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Trucker kept truckin’ while collecting injured-worker benefits

Zanesville man convicted of workers’ comp fraud

A Zanesville truck driver must pay nearly $8,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after agency investigators found him working for a living while collecting BWC disability benefits.

Douglas J. Krouskoupf, 53, pleaded guilty Jan. 9 to a first-degree misdemeanor count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge sentenced Krouskoupf to 180 days in jail, which he suspended on the condition Krouskoupf pay BWC $7,924 in restitution.

“We found Mr. Krouskoupf working for his brother’s sandblasting business on multiple occasions and that he was also driving a semi-truck while collecting BWC benefits,” said Jim Wernecke, director of BWC’s special investigations department. “Our benefits are for people who suffer a workplace injury and can’t do their job. Mr. Krouskoupf clearly doesn’t fit into that category.”

In other news, BWC netted seven fraud or fraud-related convictions in December, bringing calendar year 2018’s total to 94. In order of most recent case, December convictions include:

Jason Dudas, Mentor, Ohio
Dudas pleaded guilty Dec. 13 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working as a handyman while receiving BWC benefits. A judge ordered Dudas to pay $5,073 in restitution and serve three years of non-reporting probation.

Gabriel Seda, Grafton, Ohio
Seda pleaded guilty Dec. 6 through a Bill of Information to a fifth-degree felony count of workers’ compensation fraud after BWC found him working as a landscaper while receiving BWC benefits. A Franklin County judge ordered Seda to reimburse BWC $33,960 and sentenced him to five years of probation in lieu of a year in prison.

John House, Chris Kraft and Lynn Howard, dba Old Crow Bar, Middletown, Ohio
House, Kraft and Howard, owners of the Old Crow Bar, each pleaded guilty Dec. 3 to disorderly conduct, a fourth-degree misdemeanor, after BWC discovered they weren’t carrying workers’ compensation coverage on their business. A judge sentenced House to 10 days in jail (suspended) and fined him $200 and $90 in court costs. Kraft and Howard were both sentenced to one day in jail (suspended) and fined $100 and $90 in court costs.

Brian Lang, dba Outdoor Inspirations, Holland, Ohio
Lang pleaded guilty to a third-degree misdemeanor charge of attempted failure to comply with the law Dec. 3 after BWC discovered him running a business without workers’ compensation coverage to protect his employees. A judge scheduled sentencing for Jan. 28 after Lang paid $5,304 toward the balance he owes BWC.

Beth Turner, dba Flashions Ltd, Springfield, Ohio
Turner pleaded guilty Dec. 3 to failure to comply, a minor misdemeanor, after BWC found her operating her business without workers’ compensation coverage. Turner was fined $100 and court costs.

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

 

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Auld Lang Syne…

Standout fraud cases in 2018

By Melissa Vince, BWC Public Relations Manager

Soon we’ll all be counting down and singing that classic New Year’s song to say farewell to 2018 and hello to 2019. Or maybe you’re like me and you’ll wake up at 12:05 a.m. to realize you missed another countdown.

In the spirit of Auld Lang Syne, which roughly translates as “for old times’ sake,” we thought we’d look back at some of our more notable cases in 2018. Since January, we shared 48 blogs covering claimant, provider and employer workers’ compensation fraud cases. The following cases stand out in our memory:

Thanks for your support this year. We were proud to celebrate our 25th year of investigating, detecting and deterring fraud in Ohio. Now it’s on to 26!

And thanks for following the BWC Fraud Blog. We hope you’ll stay tuned here in 2019 for more on the latest news and information on workers’ comp fraud in Ohio. Don’t forget to also follow our Facebook page.

Cheers! Okay, everyone now: Should auld acquaintance be forgot….

Home Depot shopping trip blows fraudster’s cover

Mentor man caught working as handyman while collecting BWC benefits

 

A northeast Ohio landscaper must pay the Ohio Bureau of Workers’ Compensation (BWC) a little more than $5,000 in restitution after the agency’s investigators found him working while collecting injured-worker benefits.

Jason Dudas, 39, of Mentor, pleaded guilty Dec. 13 to one count of workers’ compensation fraud, a first-degree misdemeanor, in the Franklin County Court of Common Pleas. A judge ordered Dudas to pay BWC $5,073 in restitution and serve three years of non-reporting probation.

“We got a tip that Mr. Dudas might be working after someone spotted him getting into a truck loaded with construction supplies at a Home Depot store,” said Jim Wernecke, director of BWC’s special investigations department. “We checked it out and found Mr. Dudas working as a handyman while collecting BWC benefits. This behavior isn’t just illegal, it’s expensive and unfair because it drives up the costs of our workers’ comp system for everyone.”

In other business, a Toledo-area business owner pleaded guilty to attempted failure to comply with the law Dec. 3 after BWC discovered him running a business without workers’ compensation coverage to protect his employees.

Brian Lang, owner of Outdoor Inspirations of Holland, Ohio, pleaded guilty to the third-degree misdemeanor charge in Sylvania Municipal Court after paying $5,304 toward the balance he owes BWC. A judge scheduled sentencing for Jan. 28.

“Our investigation revealed Mr. Lang had several employees and therefore he absolutely should be carrying workers’ compensation insurance,” said Wernecke. “We put him on notice to become compliant with the law, but he failed to do that and that’s why he found himself in court Dec. 3.”

Outdoor Inspirations is a specialty landscaping and tree service company, according to its website. The company’s workers’ comp policy remains lapsed.

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

Let’s talk workers’ comp fraud

November 13, 2018 2 comments

By Melissa Vince, BWC Public Relations Manager

Fraud (/frôd/), noun
Definition: Wrongful or criminal deception intended to result in financial or personal gain.

In other words, cheating to get one over on others. There are countless ways people try to commit fraud. Check fraud, identify theft, pyramid schemes, credit card fraud and so on.

What do we do in the Ohio Bureau of Workers’ Compensation Special Investigations Department? We pursue workers’ compensation fraud.

BWC insures Ohio employers for workplace injuries and cares for employees who are hurt on the job. The vast majority of Ohio workers, employers, medical providers and others are interested in nothing other than getting injured workers healed and back on the job. There are a few though who have other ideas.

We define workers’ compensation fraud as knowingly making a false representation of a material fact to obtain or to deny workers’ compensation benefits or to avoid responsibility under the law. Workers’ compensation fraud increases premiums for employers, which reduces the money employers can invest in their employees, community and future growth.

There are a number of ways fraudsters can seek to manipulate the system, for example:

  • When an employer misrepresents the amount of payroll or classification of its employees.
  • When a medical provider intentionally receives payments to which he or she is not entitled.
  • When a worker fakes an injury, or returns to work while receiving benefits.

And there are many more detailed on our website, bwc.ohio.gov.

What’s our goal? #StopFraud in Ohio’s workers’ compensation system. You’ll see in this infographic highlighting a few stats from the last year that we work hard every day to achieve that goal.

Anyone committing fraud, or thinking of trying to get one over on us should remember this word:

ex·pose (/ikˈspōz/), verb
Definition: make (something) visible, typically by uncovering it.

Special investigations department finishes FY2018 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY2018, which closed June 30. The report details another impressive year of our department’s efforts to deter, detect, investigate and prosecute workers’ compensation fraud.

Here are some highlights in what was our 25th year as a department:

  • We closed 1,622 fraud cases, 448 more than in 2017.
  • We secured 101 convictions of claimants, employers and health care providers who defrauded our agency.
  • For every dollar we spent on our efforts, we saved the state fund nearly five ($4.81), or $1.33 more than last year.
  • We reduced our investigation time per case by 23 days on average, our lowest number on this measure since 2005.
  • All told, we saved the state fund $60.1 million in 2018, a 44 percent jump over 2017’s numbers.

We couldn’t have achieved this success without the 121 dedicated staff members who serve our department with great skill, resourcefulness and determination to bring justice to those who cheat our system. We also owe a great deal of credit to advances in technology and a key operational change we made last year to increase our efficiency and productivity.

Drones and Workplace Safety
The drone program we implemented in 2017 for our safety investigators proved itself a worthy investment in 2018. Our safety investigators relied on the tool at 10 workplace safety violation sites last year, including two that would have been especially difficult and dangerous, if not impossible, to properly investigate without it. The most challenging case involved flying the drone into an elevator shaft. Another involved an old factory site where the factory was being torn down. Thanks to our drones, our safety investigators could remain at a safe distance while navigating the drones to survey the sites and take accident scene pictures.

We have three drone pilots certified with the Federal Aviation Administration and three more waiting in the wings, so to speak. And while they find the drones fun and exciting, their enthusiasm is tempered in knowing that each operation is tied to tragedy and unfortunate events. Their drive is to ensure they gather accurate data and conduct unbiased investigations.

Hotline
In November we rolled out a new method for collecting fraud allegations. Until then, outside callers would report allegations to BWC personnel that staffed our customer contact centers. Now the callers reach our investigators directly, which allows our team to ask follow-up questions and obtain more precise information to jumpstart the investigation. It also reduced or eliminated the wait times for callers, which led to fewer dropped calls. The bottom line is the new hotline system led to a more comprehensive and detailed fraud allegation packet that we could send to our field teams.

Looking ahead
As we commence our 26th year in FY 2019, we remain united in our commitment to protecting the state insurance fund and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

1,000 Fraud Hotline calls in 6 months!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received 1,000 calls since we launched our new Fraud Hotline system six months ago during International Fraud Awareness Week 2017. That’s 167 calls a month, a little more than seven a day, or one nearly every working hour!

In our November 14, 2017 blog, we noted that calling the BWC Fraud Hotline is the most interactive and direct way for you to report an allegation of fraud. Our hotline puts you in direct contact with an agent in our Special Investigations Department, one ready and willing to listen to your concerns. (Under our old system, you reached a representative in BWC’s Customer Contact Center.)

Our hotline agents have years of investigative knowledge, skills and experience securing the essential information from sources. Whether the fraud hotline agent is Connor, Jake, Jeff, Karen, Karie or Loryn, or any of our 25 fraud analysts assigned to our special investigations unit statewide, callers know within seconds that they have reached a committed, respectful professional.

You, the general public, are essential in helping us fight fraud, waste, and abuse in workers’ comp. We are celebrating our 25th year since the creation of our Special Investigations Department in 1993 and thousands of our closed, founded cases started with a call to our Fraud Hotline.

Just last month, for example, the convictions of Rodney Alberino, James Harris and Donna Steele were each the result of just such a call.

If you’re concerned about the alleged fraudster discovering your identity, rest assured. Your identity may remain either anonymous or confidential, depending on your preference. In addition, you don’t need to prove any facts or even have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continues to occur. We’ll take care of the rest.

We look forward to hearing from you, so give us a call at 1-800-644-6292 if you suspect fraud. We will conduct the investigation and determine the facts. Together, we are successfully combatting workers’ compensation fraud in Ohio – one call at a time.

Thank you for your support!

Cleveland fraudster owes BWC nearly $200,000

Former trucker worked variety of jobs while collecting disability benefits

 

A Cleveland-area man owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $200,000 after the agency found him working for nearly seven years while collecting disability benefits.

Rodney W. Alberino, 44, of Parma Heights, pleaded guilty to a fourth-degree felony count of workers’ compensation fraud April 26 in the Cuyahoga County Common Pleas Court. He must pay BWC $193,574 in restitution and serve two years of probation.

“We got a tip that Mr. Alberino had been operating a lawn care business and working with his neighbor rehabbing houses while collecting disability benefits,” said Jim Wernecke, director of BWC’s special investigations department. “Our investigators talked to witnesses, gathered records and shot surveillance video. They found Mr. Alberino performing a number of work activities, including snow removal, landscaping, property maintenance, painting, and siding installation.”

Alberino was working as a truck driver when he was injured on the job in January 2010. He collected BWC benefits until Dec. 28, 2016.

In other fraud news:

A southwest Ohio physician who pleaded guilty April 27 to four counts of aggravated trafficking in drugs also collected $12,068 from BWC for services he did not perform.

In addition to the drug charges, Dr. Timothy Manuel, 59, pleaded guilty in Highland County Common Pleas Court to a fourth-degree felony count of workers’ compensation fraud. Sentencing is scheduled for May 24.

Manuel, who now lives in Missouri, was indicted last year after an investigation by BWC and the Ohio Board of Pharmacy found that he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care.

Randall Abel, 33, of North Canton, pleaded guilty to a first-degree misdemeanor theft charge April 25 after BWC found him working as a self-employed automotive repairman while collecting disability benefits.

Acting on a tip, investigators found Abel owning and operating RJ’s Performance Diesel while receiving disability benefits from his former employer, a local construction company.

Abel paid $6,475 in restitution to his former employer and was sentenced in the Stark County Common Pleas Court to two years of probation.

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