especially difficult and dangerous, if not impossible, to properly investigate without it. The most challenging case involved flying the drone into an elevator shaft. Another involved an old factory site where the factory was being torn down. Thanks to our drones, our safety investigators could remain at a safe distance while navigating the drones to survey the sites and take accident scene pictures.

We have three drone pilots certified with the Federal Aviation Administration and three more waiting in the wings, so to speak. And while they find the drones fun and exciting, their enthusiasm is tempered in knowing that each operation is tied to tragedy and unfortunate events. Their drive is to ensure they gather accurate data and conduct unbiased investigations.

Hotline
In November we rolled out a new method for collecting fraud allegations. Until then, outside callers would report allegations to BWC personnel that staffed our customer contact centers. Now the callers reach our investigators directly, which allows our team to ask follow-up questions and obtain more precise information to jumpstart the investigation. It also reduced or eliminated the wait times for callers, which led to fewer dropped calls. The bottom line is the new hotline system led to a more comprehensive and detailed fraud allegation packet that we could send to our field teams.

Looking ahead
As we commence our 26th year in FY 2019, we remain united in our commitment to protecting the state insurance fund and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

Central Ohio handyman guilty of workers’ comp fraud

Pataskala man owes BWC $41,000 after felony conviction

A maintenance man for a mobile home park must reimburse his former employer more than $41,000 after pleading guilty Tuesday to a felony count of workers’ compensation fraud.

Acting on a tip, investigators with the Ohio Bureau of Workers’ Compensation discovered Jason C. Smith, 35, of Pataskala, working for a mobile home park and for private individuals for nearly two years while collecting $41,413 in disability benefits from his employer, TS Tech USA Corporation in Reynoldsburg.

“You can’t claim you’re disabled and collect benefits from BWC or your employer when you’re also working under the radar and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “Workers’ comp benefits are for people who truly can’t work because they were injured on the job, not people who want to cheat the system and pad their income.”

Smith pleaded guilty to a fifth-degree felony count of workers’ compensation fraud. A Franklin County judge ordered him to pay TS Tech restitution and sentenced him to a year in jail, which he suspended in exchange for three years’ probation.

In other fraud news: A northern Ohio man was ordered to reimburse BWC $11,566 after investigators found him running a drywall business while receiving disability benefits from the agency.

Drywall installer Grant Myers, 57, of Huron, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Aug. 8 in the Franklin County Court of Common Pleas. A judge suspended a 30-day jail sentence after Myers paid BWC restitution.

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

Dayton home remodeler sentenced for workers’ comp fraud

Ohio BWC secures three fraud convictions in July

The owner of a residential construction business in Dayton who under reported his payroll by millions of dollars to lower his workers’ comp premiums is among three Ohioans convicted last month for workers’ compensation fraud, the Ohio Bureau of Workers’ Compensation (BWC) reported Friday.

Honorato Camacho, owner of Field Construction LLC, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on July 12. Acting on a tip, BWC investigators found Camacho had deliberately under reported his payroll by more than $3.5 million from 2013 to 2015.

“Mr. Camacho’s scheme saved him more than $300,000 in premiums, but look what it cost him in the end — he still owes us for the premiums and now he has a felony criminal record on top of it,” said Jim Wernecke, director of BWC’s special investigations department.

Judge Mary Wiseman in the Montgomery County Court of Common Pleas ordered Camacho to pay BWC $255,434 in restitution, the balance owed after repayments he made prior to sentencing. She also sentenced Camacho to five years’ community control.

In other July convictions:

An Akron pain specialist agreed to reimburse BWC $33,035 and stop seeing injured workers in the BWC system after pleading guilty to a fifth-degree felony count of workers’ compensation fraud. Acting on a tip from a former patient, BWC investigators found Dr. William Midian falsified patient records so he could bill the agency for services he did not render.

Arthur J. Brinkerhoff of Newcomerstown, Ohio, pleaded guilty July 25 in Franklin County to one misdemeanor count of workers’ compensation fraud after a tipster alleged he was working as a truck driver while receiving BWC benefits. Brinkerhoff was sentenced to one day in jail with credit for time served. He paid BWC $2,034 in court-ordered restitution.

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

Akron pain doc guilty of workers’ comp fraud

False billing cited in felony case

An Akron pain specialist has agreed to reimburse the Ohio Bureau of Workers’ Compensation more than $33,000 and stop seeing injured workers in the BWC system after pleading guilty to a fifth-degree felony count of workers’ compensation fraud July 26.

Acting on a tip from a former patient, BWC investigators found Dr. William Midian, 71, provided inadequate care and falsified patient records so he could bill the agency for services he did not render.

“Our investigation revealed that on several occasions in 2016, the doctor billed our agency for services we know he didn’t provide,” said Jim Wernecke, director of BWC’s special investigations department. “In addition, we found the quality of his care lacking. It certainly wasn’t at the level our injured workers expect and deserve.”

Appearing in a Franklin County courtroom, Midian agreed to reimburse BWC $33,035 for payments he improperly received and the cost of the investigation. He also agreed to withdraw from BWC’s network of approved health care providers.

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