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Posts Tagged ‘workers’ comp fraud’

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.

Cincinnati tax preparer convicted of workers’ comp fraud

A Cincinnati-area man who claimed to be permanently disabled from work while earning more than $100,000 preparing tax returns owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $57,000 in restitution.

A judge ordered Fernando Cruz, of Maineville in Warren County, to pay BWC $2,000 up front, followed by payments of at least $150 a month, according to his May 12 sentence on a fifth-degree felony conviction for workers’ compensation fraud.

“Mr. Cruz was supposed to be permanently and totally disabled from work, but we found evidence that he was working as a tax preparer from at least January 2011 through December 2014,” said Jim Wernecke, director of BWC’s Special Investigations Department. “It doesn’t matter if you’re sitting at a desk crunching numbers or spreading asphalt in the hot July sun — if you’re working and earning income, in this case more than $100,000, you’re not permanently disabled and you’re not entitled to BWC benefits.”

Cruz, 68, owes BWC $56,705. A Franklin County judge sentenced him to five years of community control and warned him that he will serve 11 months in jail if he violates the conditions of his control. She also ordered Cruz to return to court Sept. 7 with a financial statement indicating his ability to pay.

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

Office manager gets diversion program for fudging payroll reports

BWC investigative unit closes 7 fraud cases in April

A Hocking County woman who falsified payroll reports to save her employer more than $52,000 in workers’ compensation premiums will avoid a criminal record for her actions if she successfully completes a diversion program by July 20.

But Carla Mohler must plead guilty to workers’ compensation fraud if she fails to do the following by the July deadline: perform 24 hours of community service, complete a course on controlling workers’ compensation costs and reimburse the Ohio Bureau of Workers’ Compensation $5,167, the cost of investigating her.

“This case is disappointing because we offer a number of programs that could potentially lower an employer’s workers’ compensation premiums,” said BWC Administrator/CEO Sarah Morrison. “All employers need to do is call us and we’ll work with them. Cheating BWC is a perilous path that jeopardizes a company’s future while raising costs for everyone else in the system.”

Mohler, an office manager, has already completed a BWC course on controlling workers’ comp costs, and her employer, the Construction Crew in Logan, reimbursed BWC $52,171 for the premium underpayment.

Mohler’s case was one of seven work comp fraud cases BWC’s Special Investigations Department closed in April. One of those cases, which BWC reported last week, involved a Cleveland doctor who pleaded guilty to felony charges of drug trafficking, workers’ comp fraud and tampering with records.

Dr. Stephen Bernie, 77, paid $30,000 in restitution to BWC and must serve one year of probation in lieu of a six-month jail sentence. Coworker Dianne Javier also paid $30,000 in restitution to BWC and must serve one year of probation after pleading guilty to workers’ comp fraud and tampering with records.

Other cases closed last month and not yet publicly reported by BWC include:

Luebertha Greer of Youngstown, Working and Receiving
Investigators found Greer working as a telephone operator for a medical practice while receiving BWC benefits. She pleaded guilty April 18 to a first-degree misdemeanor count of workers’ compensation fraud. She was sentenced to five years of community control in lieu of 90 days in jail and ordered to pay $2,577 in restitution to BWC.

John O’Rourke of Fredericktown, Working and Receiving
Investigators found O’Rourke knowingly returned to work as a truck driver while receiving BWC benefits. O’Rourke pleaded guilty April 18 to a first-degree misdemeanor count of workers’ compensation fraud. He was sentenced to 30 days jail, which was suspended. He was also ordered to pay $2,002 in restitution to BWC and was placed on community control for two years.

Amy Powers of Fayette, dba R&A Trucking, Lapsed Coverage
Investigators discovered Powers operating a business with multiple employees without valid BWC coverage. BWC referred her case to the Fulton County Prosecutor’s office after several attempts to help Powers bring her policy into compliance with Ohio law. Powers pleaded guilty April 4 to two first-degree misdemeanor counts of attempted workers’ compensation fraud. Powers paid $28,773 in restitution to BWC during her court appearance. Sentencing will be scheduled at a later date.

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

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.