Federal prisoner adds workers’ comp fraud to record

Cleveland-area man held job while receiving disability benefits

A Cleveland-area man serving time in a federal prison on corruption charges added workers’ compensation fraud to his rap sheet Monday when he pleaded guilty to the fifth-degree felony in a Franklin County courtroom.

A judge sentenced James Todt, 50, of Brecksville, to nine months in prison, to be served concurrently with the 30-month prison term he received last fall for a scheme involving cash bribes and kickbacks when he worked for a Cleveland-based nonprofit housing agency.

“We don’t let anyone slide on workers’ compensation fraud, even if they’re already in prison,” said BWC Administrator/CEO Sarah Morrison. “We will bring them to court to face justice, and we will pursue any funds they fraudulently received.”

BWC’s Special Investigations Department started looking at Todt in July 2015 after a crossmatch with the Ohio Department of Jobs & Family Services revealed he was employed while concurrently receiving disability benefits from BWC. The investigation revealed that Todt was working for a construction company while claiming to be disabled and unable to work. He was found to have fraudulently received $33,400 from BWC.

Todt is scheduled to be released in April 2019 from a federal prison in Morgantown, West Virginia. He was sentenced last October after pleading guilty in June to conspiracy to commit bribery and two counts of theft concerning federal funds. Todt admitted to steering construction contracts to two businesses in exchange for bribes and kickbacks while he worked at Cleveland Housing Network, an umbrella nonprofit made up of 15 community development corporations.

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

 

Social networking site reveals work’ comp’ cheater

Health care worker caught working while receiving injured worker benefits

Most professionals use LinkedIn to showcase their experience, stay connected in the business community and perhaps land that dream job one day.

For Kandice M. Klink Jones of Columbus, it didn’t work out so well.

Instead, her LinkedIn profile tipped off her employer that she was working when she was supposed to be off work due to a workplace injury, an injury that was costing the employer thousands of dollars in workers’ compensation benefits. The employer asked the Ohio Bureau of Workers’ Compensation to investigate, and now, following her guilty plea Monday, Jones has a felony record and a bill for $12,938 owed to her old employer, American Nursing Care Inc.

“Our investigation revealed Jones was gainfully employed with four different employers, doing the same or similar job duties as when she was injured,” said Jim Wernecke, director of BWC’s Special Investigations Department. “The evidence we obtained confirmed she intentionally misrepresented and withheld this information in order to collect benefits she would not otherwise have been entitled to.”

Besides ordering restitution, a Franklin County judge sentenced Jones, 46, to a year in jail, which she then suspended in lieu of five years of community control.

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

Cleveland doctor sentenced on drug trafficking, fraud charges

Three from Medical Care Group sentenced to date

A Cleveland doctor sentenced last week on felony charges of drug trafficking and workers’ compensation fraud paid $30,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) and will no longer work in the BWC system.

Dr. Stephen Bernie, 77, also received a six-month suspended prison sentence and a year of probation during his sentence April 26 in a Cuyahoga County courtroom. Besides the drug and fraud charges, he also pleaded guilty on April 5 to a felony count of tampering with records.

Adding to his punishment, BWC is decertifying the physician from its network of approved providers.

“I am pleased that justice prevailed in this case and that Dr. Bernie will no longer be doing business with BWC and its injured workers,” said BWC Administrator/CEO Sarah Morrison. “The funds we recover from this case will go back to the State Insurance Fund for injured workers.”

Bernie worked for Medical Care Group, a chain of Cleveland-area medical clinics at the center of an investigation by BWC and the Westshore Enforcement Bureau in northeast Ohio since 2008.

Using undercover agents and a confidential informant, investigators found the clinics billing the state for medical procedures that never happened, inflating costs and giving out prescriptions for medications — including powerful opioids — without monitoring the patients who took them. Some patients left with prescriptions after less than a minute in the office.

Former clinic co-owner Dianne Javier also was sentenced last week after pleading guilty to workers’ compensation fraud and tampering with records. Like Bernie, she paid BWC $30,000 in restitution and received a suspended jail sentenced and a year of probation. The court also fined the company $12,500.

Another clinic employee, Kim Seltzer, was convicted in September 2015 on similar charges and is serving 51 months in the Mansfield Correctional Institution.

Because of Ohio’s confidentially laws, the State Medical Board could not discuss any details of a possible investigation into Bernie, but Communications Director Tessie Pollock said physicians convicted of felonies could face a range of disciplinary actions up to the permanent revocation of the medical license.

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

BWC nets nine fraud convictions in March

The Ohio Bureau of Workers’ Compensation secured nine convictions in March of workers and employers who cheated, or attempted to cheat, the agency out of funds reserved for legitimately injured workers and workplace safety efforts.

BWC’s Special Investigations Department has secured 38 convictions this calendar year, as of March 31. Last month’s cases include:

Ronnie Simmons Jr. of Cleveland, dba Simmons Adult Care, Lapsed Coverage
Simmons pleaded guilty March 29 to a minor misdemeanor count of attempted workers’ compensation fraud for failing to carry proper workers’ compensation insurance. Following a judge’s order, he paid his outstanding balance of $3,587 to BWC.

Michelle Litton of Marysville, Working and Receiving
Investigators found Litton operating a pet grooming business out of her home while receiving BWC benefits. She pleaded guilty March 28 to one count of workers’ compensation fraud, a first-degree misdemeanor. She was sentenced to one day of jail time and given credit for time served.

Charles Knight of Cuyahoga Falls, Working and Receiving
Investigators found Knight working as an independent contractor and construction laborer while receiving BWC benefits. Knight pleaded guilty March 23 to workers’ compensation fraud, a first-degree misdemeanor. He paid $3,731 in restitution to BWC.

Jennifer Garner of Toledo, Working and Receiving
Garner pleaded guilty March 21 to a first-degree misdemeanor count of workers’ compensation fraud. A judge ordered Garner, who was found working while receiving disability benefits, to pay BWC $7,645 in restitution and sentenced her to five years of community control and a suspended jail term of four months. Garner paid $1,000 prior to her guilty plea.

James Miller of Fulton County, Attempted Workers’ Compensation Fraud
Miller pleaded guilty March 17 to a first-degree misdemeanor count of attempted workers compensation fraud after he and his sister were found withdrawing and sharing their late father’s BWC cash benefits. A judge sentenced him to a suspended sentence of six months in jail and a $100 fine. His sister, Cecilia Williams, was sentenced in February to two years of community control, a suspended jail term of seven months and ordered to take a theft education course.

Patrick Fachman of Columbus, False Claim
Fachman pleaded guilty March 14 to one count of workers’ compensation fraud, a first-degree misdemeanor, for filing two false injured worker’s claims against a former employer. He was sentenced to one day in jail time and given credit for time served.

Jamie Miller of Columbus, Falsified Coverage Application
Miller obtained workers’ compensation coverage for a painting business she purported to own. But investigators found she was merely trying to obtain a valid BWC certificate for her husband, Shannon Miller, a painter whose coverage had lapsed. Jamie Miller pleaded guilty March 14 to one count of criminal mischief, a first-degree misdemeanor. She was given credit for two days jail time served. She must complete 24 hours of community service in lieu of fines and court costs.

Daniel Burch of Akron, dba Check Mart, Lapsed Coverage
Burch failed to cooperate with the BWC Employer Compliance Department that was helping him to reinstate BWC coverage that had been lapsed since 2008. Burch pleaded guilty March 13 to failure to comply, a second-degree misdemeanor. He was ordered to bring his policy into compliance with the law.

John Lewis of Cincinnati, Working and Receiving
Already serving time in an Indiana prison for a burglary conviction, Lewis pleaded guilty March 9 to a fifth-degree felony count of workers’ compensation fraud and was sentenced to nine months incarceration, to be served concurrent with his Indiana sentence. BWC investigators discovered Lewis had been working for a Wendy’s restaurant while collecting $32,532 in BWC benefits from June 2013 to August 2014.

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

Coal miner digs himself a hole in fraud scheme

A former coal miner from northeast Ohio owes the Ohio Bureau of Workers’ Compensation (BWC) more than $40,000 after BWC investigators found him creating phony employment records to secure BWC cash benefits.

Steven R. Kornbau, 50, of Mahoning County, pleaded guilty March 28 to a fifth-degree felony charge of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge ordered Kornbau to reimburse BWC $40,514 and sentenced him to six months in jail, which he then suspended for five years of community control.

“As Mr. Kornbau’s case shows, some people get creative in trying to cheat the workers’ compensation system” said BWC Administrator/CEO Sarah Morrison. “But that’s no match for our investigators and claims personnel who are trained to detect suspicious claims and stop fraud when they see it. The funds we recover from this case will return to where they belong — taking care of injured workers and creating safe workplaces across this state.”

Kornbau’s case centers around “working wage-loss benefits” he received from Dec. 1, 2014 until April 2, 2016. These benefits are designed to make up the difference in wages between the injured worker’s job at the time of injury and the job following recovery if it pays less.

Kornbau, a coal miner when he was injured in 2009, was supposed to be working, or at least actively looking for work, to receive the benefits. Instead, Kornbau created a fictitious company called Anderson’s Windows and Doors and submitted phony payroll records to BWC as evidence he was working. BWC staff noticed inconsistencies in the records in the summer of 2015 and contacted the agency’s Special Investigations Department.

Investigators quickly determined the company was fake, and Kornbau confessed as much during questioning.

In other recent fraud cases:

  • Robert Lester, of Columbus, pleaded guilty April 4 to a first-degree misdemeanor count of workers’ compensation fraud for filing two false claims for BWC benefits. Lester filed the claims stating he was injured at work, when, in fact, he was not employed at the time of his alleged injuries. A judge sentenced him to 13 days in jail and gave him credit for 13 days served.
  • Shawn Lines, 41, of Ashtabula, pleaded guilty April 3 to a first-degree misdemeanor count of workers’ compensation fraud for working while receiving temporary disability benefits. A Franklin County judge ordered Lines to reimburse BWC $5,370 in minimum payments of at least $125 a month.
  • Ronnie Simmons Jr., of Cleveland, owner of Simmons Adult Care, pleaded guilty March 29 to a minor misdemeanor count of attempted workers’ compensation fraud for failing to carry proper workers’ compensation insurance. Following a judge’s order, he paid his outstanding balance of $3,587 to BWC.

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

Fulton County siblings ordered to reimburse BWC $6K+

Pair took late father’s monthly cash benefits

A judge has ordered a Fulton County sister and brother to reimburse $6,657 to the Ohio Bureau of Workers’ Compensation for taking their father’s BWC benefits in the immediate months following his death in 2014.

Cecilia Williams, 36, of Fayette, pleaded guilty Dec. 20 in the Fulton County Court of Common Pleas to a fifth-degree felony count of workers’ compensation fraud. She was sentenced Feb. 27 to two years of community control and a suspended jail term of seven months. She also must take a theft education course.

Her brother, James Miller, 35, of Wauseon, was sentenced March 17 to a suspended sentence of six months in jail and a $100 fine after pleading guilty to attempted workers compensation fraud, a first-degree misdemeanor. Both have already paid restitution to BWC.

BWC’s Special Investigations Department learned in 2014 that Williams’ and Miller’s father had passed away on March 15 that year, but no one had reported his death or returned his BWC cash benefits to the agency. Agents later discovered that a total of $6,657 had been withdrawn from ATMs between the dates of March 27, 2014, and July 17, 2014.

Williams admitted to agents that she withdrew the funds using her deceased father’s debit card for personal monetary gain and then provided half of the money to her brother.

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

Gamble on work comp fraud comes up lemons

A Toledo woman who managed a gambling storefront that was raided by state agents in 2014 pleaded guilty March 21 to workers’ compensation fraud for working there while collecting injured worker benefits from the Ohio Bureau of Workers’ Compensation (BWC).

Jennifer E. Garner, 57, pleaded guilty to the first-degree misdemeanor in the Franklin County Court of Common Pleas. A judge ordered Garner to pay BWC $7,645 in restitution and sentenced her to five years of community control and a suspended jail term of four months. Garner paid $1,000 prior to her guilty plea.

“Trying to cheat BWC is never a safe bet,” said BWC Administrator/CEO Sarah Morrison. “Our Special Investigations Department is dedicated to rooting out fraud and bringing criminals to justice.”

Acting on a tip, BWC investigators found Garner managing and working at the Surf’s Up Cyberlounge in Oregon, Ohio, through most of 2014 while she collected benefits from BWC for a job injury that purportedly left her permanently and totally disabled.

On Dec. 18, 2014, agents with the Attorney General’s Office, Ohio Casino Control Commission and Oregon Police Department executed a search warrant at Surf’s Up and five other similar storefronts in northwest Ohio on suspicion of operating as illegal casinos. Gaming machines were removed from each of the six locations, but no arrests were made. Prosecutors ultimately declined to pursue the case against Surf’s Up.

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