Archive

Archive for the ‘Uncategorized’ Category

Special Investigations unveils new, improved referral form

By Jennifer Cunningham, Assistant Director, Field Operations, BWC Special Investigations Department

We value the public’s assistance in helping us identify instances of potential fraud. To make it easier for people to file reports, our Special Investigations Department (SID) worked with the BWC Information Technology division to create a simplified online fraud referral form.

The form, which you still access by visiting our website, now only requires the subject’s first name (or initial) and last name. Of course, we continue to welcome and will use any and all information a source may furnish us. For example, including an injured worker subject’s full name, date of birth (or age), address, or city and state of residence, ensures we will immediately know whom to investigate.

The simplified form uploads the allegation into our case management database and immediately assigns the referral to the appropriate SID team for review and research. It also provides tipsters an immediate confirmation, including the fraud allegation number for future reference or follow-up.

Whether the subject is an injured worker, provider, employer, or someone else, the new form routes the allegation to the appropriate SID personnel. For example, if you select Injured Worker as the subject, the allegation will automatically go to one of the three SID injured worker teams based on the ZIP code or county of residence for the injured worker.

In addition to online, fraud can also be reported by calling 1-800-644-6292 or emailing allegations.W.1@bwc.state.oh.us.

As always, SID thanks you for your assistance in reporting and stopping workers’ compensation fraud.

Categories: Uncategorized

Tennessee man’s false injury claim costs him $33K

 Ohio BWC releases latest fraud convictions

A Tennessee man pleaded guilty to felony workers’ compensation fraud Sept. 9 after collecting more than $33,000 from the Ohio Bureau of Workers’ Compensation for a work injury he falsely claimed occurred in Ohio.

Roger Frankenberg, 60, of Sevierville, Tennessee, pleaded guilty to the fifth-degree felony in Franklin County Common Pleas Court. A judge sentenced him to 11 months in jail, suspended for five years of probation, and ordered Frankenberg to pay BWC $33,210 in restitution.

“As many fraudsters discover, ripping off this agency clearly doesn’t pay, thanks to the good work of our Special Investigations Department,” said BWC Administrator/CEO Stephanie McCloud. “Not only does Mr. Frankenberg owe us $33,000, he has a felony record.”

 Acting on a tip, BWC discovered Frankenberg had returned to work for his self-owned company, Custom Renovations and Beyond Inc., while receiving BWC disability benefits from December 2015 until December 2016.

 Further investigation determined Frankenberg sustained his injury in Pennsylvania, not Ohio. But because he didn’t have insurance coverage in Pennsylvania, he fabricated a BWC claim so he could have his medical bills covered and collect indemnity payments.

In a separate case on Sept. 9, a Columbus woman pleaded guilty to workers’ compensation fraud after BWC found she had returned to work but didn’t tell the agency so she could continue to receive disability benefits.

Deborah Chenault pleaded guilty to one misdemeanor count of workers’ compensation fraud and was ordered to pay BWC $6,000 in restitution. A three-month jail term was suspended for five years of probation.

In other news, BWC secured three fraud-related convictions in August, bringing its 2020 calendar year total to 51. They include a case involving a Dayton man who stole a near $4,000 check BWC had sent his employer.

  • Eric Walker-Mabry of Dayton pleaded guilty Aug. 25 to one count each of theft of property, theft, and forgery, all fifth-degree felonies. A Montgomery County judge ordered Walker-Mabry to pay BWC $3,707 in restitution and sentenced him to five years of probation. BWC issued a full refund to the employer.

 

  • Danny Mitchell of Clarksburg, West Virginia, dba Mitchell Drilling Inc., pleaded no contest Aug. 18 in Tuscarawas County to one minor misdemeanor count of failure to comply and was found guilty after BWC found him operating his business in Ohio without BWC coverage. A judge waived fines and court costs. Mitchell Drilling paid BWC its outstanding premiums and is no longer operating in Ohio.

 

  • Nina Washington of Dayton must pay BWC $4,616 in restitution after pleading guilty Aug. 17 to a misdemeanor count of workers’ compensation fraud. A Franklin County judge also sentenced Washington to five years of probation for collecting disability benefits after she returned to work. Washington paid $500 toward her restitution the morning of her sentencing.

 

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

Video surveillance exposes Sidney couple’s scheme to defraud BWC

Agency closes 11 cases in June, July   

The Ohio Bureau of Workers’ Compensation (BWC) closed 11 cases involving workers’ compensation fraud and related charges in June and July, bringing total convictions for BWC to 47 for calendar year 2020.

“Workers’ compensation fraud can happen anywhere in Ohio,” said BWC Administrator/CEO Stephanie McCloud. “That’s why we have dedicated investigators in every corner of the state to uncover folks — whether they’re employers, injured workers or medical providers — who try to cheat the system.”

Among the June cases is a Sidney, Ohio, couple sentenced on felony charges related to workers’ compensation fraud after a BWC investigation found the husband mowing lawns, using a snow blower, and chopping wood while claiming to be permanently and totally disabled from work.

A Shelby County judge sentenced David Juillerat on June 8 to five years of probation in lieu of jail time and a fine of $1,000 for his conviction on a reduced charge of attempted tampering with records, a fourth-degree felony. Juillerat’s wife, Wendy Juillerat, was sentenced three days earlier on a similar charge, attempted complicity to tampering with records, also a fourth-degree felony. A judge sentenced her to five years of probation in lieu of jail time and to pay court costs.

David Juillerat applied to BWC in 2018 for permanent total disability benefits, claiming a work injury left him unable to drive a car or walk without the assistance of a walker. Acting on a tip that he might be faking his injury, agents with BWC’s Special Investigations Department surveilled David for several weeks in 2019. They filmed him on multiple occasions entering and leaving medical offices with a walker. Away from a medical office, however, agents filmed him walking, shopping, working on his car, chopping wood, and other activities, all without the use of a cane or walker.

As for Wendy Juillerat, agents say she admitted to helping her husband complete his application for permanent total disability and accompanied him to numerous doctor’s appointments in which she would exaggerate his physical limitations in order for the disability to be granted.

Based on BWC’s investigation, David Juillerat’s application for disability benefits was denied in late 2019, saving BWC an estimated $233,668 in benefits over the projected life of the claim.

 

Other cases in June and July include:

 

Joseph Ferguson of Toledo

Ferguson pleaded guilty July 24 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor, after a BWC investigation revealed he was working as a web development supervisor while receiving benefits from BWC from October 2017 to January 2018. The judge sentenced Ferguson to five years of community control and ordered him to pay restitution of $6,473 to BWC. If he violates the terms of his community control, he will serve 60 days in jail.

 

Ruth Asamoah of Columbus

On July 13, Asamoah pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. BWC investigators found Asamoah worked for eight employers, performing the same or similar jobs she was doing when she was injured. A Franklin County judge ordered her to pay $15,020 in restitution and sentenced her to an 11-month jail sentence, suspended for five years of probation.

 

Jeffrey Berkley of Taylor, Michigan

BWC investigators found Berkley working as a driver, transporting cars around the Midwest, while receiving BWC benefits from July 2014 to September 2014. On July 7, Berkley pleaded guilty in Franklin County to one count of workers’ compensation fraud, a first-degree misdemeanor. The judge sentenced him to a 12-month suspended jail sentence and ordered him to pay restitution of $2,668 to BWC. Berkley paid the full amount of restitution to the clerk of courts prior to the plea.

 

Marguerite Cervantes of Perrysburg

Cervantes pleaded guilty July 2 to one count of workers’ compensation fraud, a fifth-degree felony, in the Franklin County Court of Common Pleas. A BWC investigation revealed Cervantes had returned to work as a clinical nurse from April to October 2016 while collecting temporary total disability benefits. The judge sentenced her to an 11-month suspended jail sentence, five years of probation, and ordered her to pay restitution of $16,885.

 

Angela Berardelli of North Canton

A BWC investigation revealed Berardelli was working at a restaurant while receiving BWC benefits from January 2016 to June 2017. On June 30, Berardelli pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. She received a sentence of 90 days in jail suspended for 12 months of community control. The judge ordered Berardelli to pay restitution of $10,194 to BWC. She made a payment of $6,500 at the time of plea.

 

Patricia Black of Cincinnati

Black pleaded guilty June 16 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony. An investigation by BWC found Black working as an office cleaner while receiving BWC benefits from January 2018 to October 2018. Black was ordered to pay $18,407 in restitution and sentenced to 12 months in prison, suspended for three years of non-reporting community control.

 

To report suspected workers’ compensation fraud, call 1-800-644-6292 (Option 4, Option 0, Option 1) or visit bwc.ohio.gov.

 

Fraud of the Day during Fraud Awareness Week

By Jeff Baker, BWC Special Investigations Department

When the Ohio Bureau of Workers’ Compensation (BWC) created its Special Investigations Department (SID) in 1993, investigative professionals in the new department knew they would need to do more than detect, identify and investigate suspected workers’ compensation fraud. To fully meet the department’s mandate and mission, SID professionals would need to also deter fraud.

We felt one of the most effective ways to deter fraud might be to raise public awareness of what we do by reaching out to the media about our latest cases. In the years since, SID has collaborated with BWC’s Communications Department to issue news releases on many of the nearly 3,000 subjects convicted and sentenced as a result of our work.

To reach an even wider audience, we created our first social media accounts in 2011 and launched our Fraud Awareness Series via ohiobwcfraud and twitter.com/ohiobwcfraud. Through our YouTube channel, we added videos showing undercover surveillance footage of subjects caught in act of committing their crimes.

The success of our Fraud Awareness Series can be measured by its reach beyond our initial audience. That is why we take note (ok, we admit we are thrilled) whenever one of our prosecution news releases is shared or re-Tweeted by a follower. Since 2014, we have seen this occur 39 times from just one follower — Larry Benson. Larry has used our news releases as the basis for 39 of his Fraud of the Day blogs published by LexisNexis. Larry sees news releases for countless other successful fraud investigations by government agencies within hundreds of jurisdictions (local, state, and federal), so we are always delighted when he takes note of ours. We also appreciate his Fraud of the day website permits users to select their favorite examples by fraud type and state. For example, here is a filtered link to the Fraud of the Day articles for Ohio, including the 39 (and counting) articles pertaining to BWC.

Conveniently, E-mail subscribers to Fraud of the Day blogs may “get their fraud fix” by “waking up five days a week to the most current fraud article delivered straight to their inbox.”

But no matter how you access the Fraud of the Day blogs, you will note Larry’s clever use of headlines and tags referencing the subject’s type of fraud. A few of our favorites include:

The owner of an excavation business without coverage Bulldozed December 23, 2015

The owner of a transport company without coverage The Freeway to Prison February 9, 2016

A swimming pool construction/maintenance contractor Swimming in Fraud December 20, 2016

Wholly falsified statement of reported wages earned Making Stuff Up April 25, 2017

A bowling coach Gutter Ball July 5, 2017

Felon skipped court date due to imprisonment Fraud in Absentia August 8, 2017

The owner of a cleaning business with lapsed coverage Dust Bunnies  September 12, 2017

The owner of a pool and spa company without coverage Grab on to the Life Raft  January 31, 2018

The owner of a high-volume garbage hauling business Garbage In, Garbage Out March 27, 2018

A bartender Where Everyone Knows Your Name July 12, 2018

An overprescribing doctor Fraud Dispenser September 20, 2018

A business owner who misclassified employees Misclassified November 13, 2018

A doctor billing for services not rendered Lacking January 31, 2019

Felon convicted on charges of breaking and entering, gross sexual imposition, burglary and other charges That’s Quite A Rap  May 7, 2019

Machine press operator and pizza shop employee Triple Dipper September 17, 2019

Of course, as humorous as these titles may be, we know that no fraud is a matter for laughter. We certainly take all crime seriously. That is why we have dedicated our careers to detecting, identifying, investigating, prosecuting, and deterring fraud. Like Larry, we, too, are willing to deploy clever or funny headlines in news releases, but that’s only to increase the likelihood that the media and general public will take note and read and heed the releases as the cautionary tales they are.

Widening our reach, getting our word out, deters fraud. In the spirit of International Fraud Awareness Week, we invite all of you to join us in combatting crime by continuing to follow this blog and Larry’s Fraud of the Day series this week and beyond.

Categories: Uncategorized

Former deputy sheriff owes BWC $235K for workers’ comp fraud

Zanesville man earns felon status after Monday’s conviction

A Zanesville man and former county deputy sheriff must reimburse the Ohio Bureau of Workers’ Compensation nearly $235,000 in restitution following his felony conviction for workers’ compensation fraud Monday in a Franklin County courtroom.

A judge ordered Gregory A. Fitzer, 56, to pay BWC $211,536 in restitution and $23,187 in investigative costs after Fitzer pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud. She also ordered the former Muskingum County deputy sheriff to serve four years of probation in lieu of a year in jail.

“Our investigators found Mr. Fitzer knowingly and with fraudulent intent deceived our agency and his physicians in order to receive disability benefits,” said BWC Administrator/CEO Stephanie McCloud.

Acting on a tip, BWC’s Special Investigations Department discovered Fitzer worked as a process server and investigator for several law firms in and around Zanesville from January 2007 to March 2016 while collecting disability benefits from BWC. The investigation, which included surveillance, multiple interviews and a review of bank and employment records, also found he worked as a truck driver and laborer for a local retailer.

In other fraud news:

BWC secured eight fraud-related convictions in August, bringing 2019’s total to 63. They include a Central Ohio nurse practitioner convicted on health care fraud charges.

BWC assisted in the investigation that led to the Aug. 30 sentencing of nurse practitioner Amy Wood-Kirk of Grove City and fiancé Ryan Edney on one count of conspiracy to commit health care fraud. Amy Wood-Kirk prescribed large quantities of medications, including prescriptions for compounded pain cremes, outside acceptable medical standards for the personal profit of herself and Edney.

The U.S. District Court for the Southern District of Ohio sentenced Wood-Kirk to five years of probation and ordered her and Edney to repay Medicaid, TriCare, and Medical Mutual of Ohio $751,809 in restitution. Wood-Kirk was also sentenced to 180 days home confinement.

In order of most recent court appearance, other August convictions include:

Jim Hesler, dba Robert’s Roofing, Batavia, Ohio
Hesler was found guilty Aug. 23 in Clermont County Common Pleas Court on two counts of workers’ compensation fraud, both fifth-degree felonies. BWC investigated Hessler after learning he had not been reporting his payroll to the agency and several injury claims had been filed.

Investigators found his business was still in operation. Sentencing is scheduled for Oct. 8, at which time a judge may determine the amount of restitution owed BWC.

Eric Johnson, Akron, Ohio
Johnson pleaded guilty Aug. 22 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving disability benefits. Prior to entering the plea, Johnson deposited full restitution of $1,062 at the clerk of court’s office.

Gregory White, dba White’s Auto Care LLC, Lorain, Ohio
White pleaded no contest Aug. 22 to one count of failure to comply, a second-degree misdemeanor, for not reinstating his BWC policy while operating his business. A second count was dismissed as White had brought his BWC account current prior to court. White was ordered to pay court costs of $167.

Everett Ferryman, Marysville, Ohio
Ferryman pleaded guilty Aug. 21 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered him working as a truck driver and receiving cash “under the table” while receiving BWC disability benefits. The court sentenced him to a term of probation not to exceed five years but could terminate sooner upon payment of $22,851 in restitution. The court also imposed a suspended sentence of 12 months in prison.

Tammy Hill, Jackson, Ohio
Hill pleaded guilty Aug. 12 in Jackson County Municipal Court to theft by deception, a first-degree misdemeanor, after BWC found her cashing BWC benefit checks belonging to an injured worker. A judge ordered Hill to serve up to five years of probation, complete 500 hours of community service, 180 days in jail (suspended), and pay a $100 fine and court costs within 12 months.

Paul Gall, dba Sun Masters, Brooklyn Heights, Ohio
BWC found Gall had been operating his business, Sun Masters LLC, without BWC coverage since March 2014. In lieu of conviction, Gall entered a payment plan with the Ohio Attorney General’s office after making a down payment of $12,000 toward his $44,000 balance.

Robert McWhorter, New Albany, Ohio
McWhorter pleaded guilty Aug. 7 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working for his landscaping company while receiving BWC disability benefits. A judge ordered McWhorter to pay $9,888 in restitution to BWC and serve one year of probation in lieu of a 6-month jail sentence.

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

Categories: Uncategorized

Check Smart clerk outsmarts phony owner of BWC rebate check

BWC investigators report 9 convictions in October

An Akron sex offender added forgery to his criminal record last month after a clerk at a Check Smart thwarted his attempt to cash a $5,500 rebate check from the Ohio Bureau of Workers’ Compensation (BWC) that belonged to a church-owned day care center.

“We have to give credit to the clerk, she made our job easy,” said Jim Wernecke, director of BWC’s special investigations department (SID). “She could tell the man added his name to the check and he wasn’t the rightful owner. But instead of simply turning him away, she took his picture, photocopied his driver’s license and had him fill out an application. Then she confiscated the check and refused to cash it.”

A Summit County judge sentenced Keith A. Galloway, 45, to one year in prison Oct. 24 after Galloway pleaded guilty to forgery, a fifth-degree felony. The judge ordered the term be served concurrently with Galloway’s three-year sentence on unrelated drug charges and for failing to register his address with the Summit County Sheriff’s Office.

Galloway attempted to cash the rebate check in July 2017. The check was part of BWC’s $1 billion rebate to Ohio employers that year.

In other news, SID secured eight other workers’ comp fraud or fraud-related convictions in October, bringing calendar year 2018’s total to 72. In order of most recent court case, those convicted include:

Jason Moffitt of Columbus
Moffitt pleaded guilty Oct. 31 to one count of workers compensation fraud, a first-degree misdemeanor, after investigators found he had falsified records to increase his BWC cash benefits. He was sentenced to three months incarceration, which was suspended for two years of community control on the condition he pay BWC $5,325 in restitution.

Philip Ayers, dba Ayers Transportation Services, of Cincinnati
Ayers pleaded guilty Oct. 24 in Hamilton County to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him operating his business with lapsed coverage and non-compliant claims filed against his policy. A judge sentenced Ayers to two years of probation and ordered him to maintain full-time employment and cooperate fully with BWC and the Ohio Attorney General’s office on his payment plan to BWC. Ayers owes BWC more than $159,000.

Kurt Ballish, dba Kurt Ballish Construction & Custom Decks, of Chardon
Ballish pleaded guilty Oct. 22 to two misdemeanor counts of failure to comply, the same charges he pleaded guilty to in 2016. A judge in Chardon Municipal Court sentenced Ballish to one year of probation in lieu of 90 days in jail and ordered Ballish to pay fines and court costs totaling $642 by Nov. 30. Ballish owes BWC nearly $19,000.

Frank Krailler, dba Transmission Specialists of Montgomery, of Cincinnati
Krailler pleaded guilty Oct. 22 in Hamilton County to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC discovered him operating his business without workers’ comp coverage. As part of his plea deal, Krailler paid $4,000 in restitution.

Gyorgy Benedek of Columbus
Benedek, owner of Maintenance Free Building Services Inc., pleaded guilty Oct. 18 in Franklin County to a reduced charge of failure to comply after submitting a check to BWC for $43,069 in restitution.

Penny Sibila of Canton
Sibila must pay BWC $26,719 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Oct. 18 in a Franklin County courtroom. Acting on a tip, BWC investigators found Sibila working as a property manager for an apartment complex while collecting BWC benefits for an injury she suffered in 2014. In addition to restitution, a judge sentenced Sibila to two years of non-reporting probation in lieu of a seven-month jail sentence.

Thomas Banig of Cleveland
Banig pleaded guilty Oct. 17 to one count of workers’ compensation fraud, a first-degree misdemeanor, after he filed a false claim in 2014 against an employer he had not worked for since 2003. A judge sentenced Banig to 180 days incarceration, suspended for one year of community control.

Rami Khayat, dba Triple Auto Sales, of Cleveland
Khayat pleaded guilty Oct. 1 to one count of failure to comply, a second-degree misdemeanor, after BWC found he was operating his business without BWC coverage. A judge ordered Khayat to pay BWC $965 in restitution.

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

Construction worker’s fraud scheme collapses

A Marion man who claimed to be permanently disabled owes the Ohio Bureau of Workers’ Compensation (BWC) $160,000 after pleading guilty Wednesday to a fourth-degree felony charge of workers’ compensation fraud.

Appearing in a Franklin County courtroom, Jimmie Rankin, 45, was also sentenced to five years of community control for collecting BWC benefits after he had gone back to work in the construction industry and deliberately withheld that information from BWC.

“We found Mr. Rankin working as a subcontractor and getting paid with cash and checks made out to other people so he could avoid a paper trail and stay beneath our radar,” said Jim Wernecke, director of BWC’s Special Investigations Department. “But thanks in part to tips from honest citizens, we were able to stop this fraud and bring Mr. Rankin to justice.”

Working with Rankin’s employers, investigators determined Rankin had been employed at least since March 2011, a little more than three years after his workplace injury and while he was collecting temporary disability benefits. He later secured permanent total disability benefits from BWC and, while working, collected those benefits from June 2012 to May 2016.

A judged warned Rankin that if he violates the terms of his community control, he would serve 18 months in prison.

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

Tough sanctions for roofer in workers’ comp fraud case

petrickThe owner of a Sandusky roofing company who pleaded guilty to workers’ compensation fraud in September must pay nearly $27,000 in restitution to the Ohio Bureau of Workers’ Compensation and serve five years probation, according to his sentence Nov. 9 in the Erie County Court of Common Pleas.

A judge also warned Steve Petrick, Jr., that he would be jailed for six months if he fails to meet the terms of his probation. Besides monthly payments on his restitution, those terms call for Petrick to obtain and maintain full-time verifiable employment within 30 days of his sentencing. He also must obtain written permission from his probation officer before traveling out of state, and he can’t operate a motor vehicle prior to showing proof of a valid driver’s license and insurance to the Erie County Adult Probation Department.

Petrick, owner/operator of Steve Petrick Roofing, caught the attention of BWC’s Special Investigations Department after an anonymous tipster alleged he was operating his business without the required coverage.

BWC’s Employer Compliance Department attempted to assist Petrick with bringing his policy into compliance, but he claimed he had no employees and continued operating his business without coverage.

The case was forwarded to BWC fraud investigators after an injury claim was filed against the policy while the policy was lapsed. The investigation and surveillance proved Petrick Roofing had been in continuous operation with employees. Petrick again failed to come into compliance following an interview with agents.

Petrick pleaded guilty to a fifth-degree felony count of attempted workers’ compensation fraud Sept. 28.

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

Groveport woman cheated BWC out of $51,000

Health care worker sentenced on workers’ comp fraud charges Thursday

danielle-cheeks-booking-photoA Central Ohio woman must pay more than $51,000 in restitution to the Ohio Bureau of Workers’ Compensation after pleading guilty Thursday to a fifth-degree felony count of workers’ compensation fraud.

Danielle Cheeks, 41, of Groveport, must repay BWC $51,590 and serve five years probation in lieu of a six-month jail sentence for fraudulent behavior dating back to 2010, according to her Nov. 3 sentence in the Franklin County Court of Common Pleas.

BWC’s Special Investigations Department started looking at Cheeks after a BWC claims service specialist (CSS) suspected Cheeks was under-reporting her work wages in order to receive higher living maintenance wage-loss benefits from BWC. The CSS told investigators he had requested Cheeks on multiple occasions to submit her paystubs but she never complied.

Investigators determined Cheeks was working as a home health aide for three private companies, as well as for herself as an independent provider for Medicaid recipients, as early as August 2010.  This employment conflicted consistently with BWC benefits she received from August 2010 through November 2014.

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

 

Categories: Uncategorized

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

BWC’s Special Investigations Dept nets 7 convictions in June

The Ohio Bureau of Workers’ Compensation netted seven convictions in June in criminal cases related to workers’ compensation fraud.

“Investigating and putting an end to fraud helps protect the benefits of injured workers and keep employers’ premiums down,” said BWC Administrator/CEO Sarah Morrison. “That’s why BWC is so proactive in pursuing all employers, medical providers, workers and others who are suspected of committing fraud.”

Those convicted include child care center operators, skilled tradesmen and others who had lapsed policies, forged certificates of coverage or worked while receiving injured worker’s benefits.

As of June 30, BWC’s Special Investigations Department had secured 55 convictions this calendar year. June convictions include:

  • Walter Dappert, (Butler County) – The owner of Dappert Masonry Construction pleaded guilty June 8 to one count of workers’ compensation fraud, a fifth-degree felony. Investigators found he had forged a BWC certificate of coverage to show he had active coverage when, in fact, the policy had lapsed in 2010. A judge sentenced Dappert to three years community control, 40 hours of community service and restitution to BWC in the amount of $1,507. Dappert brought his BWC policy into compliance prior to sentencing.
  • Terry Shaver (Franklin County) – The Grove City man pleaded guilty June 8 to one count of workers compensation fraud, a first-degree misdemeanor, after investigators found him working for a pest control company while receiving injured worker’s benefits. A judge sentenced Shaver to 12 months probation and ordered him to pay $5,000 restitution to BWC by May 2017.
  • Karon Jones (Cuyahoga County) – The Cleveland-area child care center owner pleaded guilty June 13 in the Cuyahoga County Court of Common Pleas to a first-degree misdemeanor count of Attempted Obstructing Official Business after investigators found her coverage had lapsed from Jan. 1, 2010 through June 30, 2015. A judge ordered Jones to pay BWC $33,985 in restitution.
  • Tenora Edwards-Jones (Cuyahoga County) – The child care center owner pleaded guilty June 14 in Cuyahoga County Court of Common Pleas to one count of Failure to Comply with the Law, a second-degree misdemeanor. Edwards-Jones had lapsed coverage at two day care centers in Cleveland Heights. Prior to her sentencing, she paid BWC $28,514 to bring both policies current.
  • Angelique Braxton (Franklin County) – The home health aide pleaded guilty June 15 in the Franklin County Court of Common Pleas to a misdemeanor count of workers’ compensation fraud after she was found working for 20 months while collecting BWC benefits. She paid BWC $1,902 for its investigation and $37,962 in restitution.
  • Gary Miller (Fairfield County) – The Columbus area painter pleaded guilty June 23 to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found he had forged a BWC certificate of coverage after his policy had lapsed. A judge in Fairfield County Municipal Court sentenced Miller to two years probation and ordered him to pay $732 in fines and restitution.
  • Brian DuVernay (Allen County) – The Lima-area man, owner of A Better Way Contracting, pleaded guilty June 24 to one count of Failure to Comply, a second-degree misdemeanor, after investigators found he hadn’t submitted payroll reports, causing his BWC policy to lapse. The Lima Municipal Court fined DuVernay $150 and warned that he would be jailed and face additional charges if he did not come into full compliance with BWC.

Additionally, a Northwest Ohio woman entered into a Hardin County Diversion Program in June in lieu of conviction after investigators found she had altered several BWC certificates of coverage to make them look current after they had lapsed. Kathy S. Detwiler, owner of Detwiler Enterprises Inc., must participate in the program for one year, complete at least 160 hours of community service and abide by all regulations concerning BWC. Once completed, all charges will be dropped.

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

Check out our latest cases at ohiobwcblog.wordpress.com and view BWC’s workers’ comp fraud awareness video on YouTube.

Church secretary convicted of workers’ comp fraud

A Michigan woman has been sentenced to five years community control and ordered to pay the Ohio Bureau of Workers’ Compensation $8,600 in restitution after pleading guilty in April to a fifth-degree felony count of workers’ compensation fraud.

Mischelle Bensch, 58, of Weston, Michigan, must make minimum monthly payments of $200 to BWC until she pays off the $8,617 she received in injured worker’s benefits while working as a church secretary in Michigan, a judge ruled June 23 in the Franklin County Court of Common Pleas. The judge also fined Bensch $500 and court costs and told her she would serve a year in prison if she violates the terms of her community control.

Categories: Uncategorized

Voc rehab provider sentenced on workers’ comp fraud

 

Business owner exaggerated claims, filed phony expenses

A northeast Ohio woman who runs a vocational rehabilitation services business must pay the Ohio Bureau of Workers’ Compensation nearly $56,000 as part of her sentence for committing workers’ compensation fraud.Kristina L. Russell, 36, of North Canton, also must serve five years of community control in lieu of a nine-month prison sentence, a judge ruled June 24 in the Franklin County Court of Common Pleas. She must pay BWC $20,869.47 in restitution and $35,000 for the cost of the investigation.

“This case illustrates that we won’t tolerate fraudulent activity of any kind, not from workers, employers or health care providers,” said BWC Administrator/CEO Sarah Morrison. “A workers’ compensation system that is robust, efficient and offered at fair rates depends on honesty and integrity on everyone’s part.”

Russell owns and operates two Stark County companies, Intensity Rehab LTD of Hartville, Ohio, and Emerald Empowerment Solutions of Uniontown, Ohio. The companies provide vocational rehabilitation and job placement services to injured workers. BWC’s Special Investigations Department started looking at Russell after BWC staffers noticed she consistently billed the maximum mileage (130 miles) and time allowed per claim that she submitted to BWC’s Vocational Rehabilitation Program.

Investigators found Russell also billed BWC for mileage, travel time and wait time she either did not incur or incurred on non-BWC clients. She also submitted false bills and treatment notes for her services.

When confronted, Russell admitted to BWC’s findings. She pleaded guilty May 1 to one count of workers’ compensation fraud, a fifth-degree felony.

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

Check out our latest cases at ohiobwcblog.wordpress.com and view BWC’s workers’ comp fraud awareness video on YouTube.

 

 

# # #

Categories: Uncategorized

Columbus woman will repay $12,000 in ill-gotten workers’ comp benefits

A Columbus (Franklin County) woman has been ordered to repay more than $12,000 to BWC after investigators found she was working while receiving workers’ comp benefits. Susan Meaney was sentenced in the Franklin County Court of Common Pleas on April 15.

SID’s Intelligence Unit found during a database cross-match with the Ohio Department of Job and Family Service that Meaney earned wages from The Kroger Company during the period she also collected temporary total disability benefits from BWC.

SID collected employment records from The Kroger Company that confirmed Meaney worked and receive wages during the same time period she was supposed to be recovering from a workplace injury and was restricted from working. Further, the evidence obtained during the course of the investigation revealed Meaney intentionally misrepresented and withheld her employment in order to continue receiving the benefits.

Susan Meaney pleaded guilty to a fifth-degree felony count of workers’ compensation fraud and was sentenced to ten months of incarceration, suspended for three years of community control.  She was also ordered to pay restitution in the amount of $12,718.74.

Categories: Uncategorized

Columbus man guilty of fraud, ordered to repay $5,000

 

Keith Mitchell of Columbus (Franklin County) was sentenced in the Franklin County Court of Common Pleas this week following a BWC investigation that found he worked while receiving workers’ comp benefits.

BWC’s Special Investigations Department received an allegation that Mitchell was working for a packaging company. The investigation confirmed Mitchell was employed with Adecco and worked at Victory Packaging during periods in which he received BWC disability benefits. Evidence obtained during the investigation revealed that Mitchell intentionally misrepresented and withheld his employment in order to continue collecting the benefits.

Mitchell pleaded guilty April 12 to one count of workers’ compensation fraud, a misdemeanor of the first degree.  He was sentenced to 180 days in jail, suspended for two years of community control.  He was also ordered to pay restitution in the amount of $5,147.37.

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

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 March 2016. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“I’m pleased these claimants are now on the hook for repayment and will not continue receiving undeserved compensation,” said Buehrer. “We encourage Ohioans to contact us when they suspect fraud. Our agents look into every allegation as part of their ongoing work to put an end to fraud and deter future scams against Ohio’s injured workers and businesses.”

The following are a sampling of cases that resulted in guilty pleas or convictions during March

Kevin Gruver (Elyria, Lorain County) pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas March 16 for working while receiving benefits. SID began investigating Gruver after receiving an allegation indicating he had returned to work with Adecco while collecting benefits for a workplace injury. Investigators found that Gruver did return to work with Adecco and worked as a temporary employee for multiple companies, including Leggett & Platt, Wal-Mart, Pontoon First Energy Fieldglass, and 3M. This employment activity was inconsistent with Gruver’s receipt of temporary total disability benefits. Gruver was sentenced to 180 days in jail, suspended for two years of community control under the conditions that he maintain employment and pay restitution in the amount of $6,959.65.

Charles Bentley (Mentor, Lake County) pleaded guilty plea to one misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas on March 10 for working while receiving benefits. SID began investigating after receiving an anonymous allegation stating Bentley had been working “under the table” for a landscaping company for three years. Bentley should not have been working at all as he was receiving workers’ compensation benefits for a workplace injury. The investigation confirmed that Bentley returned to employment during the winter season as a snowplow truck driver while receiving temporary total disability benefits.  Bentley had already paid the entire restitution in the amount of $22,125.60 to BWC.  He was sentenced to 90 days in jail, suspended for 90 days of community control.

Amato Zaccone Jr. (Hubbard, Trumbull County) pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas March 10 for working while receiving benefits. SID began investigating Zaccone after a wage cross-match with the Ohio Department of Job and Family Services indicated he was working during the same time period he was receiving BWC benefits for a workplace injury. Investigators conducted field interviews and obtained financial records that confirmed Zaccone was working as a cook for McMenamy’s, LLC while receiving Temporary Total Disability. Zaccone was sentenced to 90 days in jail, suspended for one year of community control on the condition that he pay restitution in the amount of $1,045.20.

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

Check out our latest cases at ohiobwcblog.wordpress.com and view BWC’s workers’ comp fraud awareness video on YouTube.

Tuscarawas County woman ordered to repay $9K for workers’ comp fraud

December 31, 2015 2 comments

Robin Beckett of Dennison (Tuscarawas County) has been ordered to repay more than $9,000 to the Ohio Bureau of Workers’ Compensation after investigators found she knowingly committed fraud by working in violation of the workplace injury benefits she was receiving.

The Special Investigations Department Intelligence Unit noted a database cross-match with the Ohio Department of Job and Family Services showed Beckett earned wages during periods when she was also collecting disability benefits for a workplace injury. The investigation produced evidence proving Beckett knowingly and with fraudulent intent worked for Tender Touch Home Health performing various nursing duties while on temporary total disability.

Robin Beckett pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on Oct. 6 in the Franklin County Court of Common Pleas. Judge McIntosh sentenced Beckett to 10 months in prison, suspended for three years of community control. Conditions of her probation include payment of restitution totaling $9,330.29.

BWC SID: Our Journey to Excellence – Part 3 of 3

November 19, 2015 1 comment

In our constant quest for improvement, all members of the Bureau of Workers’ Compensation Special Investigations Department (SID) annually complete in-service training. The theme of this year’s training event was “Our Journey to Excellence: Past, Present and Future.” On October 22, by SID Director James Wernecke, we shared investigative successes and presented awards to teams and individuals.

Preparations: In September, all 123 SID employees had been invited to nominate a peer to receive an individual award. A management committee furnished behavioral characteristics for use by SID employees when submitting written justifications for any peer nomination. These characteristics varied according to the type of award: Star; Excellence in Service; and Leadership. In reviewing all nominations, the committee members found that several nominees were nominated by multiple colleagues. Ultimately, the committee selected eight most-worthy SID employees.

Presentations: These talented and dedicated professionals received their awards at the culmination of the October 22 event.

fraud part 3 pic 1Two employees received Star awards, including Karen McMahan (pictured at right), a Registered Nurse with the Health Care Provider Team (HCPT). They met five criteria including: approaching new challenges with a “can do” attitude; involving themselves above and beyond in community outreach and/or volunteerism; and encouraging and mentoring peers and co-workers;

Fraud part 3 pic 2Four employees earned Excellence in Service awards, including T. Michael Hostin (pictured at left), an investigator with the Safety Violations Investigation Unit (SVIU); and Pam Hunnicutt (pictured below right), an administrative professional with SVIU.

fraud part 3 pic 3They met four standards including: demonstrating extraordinary commitment by continuously providing excellent service to internal and external customers; and demonstrating a positive attitude, using strong judgment and good communication skills while promoting teamwork.

Two other employees received Leadership awards. They satisfied six criteria, including: setting a high standard of integrity; leading by example and maintaining high personal standards; inspiring a high level of commitment from others when taking on new initiatives; and sharing responsibility, authority, information, and credit when working towards the achievement of a goal.

Please, join us in thanking and congratulating each of the SID award nominees and recipients. They are the reason we are able to confidently strive towards excellence.

You can read the first article about our October 22 event here, the second article about the event here, and our most recent annual report here.

New BWC blog!

We’re pleased to partner with our colleagues at BWC as they join us in the blogosphere!

Just this week, BWC launched an agency blog called Prevention & Care.

The blog will be your one-stop for all the most recent updates from BWC, as well as offer helpful information and tips on a range of issues. The blog features sections covering a number of topics of interest, including, of course, SID’s fraud prevention and detection efforts.

Prevention & Care kicked off with a post reflecting on the importance of making safety a priority in every workplace.

Be sure to check out the blog here and keep coming back here for the latest from BWC’s Special Investigations Department.

Categories: Uncategorized

Shelby County maintenance man sentenced for workers’ comp fraud

Billy Schloss of Port Jefferson (Shelby County) pleaded guilty in the Shelby County Court of Common Pleas to one count of workers’ compensation fraud for working while collecting benefits for a workplace injury.

SID received an allegation and opened an investigation that revealed Schloss was working general maintenance for a company in Port Jefferson maintaining and fixing rental properties from February to June 2014 while collecting temporary total disability from the Ohio BWC.

Schloss was sentenced Sept. 1 to five years of community service and ordered to pay $6,762.59 in restitution.  If he violates his community control sanctions, he will be ordered to serve 180 days in the Shelby County Jail.

Categories: Uncategorized

Nelsonville man coached basketball, provided lawn care services while on workers’ comp

Brent Taylor booking photoA Nelsonville (Athens County) man pleaded guilty to one misdemeanor count of workers’ compensation fraud. Brent Taylor was ordered by a judge in Franklin County to pay restitution of $30,000.

SID opened an investigation after receiving an allegation that Taylor was engaged in work activity while he was receiving Temporary Total Disability benefits for a workplace injury. The investigation revealed Taylor knowingly engaged in work activities while receiving this benefit that does not permit a return to work. Specifically, the investigation confirmed he worked as a girls’ basketball coach and provided lawn care services while concealing his activities from BWC.

On Sept. 14, Taylor was placed on five years of community control and ordered to pay $30,000 in restitution, with $13,500 to be paid at the time of the plea, in addition to $1,750 in investigative costs.  Taylor submitted $13,500 to the Franklin County Clerk’s Office prior to his plea.

Categories: Uncategorized

Columbus woman sentenced for workers’ comp fraud

Patrice Myers Booking PhotoPatrice Myers of Columbus (Franklin County) was ordered by a judge to repay BWC more than $7,500 after she pleaded guilty to fraud for working while receiving workers’ compensation benefits.

BWC’s Special Investigations Department (SID) began investigating after receiving an allegation that Myers was working at a pharmacy while receiving benefits for a workplace injury. The investigation found that Myers knowingly worked at the pharmacy while receiving temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit. SID obtained employment records that confirmed Myers was paid every two weeks and worked approximately 30 to 40 hours per week during the same time period she received the benefits.

Myers pleaded guilty Sept. 9 in a Franklin County courtroom to one first-degree misdemeanor count of workers’ compensation fraud.  She was ordered to pay $7,566.24 in restitution to the BWC, and sentenced to 180 days in jail, suspended for five years of community control.  Myers has paid approximately $1,200 to the Franklin County Clerk’s Office as part of her restitution.

Categories: Uncategorized

Special Investigations Department identified $60.5 million in savings last year

We’re pleased to announce that SID identified $60.5 million in savings for the State Insurance Fund over the past year due to workers’ compensation fraud committed by claimants, employers and medical providers.

Recovered funds will go back to the State Insurance Fund to care for workers injured in Ohio. The Special Investigations Department Fiscal Year 2015 Annual Report was released today, and includes an overview of statistics and strategies for preventing and detecting fraud.

Since its inception in 1993, SID has completed more than 62,000 investigations and identified $1.6 billion in savings to the Ohio workers’ compensation system.

Among the more than 1,500 cases that were closed during FY 2015, 665 were closed founded, meaning the original allegation was proven. The average savings identified among the 665 cases was more than $90,903. Nearly 230 of these cases were referred for prosecution, resulting in 130 indictments and 151 convictions,  a 14 percent increase in convictions over the previous year.

During the past fiscal year, SID began implementing its fourth strategic plan, which serves as its operational guide through FY 2019. The plan includes initiatives that include implementing new technologies to conduct field work and detect cases for investigation, improving operational efficiency and ensuring employees are properly trained and appropriately assigned across our teams. This plan supports our overall mission to ensure that we effectively prevent, detect and investigate workers’ compensation fraud to protect the State Insurance Fund.

Thank you for supporting our efforts. Please keep those tips coming!

Categories: Uncategorized

Video shows Portage County man committing workers’ compensation fraud

David Robertson of Aurora (Portage County) has been sentenced for committing fraud after BWC investigators captured him on video working while receiving workers’ compensation benefits.

BWC’ Special Investigations Department (SID) received an anonymous allegation stating Robertson was employed although he was not permitted to work while receiving benefits for a prior workplace injury. Investigators conducted surveillance, retrieved records and gathered witness statements to prove Robertson returned to work at a restaurant performing a variety of tasks including dish washer and cook. Robertson was interviewed and confessed to his activities.

Robertson pleaded guilty to one felony count of workers’ compensation fraud on July 22. A Franklin County judge sentenced him to one year of probation.  He will receive six months in prison if he fails to abide by the terms of the probation.  Additionally, BWC has recovered $45,162.

Categories: Uncategorized

Reynoldsburg man ordered to pay restitution for workers’ comp fraud

Johnny Hughes, of Reynoldsburg (Franklin County), pleaded guilty and was sentenced June 23 in the Franklin County Municipal Court for one count of attempted theft, a second-degree misdemeanor.

SID’s intelligence unit discovered that Hughes received multiple narcotic prescriptions from different physicians and multiple pharmacies. Investigators found that Hughes visited hospital emergency departments around Columbus. They also proved that he received medical treatments unrelated to his BWC claim and then instructed pharmacies to submit bills for payment to BWC, concealing that his medical treatment was unrelated to his claim in order to obtain medications he was not entitled to receive as a workers’ comp benefit.

Hughes was sentenced to three years of community control and was ordered to pay $700 in restitution to BWC. He was also sentenced to 90 days in jail, which was suspended, as long as he makes regular restitution payments.

Categories: Uncategorized

Sandusky County man ordered to repay $3,500 for workers’ comp fraud

John TiptonJohn Tipton, of Clyde (Sandusky County), pleaded guilty and was sentenced June 23 in the Franklin County Court of Common Pleas for one count of workers’ compensation fraud, a first-degree misdemeanor.

A data cross-match with the Ohio Department of Public Utilities Inspection identified that Tipton might have been working while collecting BWC benefits. Investigators found that Tipton was a truck driver for a construction company from April to May 2012 and from September to November 2012 while receiving permanent total disability benefits.

Tipton was ordered to pay $3,582.43 in restitution to BWC, plus court costs. He was sentenced to 90 days in jail, which was suspended for 12 months of community control.

Categories: Uncategorized