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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