Archive

Archive for March, 2019

Employer compliance supervisor is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An employer compliance supervisor in the Cincinnati Service Office received the 2018 Fraud Finder of the Year award Feb. 21 from BWC’s special investigations department (SID).

The supervisor received the award for alerting SID to a case in which an employer failed to report payroll and failed to respond to multiple attempts to schedule a premium audit. An investigation by the SID employer fraud team revealed the employer was operating without coverage. The referral resulted in the identification and recovery of $316,103 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud in its tracks and save the BWC system hundreds of thousands of dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources needed to create safe workplaces in Ohio and to care for those who are legitimately injured on the job.”

The BWC employee, who supervises field staff members assigned to the BWC employer compliance department, said he was honored to receive the award.

“I am truly honored to be recognized for simply doing my job and trying to do my part, while seemingly small, to safeguard the State Insurance Fund,” the employee said. He offered the following advice to any BWC employee who suspects fraud: “Trust your gut.”

SID received 3,150 allegations of fraud in 2018. About a fifth of those came from BWC personnel around the state. These included claims representatives, employer representatives and others who suspected illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system. During 2018, SID closed 381 cases referred by 169 BWC employees. The investigations resulted in 192 “founded cases” (the original allegation was proven true) and identified $3.1 million in savings to the BWC system

To show their appreciation, SID leaders conducted a thank-you tour and red-flag training from November through February, presenting Fraud Finder Award certificates to BWC employees in service offices across Ohio.

“We encourage all BWC employees and the general public to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4, option 1) or visit www.bwc.ohio.gov.

Logan County man sentenced for workers’ comp fraud

On the day he was sentenced to prison for breaking and entering, gross sexual imposition, burglary and other charges, a Bellefontaine man was also ordered to pay nearly $6,400 in restitution to his employer and the Ohio Bureau of Workers’ Compensation (BWC) for collecting disability benefits while secretly working another job.

Joseph A. Wilson, 32, was sentenced to six years in prison March 8 on multiple charges, including reduced charges related to workers’ compensation fraud — petty theft, a first-degree misdemeanor, and failure to appear in court, a fourth-degree felony. A judge in the Logan County Court of Common Pleas ordered Wilson to reimburse his employer (Rent-A-Center) $2,904 and pay BWC $3,469 for the cost of its investigation.

“Workers’ compensation fraud is a crime we take seriously,” said BWC Administrator/CEO Stephanie McCloud. “Fraud steals resources needed by workers who are truly injured, and it raises the cost of our entire system. Kudos to our special investigations department for bringing this case to a close.”

BWC investigators confirmed an anonymous tip they received in late 2017 that Wilson was working on a horse farm while collecting disability benefits from Rent-A-Center. Wilson was arrested in November on warrants for five counts of gross sexual imposition, two counts of workers’ compensation fraud, two counts of failure to appear, and single counts of receiving stolen property, theft, breaking and entering and criminal damaging.

In other news:

The owner of Home Bakery in Coldwater, Ohio, pleaded guilty March 8 to three counts of failure to comply after BWC discovered him operating his business without a workers’ comp policy for three years. A Celina judge ordered Carl R. Brunswick to pay a $50 fine for each count and serve 10 days in jail for each count. The judge suspended the jail time on the condition Brunswick not have any similar violations in the next five years. Brunswick is on a repayment plan with the state to pay his past BWC premiums.

A Dayton woman convicted last month of passing a bad check to BWC must serve five years of probation and complete 40 hours of community service. Carissa Couch of Couch Family Construction pleaded guilty to the fifth-degree felony on Feb. 27 in the Montgomery County Court of Common Pleas. The plea followed multiple attempts by BWC to work with Couch to bring her policy into compliance after her check to the agency for $3,333 bounced at the bank.

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

Prison, hefty restitution ordered for Cleveland fraudster

Contractor collected $246K in disability from BWC, Social Security

A Cleveland-area man was sentenced to seven months in prison Wednesday and ordered to repay nearly $246,000 in disability benefits he fraudulently received from the Ohio Bureau of Workers’ Compensation (BWC) and the Social Security Administration.

Louis C. Cooper, 57, of North Royalton, previously pleaded guilty to wire fraud and theft of government property after investigators discovered him concealing his work as a general contractor. He was sentenced Wednesday in the U.S. District Court for the Northern District of Ohio in Cleveland.

“Acting on an anonymous tip, our investigators discovered Mr. Cooper earned at least $185,000 over the last eight years as a general contractor while telling BWC and Social Security he was too injured to work,” said BWC Administrator/CEO Stephanie McCloud. “Our benefits are for workers who truly need them, not for fraudsters to pad their income. I commend our special investigations department and the Social Security Administration for bringing Mr. Cooper’s criminal activity to an end.”

Cooper was injured on the job in 1996. Investigators from BWC and Social Security found he had developed a scheme dating back to at least 2010 to conceal his income as a general contractor by asking his clients to not pay him directly. While reporting to both agencies numerous times that he was too injured to work, Cooper collected nearly $168,000 from BWC and nearly $78,000 from Social Security.

According to court documents, Cooper must surrender to the U.S. Marshals Service on April 18 for transfer to a federal prison. He must serve three years of probation following his release. This case was prosecuted by the U.S. Attorney’s Office for the Northern District of Ohio.

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