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Posts Tagged ‘Ohio Bureau of Workers’ Comp’

Spotlight: Dan Fodor – From college intern to assistant director, special investigations central operations

By Jeff Baker, Program Administrator, BWC Special Investigations Department

fodor-picMembers of the Special Investigations Department (SID) congratulate Dan Fodor. In June 2016, Dan (shown presenting at the 2016 SID in-service meeting on Sept. 14) was promoted to assistant director, central operations.

Assistant director (AD) Fodor started his career with BWC in June 1991 as a college intern with the internal audit department. During this time, Dan completed his degree and became a certified public accountant. He earned a bachelor’s in accounting from The Ohio State University. In December 1991, Dan commenced his initial full-time position with BWC as a  financial/operational auditor and consultant. By the autumn of 1996, he had earned the title of audit senior and commenced his stellar management career.

sid-text-3In November 1999, Dan joined SID as the special agent in charge of the intelligence unit (IU), providing essential support to special investigations unit field agents through fraud detection and data analysis. Given his knowledge, skills and successes with IU, Dan accepted, in June 2014, the additional responsibility of supervising the safety violations investigation unit (SVIU), a team devoted to investigating alleged safety requirement violations that have resulted in a workplace injury, illness or death.

Throughout his career, applying uncanny intuition, uncommon sense and diligence, AD Fodor has energetically prompted our agency’s success and earned the respect of his SID colleagues.

A few examples from his 25-year career, include:

  • Guided and directed the department’s effective use of the agency’s data warehouse;
  • Developed and executed SID performance measurements and management reporting;
  • Effectively partnered with other BWC operational areas and external entities;
  • Co-administered the SID strategic planning process for several five-year plans;
  • Since 2000, IU has detected 18,950 fraud allegations, resulting in the identification of $473 million in savings; and
  • Between 2000 and June 30, 2016, IU’s fraud allegations resulted in 948 criminal referrals and 480 convictions.

These performance results demonstrate, in part, why Dan is highly qualified to direct our SID central operations. Certainly, for all of the above reasons, you can see why we thank and congratulate AD Fodor! We look forward to his continued guidance, direction, leadership and success in our department.

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For more information about IU, see our Jan.22 article, Spotlight: Intelligence unit — Predicting even more results, here. For more information about SVIU, see our 2011 article, SVIU: Investigating suspected violations of specific safety requirements, here, or our 2013 article, Completing the circle of coverage: A look at our safety violations investigation unit, here. For more information about the SID, see our most recent annual report here.

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

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

“A recent case in which two individuals stole the identity of a deceased claimant shows that some people will go to great lengths to scam the system,” said Buehrer. “They are a clear reminder why we continue our efforts to protect the dollars employers pay to support Ohio’s injured workers in their time of need.”

 The following are cases that resulted in guilty pleas or convictions during January:

Consuelo “Connie” Griffin and David Lusk (Cincinnati, Hamilton County) both pleaded guilty Jan. 14 in the Hamilton County Court of Common Pleas to counts of theft after they were discovered cashing BWC benefit checks for an injured worker who had died. SID opened an investigation after receiving an allegation from BWC’s claims department, which was unable to contact an injured worker receiving permanent total disability for a workplace injury. The claims department reported that worker’s phone was disconnected. The investigation found that while the injured worker passed away in June 2014, the BWC checks that were mailed to his home continued to be cashed. Griffin and Lusk lived in the same apartment complex as the deceased and when he was hospitalized, Griffin signed a power of attorney document giving her control over his finances. Griffin also had the injured worker’s mail forwarded to her address and the pair moved into his apartment when he was hospitalized. Griffin confessed to signing Harrell’s name on the checks and cashing them. Griffin also took money out of his bank account while he was ill and wrote checks from his account to herself for cash. His account was soon closed because Griffin and Lusk spent all the money and failed to pay any of his nursing home expenses. Lusk pleaded guilty to count of theft and one count of theft from the elderly, both fifth-degree felonies. Griffin also pleaded guilty to two counts of theft, both fifth-degree felonies. The court sentenced them to 10 months in jail, suspended, and ordered them to repay restitution of $5,072.62. They also received three years of probation.

Michelle Green (Columbus, Franklin County) pleaded guilty Jan. 13 in the Franklin County Court of Common Pleas to attempted workers’ compensation fraud, a first degree misdemeanor, for working while receiving benefits. SID’s Intelligence Unit received data from the Ohio Department of Job and Family Services (ODJFS) that indicated Green had received wages while receiving BWC benefits. The investigation confirmed Green was employed with Good Hands Home Health Care Service in Columbus. Evidence obtained during the course of the investigation also showed that she intentionally misrepresented and withheld her employment in order to continue collecting benefits. She was ordered to pay restitution in the amount of $1,899.99 and $100 in court costs.

Randy Gates, dba Gator’s Auto Repair and Towing (Caledonia, Marion County) pleaded no contest on Jan. 21 in the Marion Municipal Court to a second-degree misdemeanor count of failure to comply for operating his business without workers’ compensation insurance coverage. BWC’s Employer Fraud Team (EFT) identified that Gates continued to operate his business, Gator’s Auto Repair and Towing, without valid BWC coverage after two previous investigations for the same issue. He had been previously referred for prosecution in 2005 for failure to comply for operating a business without the required BWC coverage. The EFT attempted to work with this employer to become compliant with state law but Gates refused to submit completed outstanding payroll reports in an effort to calculate accurate premiums owed. The employer also failed to attempt to pay his balance with the BWC. On January 21, 2016, Gates entered a plea of no contest to failure to comply, a second-degree misdemeanor. Gates received a 180-day jail sentence which was suspended, and was ordered to pay fines and court costs. Gates currently has an estimated balance due of approximately $36,000 and is working with the BWC to submit outstanding payroll reports for calculation of exact premium due.

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

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

Maple Heights woman guilty of fraud, ordered to repay more than $4K

A Maple Heights (Cuyahoga County) woman has been ordered to repay more than $4,000 to the Ohio Bureau of Workers’ Compensation (BWC) after she pleaded guilty to workers’ compensation fraud.

An investigation was opened into Brandy Davis after BWC’s Special Investigations Department received information through a cross match of data with the Ohio Department of Jobs and Family Services. The cross match indicated that Davis had received wages during a period of time when she was receiving benefits for a workplace injury.

The investigation confirmed Davis worked for Beech Brook, a children’s behavioral health center, and the Jewish Family Services Association (JFSA), both in Cleveland, while receiving temporary total disability benefits.

Davis entered a guilty plea to one first-degree misdemeanor count of workers’ compensation fraud on February 3 in the Franklin County Court of Common Pleas. Judge Holbrook sentenced Davis to 180 days in jail, suspended for five years of community control, under the condition that she pay restitution totaling $4,639.75.

Bedford woman owes BWC $12,000 for workers’ comp fraud

December 11, 2015 2 comments

A Bedford (Cuyahoga County) woman has pleaded guilty to workers’ compensation fraud for misleading BWC about her status as a college student.

Rachel Madison was eligible to receive death benefits up to age 25 if enrolled at an accredited educational institution. SID began investigating after receiving an allegation that she was submitting proof of college enrollment to BWC in order to receive benefits but was not attending the classes. Her course schedule from the University of Akron showed that either she failed to attend classes and/or did not remain in full-time status, which is required to continue receiving benefits.

The investigation found Madison failed to report to BWC that she didn’t attend classes and was not enrolled as a full-time student. However, she continued to submit paperwork to BWC in order to continue receiving dependant death benefits.

Rachel Madison pleaded guilty to one count of workers’ compensation fraud on Nov. 23 in the Franklin County Court of Common Pleas.  Madison was sentenced to six months in prison, suspended for five years of community control. As a condition of her probation, she is required to pay $12,319.98 in restitution to the BWC.

Wayne County realtor pleads guilty to workers’ comp and social security fraud

James Miller of West Salem (Wayne County) recently pleaded guilty to workers’ compensation and social security fraud and has been ordered to repay more than $30,000.

BWC’s Special Investigations Department began investigating Miller after receiving an allegation that he was working as a realtor while receiving living maintenance wage loss statements. This benefit is available to an injured worker who has completed a rehabilitation plan but continues to have physical restrictions and experiences a wage loss upon return to work.

Internet research showed Miller had listings and recent sales with Howard Hanna and employment and bank records revealed he had received numerous paychecks from the company. However, he had been submitting paperwork to BWC showing he had no earnings.

Miller admitted to earning the money as a realtor but claimed that his expenses as a realtor were so great that he earned $0.  However, as part of his benefits, BWC had paid for these expenses previously and were not out-of-pocket expenses to Miller. Additionally, it was discovered that Miller was receiving monthly benefits from the Social Security Administration (SSA).

Miller entered a guilty plea to two felony counts of theft and two felony counts of tampering with records in an Ashland County courtroom. The plea represents two counts for BWC and two for SSA.

The judge sentenced Miller to 150 days of house arrest with GPS monitoring for each count, which will run concurrently. Additionally, Miller will serve four years of probation supervision and 250 hours of community service.  Conditions of community control include the payment of restitution to BWC in the amount of $11,081.68 and $20,878.79 to the SSA. Miller was also ordered to pay a fine of $ 1,000.

He will face 18 months of prison time if he fails to abide by the sanctions imposed by the court.