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Posts Tagged ‘workers’ comp fraud’

October Convictions Totaling Over $13K in Restitutions

November 26, 2021 Leave a comment

In October, the special investigations department secured three convictions with restitutions totaling $13,185.48. This brings the total convictions for 2021 to 46. Theodore Carter, Jasmine Byrd, and Charles Finks were all convicted of workers’ compensation fraud after working while receiving workers’ compensation benefits.

Theodore Carter

Columbus, Ohio (Franklin)

The Special Investigations Department opened an investigation after its Intelligence Unit identified Theodore Carter potentially earned wages during periods he had received BWC disability benefits. Carter returned to work as a full-time machine operator and as a full-time warehouse worker through two separate staffing companies while receiving compensation benefits from BWC that he was not entitled to.

On Oct. 20, 2021, Theodore Carter pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Prior to entering his plea, Carter repaid $3,121.46 of restitution in full to the clerk’s office. The judge accepted Carter’s guilty plea, ordered the restitution to be paid to the BWC, and closed the case.

Jasmine Byrd

Toledo, Ohio (Lucas County)

The Special Investigations Department found Byrd was working at a local Northwest Ohio employer between July and November 2018 while receiving over $6,000 in temporary total disability benefits.

On Oct. 13, 2021, Jasmine Byrd pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Judge Holbrook accepted the plea and sentenced Byrd to 180 days in jail, suspended for five years of community control. Byrd was ordered to pay $6,099.30 in restitution to BWC.

Charles Finks

Groveport, Ohio (Franklin County)

The Special Investigations Department opened an investigation after its Intelligence Unit identified Charles Finks potentially earned wages during periods he had received BWC disability benefits. The investigation found that Finks was working as a welding layout fitter between December 2018 and January 2019 while receiving over $3,900 in temporary total benefits he was not entitled to.

Charles Finks pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor on Oct. 19, 2021. Prior to entering his plea, Finks paid $3,964.72 in restitution to the clerk’s office. Judge Holbrook accepted the plea and sentenced Finks to one day in jail, one day of jail time credit, and waived fines and costs.

Office manager sentenced to pay back over $30K

October 25, 2021 Leave a comment

Crystal Posey was found guilty of one count of workers’ compensation fraud and must pay back $30,278.61 to the Bureau of Workers’ Compensation (BWC). BWC’s Special Investigations Unit (SIU) found Crystal Posey began working as an office manager for a chiropractic clinic in 2015 and was still employed at the end of the investigation. Evidence collected proved Posey knowingly, and with fraudulent intent, worked while simultaneously collecting BWC disability benefits to which she was not entitled.

Posey pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony. Posey was sentenced to eight months incarceration, suspended, and placed on non-reporting probation for five years. Should Posey violate the terms of her probation, she will be subject to a suspended sentence of eight months in jail.

“Our Special Investigations Department continues to do a fantastic job,” Administrator/CEO Stephanie McCloud said. “By shutting down fraud, this team helps ensure the funds are there for Ohio’s injured workers and employers.”

In other news:

Jason Strzala, dba Goodfellas Plumbing and Drain Inc                               

The Special Investigations Department received a referral from the BWC Employer Compliance Department after Jason Strzala, owner of Goodfellas Plumbing and Drain, failed to cooperate with the compliance officer and continued to operate without BWC coverage. The Employer Fraud Team made further attempts to assist Strzala with reinstating the policy; however, he failed to take the steps necessary to reinstate coverage on the policy.

On September 1, 2021, Strzala pleaded no contest and was found guilty in Parma Municipal Court on two (2) counts of failure to comply, both second-degree misdemeanors. Strzala was sentenced to 60 days in jail, suspended.

Jennifer Soich-Zecher

The Special Investigations Department received an anonymous call to report Jennifer Soich-Zecher working while concurrently receiving BWC benefits.

The Northeast Region SIU’s investigation found Soich-Zecher was employed as a cashier and customer service associate with Walmart and Dollar Tree while collecting BWC disability benefits. The investigation identified that Soich-Zecher worked and received benefits between February and August 2019 and confirmed that she knowingly and with fraudulent intent was working while collecting BWC disability benefits to which she was not entitled.

On September 9, 2021, Jennifer Soich-Zecher pleaded guilty in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. Soich-Zecher was sentenced to five years community control, 180 days jail (suspended) and ordered to pay restitution in the amount of $2,191.45.

Davida Taylor

The Special Investigations Department opened an investigation after it identified Davida Taylor potentially earned wages during time periods she had received BWC disability benefits.

The Northeast Region SIU’s investigation found Taylor maintained employment as a Clinical Technician/Patient Care Nurse Assistant with the Cleveland Clinic while concurrently collecting BWC disability benefits. The investigation identified that Taylor worked and received benefits between March and August 2019.

Davida Taylor pleaded guilty in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. Taylor was sentenced to non-reporting probation for four years and ordered to pay restitution of $12,206.16 to the BWC. If Taylor violates the terms of her probation, she is subject to a suspended sentence of nine months in jail.

Former doctor sentenced to pay back over $500K

August 13, 2021 1 comment

Former New Albany doctor, Khaled Amr, admitted to staging a break-in at his Columbus practice for a fraudulent insurance claim and running a pill mill. Amr was sentenced to spend five years on probation and ordered to forfeit more than a half-million dollars.

Amr was arrested in 2019 at his home, where he was found hiding in a closet. According to court records, Amr was operating a pill mill out of his practice, Columbus Pain Specialists, for more than seven years. Amr was selling Oxycodone in exchange for financial kickbacks and staged a break-in at his practice to make a fraudulent insurance claim, resulting in more than $1 million being paid to him.

He will be ordered to surrender his medical license and DEA license as part of the terms of his probation. He also was ordered to pay a $5,000 fine and forfeit more than $524,000 that were proceeds of his criminal behavior.

In other news

On August 9, 2021, Lisa Buckner pled guilty to one count of workers’ compensation fraud, a misdemeanor of the first degree. Buckner returned to work at Fayette County Community Action, however, she had not reported this employment to the Bureau of Workers’ Compensation (BWC) and continued to receive disability benefits.

The investigation confirmed that Buckner knowingly and with fraudulent intent was working while simultaneously collecting BWC disability benefits to which she was not entitled. Restitution of $5,119.82 had previously been paid in full through a lump sum settlement. A Fayette County judge accepted Buckner’s guilty plea, ordered one day in jail, gave her one day jail time credit, and closed the case for time served.

Robert Swartz, dba Bamboo Relaxing Massage

The Special Investigations Department received an allegation from the Ohio Investigative Unit regarding Robert Swartz, owner of Bamboo Relaxing Massage. Swartz came under scrutiny by a task force investigating illegal activities at massage parlors. BWC investigators joined the Ohio Investigative Unit and other federal, state and local agencies in a joint investigation. It was discovered Swartz was operating his business without BWC coverage.

On July 15, 2021, Robert Swartz pleaded guilty in Cuyahoga County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony. On the workers’ comp fraud charge, Swartz was sentenced to five years of community control and restitution ordered in the amount of $1,156.56 to BWC.

As part of the task force investigation, Swartz also pleaded guilty to engaging in pattern of corrupt activity, promoting prostitution, grand theft, and practicing medicine without a license.

Cynthia Whitner

The Special Investigations Department opened an investigation after it’s Intelligence Unit identified Cynthia Whitner had potentially earned wages during periods she received BWC disability benefits. The investigation found Whitner knowingly and with fraudulent intent was hired and worked for I-Force while simultaneously collecting BWC disability benefits to which she was not entitled.

On July 14, 2021, Whitner pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Whitner was found guilty and, at the defendant’s request, deferred sentencing until September 23.

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

Real estate agent owes BWC over $151K after fraud conviction

June 11, 2021 Leave a comment

A Columbus-area real estate agent and broker pleaded guilty to one count of workers’ compensation fraud, a felony of the fourth degree.

David L. Garner, 66, worked from 2009 through 2018 as both a real estate agent selling homes, and as a real estate broker providing broker price opinions while receiving the Bureau of Workers Compensation (BWC) disability benefits. Evidence obtained during the investigation revealed Garner intentionally misrepresented and withheld this activity from BWC to collect disability benefits he otherwise would not have been entitled to.

On June 6, a Franklin County judge found Garner guilty and proceeded to sentencing. The judge placed Garner on community control for 3 years and ordered him to pay BWC $151,705.15. If Garner violates the terms of his community control, he is subject to a suspended sentence of 18 months in prison.

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

Workers’ comp fraud lands cheaters costly penalties

May 7, 2021 Leave a comment

Convicts include Central Ohio doc ordered to pay $71K to BWC

Four Ohioans convicted or sentenced for workers’ compensation fraud in April include a Central Ohio physician who unlawfully distributed controlled substances and overbilled the Ohio Bureau of Workers’ Compensation (BWC).

On April 15, U.S. Judge Michael Wilson of the Southern District of Ohio ordered Kedar Deshpande, MD, to pay $117,122 in restitution, including $70,957 to BWC. The judge also sentenced Deshpande to three years of supervised release, 12 months of which is to be served under home detention, for felony counts of unlawful distribution of controlled substances and false statements relating to health care matters.

“Our Special Investigations Department found Dr. Deshpande upcoded patient office visits by falsely representing the level of examination he performed on our injured workers so he could receive inflated reimbursement from BWC,” said BWC Interim Administrator/CEO John Logue. “Congratulations to our investigators for their work on this important case and for bringing three other fraud cases to a close last month.”

Deshpande is the former owner and operator of the now-closed Orthopaedic & Spine Center, which had three locations in Central Ohio. A multi-jurisdictional task force of state and federal authorities found Deshpande pre-signed blank prescriptions for unqualified and non-licensed staff to complete and dispense to patients in his absence. The staff would fill-in the prescriptions with Schedule II controlled substances before dispensing to patients. The staff would mostly dispense the pre-signed prescriptions when Deshpande was on vacation, arrived late to the office, or was otherwise not at the clinic.

Other April fraud cases include:

William Knox of Athens, Ohio

Knox pleaded guilty April 7 in the Franklin County Common Pleas Court to one count of workers’ compensation fraud and one count of forgery, both fourth-degree felonies. Knox was sentenced to community control for five years and ordered to pay BWC restitution of $131,752.

BWC investigators found Knox inflated his weekly income from his employer of record so he could be paid at a higher weekly rate of compensation from BWC.

Tanya Houston of Shaker Heights, Ohio

A Franklin County judge ordered Houston to pay $23,489 to BWC and serve five years of probation in lieu of a one-year prison sentence after she pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on April 7. BWC discovered Houston working while collecting injured-worker benefits.

Frank Phillips of Hamilton, Ohio

Phillips pleaded guilty April 26 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. He was ordered to pay BWC $12,588 in restitution and serve five years on community control.

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

BWC secures 7 fraud-related convictions in February

March 12, 2021 Leave a comment

A doctor who ran a pill mill in Dayton and the owner of a massage parlor in Medina were among seven Ohioans convicted or sentenced in February on workers’ compensation fraud or related charges.

Morris Brown, M.D., 73, was sentenced Feb. 8 to two years in prison after investigators with the Ohio Bureau of Workers’ Compensation (BWC) and other state and federal authorities discovered his involvement in an opioid ring. Brown was convicted in February last year, according to a news release from the U.S. Department of Justice.

“I’m proud of our Special Investigations Department for its role in bringing this criminal activity to an end,” said BWC Interim Administrator/CEO John Logue.

Others convicted or sentenced in February include:

  • Yulian Fu, Lucky Jade LLC, Medina, Ohio

Yulian Fu pleaded guilty Feb. 11 to one count of workers’ compensation fraud, a fifth-degree felony, after his business came under scrutiny by a task force investigating illegal activities at     massage parlors. BWC investigators – joining The Ohio Investigative Unit and other federal, state and local agencies – discovered Fu was operating his business without BWC coverage. Multiple defendants, charges, and convictions were involved in this case. On the workers’ comp fraud charge, Fu was sentenced to three years discretionary post release control.

  • Frederick Romito Jr., Youngstown, Ohio

Frederick Romito Jr. pleaded guilty Feb. 22 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a home remodeler while collecting BWC disability benefits. Romito was sentenced to five years of community control with an 11-month suspended prison sentence. He was ordered to pay $17,467 in restitution to BWC.

  • Rhonda Rauch, dba The Yard Butler and Landscape Services, Lancaster, Ohio

Rhonda Rauch, owner of The Yard Butler Lawn and Landscape Services LLC, pleaded guilty Feb. 16 to one count of workers’ compensation fraud, a fifth-degree felony. BWC found Rauch had presented six forged/altered BWC Certificates of Coverage to Fairfield County Library in order to secure various bids for landscaping and snow removal services. Rauch was sentenced to five years of community control and ordered to pay restitution of $4,448 to BWC.

  •  Bridget Casas, Cleveland, Ohio

Bridget Casas pleaded guilty Feb. 9 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found her working as a caregiver while receiving temporary disability benefits from BWC. Prior to her guilty plea, Casas paid BWC $9,606 in restitution. She was sentenced to two days in jail and granted credit for time served.

  •  Manish Walia, dba Imaginarium Foods, Lima, Ohio

Manish Walia, co-owner of Imaginarium Foods, pleaded guilty Feb. 3 in Lima Municipal Court to one count of failure to comply, a second-degree misdemeanor. Walia was sentenced to a $250 fine and court costs. Walia had requested a BWC policy after a worker had filed a claim against his company, a Dunkin Donuts/Baskin Robins location. BWC discovered he had been operating the business without workers’ compensation coverage.

  • Donnie Schilling, dba Cleveland Tire and Wheel, Cleveland, Ohio

Donnie Schilling was convicted Feb. 1 for the second time in eight years for workers’ compensation fraud after BWC found him operating his business without coverage. Schilling pleaded guilty to one count of worker’s compensation fraud, a fifth-degree felony. A judge placed him on community control for one year to ensure he pays his outstanding debt to BWC. Schilling pleaded guilty to a similar charge in 2013.

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

Ohio business owners owe more than $800K following fraud-related convictions

February 21, 2020 Leave a comment

William H. Foster III

Three Northeast Ohio men owe the Ohio Bureau of Workers’ Compensation (BWC) more than $800,000 after investigators discovered they were operating their businesses without workers’ compensation coverage.

“These business owners learned the hard way they cannot operate their business without workers’ compensation coverage, and now they owe us hundreds of thousands of dollars,” said BWC Administrator/CEO Stephanie McCloud. “I’m pleased our investigators stopped these employers from continuing to break the law and cheat our system.”

William H. Foster III, owner of American Construction Group LTD, pleaded guilty Feb. 11 in a Summit County courtroom to a second-degree misdemeanor of obstructing official business after failing to work with BWC to reinstate his policy. A judge sentenced Foster to credit for time served in jail and to follow the payment agreement he made with the BWC and the Ohio Attorney General’s Office to reinstate his policy. Foster owes BWC more than $360,000 in past premiums and penalties.

Paul “Bob” Collier Jr.

In Stark County, Paul “Bob” Collier Jr. and Miklos Fioretto pleaded guilty on Jan. 17 and Feb. 5, respectively, to a fourth-degree felony charge of workers’ compensation fraud for failing to maintain coverage on their East Sparta, Ohio, business. Investigators discovered that Fioretto and Collier changed the name of their pallet manufacturing business to avoid paying past premiums and penalties associated with the business.

Both men were sentenced to three years of community service. A condition of probation is to pay BWC restitution of $458,125.

In other news: A Columbus woman was ordered to pay BWC $6,941 in restitution on Tuesday after pleading guilty to a first-degree misdemeanor charge of workers’ compensation fraud.

BWC investigators discovered Jamia Smith, 39, working for a staffing firm while concealing that information from BWC to continue collecting disability benefits. A judge also sentenced Smith to three years of probation in lieu of six months in jail.

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

Fraudulent billing leads to occupational therapist’s conviction

January 17, 2020 Leave a comment

Agency secures 6 fraud-related convictions in December   

A northeast Ohio occupational therapist was convicted last month for felony workers’ compensation fraud for billing the Ohio Bureau of Workers’ Compensation (BWC) for treatment services she did not provide to patients.

Susanna Kagalitskaya Freedman, of Euclid, pleaded guilty Dec. 17 in a Cuyahoga County court to a fifth-degree felony count of workers’ compensation fraud. The judge sentenced her to five years of probation and a $2,500 fine. Additionally, Freedman was permanently decertified to treat BWC patients for claim-related injuries.

“As an agency, we expect providers to give superior care and service to injured workers,” said BWC Administrator/CEO Stephanie McCloud. “This particular provider obviously did not meet the standard of care injured workers deserve and she cheated our system.”

Numerous red flags in Freedman’s billing practices and treatment notes sent to BWC prompted BWC’s Special Investigations Department (SID) to initiate an investigation starting in October 2017. Investigators discovered Freedman was falsifying documents, indicating services had been rendered when they had not. BWC would then pay for the substandard care based on the falsified information Freedman provided.

SID secured five other fraud-related convictions in December, bringing calendar year 2019’s total to 94.

Jeffrey Jakob of Toledo
Jakob pleaded guilty Dec. 31 in Toledo Municipal Court to one count of failure to comply, a second-degree misdemeanor, after BWC found he was operating his business, J.A. Jakob Marine Contracting, with lapsed coverage since March 2015. BWC agents made multiple attempts to assist Jakob in getting his coverage reinstated, but he failed to do so. The judge ordered him to one year of probation and to comply with a reinstatement payment plan with the Ohio Attorney General’s office. He must also remain current on installment payments to BWC.

Harold Brown of Bellefontaine
Brown pleaded guilty Dec. 23 to three second-degree misdemeanor charges of failure to comply for running his business, Brown’s Lawn & Tree Service, without workers’ compensation coverage. BWC investigators discovered his BWC policy had been lapsed since September 2010. Brown received 30 days in jail (suspended), a $250 fine, and was ordered to make regular payments to BWC and the Attorney General until a reinstatement payment plan was paid in full. The current amount due on Brown’s BWC policy is approximately $133,000.

Marie Olinger of Delta
On Dec. 17, a Franklin County judged ordered Olinger to three years of community control for working while receiving more than $2,800 in disability benefits from BWC. The investigation found Olinger had returned to work at the Dental Center of Northwest Ohio between January and March 2017 while receiving temporary total disability benefits.

Rodney Filibeck of Mansfield
Filibeck pleaded guilty Dec. 16 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. After receiving an anonymous tip, BWC investigators determined Filibeck was working construction jobs while receiving BWC disability benefits between September 2016 and June 2017. The judge handed down a 60-day jail sentence, suspended for 12 months of community control and ordered him to pay $2,519 in restitution to BWC.

Deangelo Speed of Shaker Heights
Speed pleaded guilty Dec. 2 in a Franklin County courtroom to a fifth-degree felony count of workers’ compensation fraud. BWC agents found Speed working as a truck driver while collecting BWC benefits from Oct. 20, 2015, through Jan. 27, 2017. The judge ordered Speed to pay BWC $7,599 in restitution and court costs by March 2, 2020. The judge also sentenced Speed to a six-month jail sentence, suspended for six months of probation.

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

Thank you!

November 22, 2019 1 comment

Thanks for following, liking and sharing our International Fraud Awareness Week posts!

It’s great to be part of a large network of individuals and organizations with the same mission – to #StopFraud!

We appreciate the opportunity to share our story and learn what our counterparts are doing in their fight to stop all kinds of fraud.

While we hope you never come across workers’ comp fraud, if you do, we want you to know how to recognize it and where to find us.

 

BWC secures 14 fraud-related convictions in October

November 22, 2019 Leave a comment

Fraudsters owe BWC more than $283,000 in restitution

The Ohio Bureau of Workers’ Compensation (BWC) secured 14 fraud-related convictions in October, with those convicted owing BWC a combined $283,146 in restitution.

Those convicted include injured workers found working while collecting disability benefits, family members collecting their deceased parent’s compensation benefits, and business owners whose coverage had lapsed.

“When people cheat BWC or fail to cover their own employees, they are cheating the injured workers who really need our help and the employers in our system that follow the law,” said BWC Administrator/CEO Stephanie McCloud.

In order of most recent court appearance, those convicted in October include:

Bruce Starkey of Cincinnati, Ohio
Starkey pleaded guilty Oct. 17 and was sentenced in Hamilton County Common Pleas Court Nov. 4 on one count of workers’ compensation fraud, a fifth-degree felony. Starkey received 100 hours of community service and was required to pay BWC full restitution for the $1,459 in permanent total disability benefits he took from his mother’s bank account after she passed. He failed to inform BWC of her passing and wrote 15 checks, forging his mother’s signature.

Cecil Piner of Xenia, Ohio
Piner pleaded guilty Oct. 31 in Franklin County Common Pleas Court on one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him driving a school bus while receiving $17,901 in disability benefits. He was sentenced to five years’ probation in lieu of 12 months in jail and ordered to pay court costs and full restitution.

Kyle Foreman of New Carlisle, Ohio
Foreman pleaded guilty Oct. 30 in Clark County Municipal Court on two counts of failure to comply, both second-degree misdemeanors. His coverage for Kyle S. Foreman Enterprises had lapsed since November 2017, and he failed to pay the premiums before taking his company into bankruptcy. He was ordered to pay a $100 fine and court costs for each count.

Michelle Smith of Cincinnati, Ohio
Smith, 57, pleaded guilty Oct. 23 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered she owned and ran two businesses, Expression Unique LLC and Later in Life Brides, while collecting BWC benefits for workers deemed permanently and totally disabled. A Franklin County judge ordered Smith to pay BWC $40,873 dollars in restitution and serve five years of non-reporting community control (probation). If she violates her probation, she must serve a year in prison.

Louis Tombazzi of Cleveland, Ohio
BWC found Tombazzi owed the agency approximately $75,000 in premiums after letting the policy lapse for his business, Garda Architectural Fabrication. He pleaded guilty Oct. 16 in Cleveland Municipal Court to one count of failure to comply, a second-degree misdemeanor, and was ordered to serve 90 days in jail (suspended), pay a $400 fine, and serve two years’ probation. He also was ordered to report monthly to the court his effort to reduce or pay off his BWC obligation.

Natalia Daniels of Concord Township, Ohio
Daniels pleaded guilty Oct. 16 to one count of workers’ compensation fraud, a first-degree misdemeanor, after receiving $3,600 in BWC disability benefits while working as a bus driver for a senior living facility and as a laborer for an insurance company. A judge ordered her to pay full restitution to BWC and serve 18 months of probation in lieu of a 180-day jail sentence.

Vicki Aloisio of West Chester, Ohio
Aloisio was convicted Oct. 11 on two counts of failure to comply, both second-degree midemeanors, for failing to carry BWC coverage on her business, Richard Aloisio Trucking Inc., despite numerous BWC attempts to assist her. Aloisio owes $28,000 in past-due premiums and penalties. Sentencing in a Butler County courtroom is scheduled for Dec. 6.

Ahmad Al-thamra of Akron, Ohio
Al-thamra pleaded guilty Oct. 10 in Akron Municipal Court to two counts of failure to comply, both second-degree misdemeanors, for failing to maintain workers’ compensation coverage on his business, The Family Corner Store. He was ordered to pay $300 in fines and ordered to pay court costs and obey all laws for one year.

Jason Gaschler of Cheswick, Pennsylvania
Gaschler pleaded guilty Oct. 10 of one count of theft, a first-degree misdemeanor, for operating a construction company, General License Contracting, in Pennsylvania while receiving $6,864 in BWC benefits. He was sentenced to one day in jail (time served) and made full restitution at the time of his hearing.

Jason Rissner of Rockford, Ohio
Rissner pleaded guilty Oct. 9 in Mercer County Common Pleas Court to one count of petty theft, a first-degree misdemeanor, after he was caught operating his own construction company while receiving $35,261 in temporary total disability benefits from his employer, O’Reilly Auto Parts. He was ordered to spend 180 days in jail, which would be suspended if he committed no more crimes within a year and pay full restitution to O’Reilly.

Brian Franklin of Sharonville, Ohio
Franklin avoided conviction on one charge of workers’ compensation fraud, a fifth-degree felony, after he agreed Oct. 8 in Franklin County to pay BWC $18,081 in restitution. BWC found Franklin working at a community center in 2018 while collecting BWC benefits.

Marshann Kinman of Cedar Grove, Ohio
Kinman pleaded guilty Oct. 8 to one count of workers’ compensation fraud, a fifth-degree felony, in Hamilton County Common Pleas Court. Kinman failed to let BWC know her mother had passed so she could take $6,321 in BWC widow death benefits intended for her mother. Kinman received two years of community service and was ordered to pay BWC full restitution.

Charles Ayler of Cincinnati, Ohio
Ayler pleaded guilty Oct. 3 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving BWC benefits. He was sentenced to 180 days in jail, which was suspended for two years of community service, the promise to avoid similar offenses, and to pay BWC full restitution of $6,090 and court costs of $150 by Dec. 31, 2020.

Ronald J. Dorfeld of Brunswick, Ohio
Dorfeld must pay BWC $78,957 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Oct. 1 in a Franklin County courtroom. BWC found Dorfield operating his own business, Xtreme Multimedia Marketing, while receiving disability compensation. A Franklin County judge sentenced Dorfeld to ninth months in jail, which was suspended for five years’ probation and full restitution.

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

Happy Anniversary to Us!

November 20, 2019 Leave a comment

On Nov. 14, 2019, our BWC Special Investigations Department celebrated the second anniversary of its Fraud Hotline system.

We launched this system during Fraud Awareness Week 2017 as an important new customer service tool for external sources to report their suspicions of workers’ compensation fraud. What a successful launch and two years it has been!

We’ve received more than 3,300 calls since then, an average of nearly seven each work day!

If you suspect workers’ compensation fraud in Ohio, call us on it.

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

Today, during International Fraud Awareness Week 2019, we thank you for your support!

A letter from Jim Wernecke – Director of BWC Special Investigations

November 18, 2019 Leave a comment

As Director of the BWC Special Investigations Department (SID), I am honored to kick off Fraud Awareness Week. I invite you to view my video message, “Fraud Hurts Us All.

In the video I discuss how workers’ compensation fraud increases premiums for employers, which reduces the money employers can invest in their employees, community and future growth. I explain how BWC employees are improving workplace health and safety, getting injured workers back to work, and keeping premium rates low for employers. I describe how SID employees protect the State Insurance Fund by detecting, investigating, and deterring fraud.

Lastly, I invite viewers to report, via an online form, suspected workers’ compensation fraud.

I also invite you to check back daily as we share success stories in our efforts to combat workers’ comp. fraud. Some stories we will highlight are:

We would not have achieved these successes without the dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law. Since our inception in 1993, we have identified over $1.9 billion in savings, as well as:

  • Completed over 69,000 investigations
  • Referred 5,420 subjects for prosecution
  • Secured 2,941 criminal convictions

We are honored and eager to join our fraud-fighting colleagues around the country and abroad each November to participate in International Fraud Awareness Week.

The campaign, which runs through Saturday, was established by the Association of Certified Fraud Examiners to highlight the issue of fraud and minimize its impacts.

Most weeks, you’ll find us sharing our fraud news on #FraudFriday. But this week, we’ll have a new fraud feature each day! So keep an eye here on our blog and on our Facebook and Twitter pages!

Happy Fraud Awareness Week!

Northeast Ohio business owners owe BWC nearly $1.3 million following fraud convictions

November 8, 2019 Leave a comment

Two northeast Ohio businessmen must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $1.3 million in restitution following their recent convictions on multiple fraud charges in separate, unrelated cases.

“We look forward to recouping these dollars and directing them where they belong — taking care of injured workers, creating safe workplaces, and giving employers excellent coverage and service,” said BWC Administrator/CEO Stephanie McCloud.

Sentenced Monday in a Cuyahoga County courtroom, Robert E. Fitz must pay BWC $961,956 in monthly installments and serve five years of probation for his Sept. 30 conviction on a fourth-degree felony charge of workers’ compensation fraud.

Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, had refused to cooperate with BWC to bring his lapsed policy into compliance, leaving the agency to pick up the costs on 43 injury claims since 2003, five in the last five years.

On Oct. 21 in Stark County, a judge ordered an Alliance man to pay BWC $300,230 in restitution after BWC found him defrauding the agency in multiple ways, including working at two businesses he owned while collecting workers’ compensation for work injuries he claimed left him permanently and totally disabled.

Roger L. Kale, Jr., 51, also must serve five years of probation and perform 100 hours of community service. BWC’s Special Investigations Department also found the following:

  • To establish his compensation rate for his 2009 workplace injury, Kale reported wages for himself that were higher than what he reported on his BWC payroll reports for all of his employees combined.
  • Kale operated A-1 Brosch Tree Service without workers’ compensation coverage required by Ohio law.
  • Kale under-reported his payroll and misclassified his employees to lower the cost of his BWC premiums.
  • Kale presented clients an altered BWC certificate of coverage to make it appear his business had coverage when it did not. One client reported Kale to BWC.

Video obtained from the Ohio State Highway Patrol shows Kale operating a tow truck while claiming to be permanently disabled.

Kale pleaded guilty to one count of tampering with records, a fourth-degree felony; three counts of workers’ compensation fraud, all fourth-degree felonies, and two first-degree misdemeanor charges of workers’ compensation fraud.

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

Cincinnati caterer convicted of workers’ comp fraud

November 1, 2019 1 comment

Woman ran catering business while collecting disability benefits

 

A Cincinnati woman claiming to be permanently disabled from work owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $41,000 after her felony conviction Oct. 24 for workers’ compensation fraud.

Michelle D. Smith, 57, pleaded guilty to the fifth-degree felony in the Franklin County Common Pleas Court after BWC discovered she owned and ran two businesses, Expression Unique LLC and Later in Life Brides, while collecting BWC benefits for workers deemed permanently and totally disabled.

“Our Special Investigations Department found records indicating Ms. Smith worked 35 hours per week at her businesses,” said BWC Administrator/CEO Stephanie McCloud. “I don’t think that meets anyone’s definition of ‘permanently and totally disabled,’ let alone BWC’s.”

Smith, who was injured on a job in 2000, declined through her attorney to be interviewed by BWC investigators about her case. Investigators gleaned much of their evidence from customer interviews and a catering contract Smith had with the city of Cincinnati.

A Franklin County judge ordered Smith to pay BWC $40,873 dollars in restitution and serve five years of non-reporting community control (probation). If she violates her probation, she must serve a year in prison.

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

Nearly $1 million owed BWC in employer fraud case

October 4, 2019 Leave a comment

Cleveland-area business owner convicted of fraud Monday

A northeast Ohio business owner owes the Ohio Bureau of Workers’ Compensation nearly $1 million in restitution following his conviction Monday in Cleveland on workers’ compensation fraud charges.

Robert E. Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud after refusing to cooperate with BWC to bring his lapsed policy into compliance.

“Mr. Fitz owes at least $965,000 in unpaid premiums and for the costs of injured worker claims that occurred while his policy was lapsed,” said BWC Administrator/CEO Stephanie McCloud. “If he had just followed the law and paid his premiums, he wouldn’t be in this trouble today.”

At his conviction hearing in the Cuyahoga County Court of Common Pleas, Fitz agreed to work with BWC and the Ohio Attorney General’s Office to provide his company’s financial reports and enter a reinstatement payment plan prior to his sentencing date of Nov. 4.

According to BWC’s Special Investigation Department, Fitz’s BWC policy has been lapsed since Sept. 1, 2003. Since then, BWC has picked up the costs on 43 injury claims, including five since 2014.

In other fraud news, a northeast Ohio man must pay BWC nearly $79,000 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Tuesday in a Franklin County courtroom.

Ronald J. Dorfeld of Brunswick, Ohio, must pay BWC $78,957 and serve five years of probation in lieu of a nine-month jail sentence for working while collecting BWC disability benefits.

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

Special investigations department concludes FY 2019 with impressive results

September 27, 2019 Leave a comment

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 FY 2019, 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 26th year as a department:

  • We closed 1,732 fraud cases, 7% more than in 2018.
  • 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 $5.
  • We reduced our investigation time per case by 2.9 days on average, to 189 investigative days, our lowest number on this measure since 2005.
  • All told, we saved the state fund $65.1 million in 2019, an 8 % increase over 2018’s numbers.

We couldn’t have achieved this success without the 119 dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law.

In 2019, our investigative teams continued to work closely with the law enforcement community at the local, state, and federal levels. We collaborated on several investigations, including cases involving physicians running pill mills in Ohio and surrounding states. In addition, our teams joined other state and federal investigators participating in the Document and Benefit Fraud Task Force, the Ohio Medicaid Prescription Program Integrity Group, and the Pill Mill Coordination team for the Ohio Attorney General’s Medicaid Fraud Control Unit.

As we commence our 27th year in FY 2020, we remain united in our commitment to protecting the State Insurance Fund for injured workers 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.

Akron business owner convicted of manslaughter, workers’ comp fraud

August 2, 2019 Leave a comment

Company has history of worker injuries, noncompliance with BWC

The owner of an Akron construction company pleaded guilty to involuntary manslaughter July 24 after one of his workers fell to his death in late 2017.

James D. Coon, the owner of James Coon Construction, also pleaded guilty in a Summit County courtroom to a fourth-degree felony charge of workers’ compensation fraud. Investigators with the Ohio Bureau of Workers’ Compensation (BWC) found Coon lacked BWC coverage when his employee died and that he repeatedly lied about his business to minimize his premiums or avoid paying them altogether.

“This tragic case underscores the critical importance for workplace safety protocols and workers’ compensation insurance,” said BWC Administrator Stephanie McCloud. “Our investigation found Mr. Coon willfully and deliberately disregarded his responsibilities under the law, and now several lives are devastated by it.”

Gerardo “Jerry” Juarez Sr., a 39-year-old married father of five, died Nov. 4, 2017, at the scene of his fall. It was his second day on the job. The federal Occupational Safety and Health Administration notified BWC of the accident four days later.

According to BWC’s special investigations department, Juarez was working on a sloped roof of a 3-story apartment complex without a fall protection device when he slipped and fell 25 feet to his death. Among the investigation’s findings:

  • Two other Coon employees were injured in falls prior to Juarez’s death, also during a time when Coon lacked BWC coverage.
  • Coon told BWC he no longer operated his business. But in March 2018 — five months after Juarez’s death — agents observed six Coon employees at a worksite tearing shingles from a roof. They had no safety equipment.
  • Coon consistently reported to BWC over the years of having no employees. A BWC audit found nearly $286,000 in payroll to employees from July 1, 2009 through July 1, 2018.

Coon owes BWC $303,152 to date for unpaid premiums and claims costs for workers injured during a policy lapse. His conviction for involuntary manslaughter, a third-degree felony, is punishable by a maximum five years in prison and a fine of up to $10,000. Sentencing is set for August 21.

BWC safety services and grants: BWC offers free safety consultations and grant dollars to assist employers with the purchase of equipment that improves workplace safety. For more, visit bwc.ohio.gov and click on the Safety & Training link.

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

BWC reports 4 fraud-related convictions in June

July 12, 2019 Leave a comment

Four Ohioans were convicted for workers’ compensation fraud or related charges in June, including a Springfield man who must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $13,000 after investigators found him working two jobs while collecting disability benefits.

Clark A. Howard pleaded guilty June 18 to a fifth-degree felony count of workers’ compensation fraud after BWC investigators discovered him working for a pizza shop in London, Ohio, and as a machine press operator for another business. A Franklin County judge ordered Howard to pay BWC $13,518 in restitution.

“We’re here to support injured workers as they try to get back to work and back to life, not supplement the income of able-bodied people cheating our system,” said BWC Administrator/CEO Stephanie McCloud.

The judge also sentenced Howard to 30 months of community control (probation) in lieu of a year in jail.

Other June convictions include:

Ben Patterson of Xenia, Ohio, dba C&B Landscaping
Patterson pleaded guilty June 25 to one count of failure to comply, a second-degree misdemeanor, for operating his landscaping company without BWC coverage since 2009. Investigators worked with Patterson to reinstate coverage, but Patterson failed to establish a payment plan.

Patterson paid all outstanding BWC premiums, related fees and interest on June 24, the day before his court hearing. A Xenia Municipal Court judge fined him $150 and court costs and sentenced him to 90 days in jail, suspended upon the condition he not have a similar offense for five years.

Patricia Simon of Columbus, Ohio
Simon pleaded guilty June 18 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC determined she intentionally submitted a false statement to support her claim for workers’ compensation benefits. A Franklin County judge ordered her to pay a $250 fine and $128 to BWC for investigative costs.

Lori Hines of Waynesfield, Ohio, dba Marshall’s Hydraulic Services
Hines pleaded guilty June 7 to one count of failure to comply, a second-degree misdemeanor, after BWC found Marshall’s Hydraulic Services operating without BWC coverage since January 2017.

An Auglaize County Municipal Court judge sentenced Hines to a year of non-reporting probation, a 90-day suspended jail term and a $100 fine. Hines subsequently paid her BWC balance in full and the company’s coverage was reinstated.

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

Toledo contractor owes BWC $57K following fraud conviction

June 21, 2019 Leave a comment

Lapsed policy, refusal to cooperate costs Holland man

By Tony Gottschlich, BWC Public Information Officer

A Toledo-area contractor owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $57,000 in restitution after pleading guilty to workers’ compensation fraud in a Toledo courtroom last month.

Eric L. Hughes, 53, of Holland, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud May 19 after failing to renew his BWC policy despite repeated attempts by the agency to bring him into compliance. A Lucas County judge ordered Holland to pay BWC $56,959 in restitution and serve three years of community control (probation).

“Ducking his legal obligation to protect his workers clearly didn’t pay for Mr. Hughes,” said BWC Administrator/CEO Stephanie McCloud. “He could have resolved this issue fairly easily when we first contacted him in 2017, and we would have given him a payment plan to boot. Now he’s got a $57,000 debt and a felony record.”

According to BWC’s special investigations department, Hughes worked as a handyman and general contractor on residential and commercial buildings, usually with just one employee. But after securing a sizable contract to replace a roof on a fire-damaged building in 2017, he hired a crew of eight to 10 workers and started the job while his BWC policy was still lapsed. The company that hired Hughes later fired him after learning of the lapse.

A BWC audit in 2018 determined Hughes owed the agency nearly $57,000 in past premiums, based largely off his payroll for the time he worked on the roofing job.

In other news, a Springfield man must pay BWC $13,518 in restitution after agency investigators found him working in a machine shop and at a restaurant while collecting BWC benefits.

Clark Howard, 35, pleaded guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud in a Franklin County courtroom.

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

BWC secures six convictions in May

June 7, 2019 Leave a comment

Five Ohio workers and one business owner were convicted in May on workers’ compensation fraud and related charges.

The six convictions raise BWC’s total convictions for the 2019 calendar year to 38.

“When people cheat the BWC system, they are cheating the employers and hard-working Ohioans across this state who play by the rules,” said BWC Administrator/CEO Stephanie McCloud. “Congratulations to our special investigations department for stopping this fraudulent behavior.”

In order of most recent case, those convicted include:

James Nichols of Cleveland, Ohio
BWC investigators found Nichols working as a janitor and office manager while collecting BWC benefits. Nichols pleaded guilty May 13 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 150 days in jail, suspended for two years of community control. He was ordered to pay BWC $3,525 in restitution. He made a $1,000 payment at sentencing.

Deborah Rosenlieb of Cuyahoga Falls, Ohio
Rosenlieb pleaded guilty May 9 in Summit County Common Pleas Court to workers’ compensation fraud, a fourth-degree felony, after investigators found her collecting her late father’s BWC benefits for two years. A judge ordered her to pay BWC $29,418 in restitution and serve two years of community service.

Jesse Lemaster, dba Lemaster Tree Care, Springfield, Ohio
Lemaster pleaded guilty May 8 to two counts of failure to comply, both second-degree misdemeanors, for operating his business without a valid BWC policy. He was sentenced to 30 days in jail on each charge, which was suspended pending a July 10 hearing, at which time he is to prove to the court he has valid workers’ compensation coverage.

Natasha Mitchum of Youngstown, Ohio
Mitchum pleaded guilty May 2 in Franklin County Common Pleas Court to workers’ compensation fraud, a first-degree misdemeanor, after BWC found her working as a call center employee/customer service representative while receiving disability benefits. She was sentenced to 180 days in jail, suspended for three years of community control, and ordered to pay BWC $1,863 in restitution.

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

BWC secures 7 fraud convictions in April

May 24, 2019 Leave a comment

Fraudsters ordered to pay BWC nearly $107,000 in restitution

The Ohio Bureau of Workers’ Compensation secured seven fraud convictions in April, all workers who were discovered working for a living while collecting disability benefits from the agency.

Those convicted were ordered to pay BWC a combined total of $106,995 in restitution.

“We look forward to recouping those dollars so they can serve a legitimate purpose – taking care of injured workers,” said BWC Administrator/CEO Stephanie McCloud.

In order of most recent court appearance, those convicted in April include:

Clinton Walker of Cincinnati, Ohio
Walker pleaded guilty April 25 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. He was ordered to pay BWC $9,831 in restitution and $3,600 in investigative costs. He provided a cashier’s check to BWC at his hearing for the full amount.

Ernest Thomas of Boardman, Ohio
Thomas pleaded guilty April 23 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, which was suspended for six months of probation, and ordered to pay a $500 fine and court costs. Thomas paid restitution and investigative costs totaling $10,605 to BWC at the time of his plea.

Michael D. Myers of Lebanon, Ohio
Myers pleaded guilty April 22 to a fifth-degree felony charge of workers’ compensation fraud in Franklin County after BWC found him working while collecting disability benefits in 2016 and 2017. A judge ordered Myers to pay BWC $45,338 in restitution, perform 25 hours of community service and serve one year of probation in lieu of six months in prison.

Antonio Daniels of Streetsboro, Ohio
Daniels pleaded guilty April 17 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working as an industrial assembler while collecting BWC benefits. A Franklin County judge ordered Daniels to pay BWC $6,409 in restitution and serve five years of probation in lieu of 30 days in jail.

Kristin Stuhldreher of Youngstown, Ohio
Stuhldreher pleaded guilty April 16 to a fifth-degree felony count of workers’ compensation fraud after investigators found her working as a restaurant manager while collecting BWC disability benefits. A judge ordered her to pay BWC $18,239 in restitution and serve five years of probation.

Amanda Treadway of Reynoldsburg, Ohio
Treadway was ordered to pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC discovered Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.

Antoine Harris of Cincinnati, Ohio
Harris was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3 after BWC found him working as a truck driver while collecting disability benefits. Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.

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

Ohio woman keeps BWC benefits alive after father dies

May 17, 2019 Leave a comment

Owes BWC more than $29,000 after fraud conviction

A northeastern Ohio woman pleaded guilty May 9 to workers’ compensation fraud after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found her collecting her father’s benefits for more than two years after he died.

Deborah Rosenlieb of Cuyahoga Falls pleaded guilty to the fourth-degree felony in the Summit County Common Pleas Court, where a judge ordered her to pay BWC $29,418 in restitution. The judge also ordered Rosenlieb to serve two years of community service.

“Ms. Rosenlieb’s father was receiving death benefits on behalf of his late wife, but when her father died in January 2016 she didn’t let us know,” said BWC Administrator/CEO Stephanie McCloud. “She knew she wasn’t entitled to these benefits, but she used them for personal expenses until we learned of her scheme in April 2018.”

In other news:

A Cleveland man must pay BWC $3,525 in restitution after pleading guilty Monday to a misdemeanor count of workers’ compensation fraud after BWC found him working as a maintenance technician and office manager while collecting disability benefits.

James Nichols, 57, also must serve two years of probation and pay court costs. He paid $1,000 toward his restitution prior to entering his guilty plea in the Franklin County Common Pleas Court.

A Youngstown woman pleaded guilty May 2 to a misdemeanor count of workers’ compensation fraud after BWC found her working for a call center while collecting disability benefits.

A Franklin County judge ordered Natasha Mitchum, 42, to pay BWC $1,863 in restitution and serve three years of probation.

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

Fraud hurts us all

May 10, 2019 Leave a comment

Fraud hurts us all, says Jim Wernecke, head of BWC’s special investigations department, in this video.

 

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

Order up! Restaurant manager earns fraud conviction

April 26, 2019 Leave a comment

A Youngstown woman must pay the Ohio Bureau of Workers’ Compensation more than $18,000 in restitution after the agency found her working as a Steak ‘n Shake manager while collecting BWC disability benefits, a judge ruled April 16.

Kristin Stuhldreher, 54, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. In addition to $18,239 in restitution, Stuhldreher also must serve five years of probation.

“Our investigators found Ms. Stuhldreher worked for seven months in 2017 while concealing her employment from us so she could continue to receive BWC benefits,” said BWC Administrator/CEO Stephanie McCloud. “Clearly, she wasn’t disabled from work, and I’m grateful to our investigators for bringing this fraudulent scheme to an end.”

According to BWC’s Special Investigations Department, Stuhldreher collected workers’ compensation benefits after suffering an injury in late 2010 while working for another employer. She required surgery for that injury years later while working for Steak ‘n Shake. She took time off for the surgery, but didn’t tell BWC when she returned to work.

In other news:

A northeast Ohio man pleaded guilty April 17 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working as an industrial assembler while collecting BWC benefits.

A Franklin County judge ordered Antonio Daniels of Streetsboro to pay BWC $6,409 in restitution and serve five years of probation in lieu of 30 days in jail.

A northeast Ohio woman was sentenced April 8 to five years of probation after BWC found her working as a self-employed photographer while receiving disability benefits from her employer.

A Trumbull County judge ordered Kimberly Floyd of Warren, owner of Floyd’s Photography and KLG Sports Photography, to also pay $325 in court fees. Floyd pleaded guilty Feb. 4 to a fifth-degree felony count of workers’ compensation fraud.

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

Ducking workers’ comp coverage costs Mansfield freight hauler $144K

April 12, 2019 Leave a comment

The owner of a Mansfield freight hauling and trucking company must pay $144,400 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) following his sentence Monday for his conviction on four felony charges related to workers’ compensation fraud.

A Richland County judge also ordered Robert Tate, owner of Elite TNT Enterprises, to serve two years of probation for his conviction Feb. 20 on two counts of workers’ comp fraud, fourth-degree felonies, and two counts of tampering with records, third-degree felonies. Tate must bring his BWC policy into compliance with state law and pay the agency $137,447 in unpaid policy premiums and $6,953 for the costs of its investigation.

“We reached out to Mr. Tate several times to follow the law and protect his employees with workers’ compensation coverage, but he chose to ignore us and it cost him,” said BWC Administrator/CEO Stephanie McCloud.

BWC’s special investigations department discovered in 2017 that Tate was operating his business without BWC coverage. After several attempts to work with Tate, agents subpoenaed bank records and audited his business, finding Tate under-reported his payroll over several payroll periods in an attempt to lower the amount he owed the agency. They also found he falsified new applications for BWC coverage by failing to list previous policies with the agency and he under-reported the number of workers he employed.

In other news:

  • A Reynoldsburg woman must pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC investigators discovered Amanda Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.
  • A Cincinnati man found working as a truck driver while collecting BWC disability benefits was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3. Antoine Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.
  • A Cleveland Heights woman found working as a restaurant hostess while collecting BWC disability benefits pleaded guilty to a misdemeanor count of workers’ compensation fraud March 28 in Franklin County Municipal Court. A judge ordered Morgan Hines to pay BWC $4,089 in restitution, $88 in court costs and a $250 fine. The judge also sentenced her to two years of probation.

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

Logan County man sentenced for workers’ comp fraud

March 22, 2019 3 comments

On the day he was sentenced to prison for breaking and entering, gross sexual imposition, burglary and other charges, a Bellefontaine man was also ordered to pay nearly $6,400 in restitution to his employer and the Ohio Bureau of Workers’ Compensation (BWC) for collecting disability benefits while secretly working another job.

Joseph A. Wilson, 32, was sentenced to six years in prison March 8 on multiple charges, including reduced charges related to workers’ compensation fraud — petty theft, a first-degree misdemeanor, and failure to appear in court, a fourth-degree felony. A judge in the Logan County Court of Common Pleas ordered Wilson to reimburse his employer (Rent-A-Center) $2,904 and pay BWC $3,469 for the cost of its investigation.

“Workers’ compensation fraud is a crime we take seriously,” said BWC Administrator/CEO Stephanie McCloud. “Fraud steals resources needed by workers who are truly injured, and it raises the cost of our entire system. Kudos to our special investigations department for bringing this case to a close.”

BWC investigators confirmed an anonymous tip they received in late 2017 that Wilson was working on a horse farm while collecting disability benefits from Rent-A-Center. Wilson was arrested in November on warrants for five counts of gross sexual imposition, two counts of workers’ compensation fraud, two counts of failure to appear, and single counts of receiving stolen property, theft, breaking and entering and criminal damaging.

In other news:

The owner of Home Bakery in Coldwater, Ohio, pleaded guilty March 8 to three counts of failure to comply after BWC discovered him operating his business without a workers’ comp policy for three years. A Celina judge ordered Carl R. Brunswick to pay a $50 fine for each count and serve 10 days in jail for each count. The judge suspended the jail time on the condition Brunswick not have any similar violations in the next five years. Brunswick is on a repayment plan with the state to pay his past BWC premiums.

A Dayton woman convicted last month of passing a bad check to BWC must serve five years of probation and complete 40 hours of community service. Carissa Couch of Couch Family Construction pleaded guilty to the fifth-degree felony on Feb. 27 in the Montgomery County Court of Common Pleas. The plea followed multiple attempts by BWC to work with Couch to bring her policy into compliance after her check to the agency for $3,333 bounced at the bank.

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

Prison, hefty restitution ordered for Cleveland fraudster

March 15, 2019 2 comments

Contractor collected $246K in disability from BWC, Social Security

A Cleveland-area man was sentenced to seven months in prison Wednesday and ordered to repay nearly $246,000 in disability benefits he fraudulently received from the Ohio Bureau of Workers’ Compensation (BWC) and the Social Security Administration.

Louis C. Cooper, 57, of North Royalton, previously pleaded guilty to wire fraud and theft of government property after investigators discovered him concealing his work as a general contractor. He was sentenced Wednesday in the U.S. District Court for the Northern District of Ohio in Cleveland.

“Acting on an anonymous tip, our investigators discovered Mr. Cooper earned at least $185,000 over the last eight years as a general contractor while telling BWC and Social Security he was too injured to work,” said BWC Administrator/CEO Stephanie McCloud. “Our benefits are for workers who truly need them, not for fraudsters to pad their income. I commend our special investigations department and the Social Security Administration for bringing Mr. Cooper’s criminal activity to an end.”

Cooper was injured on the job in 1996. Investigators from BWC and Social Security found he had developed a scheme dating back to at least 2010 to conceal his income as a general contractor by asking his clients to not pay him directly. While reporting to both agencies numerous times that he was too injured to work, Cooper collected nearly $168,000 from BWC and nearly $78,000 from Social Security.

According to court documents, Cooper must surrender to the U.S. Marshals Service on April 18 for transfer to a federal prison. He must serve three years of probation following his release. This case was prosecuted by the U.S. Attorney’s Office for the Northern District of Ohio.

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

Receptionist owes BWC $19K after fraud conviction

February 15, 2019 Leave a comment

Agency secures six convictions in January

A Bellefontaine woman who worked as a receptionist while claiming to be disabled from work owes the Ohio Bureau of Workers’ Compensation nearly $19,000 following her conviction last month on a felony workers’ compensation fraud charge.

A Franklin County judge on Jan. 16 ordered Dawn M. Hattery, 50, to reimburse BWC $17,937 and pay $1,000 in investigation costs for working while collecting BWC benefits from January to November 2017. The judge also sentenced her to five years of probation after she pleaded guilty to the fifth-degree felony.

“Ms. Hattery not only broke the law deceiving this agency, she earned a criminal record that will follow her for years to come,” said BWC Administrator/CEO Stephanie McCloud. “Our role is to compensate workers while they’re recovering from injury, not pad the income of people trying to cheat the system.”

In other convictions last month:

Marc E. Pope, 50, of Cleveland, paid BWC $23,793 in restitution Jan. 30 before his guilty plea on two first-degree misdemeanor counts of workers’ compensation fraud in the Franklin County Court of Common Pleas. BWC found Pope working multiple jobs while collecting disability benefits from the agency.

Kenneth Miller, owner of Grant Street Pallet Inc. in Lisbon, Ohio, pleaded no contest Jan. 29 to a second-degree misdemeanor count of failure to comply after entering a reinstatement payment plan with BWC. A judge sentenced Miller to 10 days in jail and fined him $750, then suspended both.

Larry West, owner of the Bluebird Restaurant in Norwood, paid all past-due installments and premiums on his BWC policy before pleading guilty Jan. 25 to a reduced charge of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to one day in jail, then credited with time served.

Douglas J. Krouskoupf of Zanesville 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.

Stephan L. Evans Sr, dba AB Shelby’s Auto Tractor and Trailer Repair in Akron, pleaded guilty Jan. 7 to one count of failure to comply, a second-degree misdemeanor, after BWC found him operating his business without workers’ compensation coverage. An Akron Municipal Court judge sentenced Evans to one year of obeying the law and ordered him to pay $324 in court costs.

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

Construction worker hammered with fraud conviction

February 8, 2019 Leave a comment

Cleveland man reimburses BWC $24,000

A Cleveland construction worker who worked multiple jobs while collecting disability benefits from the Ohio Bureau of Workers’ Compensation reimbursed the agency nearly $24,000 on Jan. 30 before pleading guilty to workers’ compensation fraud.

Marc. E. Pope, 50, paid BWC $23,793 in restitution before his guilty plea on two first-degree misdemeanor counts of workers’ compensation fraud in the Franklin County Court of Common Pleas.

“We found Mr. Pope working as a laborer for several businesses while claiming to be disabled from work,” said BWC Administrator/CEO Stephanie McCloud. “When someone scams the system, they are really hurting injured workers who rely on us to help them recover from their injury and return to work.”

In other fraud-related news:

A Cincinnati-area restaurant owner who would not cooperate with BWC to reinstate his policy finally did so after a Hamilton County grand jury indicted him on a fourth-degree felony count of workers’ compensation fraud.

Larry West, owner of the Bluebird Restaurant in Norwood, paid all past-due installments and premiums on his BWC policy before pleading guilty Jan. 25 to a reduced charge of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to one day in jail, then credited with time served.

The owner of a pallet company in eastern Ohio was sentenced to two years of probation Jan. 29 for failing to carry workers’ compensation insurance on his business.

Kenneth Miller, owner of Grant Street Pallet Inc. in Lisbon, Ohio, pleaded no contest to a second-degree misdemeanor count of failure to comply after entering a reinstatement payment plan with BWC. A judge sentenced Miller to 10 days in jail and fined him $750, then suspended both.

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

Trucker kept truckin’ while collecting injured-worker benefits

January 18, 2019 Leave a comment

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.

 

Auld Lang Syne…

December 28, 2018 Leave a comment

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

December 21, 2018 Leave a comment

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.

Cleveland-area businessman convicted of workers’ comp fraud

December 14, 2018 Leave a comment

‘Disabled’ man plows snow, mows lawns

A northeast Ohio business owner must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $34,000 in restitution after the agency found him working and running a business while collecting disability benefits.

Gabriel Seda of Grafton, Ohio, pleaded guilty Dec. 6 through a Bill of Information to a fifth-degree felony count of workers’ compensation fraud. A judge in the Franklin County Court of Common Pleas ordered Seda to reimburse BWC $33,960 and sentenced him to five years of probation in lieu of a year in prison.

“Our investigation found Mr. Seda plowing snow, mowing lawns and landscaping for a business he owned, GS Snow Removal and Lawn Care,” said Jim Wernecke, director of BWC’s special investigations department. “Clearly, he wasn’t so disabled that he couldn’t work.”

In other news, the owner of a graphic design and screen-printing shop in Springfield who failed to turn herself in to the court earlier this year pleaded guilty to “failure to comply” Dec. 3 after BWC’s fugitive task force tracked her down in November.

A judge fined Beth Turner, owner of Flashions LTD in Springfield, $100 and court costs for the minor misdemeanor charge. Turner’s conviction followed a BWC investigation that found her running her business with employees under lapsed BWC coverage. She was charged in May after she stopped cooperating with BWC to bring her policy back into compliance. She has since done so.

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

Southwest Ohio business owner gets prison time, hefty fine for work comp fraud

December 7, 2018 4 comments

Business owner defrauded BWC of $425K

The owner of a former payroll services company in southwest Ohio was sentenced to six months in federal prison and fined $10,000 today for defrauding the Ohio Bureau of Workers’ Compensation (BWC) out of more than $425,000.

John R. Cacaro, 59, owner of the now-defunct Employers Choice Plus LLC, also must serve one year of house arrest and three years of supervised release under a sentence handed down by U.S. District Judge Michael H. Watson in the U.S. District Court for southern Ohio.

“Multiple businesses entrusted Mr. Cacaro with processing their payroll and remitting insurance premiums to our agency and he broke that trust,” said Jim Wernecke, director of BWC’s special investigations department. “Justice was served today and I can’t thank our partners in this investigation enough, the IRS Criminal Investigation unit and the U.S. Attorney for the Southern District of Ohio.”

Cacaro was convicted in June on wire fraud and money laundering charges after BWC and IRS investigators discovered a scheme he concocted to short BWC on the insurance premiums he received from employers and pocket the difference.

“John Cacaro made a conscious decision to keep over $425,000 in workers’ compensation premiums so he could live a lavish lifestyle that included the purchase of a second residence in Naples, Florida, and a motor home,” said IRS Special Agent in Charge Ryan L. Korner. “Now he is a convicted felon headed to prison.”

At his sentencing today, Cacaro submitted a cashier’s check to the court for $425,247 in restitution to BWC. He noted that he has voluntarily closed Employers Choice Plus and he will likely have gainful employment through his car transportation business when he leaves prison.

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

Drug-trafficking nurse practitioner, other work comp cheats convicted in November

December 7, 2018 4 comments

Eight Ohioans convicted on workers’ compensation fraud or related charges in November include a Springfield nurse practitioner who pleaded guilty to felony drug trafficking and a Cleveland-area man who collected $245,000 in disability benefits while working construction jobs since 2009.

Douglas Shrewsbury pleaded guilty Nov. 16 to several drug charges in the Clark County Court of Common Pleas after multiple authorities found him running a pain clinic without a proper license. The charges included aggravated trafficking in drugs, a first-degree felony, aggravated possession of drugs, a second-degree felony, and Medicaid fraud, a fourth-degree felony.

“Mr. Shrewsbury wrote 56 prescriptions for schedule II narcotics to injured workers in our system without an overseeing physician, which is beyond his scope and illegal,” said Jim Wernecke, director of the Ohio Bureau of Workers’ Compensation special investigations department.

Other agencies involved in the investigation included lead agency the Ohio Board of Pharmacy, the Springfield Police Department, Ohio Board of Nursing, State Medical Board of Ohio, Attorney General’s Medicaid Fraud Control Unit, Ohio Bureau of Criminal Identification and Investigation, and the Clark County Prosecutor’s Office.

Shrewsbury’s sentencing is scheduled for Dec. 27.  

In the Cleveland-area case, Louis Cooper of North Royalton pleaded guilty Nov. 19 in a federal courtroom to one count of theft of government property and wire fraud. He was released on a $20,000 unsecured bond and must surrender his passport and participate in a pre-sentence investigation prior to his March 5 sentencing.

Acting on a tip, BWC investigators found Cooper working as a self-employed general contractor, installing flooring and drywall and remodeling bathrooms. Due to concealing his work activity, Cooper fraudulently secured approximately $245,000 in benefits from the Social Security Administration and BWC, of which $167,000 came from BWC.

In order of most recent court appearance, other BWC subjects convicted in November include:

Dean Richards of Lancaster
Richards pleaded guilty Nov. 29 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC agents found him working as a construction subcontractor while receiving permanent disability benefits from BWC. He was sentenced to 23 days in jail, credited for time served, and ordered to pay BWC $6,614 in restitution.

James T. Wilson Jr, dba Performance Companies, of New Albany
Wilson pleaded guilty Nov. 19 in a Columbus courtroom to a second-degree misdemeanor count of failure to comply after BWC investigators found him operating Performance Companies LLC/Enviro Recycling Group without workers’ compensation coverage. Sentencing will occur after BWC finishes auditing his business records.

Dwayne Dotson of Cleveland
Dotson pleaded guilty Nov. 14 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a self-employed general contractor while receiving disability benefits. He was given three years of probation and ordered to pay BWC $14,453 in restitution.

Yue Liang, dba New Sheng Hung, of Cleveland
Liang pleaded guilty Nov. 13 to a first-degree misdemeanor charge of workers’ compensation fraud after he lapsed on a repayment plan related to his 2014 conviction on a similar charge. The food warehouse and market owner agreed to pay BWC $5,500 toward the balance owed to the agency and an additional $2,000 in restitution. He was sentenced to one year of community control and ordered to bring his policy into compliance.

Douglas Rheaume of New Franklin
Rheaume pleaded guilty Nov. 13 to a fifth-degree felony count of workers’ compensation fraud after BWC found the former sheriff’s deputy operating a baseball training facility and working as an insurance agent while collecting BWC benefits. A judge sentenced Rheaume to a suspended nine-month prison term and ordered him to serve two years of probation. Additionally, he was ordered to pay $56,000 in restitution to BWC.

Stephanie Terry, dba Universal Fleet & Tire Service, of Cincinnati
Terry pleaded guilty Nov. 5 to one count of obstructing official business, a second-degree misdemeanor, after BWC found her operating her business with employees and lapsed BWC coverage. Two of her employees had filed injury claims while the coverage was lapsed. Terry paid $27,947 to BWC for the balance she owed the agency.

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

Two Ohio business owners convicted for failing to carry workers’ comp coverage

November 23, 2018 Leave a comment

Second conviction for both employers

A Columbus-area business owner with a criminal history against the Ohio Bureau of Workers’ Compensation pleaded guilty Monday to failing to carry workers’ compensation coverage on his asphalt paving business.

James T. Wilson Jr., 52, of New Albany, pleaded guilty in a Columbus courtroom to a second-degree misdemeanor count of failure to comply after BWC investigators found him operating Performance Companies LLC/Enviro Recycling Group without workers’ compensation coverage. The plea came nine years after Wilson’s first case with BWC, when he pleaded guilty to a fourth-degree felony theft charge and was ordered to pay BWC more than $180,000 in restitution.

“We attempted to work with Mr. Wilson to bring his business into compliance with Ohio law, but ultimately we had to go with this course of action,” said Jim Wernecke, director of BWC’s special investigations department. “I can’t say this enough to employers in our system: If you’re struggling with your BWC premiums, reach out to our agency and work with us. Don’t risk a criminal conviction.”

Wilson’s sentencing will be scheduled for a later date after BWC has finished auditing his business records.

In other news, the owner of a food warehouse and market in Cleveland pleaded guilty Nov. 13 to a first-degree misdemeanor charge of workers’ compensation fraud after he lapsed on a repayment plan related to his 2014 conviction on a similar charge.

Yue Liang, owner of New Sheng Hung, agreed to pay BWC $5,500 toward the balance owed to the agency and an additional $2,000 in restitution. He was sentenced to one year of community control and ordered to bring his policy into compliance.

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

IFAW: That’s a wrap

November 16, 2018 Leave a comment

It’s time to wrap another impressive International Fraud Awareness Week.

We specialize in workers’ comp fraud but enjoy hearing about what our counterparts are doing in their fight to stop all kinds of fraud. We also appreciate the opportunity to share our story with you.

We’ve shared a lot about ourselves, including what we do, why we do it, a little about how we do it, how Ohioans can help and much more.

Thanks for connecting with us this week. While we hope you never come across workers’ comp fraud, if you do, we want you to know how recognize it and where to find us.

If you do still have questions, don’t worry, we’re here all year long.

Our fraud hotline is, well, hot! Thanks for making us aware of fraud all year long!

November 16, 2018 1 comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received more than 2,300 calls since we launched our new Fraud Hotline system on November 14, 2017, during International Fraud Awareness Week 2017.

The nearly 200 calls a month, means we have received 9 each work day, or more than one 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, document, and promptly act upon, your concerns.

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 most important call at a time.

Today, during International Fraud Awareness Week 2018, we thank you for your support!

‘Records told the story’ in fraud case: Northeast Ohio business overbills agency; owner found guilty of workers’ comp fraud

November 15, 2018 1 comment

By Jennifer Cunningham, Assistant Director, BWC Special Investigations Department

The bills coming from a Northeast Ohio health care facility to the Ohio Bureau of Workers’ Compensation (BWC) looked suspicious.

Too many, it seemed, were for treatment to a company co-owner and others closely connected to the business. Our agency had paid more than $110,000 for claims on one of those cases alone and $27,000 for treatment provided to co-owner Jeffrey L. Guerin. So, in late winter of 2013, our special investigations department decided to take a closer look at PT Plus LLC of Willoughby Hills, a provider of physical therapy and massage therapy about 20 miles northeast of Cleveland.

After a preliminary investigation by our Health Care Provider Team, we used an undercover agent posing as an injured worker to get an inside look at the practice. In roughly 23 visits over three months our agent observed — and records later proved — PT Plus billed BWC for services that weren’t rendered to patients. In one case, our agent witnessed an injured worker refuse treatment, but PT Plus billed BWC anyhow, using spurious treatment notes to support the claim.

Our agents subsequently interviewed three former PT Plus employees, all of whom alleged co-owner Guerin committed health care fraud out of the business. Specifically, they claimed Guerin billed BWC and other third-party payers for treatment not rendered to patients. They said Guerin managed the day-to-day operations of the business and had total control over the billing process. They said he altered the units of service recorded on fee sheets and the patient’s in/out time recorded on treatment notes to correspond with the amount of treatment billed to BWC.

As we were investigating, PT Plus went out of business around July 2014. Our agents learned the business records and patient charts were stored at Guerin’s business partner’s residence. We conducted a search warrant and interviewed the co-owner, who denied any involvement in the company’s day-to-day operations and billing responsibilities. That was Guerin’s role, he said.

Our agents interviewed Guerin, who admitted sole responsibility for billing and overseeing his company’s daily operations. He told our agents that beginning in 2009 he had auditors review his businesses records to look for discrepancies. He said they found that he had actually under-billed BWC about 60 percent of the time, thus shorting his business money. For the audits that revealed overbilling, it didn’t amount to much money, he said. Taken collectively, it was all a wash and that’s why he didn’t inform BWC or any other third-party payer, he explained. But that’s not what our agents found.

During the interview, Guerin retrieved the audit worksheets from his basement and surrendered them to the agents. The agents conducted a cursory review and discovered the majority of the 2014 audit worksheets recorded overbilling. “He offered bizarre justifications and excuses for the records,” one agent told me. “He was cooperative, but we could tell he wasn’t truthful. I think he felt he could explain his way out of it, but the records told the story.

Back at the office, the health care provider team conducted its own audit. The methodology entailed comparing the type, amount (Units of Service) and length (In/Out Times) of treatment that the therapists recorded on the billing and treatment records with the bills Guerin sent to BWC. The audit revealed more than 170 instances where Guerin altered data so he could bill and receive reimbursement for more treatment than was rendered.

On May 18, 2018, Guerin pleaded guilty to one count of workers’ compensation fraud, a first- degree misdemeanor, in Franklin County Municipal Court. He paid BWC restitution in the amount of $7,154 on the same day.

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.

Check Smart clerk outsmarts phony owner of BWC rebate check

November 9, 2018 2 comments

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.

Foregoing workers’ comp coverage costs Ohio businesses

November 2, 2018 Leave a comment

The Ohio Bureau of Workers’ Compensation (BWC) secured court convictions in October against three Ohio business owners — including a Cleveland-area man for the second time since 2016 — who failed to protect their workers with proper BWC coverage.

“We made every attempt to bring these employers into compliance with Ohio law, but they wouldn’t cooperate and we were forced to bring charges against them,” said Jim Wernecke, director of BWC’s special investigations department (SID). “I can’t stress this to employers enough: If you’re struggling with your BWC premiums, work with us. Avoiding us will only make your situation worse.”

Among those convicted were Kurt A. Ballish of Chardon, Ohio, owner of Kurt Ballish Construction & Custom Decks. He 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 ordered Ballish, who owes BWC nearly $19,000, to become compliant with Ohio’s workers’ compensation law or go to jail. He 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.

In Cincinnati, the owner of a now-closed transportation services company must pay BWC more than $159,000 in restitution following his guilty plea to a reduced charge of workers’ compensation fraud.

Philip Ayers, owner of Ayers Transportation Services, pleaded guilty Oct. 24 in a Hamilton County courtroom to the first-degree misdemeanor charge. 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.

In another employer case, the owner of Triple R Auto Sales in Cleveland pleaded guilty to one count of Failure to Comply Oct. 1 after BWC discovered the business had been in operation for 11 years without workers’ comp coverage.

A judge in Cleveland Municipal Court ordered Rami Khayat to pay BWC $965 in restitution. An injured-worker claim filed against Khayat’s business triggered BWC’s investigation.

In other news, a Columbus tow-truck driver who falsified records to increase his BWC cash benefits pleaded guilty Wednesday to a first-degree misdemeanor count of workers’ compensation fraud.

A Franklin County judge sentenced Jason E. Moffitt to two years of community control in lieu of a three-month jail sentence. The judge also ordered Moffitt to pay BWC $5,325 in restitution.

BWC investigators say Moffit intentionally inflated his income on an earnings statement and signed another person’s name to it. The letter was used to establish Moffitt’s BWC compensation payments.

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

Lapsed policy costs Columbus cleaner $43,000

October 26, 2018 Leave a comment

BWC wraps three fraud-related cases over the last week

The owner of a Columbus cleaning company who continued to run his business after his workers’ compensation insurance lapsed in 2010 paid more than $43,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) at his court hearing Oct. 18.

Gyorgy Benedek, owner of Maintenance Free Building Services Inc., pleaded guilty to a reduced charge of Failure to Comply after submitting a check to BWC for $43,069 in the Franklin County Court of Common Pleas. The plea followed a BWC investigation that revealed Benedek provided falsified BWC certificates of coverage to land a cleaning contract with another company.

“We got a tip from a company doing business with Mr. Benedek that his BWC certificates looked suspicious, so we checked it out,” said Jim Wernecke, director of BWC’s special investigations department. “We found multiple problems with the certificates indicating Mr. Benedek was attempting to skirt his legal obligation to protect his employees and carry proper insurance.”

Among BWC’s findings:

  • Benedek provided three BWC certificates showing the signature of former BWC Administrator/CEO Marsha P. Ryan when it should have been the signature of her successor, Stephen Buehrer.
  • The certificates were dated during a period Benedek’s policy was lapsed.
  • Benedek reported zero payroll between 2009 and 2015, but a BWC audit found he had more than 30 employees during that time and unreported payroll of more than $650,000.

In two other recent cases, a Canton woman must pay BWC $26,719 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation on Oct. 18, and a Cincinnati-area business owner avoided a felony fraud conviction by paying $4,000 in restitution to BWC at his court hearing Oct. 22.

Acting on a tip, BWC investigators found Penny L. Sibila of Canton working as a property manager for an apartment complex from May 11, 2015 to July 27, 2016, while collecting BWC benefits for an injury she suffered in 2014.

Investigators observed Sibila performing several office functions and learned she collected commissions for landing new tenants. They also found she used the alias “Linda” to conceal her return to work from BWC.

In addition to restitution, a Franklin County judge sentenced Sibila to two years of non-reporting probation in lieu of a seven-month jail sentence.

 

In Hamilton County on Monday (Oct. 22), Frank Krailler of Loveland pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him operating his business, Transmission Specialists of Montgomery, without BWC coverage.

Krailler paid BWC $4,000 in restitution at his hearing in a Hamilton County court room, but an outstanding balance remains.

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

BWC reports 7 fraud-related convictions in September

October 12, 2018 Leave a comment

Six Ohioans and a Florida resident owing the Ohio Bureau of Workers’ Compensation (BWC) more than $450,000 in back premiums and restitution were convicted on fraud or fraud-related charges in September.

Those convicted include a Jackson Twp. business owner who misclassified his employees and underreported his payroll to shave $350,000 off his BWC premiums. Others include a basketball coach, a taxi service owner and a valet attendant.

“Whether it’s employers trying to avoid paying their fair share or claimants trying to hide their work activity, cheating the system is not tolerated,” said Jennifer Cunningham, assistant director of BWC’s special investigations department. “We exist to find and prosecute these cheaters to reduce costs to employers and ensure honest claimants receive the benefits they need.”

September’s cases bring total convictions since January to 61, as of Sept. 30. Those convicted, in order of most recent court case, include:

Christine Estrict, Working and Receiving, Cleveland, Ohio
Estrict, aka Christina Estrict, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud on Sept. 26 in the Franklin County Court of Common Pleas after BWC found her working as a youth basketball coach and referee while collecting BWC benefits. A judge sentenced her to 180 days in jail, then suspended the sentence for five years of probation. He ordered her to pay BWC $4,156 in restitution.

Glenn J. Miller III, Working and Receiving, Augustine, Florida
Miller pleaded guilty Sept. 26 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working as a truck driver while collecting BWC benefits. A judge sentenced him to six months incarceration, suspended for three years of community control with the condition to pay restitution of $16,000 to BWC.

James M Horton, dba All Around Transportation, Lapsed Coverage, Hamilton, Ohio
Horton, of Clarksville, pleaded guilty to a second-degree misdemeanor count of Failure to Comply Sept. 25 in Hamilton Municipal Court after BWC discovered his policy lapsed in July 2016. Horton, who owes BWC more than $55,000 in back premiums, faces up to 90 days in jail and a $750 fine at his sentencing Dec. 5 if he fails to enter a repayment plan by then.

Anthony Caputo, Working and Receiving, Strongsville, Ohio
Caputo pleaded guilty Sept. 17 in Franklin County to a first-degree misdemeanor count of workers’ comp fraud after investigators found him working as a valet attendant at a Cleveland-area hospital while collecting BWC benefits. A judge fined him $500 in lieu of a 10-day jail sentence. Caputo paid BWC $4,021 in restitution prior to his plea.

Linda Cline, Working and Receiving, Springfield, Ohio
Cline pleaded guilty in a Franklin County courtroom to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found her working while collecting BWC benefits. A judge ordered Cline to serve six months of community control and to pay $1,500 in investigative costs. Cline paid BWC $6,759 in restitution prior to her plea.

Craig Snee, dba Earth ‘n Wood, Underreporting and Misclassification of Payroll, North Canton, Ohio
A Stark County jury found Snee guilty Sept. 12 of a fourth-degree felony count of workers’ compensation fraud after BWC found he had misclassified his employees and underreported his payroll to save $350,000 in BWC premiums. Sentencing is scheduled for Oct. 17.

Clarice Ward, Working and Receiving, Euclid, Ohio
Ward pleaded guilty Sept. 4 to a fifth-degree felony count of workers’ compensation fraud after investigators found her working while collecting BWC benefits. A Cuyahoga County judge sentenced her to six months in prison, suspended for five years of community control, and ordered her to pay BWC $26,578 in restitution.

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

Taxi service owes BWC $55K in back premiums

October 5, 2018 3 comments

Owner pleads guilty to ‘failure to comply’ with workers’ comp law

The owner of a taxi service in southwest Ohio who owes the Ohio Bureau of Workers’ Compensation more than $55,000 in back premiums has until December to enter a repayment plan with the agency or he could face jail time and fines.

James M. Horton of Clarksville, owner of All Around Transportation in Hamilton, pleaded guilty to a second-degree misdemeanor count of Failure to Comply Sept. 25 in Hamilton Municipal Court. He faces up to 90 days in jail and a $750 fine at his sentencing Dec. 5 if he fails to enter a repayment plan by then.

“We understand the pressures of running a business, and that’s why we work with employers to bring them into compliance before involving the criminal justice system,” said Jim Wernecke, director of BWC’s special investigation department. “Unfortunately, Mr. Horton didn’t follow through on his side, and as a result of a subsequent investigation criminal charges were filed.”

Horton’s BWC policy lapsed in July 2016.

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

BWC calls foul on Cleveland youth basketball coach

September 28, 2018 Leave a comment

Coach convicted of workers’ comp fraud Wednesday

A basketball coach in Cleveland must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $4,000 after the agency’s investigators found her working while collecting injured-worker benefits.

Christine Estrict, aka Christina Estrict, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Wednesday in the Franklin County Court of Common Pleas. A judge sentenced her to 180 days in jail, then suspended the sentence for five years of probation. He ordered her to pay BWC $4,156 in restitution.

“We received an anonymous tip in 2016 that Ms. Estrict was working as a paid referee while receiving BWC benefits, which is against state law,” said Jim Wernecke, director of BWC’s special investigations department. “Our investigation found her working as a basketball coach in Beachwood City Schools and also as a coach and athletic director for a charter school.”

In other news, a former Ohioan now living in Florida pleaded guilty Wednesday to a fifth-degree felony count of workers’ compensation fraud after BWC found him working as a truck driver in 2015 while collecting BWC benefits.

A Franklin County judge ruled Glenn J. Miller III, 44, must serve three years of probation and pay BWC $16,000 in restitution.

Also this week, a Dayton-area business owner who owed BWC more than $190,000 in back premiums this year avoided jail time Monday when a judge fined him $250 for failing to comply with Ohio law requiring him to carry workers’ compensation coverage.

A Kettering Municipal Court judge suspended his 30-day jail sentence for Randall Mount, the owner of Ram Restoration in Centerville, and sentenced Mount to two years non-reporting probation instead. Mount and BWC informed the court that Mount is in a repayment plan with BWC and the agency had reinstated his coverage Aug. 13.

Mount’s business remediates water, fire and mold damage and performs other construction work, according to its website.

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

Cleveland-area valet attendant convicted of workers’ comp fraud

September 21, 2018 Leave a comment

BWC also reports four fraud convictions in August

A Cleveland-area man collecting disability benefits from the Ohio Bureau of Workers’ Compensation pleaded guilty to workers’ compensation fraud Monday after investigators found him working as a valet attendant at Southwest General Hospital in Middleburg Heights.

Anthony Caputo, 67, paid BWC $4,021 in restitution prior to his plea in the Franklin County Court of Common Pleas, where a judge fined him $500 in lieu of a 10-day jail sentence for the first-degree misdemeanor.

“Acting on a tip in 2017, our investigators found Mr. Caputo had worked for no less than four employers while receiving BWC benefits,” said Jim Wernecke, director of BWC’s special investigations department. “In fact, we found he went back to work just a few weeks after his on-the-job injury at a restaurant in August 2016.”

In another fraud case, a Springfield woman pleaded guilty to workers’ compensation fraud Sept. 13 after investigators found her working as a consultant to a South Charleston employer while collecting BWC benefits.

Linda Cline paid BWC $6,759 in restitution prior to pleading guilty to the first-degree misdemeanor in the Franklin County common pleas court. A judge sentenced her to six months of probation.

In other news, BWC secured fraud convictions against three Ohioans and one Texan in August, bringing the calendar year’s total to 54 as of Aug. 31. Those convicted include:

  • Walter Patterson of Olmsted Twp. – Patterson pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in Franklin County. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.
  • Jason Smith of Pataskala – Smith pleaded guilty Aug. 14 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 12 months incarceration, suspended for three years of community control. He was ordered to pay restitution of $41,413 to his former employer, TS Tech Corporation.
  • Grant Myers of Huron – Myers pleaded guilty Aug. 8 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 30 days incarceration, suspended. He paid BWC $11,566 in restitution.
  •  Stacy Driskell of Cedar Park, Texas – Driskell pleaded guilty Aug. 3 to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found her working for a mortgage lending law firm in Texas while collecting BWC benefits. A judge fined Driskell $300 plus court costs. Prior to the plea, Driskell paid full restitution of $3,056 to BWC.

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

2,000 Fraud Hotline calls in 10 months!

September 14, 2018 Leave a comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received 2,000 calls since we launched our new Fraud Hotline system ten months ago during International Fraud Awareness Week 2017. The 200 calls a month, means we have received nearly 10 each work day, or more than one 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.

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.

These same agents also receive and process fraud referral forms submitted by sources who report their suspicions via a Report Fraud link on bwc.ohio.gov. Just last month, for example, the convictions of Jason C. Smith and Walter M. Patterson were the result of fraud referral forms submitted to our hotline.

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 and referral form at a time.

Thank you for your support!

Cleveland-area bartender served felony conviction for workers’ comp fraud

September 7, 2018 Leave a comment

Euclid woman owes BWC more than $25K in restitution

A Cleveland-area bartender must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $25,000 after pleading guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud.

BWC learned in late 2016 that Euclid resident Clarice L. Ward was not attending her physical therapy appointments for her workplace injury and that the BWC-contracted company managing her care couldn’t reach her. As BWC investigated her case, the agency received an anonymous tip that Ward was working at Final Score Bar in Willowick, Ohio, while collecting BWC disability benefits.

“Ms. Ward would not cooperate with our investigators, so we interviewed her former employer and obtained evidence proving her fraudulent activity,” said Jim Wernecke, director of BWC’s special investigations department.

Ward, 40, pleaded guilty Tuesday in the Cuyahoga County Court of Common Pleas, where the judge sentenced her to six months in prison, suspended for five years of community control, and ordered her to pay BWC $26,578 in restitution.

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

Workers’ comp fraud scheme burns cook for $46K

August 31, 2018 2 comments

Northeast Ohio man guilty of 5th degree felony

 

A northeast Ohio man who worked as a cook for nearly three years while collecting disability benefits from the state owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $46,000 following his fraud conviction last week.

Walter M. Patterson, 58, of Olmsted Twp., pleaded guilty Aug. 21 to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge ordered Patterson to reimburse BWC $45,906 and serve five years of community control.

“It’s a mistaken perception among some people that workers’ compensation fraud is not that big a deal, that BWC ‘can afford it,’” said Jim Wernecke, director of BWC’s special investigations department. “As this case demonstrates, we take fraud very seriously and intend to recoup every ill-gotten dollar fraudsters take from this agency so those funds can serve injured workers who truly need them.”

Acting on a tip, BWC investigators found Patterson working as a cook at the Valley Tavern in Valley View, Ohio, and learned that he had previously worked as a cook at the County Line Bar in Brecksville.

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

Central Ohio handyman guilty of workers’ comp fraud

August 17, 2018 Leave a comment

Pataskala man owes BWC $41,000 after felony conviction

A maintenance man for a mobile home park must reimburse his former employer more than $41,000 after pleading guilty Tuesday to a felony count of workers’ compensation fraud.

Acting on a tip, investigators with the Ohio Bureau of Workers’ Compensation discovered Jason C. Smith, 35, of Pataskala, working for a mobile home park and for private individuals for nearly two years while collecting $41,413 in disability benefits from his employer, TS Tech USA Corporation in Reynoldsburg.

“You can’t claim you’re disabled and collect benefits from BWC or your employer when you’re also working under the radar and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “Workers’ comp benefits are for people who truly can’t work because they were injured on the job, not people who want to cheat the system and pad their income.”

Smith pleaded guilty to a fifth-degree felony count of workers’ compensation fraud. A Franklin County judge ordered him to pay TS Tech restitution and sentenced him to a year in jail, which he suspended in exchange for three years’ probation.

In other fraud news: A northern Ohio man was ordered to reimburse BWC $11,566 after investigators found him running a drywall business while receiving disability benefits from the agency.

Drywall installer Grant Myers, 57, of Huron, pleaded guilty to a first-degree misdemeanor count of workers’ compensation fraud Aug. 8 in the Franklin County Court of Common Pleas. A judge suspended a 30-day jail sentence after Myers paid BWC restitution.

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

Dayton home remodeler sentenced for workers’ comp fraud

August 10, 2018 1 comment

Ohio BWC secures three fraud convictions in July

The owner of a residential construction business in Dayton who under reported his payroll by millions of dollars to lower his workers’ comp premiums is among three Ohioans convicted last month for workers’ compensation fraud, the Ohio Bureau of Workers’ Compensation (BWC) reported Friday.

Honorato Camacho, owner of Field Construction LLC, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on July 12. Acting on a tip, BWC investigators found Camacho had deliberately under reported his payroll by more than $3.5 million from 2013 to 2015.

“Mr. Camacho’s scheme saved him more than $300,000 in premiums, but look what it cost him in the end — he still owes us for the premiums and now he has a felony criminal record on top of it,” said Jim Wernecke, director of BWC’s special investigations department.

Judge Mary Wiseman in the Montgomery County Court of Common Pleas ordered Camacho to pay BWC $255,434 in restitution, the balance owed after repayments he made prior to sentencing. She also sentenced Camacho to five years’ community control.

In other July convictions:

Arthur J. Brinkerhoff of Newcomerstown, Ohio, pleaded guilty July 25 in Franklin County to one misdemeanor count of workers’ compensation fraud after a tipster alleged he was working as a truck driver while receiving BWC benefits. Brinkerhoff was sentenced to one day in jail with credit for time served. He paid BWC $2,034 in court-ordered restitution.

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

Ohio BWC secures 7 convictions in June

July 13, 2018 Leave a comment

More than a quarter million dollars owed in restitution

Six current and one former Ohioan who owe more than $269,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) were convicted in June on charges related to workers’ compensation fraud.

Those convicted included six employers and one injured worker who was working in Colorado while collecting disability benefits from BWC. Three employers account for the bulk of the restitution owed.

“If these employers had just played by the rules and reached out to us for help when they were struggling, we could have had a better outcome for all involved,” said Jim Wernecke, director of BWC’s special investigations department. “Instead, they went in a different direction and now they have a criminal record in addition to their unpaid BWC premiums.”

In order of most recent court appearance, those convicted include:

Randall Mount, dba Ram Restoration, Lapsed Coverage, Dayton, Ohio
Mount pleaded no contest June 25 to one count of failure to comply, a second-degree misdemeanor, after BWC found him operating without coverage since January 2016. BWC worked with Mount to bring his policy current, but Mount failed to follow through.

Sentencing is scheduled for Aug. 13. The judge advised Mount that he should come to sentencing prepared to show actual steps taken toward reinstatement and compliance with the law. Mount owes more than $190,000 in premiums and claims costs billed to his policy while his coverage was lapsed.

Karrie Hoskisson, Working and Receiving, Colorado Springs, Colorado
Hoskisson, 44, formerly of Canal Winchester, pleaded guilty to a first-degree misdemeanor theft charge June 21 after BWC found her living and working in Colorado Springs, Colorado, as a night watchman while receiving BWC benefits.

The former dog groomer was sentenced to 36 days in jail. A Franklin County judge gave her credit for time served because she was jailed in Colorado after her arrest in May and again in Columbus following her extradition to Ohio.

John Triskett, dba The Gyro Spot, Under Reporting Payroll, Parma, Ohio
Triskett pleaded guilty June 19 to one count of Attempted Workers’ Compensation Fraud, a second-degree misdemeanor, after BWC found his business lacked workers’ comp coverage. A judge sentenced Triskett to 30 days in jail (suspended), six months of probation and ordered Triskett to pay a $100 fine and $1,140 in restitution to BWC.

Jason Brown, dba Bolts Carriers LLC, Lapsed Coverage, Bellefontaine, Ohio
Brown pleaded no contest June 12 in the Bellefontaine Municipal Court to two counts of failure to comply, both second-degree misdemeanors. Brown was sentenced to 20 days jail and fined $450 for each charge. The judge suspended the sentence conditionally, giving Brown until Dec. 12 to prove to the court that his BWC policy had been reinstated.

The policy for Bolts Carriers LLC had been lapsed since September 2015. Prior to sentencing, Brown paid approximately $1,900 toward his balance of more than $55,000.

Howard McIntosh, dba Custom Canvas, Lapsed Coverage, Lakeview, Ohio
McIntosh pleaded no contest June 12 in the Bellefontaine Municipal Court to three counts of failure to comply, all second-degree misdemeanors. McIntosh was sentenced to 30 days jail and fined $450 for each charge. The judge suspended the  sentence conditionally, giving McIntosh until Sept. 1 to prove to the court his BWC policy had been reinstated. One week prior to his court appearance, McIntosh remitted a $1,000 payment toward his BWC balance of more than $23,000.

Stephen Frair, dba Frair Ltd, Lapsed Coverage, Columbus, Ohio
Frair pleaded guilty June 5 in Franklin County Municipal Court to two counts of failure to comply, both second-degree misdemeanors, after letting his policy lapse in July 2015. Frair told BWC he closed his business Nov. 1, 2017. A judge fined him $165.

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

Truck-driving fraudster owes Ohio BWC more than $78,000

July 6, 2018 Leave a comment

Judge orders restitution, 5 years probation

A judge on June 28 ordered a Zanesville-area truck driver to pay $78,321 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after investigators found the driver had gone back to work without telling BWC so he could continue to collect disability benefits.

The Franklin County judge also sentenced Walter Lee, 54, of Frazeysburg to five years of probation and a 14-day suspended jail term. Lee pleaded guilty on April 24 to a fifth-degree felony count of workers’ compensation fraud.

“Our investigators discovered through state records that Mr. Lee had returned to work as a truck driver on May 3, 2013, but he deliberately concealed that information from BWC,” said Jim Wernecke, director of BWC’s special investigations department.

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

Dog groomer, two businesses plead to workers comp fraud-related charges

June 29, 2018 Leave a comment

A former central Ohio dog groomer pleaded guilty to a theft charge June 21 after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found her living and working in Colorado Springs, Colorado, while receiving BWC benefits.

Karrie Hoskisson, 44, formerly of Canal Winchester, pleaded guilty to a first-degree misdemeanor theft count and was sentenced to 36 days in jail. A Franklin County judge gave her credit for time served because she was jailed in Colorado after her arrest in May and again in Columbus following her extradition.

“Ms. Hoskisson failed to follow through with us following her not guilty plea to theft and workers’ compensation fraud charges in 2016, so we had her arrested by the U.S. Marshal’s Office and extradited to Ohio,” said Jim Wernecke, director of BWC’s special investigations department.

Wernecke said marshals arrested Hoskisson on May 16 when she appeared for a medical exam related to her 2004 work injury. He said Hoskisson collected $15,000 in BWC benefits during the time she was also working as a night watchman in Colorado.

Two business owners convicted

In other news, the owner of a Dayton-area business that owes BWC more than $190,000 must prove to a judge that he’s taken steps to bring his policy back into compliance when he’s sentenced on a related criminal charge Aug. 13.

Randall Mount, the owner of Ram Restoration in Centerville, pleaded no contest Monday in Kettering Municipal Court to a second-degree misdemeanor count that he failed to comply with Ohio law requiring him to carry workers’ compensation coverage for his business. Mount’s business remediates water, fire and mold damage and performs other construction work, according to its website.

Back premiums and claims costs have accrued since Mount’s policy lapsed in January 2016. BWC worked with Mount for five months to bring his policy into compliance, but Mount ultimately failed to do so.

In another employer case, the owner of a Columbus automotive repair shop pleaded guilty June 5 to two second-degree misdemeanor counts of Failure to Comply after letting his policy lapse in July 2015.

Steve Frair told BWC he closed his Essex Avenue business Nov. 1, 2017. A judge in the Franklin County Municipal Court fined Frair $165. Frair owes BWC $626 in back premiums and penalties.

Three Ohio businesses plead in work comp fraud cases

June 22, 2018 Leave a comment

Two owners owe a combined $78K in back premiums

Two business owners from Bellefontaine, Ohio, that owe approximately $78,000 in back premiums to the Ohio Bureau of Workers’ Compensation can avoid fines and jail time if they bring their BWC policies back into compliance later this year, a municipal judge ruled June 12.

“Letting your workers’ compensation coverage lapse is a serious matter that puts employees and businesses at risk for potentially staggering medical costs and related expenses,” said Jim Wernecke, director of BWC’s special investigations department. “We tried to work with these owners, but they ultimately didn’t do what they needed to do to avoid criminal charges.”

Jason Brown, the owner of the trucking company Bolts Carriers LLC in Bellefontaine, pleaded no contest to two second-degree misdemeanor counts of Failure to Comply after BWC found he defaulted on a reinstatement payment plan in September 2015. Prior to sentencing, Brown paid approximately $1,900 toward his balance of more than $55,000. He has until Dec. 12 to bring his policy into compliance or he could face 20 days jail and a $450 fine on each of the two charges.

In a separate case, the owner of a boat canvas shop in Bellefontaine whose policy lapsed 18 years ago has until Sept. 1 to bring the company’s policy into compliance. One week prior to sentencing, Desee McIntosh of Custom Canvas remitted a $1,000 payment toward his balance of more than $23,000. He pleaded no contest to three second-degree misdemeanor counts of Failure to Comply. He faces 30 days in jail and $450 in fines for each count.

In other news, the owner of The Gyro Spot Bar & Grill in Parma, Ohio, pleaded guilty Tuesday to one count of Attempted Workers’ Compensation Fraud, a second-degree misdemeanor, after BWC found his business lacked workers’ comp coverage.

As BWC agents worked with owner John Triskett to bring his business into compliance, they found he intentionally under-reported his payroll and used other inaccurate information to keep his policy payments significantly less than the amount he actually owed.

A judge sentenced Triskett to 30 days in jail (suspended), six months of probation and ordered Triskett to pay a $100 fine and $1,140 in restitution to BWC.

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

Eight Ohioans plead to work comp fraud-related charges in May

June 15, 2018 Leave a comment

The eight Ohioans who pleaded guilty and no contest in May to fraud-related charges against the Ohio Bureau of Workers’ Compensation (BWC) include a homicide suspect, a Cincinnati bus driver who collected disability benefits while working two other jobs, and a health care provider who billed BWC for work his company didn’t perform.

“Our convictions in May illustrate a range of fraud types that we see at BWC, some more serious than others,” said Jim Wernecke, director of BWC’s special investigations department. “But regardless of severity, we approach each case with equal determination to find the truth, prosecute the guilty and reclaim funds that support injured workers and create safer workplaces in our state.”

The cases, in order of most recent court date, include:

Samantha Coleman, Cincinnati — Working and Receiving
Coleman was working as a bus driver for the Southwest Ohio Regional Transit Authority (SORTA) when she was injured on the job in November 2015. While collecting disability benefits from SORTA, she continued to work her other two jobs as a tax preparer and security guard.

Coleman pleaded guilty May 30 in Hamilton County to one count of worker’s compensation fraud and one count of theft, both fifth-degree felonies. She was placed in the county’s diversion program because she had no prior record. Over the next year, she must reimburse SORTA $7,088, complete 120 hours of community service and participate in a counseling program.  If she successfully completes these requirements the case will be dismissed and she will not receive a conviction.

Bryan Gentry, Canal Fulton — Tampering with Records
Gentry pleaded guilty to a third-degree felony count of Tampering with Records after SID determined he created a phony BWC certificate of coverage to secure a tree-trimming job in Stark County. The judge sentenced him to a year in prison, to be served concurrently with a three-year term for assault and receiving stolen property.

Gentry, who’s imprisoned in Richland Correctional Institution in Mansfield, is also a suspect in the 2017 killing of a Stark County man who was romantically involved with Gentry’s girlfriend.

Gabriella Benkovits, Lakewood — Working and Receiving
Benkovits pleaded guilty May 22 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found her working as a bartender while collecting disability income. She must pay BWC $7,595 in restitution and serve two years of probation.

Jeffrey Guerin, Willoughby Hills — Services Not Rendered
Guerin pleaded guilty in a Franklin County court to a first-degree misdemeanor count of workers’ compensation fraud. BWC found him billing the agency for work his now-defunct company, PT Plus in Willoughby Hills, did not perform. Guerin paid $7,154 in restitution to BWC and agreed to leave the BWC network of providers.

Carolyn Tibbetts, Toledo — Lapsed Coverage
Tibbets, the owner of Little Explorers Toledo Learning Center, pleaded no contest May 17 to three charges of failure to comply after investigators found her operating her child care center without BWC coverage. Tibbets worked with BWC to bring her businesses into compliance, but she failed to continue payments on a balance of more than $12,000. The charges are second-degree misdemeanors.

A judge referred her case to Lucas County’s probation department to be considered for its Alternatives Program. No further court action will be taken against Tibbetts if she’s accepted into the program.

Marshall Winn IV, Niles — Working and Receiving
Winn, a truck driver from northeast Ohio, pleaded guilty May 14 to a fifth-degree felony count of workers’ compensation fraud after investigators found him working while collecting disability benefits. A Franklin County judge sentenced him to five years of probation in lieu of nine months in prison and ordered him to pay BWC $12,450 in restitution and court costs.

Judith Barlock, Parma — Lapsed Coverage
Barlock, the owner of Chase Professional Transport, failed to bring her company back into compliance after BWC discovered her policy had lapsed. She pleaded guilty May 2 to one count of failure to comply, a second-degree misdemeanor. A judge sentenced her to 90 days in jail (60 days suspended) and five years of probation. The court deferred the balance of jail time and $750 of her fine until a June 20 probation review. The amount of restitution owed BWC will be determined at that review.

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

Ohio murder suspect defrauds state work comp bureau

June 8, 2018 3 comments

Northeast Ohio tree trimmer falsified coverage certificate

One month after his alleged role in murdering his girlfriend’s other lover in February 2017, Bryan T. Gentry created a phony proof-of-coverage certificate from the Ohio Bureau of Workers’ Compensation (BWC) to land a tree-trimming job and avoid paying for actual coverage.

The Stark County man’s handiwork earned him a one-year prison sentence May 24 when a Summit County judge found him guilty of tampering with records, a third-degree felony. On the same day, the judge also found Gentry, 27, of Canal Fulton, guilty for the second-degree felonious assault of an Akron man last year, a crime apparently unrelated to his BWC case or to one involving a deadly love triangle.

“It seems our case might be the least of Mr. Gentry’s legal troubles right now, but we can’t let unrelated crimes stop us from doing our job,” said Jim Wernecke, director of BWC’s special investigations department. “Our job is to deter, detect and prevent worker’s comp fraud. We don’t let anyone slide.”

The judge gave Gentry three years in prison for the assault charge, to be served concurrently with his sentence for tampering and still another prison sentence he earned in December for receiving stolen property. Police tracked Gentry down last year after finding his mail in a stolen truck.

In the BWC case, Wernecke said a customer of Gentry’s tree service contacted the agency last summer after he suspected Gentry’s BWC certificate wasn’t legitimate. Two clues tipped off the customer, an insurance salesman: The certificate lacked a policy number, and Gentry noted a policy period of one day, “3/10/2017 through 3/10/2017.” BWC’s practice is to note a full policy year, such as 07/01/2016 through 06/30/2017.

BWC agents determined Gentry doctored a relative’s certificate to look like his own so he and his six workers could get the job. Agents interviewed Gentry on Jan. 31 at the Lorain Correctional Institution in Grafton, Ohio, where he lied and denied forging the certificate, but was “soft-spoken and very well-mannered” while doing it, they said.

Two days later, Gentry’s life got more complicated. Acting on a tip from Gentry’s girlfriend, Stark County authorities recovered the body of 25-year-old man from the backyard of his Massillon home. They found him in a plastic tote, encased in concrete and buried six feet below ground.

For more on that case, see these articles in the Massillon Independent and People magazine.

Gentry has since been relocated to the Richland Correctional Institution in Mansfield.

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

Case update: Ohio doctor sentenced to 5-year prison term

May 25, 2018 Leave a comment

Dr. Timothy Manuel, a Highland County physician who improperly prescribed opioids to injured workers, was sentenced Thursday to five years in prison and ordered to pay $12,060 in restitution to BWC.

Manuel, 59, was the subject of a joint investigation by BWC and the Ohio Board of Pharmacy that found he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care in southwestern Ohio. He also billed BWC for medical services that weren’t provided.

Manuel was taken into custody following his sentencing in the Highland County Court of Common Pleas. Read more on the case in this Hillsboro Times Gazette article.

Youngstown auditor is BWC’s Fraud Finder of the Year

May 25, 2018 Leave a comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An external auditor in the Youngstown Claims Office received the 2017 Fraud Finder of the Year award May 22 from BWC’s special investigations department (SID).

The auditor, who does not want to be identified given the sensitive nature of his job, received the award for alerting SID to a case in which an employer failed to report payroll and failed to respond to multiple attempts to schedule a premium audit. An investigation by the SID Employer Fraud Team revealed that most of the employer’s Ohio employees were reported to ODJFS, but not to BWC. The referral resulted in the identification and recovery of $804,352 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud and save the BWC system nearly a million dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources we need to take care of injured workers, create safe workplaces and provide the best service possible to employers at affordable rates.”

The auditor, who handles employer policy underwriting and premium audits, said he appreciates the recognition and is glad he could help.

“This is why we do what we do,” he said. “After spotting a red flag in this case, I dug a little deeper and found more red flags. Persistence paid off, and it’s a good thing, because this kind of behavior drives up our costs and hurts all the honest players in our system.”

SID received 2,320 allegations of fraud in 2017, with about a fourth of those coming from BWC personnel around the state — claims representatives, employer representatives and others who suspect illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system. During 2017, SID closed 311 cases referred by 158 BWC employees. The SID investigations found fraud in 146 of the 311 cases and generated $2,724,426 in identified savings.

To show their appreciation, SID leaders conducted a thank-you tour and red flag training from March through May, presenting Fraud Finder Award certificates to BWC employees in customer service offices across Ohio.

“We encourage all BWC employees to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4) or visit www.bwc.ohio.gov.

Cleveland bartender’s Facebook post exposes work comp fraud

May 25, 2018 Leave a comment

Restaurant worker owes BWC nearly $7,600

A Cleveland bartender must repay the Ohio Bureau of Workers’ Compensation $7,595 after pleading guilty Tuesday to workers’ compensation fraud.

In addition to restitution, Gabriella Benkovits, 26, of Lakewood, must serve two years of probation for the first-degree misdemeanor, a judge in the Franklin County Court of Common Pleas ruled.

“The company managing Ms. Benkovits’ medical claim for her 2012 work injury alerted us that they found a Facebook post indicating she was working as a bartender in Westlake,” said Jim Wernecke, director of SID’s special investigations department. “Our investigation revealed she worked at three different establishments from July 2015 to February 2016 while collecting disability benefits she wasn’t entitled to.”

Wernecke said Benkovits deliberately concealed her employment from BWC, her physicians and other parties officially involved in her injury case.

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

Truck driver guilty of workers’ comp fraud

May 18, 2018 Leave a comment

A truck driver from northeast Ohio must pay more than $12,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) after the agency’s investigators found him working again while collecting disability benefits.

Marshall Winn IV of Niles in Trumbull County pleaded guilty Wednesday to a fifth-degree felony count of workers’ compensation fraud in Franklin County Common Pleas Court. A judge sentenced him to five years of probation in lieu of nine months in prison and ordered him to pay BWC $12,450 and court costs.

“Mr. Winn was injured in 2014 and claimed he was disabled from work, but we found evidence that he started working again in January 2015 and that he was running his own trucking business,” said Jim Wernecke, director of BWC’s special investigations department.

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

Trucker and 10 others convicted in April for cheating BWC

May 11, 2018 2 comments

Agency owed more than $500,000 in restitution

An Ohio truck driver who worked for more than two years while collecting disability benefits could be ordered to pay more than $78,000 in restitution at his sentencing for workers’ compensation fraud June 14.

Walter Lee, of Frazeysburg in Muskingum County, pleaded guilty to the fifth-degree felony April 25 in Franklin County Common Pleas Court. The judge ordered a pre-sentence investigation due to the large amount of restitution — $78,321 — owed to the Ohio Bureau of Workers’ Compensation (BWC).

“Our investigators discovered Mr. Lee knowingly returned to work as a truck driver while collecting disability benefits from our agency,” said Jim Wernecke, director of BWC’s special investigations department. “We’re glad he can work again, but he can’t tell us he’s disabled and collect our benefits while doing it. Those funds are for injured workers who truly need them.”

Lee was injured on the job in 2002. BWC’s investigation found him working from May 3, 2013 to Oct. 2, 2015 while collecting agency benefits.

Lee’s case was one of 11 convictions BWC secured in April along with $515,713 in restitution ordered. Other cases include:

Timothy Manuel, M.D. (Wilmington, Ohio), Drug Trafficking
Manuel pleaded guilty April 27 to four counts of aggravated trafficking in drugs and a fourth-degree felony count of workers’ compensation fraud.

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. He also collected $12,068 from BWC for services he did not perform.

His sentencing is scheduled for May 24 in Highland County Common Pleas Court.

Rodney Alberino (Parma Heights, Ohio), Working and Receiving
Alberino was ordered to pay BWC $193,574 in restitution after pleading guilty April 26 to one count of workers’ compensation fraud, a fourth-degree felony. He was also ordered to serve two years of probation. BWC investigators discovered that Alberino had been working a variety of jobs for nearly seven years while collecting disability benefits.

Randall Abel (North Canton, Ohio), Working and Receiving
Abel 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. 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.

James Harris (Cleveland, Ohio), Working and Receiving
Harris pleaded guilty April 25 in Franklin County Common Pleas Court to one count of workers compensation fraud, a fifth-degree felony, after investigators found him working for a property management company while receiving BWC benefits. He was sentenced to three years of probation and ordered to pay BWC $10,498 in restitution.

Tina Valley (Akron, Ohio), False Claim
Valley pleaded guilty April 16 in Akron Municipal Court to workers’ compensation fraud, a first-degree misdemeanor, after filing a false injury claim. She claimed she was injured from a slip and a fall while working at a local fast food restaurant. Surveillance video from the business showed she never actually slipped and fell.

A judge gave Valley a six-month suspended jail sentence and ordered her to perform three days of community service and pay court costs and fines totaling $527.

Thomas Cannell (Northfield, Ohio), Working and Receiving
Cannell pleaded guilty April 11 in United States District Court to one count of theft of government property and one count of wire fraud after BWC and
federal investigators discovered he had been working for decades while collecting disability income from BWC and the Social Security Administration.

Cannell was ordered to pay restitution of $684,048 ($479,288 to Social Security and $204,761 to Ohio BWC).  A sentencing date has not yet been set.

Vincent Dombrow (Findlay, Ohio), Working and Receiving
Dombrow pleaded guilty April 9 in Franklin County Common Pleas Court to obstructing official business, a second-degree misdemeanor, after investigators found he had returned to work while collecting BWC benefits. A judge sentenced him to 90 days in jail, which was suspended after Dombrow paid restitution of $3,941.

Kenneth Gilmore (Cleveland, Ohio), False Claim
Gilmore pleaded guilty April 2 in Lorain County Common Pleas Court to multiple felony counts related to his attempts to fraudulently obtain prescription pain killers. A judge sentenced him to 30 months in jail and ordered he pay $6,075 in restitution BWC.

Investigators found Gilmore had submitted three false claims of work injuries at Cleveland-area hospitals between December 2013 and June 2014. He admitted to BWC that he filed the claims to obtain narcotics. 

Donna Steele (New Lebanon, Ohio), Working and Receiving
Steele pleaded guilty April 4 in Franklin Municipal Court to workers’ compensation fraud, a first-degree misdemeanor, after BWC found her running a babysitting business in her home while collecting disability benefits. She paid BWC $10,611 in restitution, plus a fine of $250 and court costs.

Kalyan Ravula, dba United Car Lot (Columbus, Ohio), No Coverage
Ravula pleaded guilty April 3 to one count of failure to comply, a second-degree misdemeanor, and was fined $100 after BWC found him operating a business without workers’ compensation coverage.

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

Ohio BWC secures five fraud-related convictions in March

April 20, 2018 Leave a comment

The Ohio Bureau of Workers’ Compensation secured five fraud-related convictions in March and restitution orders totaling more than $41,000.

Those convicted include a remodeling contractor, a babysitter and the owner of a Dayton drive-thru business, as well as a landscaper and a graphic artist. The following cases bring BWC’s total convictions this year to 12 as of March 31.

“Employers must have workers’ comp insurance to support injured workers in their time of need,” said Jim Wernecke, director of BWC’s special investigations department. “With these cases closed, we can put their premium dollars back to work caring for injured workers and promoting safety in every Ohio workplace.”

Scott Jones of Perrysburg, Ohio (Wood County), Working and Receiving
Jones was found guilty on March 21 of a first-degree misdemeanor count of workers’ compensation fraud after investigators found him remodeling bathrooms, convenience stores and performing other construction work while collecting BWC benefits.

A Franklin County judge ordered Jones to pay BWC $3,957 in restitution by Oct. 30 this year or face 45 days in jail. Jones paid $1,000 toward the restitution when he appeared in court.

 Sharrounda Fuller, Columbus, Ohio (Franklin County), Working and Receiving
Investigators discovered Fuller operating a day care out of her home while collecting workers’ compensation benefits from her self-insured employer. She pleaded guilty March 20 to a fifth-degree felony count of workers’ compensation fraud. She must pay $11,514 in restitution to her former employer, a home health care company, and serve five years of probation, according to her sentence in the Franklin County Court of Common Pleas.

Christine Niffa, dba Christy’s Drive Thru, Dayton, Ohio (Montgomery County), Lapsed Coverage
BWC discovered that Christy’s Drive Thru in Dayton had been operating with lapsed workers’ comp coverage since March 2013. After charges were filed, Niffa appeared in court March 8 and pleaded guilty to disorderly conduct, a minor misdemeanor. She paid BWC the balance due and her policy was reinstated.

Charles Parry

Charles Parry, Plain City, Ohio (Union County), Working and Receiving
BWC investigators found Parry operating a landscaping business for 10 months while receiving temporary total disability benefits. Parry pleaded guilty March 8 to one count of theft, a first-degree misdemeanor. He paid restitution of $6,527 to BWC and was sentenced to one day in jail, suspended for time served.

John Bezusko, Tacoma, Washington, Working and Receiving
Injured on the job in 1991, Bezusko pleaded guilty to workers’ compensation fraud March 5 after investigators found him working in Colorado while collecting BWC benefits. Bezusko must pay $19,530 in restitution to BWC and serve five years probation for the first-degree misdemeanor, according to his sentence in a Franklin County courtroom.

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

Northeast Ohio man charged in $684K work comp/Social Security fraud scheme

April 13, 2018 2 comments

Voicemail greeting exposes scheme

 

Thomas H. Cannell’s friendly voicemail greeting blew his cover, and now the fireplace salesman from northeast Ohio faces potential prison time and a bill for more than $684,000 for defrauding the Ohio Bureau of Workers’ Compensation (BWC) and the Social Security Administration for decades.

The 62-year-old Cannell, a resident of Northfield Village in Summit County, was charged with theft of government funds and wire fraud Wednesday in the United States District Court in Cleveland after BWC discovered him concealing work income since 1993 while collecting $204,761 in permanent total disability benefits from BWC and $479,288 in Supplemental Security Income from Social Security.

“One of our claims specialists returned a phone call from Mr. Cannell in 2015 and heard the voicemail greeting, ‘Hello, you have reached Tom at Your Fireplace Shop,’” said Jim Wernecke, director of BWC’s special investigations department. “We took it from there.”

Wernecke said Cannell concocted a scheme to avoid being paid directly by the Summit County business owner. He said the owner had no knowledge of anything illegal going on and cooperated fully with BWC and Social Security investigators.

Sentencing for Cannell has not yet been scheduled. According to the U.S. Attorney for the Northern District of Ohio’s office, the court will first review Cannell’s prior criminal record, if any, his role in the offense and other characteristics of the violation. In all federal cases, the sentence will not exceed the statutory maximum. In most cases, it will be less.

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

For Cleveland man, there’s something about workers’ comp fraud

April 13, 2018 2 comments

Habitual offender, already in prison, convicted for fifth time on fraud-related charges

Kenneth L. Gilmore doesn’t give up easily, even if the price means prison, probation and steep financial penalties.

After three previous convictions for crimes against the Ohio Bureau of Workers’ Compensation, the 54-year-old Cleveland man found himself in court again on April 2, where he pleaded guilty to workers’ compensation fraud and other felonies in connection with deceiving hospitals to obtain prescription painkillers.

“Mr. Gilmore filed a legitimate injury claim with us in 2001, but since then he’s filed several fake claims to obtain narcotics and have us pay for it,” said Jim Wernecke, director of BWC’s special investigation department.

Taking a break from the Lorain Correctional Institution, where he’s serving a 27-month sentence on similar charges in a federal case, Gilmore pleaded guilty last week in the Lorain County Court of Common Pleas to 10 felonies. They include three counts of forgery, a fifth-degree felony (F5), three counts of tampering with records (F3), two counts of deception to obtain dangerous drugs (F2), one count of workers’ compensation fraud (F5) and one count of theft (F5). He was sentenced to 30 months in jail, to be served concurrently with his federal sentence, and ordered to pay BWC $6,075 in restitution.

Gilmore’s previous BWC-related convictions occurred in 2003, 2008 and 2010. The most recent case stems from 2013 and 2014, when he filed false applications for injured-worker benefits at a hospital emergency department in Lorain and at another in Twinsburg in Summit County. The companies he listed as his employers later confirmed Gilmore never worked for them. Gilmore confessed as much when interviewed by BWC agents.

In the federal case, Gilmore posed as an injured U.S. Marshal in 2017 at a Cleveland hospital to obtain narcotics. He was convicted of one count of impersonating a peace officer and five counts of obtaining dangerous drugs by deception.

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

Day care owner guilty of work comp fraud

March 23, 2018 Leave a comment

BWC helps self-insured employer secure case

A Columbus day care owner and nursing assistant pleaded guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud after her former employer reported her to the Ohio Bureau of Workers’ Compensation (BWC) for the crime.

Sharrounda Fuller, 42, must pay $11,514 in restitution to her former employer, a home health care company, and serve five years of probation, according to her sentence in the Franklin County Court of Common Pleas.

“The employer is self-insured, so it was paying Ms. Fuller’s benefits out-of-pocket when it learned she had opened a day care center out of her home” said Jim Wernecke, director of BWC’s special investigations department. “After the company asked for our assistance in pursuing criminal charges, we discovered she also had worked for three other home health care businesses while collecting disability benefits.”

Wernecke said that while self-insured companies manage their own workers’ compensation programs, BWC will investigate alleged fraud cases on their behalf, because “workers’ comp fraud impacts all of us.”

“Workers’ comp benefits are for people who legitimately can’t work because they were injured on the job,” he said. “When people cheat the system, it just drives up the costs for all the honest stakeholders in the system.”

In other news, a northwest Ohio man who remodeled bathrooms, convenience stores and performed other construction work while collecting BWC benefits was found guilty Wednesday of a first-degree misdemeanor count of workers’ compensation fraud.

A Franklin County judge ordered Scott J. Jones of Perrysburg to pay BWC $3,957 in restitution by Oct. 30 this year or face 45 days in jail. Jones paid $1,000 toward the restitution Wednesday morning.

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

Ohio Safety Congress & Expo for 2018: Another complete success

March 16, 2018 Leave a comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

As part of our Special Investigations Department (SID) mission to effectively and proactively prevent losses to the workers’ compensation system and to deter, detect, investigate and prosecute workers’ compensation fraud, we recognize the importance of educating and informing our stakeholders about how they may join us to combat fraud.

That’s why we annually schedule and conduct dozens of fraud presentations to groups of internal and external stakeholders throughout the state.

On March 7 and 8, at the Ohio Safety Congress & Expo 2018, Shawn Fox, a SID special agent in charge, facilitated a workers’ compensation fraud presentation and Josh Grappy, a forensic computer specialist with the SID digital forensics unit, conducted a session on commercial uses, regulations and best practices for drones.

This annual event was another complete success. To a packed house, we shared techniques used to combat workers’ compensation fraud and to investigate safety violations. In the photo above SID Special Agent in Charge Shawn Fox walks attendees of a BWC Safety Congress & Expo through the steps he and his staff take when investigating a fraud allegation.

SID employees consistently promote fraud prevention strategies to stakeholders by means of social media, articles in periodicals, and presentations, such as participation in the annual Ohio Safety Congress & Expo, safety councils, MCOs and community-based organizations. These efforts educate, inform and build understanding of the BWC’s overall mission “to protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates.”

Since July 1, 2017, SID has conducted 51 fraud presentations describing and demonstrating how we accomplish our mission. Our SID employees share examples of successful cases and furnish all attendees with the means to detect and report suspected fraud.

We welcome requests for fraud presentations from all interested organizations. To schedule a fraud presentation, simply e-mail your request to Jeffrey.B.1@bwc.state.oh.us and we will promptly contact you to discuss your group’s event.

We hope you’ll contact us and look forward to meeting you soon!

For more details pertaining to our fraud prevention efforts, view our Annual Report here.

Graphic artist guilty of work comp fraud

March 16, 2018 Leave a comment

Former Ohioan found working in Colorado

A former Ohioan injured on the job in 1991 pleaded guilty to workers’ compensation fraud March 5 after investigators found him working in Colorado while collecting injured workers’ benefits from the Ohio Bureau of Workers’ Compensation (BWC).

John W. Bezusko, 50, must pay $19,530 in restitution to BWC and serve five years probation for the first-degree misdemeanor, according to his sentence March 5 in a Franklin County courtroom.

“We reviewed bank records, emails and other evidence showing Mr. Bezusko worked as a graphic designer for his home-based business while living in Grand Junction, Colorado,” said Jim Wernecke, director of BWC’s special investigations department (SID).

Also last week, a judge ordered Eric Payne of Hamilton, Ohio, to pay BWC $4,065 in restitution and serve two years probation after Payne pleaded guilty March 6 to a fifth-degree felony count of workers’ compensation fraud. The judge also warned Payne that if he violates his probation, he must serve 11 months in prison.

SID investigators found Payne working as a building inspector and a temporary laborer for a mobile home park while collecting more than $8,000 from BWC in 2015.

In other news, SID secured two fraud convictions in February.

Charles Malone, of Lancaster, pleaded guilty Feb. 12 to a first-degree misdemeanor count of workers’ compensation fraud after he was discovered working for a heating and air conditioning company while simultaneously collecting benefits. A Franklin County judge sentenced Malone to 180 days in jail, suspended for five years of community control (probation), under the condition that he maintains employment and pays $6,879 in restitution.

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

Central Ohio man convicted of work comp fraud

February 16, 2018 Leave a comment

Employment scheme implicates girlfriend

A Lancaster man must pay the Ohio Bureau of Workers’ Compensation nearly $7,000 in restitution after pleading guilty to workers’ compensation fraud Monday for a scheme that could land his girlfriend in court as well.

Charles Malone, 43, worked for a heating and air conditioning company for six months in 2016 while simultaneously collecting injured worker benefits from BWC. To hide his employment, he duped his employer into issuing his paychecks to his girlfriend in her name.

“He gave his employer a plausible explanation, and they fell for it,” said Jim Wernecke, director of BWC’s special investigations department. “As for the girlfriend, she could also face charges for her role in helping Mr. Malone defraud our agency.”

A judge in the Franklin County Court of Common Pleas sentenced Malone to 180 days in jail, the maximum for a first-degree misdemeanor. He then suspended the jail sentence for five years of community control (probation) under the condition that Malone maintains employment and pays BWC $6,879 in restitution.

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

BWC secures three convictions in January

February 9, 2018 Leave a comment

Two for work comp fraud, one for lapsed coverage

A funeral home worker and two cleaning company owners owe the Ohio Bureau of Workers’ Compensation $30,000 after pleading guilty to workers’ compensation fraud or related charges in January, the bureau’s first convictions of the new year.

“It’s thanks to honest citizens who report suspected fraud that we’re able to investigate many of our cases and stop this criminal activity in its tracks,” said Jim Wernecke, director of BWC’s special investigations department (SID). “The money we recover from people trying to cheat our system will go where it rightfully belongs — taking care of injured workers and helping employers create safer workplaces across this state.”

Those convicted include:

Oran Lewis of Columbus, Working and Receiving — Acting on a tip, investigators surveilled Lewis and uncovered evidence proving he worked for two funeral homes as a funeral procession escort on multiple occasions while collecting injured worker benefits from BWC.

Lewis pleaded guilty on Jan. 24 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 180 days in jail, which was suspended for one year of community control (probation). He must pay $10,442 in restitution to BWC.

Amanda Joy Klapp of Hudson, Ohio, dba Amanda Joy Cleaning Company LLC, Under Reporting Payroll — BWC’s employer fraud team received an anonymous allegation that Klapp was operating her business without workers’ compensation coverage. Agents discovered that Klapp had employees when she opened her business in 2013, but she didn’t secure BWC coverage until 2015. She then intentionally under-reported her payroll to avoid paying a higher premium. When she stopped paying her premiums and her policy lapsed, she attempted to take out a new policy using her husband’s name to avoid paying the balance owed on her original policy.

Klapp pleaded guilty Jan. 9 to three counts of workers’ compensation fraud, all first-degree misdemeanors, in Stow Municipal Court in Summit County. A judge sentenced her to 180 days in jail with 150 days suspended and ordered her to serve 30 days of house arrest. The judge fined Klapp $500 on each count, then suspended half the total. The judge ordered Klapp to bring her workers’ compensation coverage into compliance within 30 days and to pay $14,000 in restitution to BWC.

Robert Settlemoir of Columbus, dba Pro Clean Carpet and Upholstery, Lapsed Coverage — Investigators found Pro Clean Carpet and Upholstery had been operating since 2011 without workers’ compensation coverage. BWC attempted to work with Settlemoir to bring his policy into compliance, but Settlemoir failed to take the necessary steps.

Settlemoir pleaded guilty on Jan. 25 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, suspended for two years of community control. Conditions of community control are that Settlemoir obtain employment and pay restitution of $5,482 to BWC.

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

Working while receiving?

February 2, 2018 Leave a comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

Working while receiving benefits is one of the most common types of fraud our investigators uncover. In fiscal year 2017, 57 out of 133 criminal convictions were claimants working while receiving lost time benefits to which they were not entitled.

Working while receiving is one of the most obvious and flagrant abuses of the system. It is particularly regrettable since the claimants were, at one time, truly injured and entitled to workers’ compensation benefits.

We make every effort to ensure that each claimant knows the well-established rules. The fraud warning messages are clear, explicit and conspicuously placed on forms. For example, a fraud warning message (pictured below) appears on the BWC form to be signed by a claimant to request temporary total lost time benefits.

Fortunately, the vast majority of claimants return to work when they are able and notify BWC that they intend to do so. They understand and accept that their lost time benefits achieved their essential purpose – they provided compensation while the claimant temporarily could not work and was recuperating from an accident, illness or injury.

No matter how clever an individual may be, if he or she commits the crime of returning to work while receiving workers’ compensation benefits, the tell-tale signs remain. Rest assured, we are looking for, investigating, and prosecuting these cases. They will lose their lost time benefits and perhaps their freedom as well.

Funeral escort earns felony conviction for work comp fraud

January 26, 2018 Leave a comment

Judge shows little sympathy, orders $10K in restitution

A Columbus man injured in 2014 while working as a motorcycle escort for funeral processions must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $10,400 after pleading guilty to workers’ compensation fraud Wednesday in a Columbus courtroom.

Acting on a tip, BWC investigators conducted surveillance and collected evidence proving Oran Lewis, 66, worked for two different funeral homes in 2015 while collecting disability benefits from BWC.

“It doesn’t matter if you’re driving a vehicle or doing hard labor — it’s against the law to collect disability benefits from BWC when you’re also working and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “What’s more, we’re not talking about a one-time incident or occasional odd job here and there. We found Mr. Lewis performing this service 29 times between May and October of 2015.”

Lewis confessed to the crime and cooperated with BWC when he was approached by agents.

A Franklin County Court of Common Pleas judge also sentenced Lewis to 180 days in jail (suspended) and one year of probation for the fifth-degree felony.

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

Cleaning company owner soils record with fraud conviction

January 19, 2018 Leave a comment

Northeast Ohio woman to serve house arrest, pay $14K restitution

The owner of a Hudson, Ohio, cleaning business must serve 30 days under house arrest and pay $14,000 in restitution to the Ohio Bureau of Workers’ Compensation after pleading guilty to workers’ compensation fraud Jan. 9.

Amanda Joy Klapp, owner of Amanda Joy’s Cleaning Company, also must bring her BWC coverage into compliance within 30 days and pay $750 in fines.

“Our agents found Ms. Klapp trying to cheat BWC in a number of ways,” said Jim Wernecke, director of BWC’s special investigations department. “She had employees when she opened her business in 2013, but she didn’t secure BWC coverage until 2015. She then intentionally under-reported her payroll to avoid paying a higher premium. And when she stopped paying her premiums and her policy lapsed, she attempted to take out a new policy using her husband’s name to avoid paying the balance owed on her original policy.”

Appearing in Stow Municipal Court in Summit County, Klapp pleaded guilty to three first-degree misdemeanor counts of workers’ compensation fraud and was fined $500 on each count. The judge suspended half of the fines and 150 days of a 180-day jail sentence, ordering the remaining 30 days to be served under house arrest.

In other news, the bureau secured three fraud-related convictions in December, bringing the total number of convictions in calendar year 2017 to 130.

Eric Payne of Hamilton, Ohio, pleaded guilty Dec. 13, in the Franklin County Court of Common Pleas to a fifth-degree felony count of workers’ compensation fraud after BWC agents found him working as a home and building inspector while collecting $8,126 in temporary total disability between February and August 2015. Sentencing is scheduled for Jan. 23.

David Proffitt of Plain City, Ohio, pleaded guilty Dec. 12 to a first-degree misdemeanor count of workers’ compensation fraud after investigators found him working as a golf coach while collecting BWC benefits. A Franklin County judge declined to sentence Proffitt or order restitution.

Beth Amirault of Dublin, Ohio, dba A Place to Grow, pleaded guilty Dec. 5 to a second-degree misdemeanor count of failure to comply after investigators found she had been operating her child care center without work comp coverage since 2005. Amirault initially cooperated with BWC to bring her policy back into compliance, then failed to follow through on her reinstatement plan. A Franklin County judge sentenced her to 90 days in jail (suspended), two years of probation and ordered her to pay fines and court costs.

To report suspected workers’ compensation fraud, visit bwc.ohio.gov or call 1-800-644-6292 and select option “0”, then option “4”.

Five Northeast Ohioans convicted of work comp fraud

December 15, 2017 Leave a comment

Four claimants and one employer from northeast Ohio were sentenced in November for defrauding the Ohio Bureau of Workers’ Compensation (BWC).

The cases bring the year’s total convictions for BWC’s special investigations department (SID) to 121.

“BWC is in the business of caring for injured workers and promoting safe workplaces, not doling out thousands of dollars to cheaters,” said SID Director Jim Wernecke. “We’ll return these funds to where they belong and turn our attention to others working the system to avoid paying their share or to collect payments they don’t deserve.”

Among those convicted last month:

Geoffrey Cigany, of Chardon, Ohio, pleaded guilty Nov. 8 to a first-degree misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. An anonymous allegation led to an investigation that found Cigany worked as a handyman/carpenter for WC Gotts Holdings, Inc. while receiving benefits between March 2014 and September 2014. Cigany paid restitution in full in the amount of $8,499. A Franklin County judge ordered Cigany to pay a fine and waived court costs.

Harvey Short, dba ASAP Transport, of Garfield Heights, Ohio, was convicted Nov. 16 of a second-degree misdemeanor count of failure to comply for falsifying his workers’ compensation certificate of coverage. The certificate raised suspicion after Short provided it to a local company as proof of coverage because it showed a different policy number than the one he provided the prior year. Short admitted to falsifying the certificate and was ordered by a Garfield Heights Municipal Court judge to pay restitution of $150 and court fees.

Laitanya Dinkins, of Euclid, Ohio, pleaded guilty Nov. 2 to a first-degree misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. A database cross match with the Ohio Department of Job and Family Services tipped investigators off that Dinkins returned to work as a home health aide while receiving BWC benefits. A Franklin County judge sentenced Dinkins to 90 days in jail (suspended) and three years of community control. She was also ordered to pay restitution of $3,716.

Christopher Gattarello, of Lyndhurst, Ohio, pleaded guilty Nov. 22 to a fifth-degree felony count of workers’ compensation fraud for working while receiving benefits from BWC. The investigation began after a claims representative noted construction noise in the background during every phone conversation with Gattarello about his injury claim. Investigators found Gattarello, the owner of several Cleveland-area garbage-hauling companies, returned to work as a driver/heavy equipment operator. Gattarello was sentenced in a Franklin County courtroom to 186 days in jail with credit for time served. He was already serving 57-months in prison on federal charges of money laundering and violating the Clean Air Act. Read more about his case and view surveillance video here.

Timothy S. Lumsden, of Avon Lake, Ohio, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud for working while receiving BWC benefits. Acting on a tip in 2015, BWC investigators determined Lumsden had returned to work as an independent carpenter at the Federal Knitting Mills Building in Cleveland while collecting temporary total disability benefits. A Franklin County judge ordered Lumsden to pay BWC $5,385 in restitution. He also sentenced Lumsden to 11 months in jail (suspended) and community control for three years.

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

Ohio carpenter nailed for work comp fraud

December 8, 2017 Leave a comment

Pomeroy man one of two southeastern Ohioans convicted of fraud last week

A southeastern Ohio man must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $23,000 after investigators found him working several jobs while collecting injured worker’s benefits.

Ernest Shawn Baker, 45, of Pomeroy in Meigs County, also must serve five years of community control after pleading guilty to a fifth-degree felony count of workers’ compensation fraud Nov. 29 in the Franklin County Court of Common Pleas. His probation could terminate sooner upon full payment of $23,128 in restitution.

“We discovered that Mr. Baker went back to work as a carpenter soon after his injury in 2014, and he deliberately didn’t tell us,” said Jim Wernecke, director of BWC’s special investigations department. “We interviewed union officials and others and found he had worked for a dozen different employers while defrauding our agency.”

In another fraud case, an Athens County man on BWC benefits since 1997 has lost his benefits after investigators found him working again for cash under the table.

Mark McIntosh, 51, of Millfield, pleaded guilty Nov. 28 in a Franklin County courtroom to a first-degree misdemeanor count of workers’ compensation fraud. A judge fined McIntosh $100, then suspended it, and declined to order restitution because of McIntosh’s age and financial situation.

McIntosh worked as a log seller and chain saw operator when he was injured on the job in January 1997. Acting on a tip, BWC investigators found him overseeing a firewood processing plant and hauling firewood while concurrently receiving permanent total disability benefits.

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

Cleveland convict adds work comp fraud to criminal record

December 1, 2017 1 comment

State crimes followed 2015 conviction on several federal charges

A Cleveland garbage hauler and construction worker serving time in a federal prison for fraud, money laundering and violating the Clean Air Act pleaded guilty to workers’ compensation fraud last week.

Christopher Gattarello, 53, pleaded guilty Nov. 22 to a fifth-degree felony count of workers’ compensation fraud for working while receiving temporary disability benefits from the Ohio Bureau of Workers’ Compensation. A judge in the Franklin County Court of Common Pleas sentenced Gattarello to 186 days in jail with credit for time served.

“This was pretty easy detective work on our part, thanks to our customer claims staff,” said Jim Wernecke, director of BWC’s special investigations department. “Every time our claims representatives telephoned Gattarello about his injury claim, they could hear construction noise in the background. We simply followed up from there.”

Wernecke noted that Gattarello’s fraud against BWC started in March 2015, the same month he was convicted on the federal charges. BWC investigators determined Gattarello worked as a driver/heavy equipment operator through Aug. 16 that year and again from November 2015 through June 2016 while concurrently receiving BWC benefits.

Gattarello, the owner of several Cleveland-area garbage-hauling companies, was sentenced in June this year to 57-months in prison for ordering the 2012 demolition of the asbestos-laden National Acme Building in Cleveland’s Glenville neighborhood. Gattarello had been leasing the building and storing garbage there. The demolition released harmful toxins into the air near several homes and a school.

In a related case, Gattarello also was convicted in 2015 for conspiracy to commit wire fraud and money laundering for defrauding a Louisiana company out of nearly $1.2 million. He was accused of submitting false invoices for work his companies never performed, then using more than $12,000 of ill-gotten money to pay off his personal credit card.

Other news
In a separate BWC fraud case last week, another Cleveland-area man pleaded guilty to a fifth-degree felony count of workers’ compensation fraud for working while receiving BWC benefits.

A Franklin County judge on Nov. 22 ordered Timothy S. Lumsden, 50, of Avon Lake, to pay BWC $5,385 in restitution. He also sentenced Lumsden to 11 months in jail (suspended) and community control for three years.

Acting on a tip in 2015, BWC investigators determined Lumsden had returned to work as an independent carpenter at the Federal Knitting Mills Building in Cleveland while collecting temporary total disability benefits.

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

Thanks for your allegations, especially 34,634 calls to our Fraud Hotline!

November 24, 2017 Leave a comment

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In observance of Thanksgiving, we are giving thanks for the vigilance of everyday citizens and their willingness to detect and report suspected fraud committed against the Ohio workers’ compensation system.

We realize that such partnerships are necessary to achieve our fraud prevention goals. Since the creation of our Special Investigations Department (SID) in 1993, tens of thousands of our allegations have been furnished by external sources. Each and every reported allegation is entered by an agent into our secure database and reviewed. Effective this week, as a result of calls to our BWC Fraud Hotline, 34,634 allegations have helped us achieve over 1.7 billion in savings.

An investigative professional will promptly answer your call and conduct a brief and effective interview. These agents have years of investigative knowledge, skills and experience securing the essential information from sources like you. Whether your fraud hotline agent is Jake, Taylor, Karen, Connor, Jeff, or any of eight of our most experienced fraud analysts assigned to special investigations units (SIUs) statewide, you will know within seconds that you have reached a committed, successful professional.

Your fraud hotline agent will know and promptly secure the information needed by our teams of 125 SID employees. You do not need to have proven any facts; you do not even need to have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continue to occur. We will conduct the investigation and determine the facts. Your Fraud Hotline call initiates the process, and in as few as five minutes.

A suspicion can also be reported by means of any of the following: an “after hours” message to our Fraud Hotline voicemail 614.728.2617, online, an email to our secure BWC Allegations@bwc.state.oh.us account, the U.S. Postal Service or in-person at any BWC claims office. Calling the BWC Fraud Hotline is the most interactive and direct way that you, our partners in fraud prevention and detection, can help.

So, thank you for your 34,634 (and counting) calls to our Fraud Hotline! We are indeed thankful for each one.

What do you know about workers’ comp fraud? Our sleuths have questions – and answers!

November 17, 2017 Leave a comment

By Melissa Vince, BWC Public Relations Manager

We’ve had a great time talking workers’ comp fraud this International Fraud Awareness Week. We enjoyed sharing what we do to detect, deter and put a stop to workers’ compensation fraud in Ohio.

Our fraud investigators especially look forward to participating every year because they want to raise awareness and encourage tips from the public, but also because they truly enjoy what they do.

And we appreciate them because they do a great job. So, in honor of them, we let them take a little break to have some fun putting together this quiz challenging your knowledge of workers’ compensation fraud.

So, fire up that brain and let’s get started. Just flip your monitor over for the answers listed at the bottom.

Thanks for following us this week! We’ll be back next year for Fraud Awareness Week, but don’t go away because we’re here all year long on our blog, Twitter and Facebook.

  1. True or false?
    Fraud and abuse are the same.
  2. True or false?
    Proving fraud requires evidence of “knowledge and intent”
  3. True or false?
    Abuse can be criminally prosecuted under the law.
  4. BWC has teams focused on investigating the following types of fraud:
    a) Claimant
    b) Employer
    c) Medical provider
    d) All of the above
  5. Which is an example of fraud?
    a) Billing for services not rendered (a doctor bills for procedures not performed)
    b) Classifying full-time employees as independent contractors/subcontractors.
    c) A claimant performing physical activity outside of his or her restrictions
    d) All of the above
  6. What are the two most common fraud allegations our investigators receive related to medical providers?
    a) Billing for services not rendered (a doctor bills for procedures not performed)
    b) Unlicensed provider (not licensed to practice medicine in the State of Ohio)
    c) Unbundling (charging separately for bundled services)
    d) Upcoding (billing for a more expensive service than the one provided to the claimant)
  7. What is the most common fraud allegation our investigators receive related to employers?
    a) No coverage
    b) Lapsed coverage
    c) Falsified certificate of premium coverage
    d) Underreporting payroll
  8. What is the most common fraud allegation our investigators receive related to claimants?
    a) Physical activity (performing physical activity outside of his or her restrictions; malingering)
    b) Work/Comp (working while receiving lost time benefits)
    c) False claim (staged accidents; false injuries)
    d) Altered documents

 

It’s not easy being Green: Cleveland florist convicted of work comp fraud

November 17, 2017 Leave a comment

Green Thumb Florists owes BWC $32,000

The owner of a Cleveland flower shop owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $32,000 in restitution after pleading guilty to workers’ compensation fraud in late September.

Mary Green, the owner of Green Thumb Florists, was ordered to pay BWC $31,562, sentenced to five years of community control and fined $315 after pleading guilty Sept. 27 to one fourth-degree felony count of workers compensation fraud in the Cuyahoga County Court of Common Pleas.

Acting on a tip, agents with BWC’s special investigations department (SID) discovered Green had altered a BWC certificate to make it appear her business had proper workers compensation coverage, as required by state law. Agents also discovered her actual policy had been in lapsed status since 2011.

“Our agents made multiple site visits, witnessed multiple employees and put Mary Green on notice to bring her BWC policy into compliance with the law,” said SID Director Jim Wernecke. “But when she wouldn’t cooperate, we brought her case to the county prosecutor and now she has a felony on her record. It didn’t have to go this far. We really need employers to reach out to BWC if they’re struggling to pay their premiums.”

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

Suspect fraud? Call our Fraud Hotline!

November 14, 2017 6 comments

By Jeff Baker, Program Administrator, BWC Special Investigations Department

In recognition of International Fraud Awareness Week 2017, we are increasing awareness of fraud and the vigilance of everyday citizens to report suspected fraud committed against the Ohio workers’ compensation system.

A suspicion can be reported online, by email to our secure BWC Allegations@bwc.state.oh.us account, U.S. Postal Service or by calling our Fraud Hotline at 1-800-644-6292. Calling the BWC Fraud Hotline is the most interactive and direct way that you, our partners in fraud prevention and detection, can help.

We realize that such partnerships are necessary to achieve our fraud prevention goals. Since the creation of our Special Investigations Department (SID) in 1993, thousands of our closed, founded cases started with a call to our Fraud Hotline. For example, the conviction of Tim Tokles on August 30, 2017 was the result of just such a call.

You may suspect someone is working while receiving compensation, filed a false claim for an injury that did not happen or is committing another type of workers’ compensation fraud. Calling a fraud hotline may seem rather intimidating. We understand that it can be a nerve-wracking decision to make the call. The person you suspect of fraud could be a friend, a loved-one or even an immediate family member.

Above all, we realize the importance of personal security and safety to each caller.

When you call the SID Fraud Hotline, you will speak with a real person on the other end, one who is ready and willing to listen to your concerns and has years of investigative knowledge, skills and experience securing the essential information from sources like you. Whether your fraud hotline agent is Jake, Taylor, Karen, Connor, Jeff, or any of eight of our most experienced fraud analysts assigned to special investigations unit (SIUs) statewide, you will know within seconds that you have reached a committed, successful professional.

Your fraud hotline agent will know and promptly secure the information needed by our teams of 125 SID employees. Your identity will remain either anonymous or confidential, depending upon your preference. You do not need to have proven any facts; you do not even need to have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continue to occur. We will conduct the investigation and determine the facts.    

The entire process entails as few as five minutes. Nonetheless, collecting the right information from a caller requires our SID Fraud Hotline professionals to devote as much time as the caller’s unique allegation merits.

When calling, please provide the information you have, including:

  • The name and address (if known) of the subject you’re reporting;
  • A description of the suspect’s behavior; and
  • Any other information that might pertain to the suspected fraudulent activity.

It is through the vigilance of citizens like you, that we are combatting workers’ compensation fraud in Ohio.

 

In pursuit of fairness – #FraudWeek 2017

November 13, 2017 1 comment

By Jim Wernecke, Director, BWC Special Investigations Department

I have always appreciated the importance of fairness and integrity. I have used these virtues as a guide throughout my career, from early on when I supervised 15 employees at a small manufacturing company, to my 25 years with the Ohio State Highway Patrol and now as head of the Ohio Bureau of Workers’ Compensation’s Special Investigations Department.

I am privileged to lead 122 professionals who work to deter, detect and investigate workers’ compensation fraud in the state of Ohio. We pursue cases of claimant, medical provider and employer fraud.

What drives a claimant to file a false claim; an employer to purposely misclassify their workers; or a physician to fudge paperwork to secure higher service payments? We can debate the reasons, and they probably vary in each case, but my drive to halt wrongdoing comes from an appreciation for standards, rules and enforcement of the law that are conducted uniformly, fairly and systematically. In short, I want to know that others are following the same rules you and I follow.

It is easy to translate this philosophy into the world of workers’ compensation when you think about employer premiums, medical services and protection of our injured workers. Injured workers deserve a fair system that’s focused on their care and recovery. Employers want their competitors to play by the same rules, and they want assurance that any employee who attempts to gain undeserved benefits will be held accountable. And we all want truthful and professional physicians delivering our medical care.

These are among the many reasons I count fairness and integrity among the most important qualities you’ll find in a person. Treat people fairly, and treat them the way you want to be treated. Our integrity is on the line when we don’t accept the responsibility and tell the truth. Once trust is lost, it’s likely gone forever. I’m sure many of you feel the same.

We take great care to protect the dollars Ohio employers set aside to care for their injured workers. We’re not too shy to say we think we do a pretty good job, but we’re always seeking improvement. That’s why we enjoy taking part in International Fraud Awareness Week each year. We’re not only able to highlight our successes, but also engage and learn from our fraud-fighting peers across the country. This year will be no different.

Those of you who follow workers’ comp fraud in Ohio know we share our fraud news weekly on “Fraud Friday,” but we always take it to another level during IFAW. Please join us this week and all year long as we share new cases, tips for identifying and preventing fraud, insights from our investigators, and much more on our Facebook and Twitter pages.

Happy Fraud Awareness Week!

Fraud scheme doesn’t float for Ohio swimming pool business owner

November 3, 2017 2 comments

A Mansfield-area businessman must pay more than $33,000 in restitution to the Ohio Bureau of Workers’ Compensation for filing phony records and scheming to avoid his debt for past premiums.

Roger L. Graszl, the owner of Premier Gunite Unlimited Pools & Spas in Lexington, Ohio, also was sentenced to five years probation Wednesday in the Richland County Court of Common Pleas. The sentencing followed his guilty plea Sept. 13 to two third-degree felony counts of tampering with records.

“We discovered Mr. Graszl wasn’t carrying workers’ compensation insurance after one of his employees was injured and filed for benefits,” said Dan Fodor, assistant director of BWC’s special investigations department. “We tried multiple times to bring Mr. Graszl into compliance, but he failed to cooperate.”

Fodor said Graszl also tried several times to obtain a certificate of coverage from BWC using fictitious information on his application.

“He thought he could sneak in under our radar and obtain a certificate so he could continue to operate his business,” Fodor said. “Obviously, it didn’t work. It’s pretty hard to fool BWC and our agents.”

Ohio law requires businesses to carry workers’ compensation coverage.

Graszl owes BWC $27,516 for past premiums and $5,833 for the cost of the agency’s investigation.

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

Toledo woman convicted for taking late boyfriend’s work comp benefits

October 20, 2017 Leave a comment

Four others convicted in recent fraud cases

A Toledo woman who cashed her late boyfriend’s work comp benefits for more than a year after his death must reimburse the Ohio Bureau of Workers’ Compensation more than $18,000 or serve 10 months in prison, a Lucas County judge ruled Oct. 5.

The judge ordered Suzette Hedrick, 58, to reimburse BWC $18,576 and serve five years of probation after she pleaded guilty to attempted grand theft, a fifth-degree felony.

“Our investigation found that Ms. Hedrick deliberately withheld from BWC that her boyfriend had died, which enabled her to illicitly use his electronic benefits card for personal gain,” said Jim Wernecke, director of BWC’s special investigations department (SID). “We understand the financial hardship some people experience following the loss of a loved one, but that doesn’t diminish the seriousness of this crime.”

An internal claims specialist discovered last year that Hedrick’s boyfriend, who was on permanent total disability, had passed away on Oct. 3, 2015, but someone was still withdrawing his monthly benefits. The agency stopped paying benefits immediately. Hedrick admitted to agents that she used the card to pay her bills, and she accepted responsibility.

In other news:

  • Elizabeth Brown, of Groveport, Ohio, pleaded guilty Oct. 12 to one misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. Investigators discovered Brown had worked in customer service for four separate companies from September 2015 to January 2016 while on temporary disability benefits. After her plea, she reimbursed BWC $3,905.
  • Timothy Snedeker, of Newark, Ohio, was found guilty Oct. 3 of three misdemeanor counts of lapsed coverage for failing to carry workers’ compensation coverage on his business, Tim’s Tree Service. A Newark Municipal Court judge sentenced Snedeker to one year in prison, which he suspended for 90 days probation. Snedeker reimbursed BWC, and his business is now in active compliance.

    Theodore Skwarski, of Cleveland, Ohio, pleaded guilty Sept. 6 to unauthorized use of property/computer system, a second-degree misdemeanor, after BWC investigators found him operating Ted’s Auto Service without proper work comp coverage. A judge sentenced Skwarski to 90 days in jail (suspended), one year of community control and 20 hours of community service to be completed within the next six months. Skwarski told BWC he was no longer operating his business, but investigators discovered otherwise. He entered a payment plan and is currently operating with active coverage.

    Michael Humble, of London, Ohio, pleaded guilty Sept. 6 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working while receiving permanent total disability benefits. He was sentenced to one day of jail, which was suspended for the payment of $3,834 in restitution.

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

BWC fraud investigators secure 8 convictions in August

September 15, 2017 Leave a comment

Business owners, claimants and a healthcare provider who attempted to cheat the Ohio Bureau of Workers’ Compensation (BWC) are among eight convictions secured by the agency in August.

The cases bring the year’s total convictions for BWC’s special investigations department (SID) to 100.

“Employer premiums are set aside to care for Ohio’s injured workers,” said SID Director Jim Wernecke. “We’re holding employers, medical providers and injured workers who cheat the system accountable to protect those dollars for Ohioans who need assistance until they can return to work.”

Among those convicted last month:

Natoya Finley, dba Close to Home Child Development Center, of Cleveland, Ohio
Finley and Rebecca Barbee-Whitt, co-owner of the child care center, were operating the center without workers ‘compensation coverage. The pair ignored requests from BWC investigators to reinstate the policy. Finley entered into a payment plan July 24 after she was charged with four counts of failure to comply, all second-degree misdemeanors, in the Cleveland Municipal Court. She then withdrew her not guilty pleas and agreed to the Selective Intervention Program. She is required to report monthly compliance with the established payment plan. Barbee-Whitt has a warrant for her arrest for failure to appear on the charges.

Thomas N. Jung, dba Tom’s Industrial Truck Service, of Lima, Ohio
Jung pleaded guilty Aug. 4 in Lima Municipal Court to three counts of failure to comply, all second-degree misdemeanors. BWC’s Employer Fraud Team found Jung was operating his business, Tom’s Industrial Truck Service, with lapsed workers’ compensation coverage. Jung was previously investigated in 2012 for lapsed coverage and before bringing his policy into compliance. Jung’s sentencing is scheduled for Oct. 2. He will not receive jail time if he brings his policy into good standing prior to sentencing.

Mark J. Cothern of Danville, Ohio
Cothern pleaded guilty Aug. 11 in the Knox County Court of Common Pleas to a fifth-degree felony count of attempted workers’ compensation fraud.  BWC’s investigation, which involved surveillance and multiple undercover operations, found that Cothern had worked at the Scoreboard Drive-in performing various duties while receiving temporary total benefits. Cothern was sentenced to 180 days in jail, which was suspended for three years of community control, obtain and maintain full-time employment and repay restitution in the amount of $9,406.46.

Alfred Bowlson of Toledo, Ohio
Bowlson pleaded guilty Aug. 29 in the Franklin County Common Pleas Court to a fifth-degree felony count of workers’ compensation fraud. Bowlson reported wages for employment to the State of Ohio for his work as a maintenance person in various apartment complexes in the Toledo area while receiving BWC disability. He was also receiving vocational rehabilitation and indicated he was discouraged at being unemployed and unable to provide for his family. Bowlson was sentenced to non-reporting community control for five years and ordered to pay restitution of $18,501.46 to the BWC. He will serve 11 months in prison if he violates these terms.

Elton Rista, dba ED & R Dining Services, of Avon Lake, Ohio
Rista, owner and operator of Ed & R Dining Services, pleaded guilty to a second-degree misdemeanor count of failure to comply Aug. 18. BWC investigators found Rista was operating his business without workers’ compensation coverage between June 2011 and August 2015. A Lorain County Court of Common Pleas judge sentenced Rista to 90 days in jail (suspended) and two years of non-reporting community control. He must also pay restitution of $9,478, return to compliance with workers’ compensation laws, and pay court costs.

Shardette Nyarko of Columbus, Ohio
Nyarko pleaded guilty Aug. 1 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. BWC received an allegation that Nyarko may have filed false BWC claims. The investigation found Nyarko filed three false claims in order to receive BWC benefits. Nyarko filed the claims stating she was injured at work, when in fact, she was not employed at the time of the alleged injuries. A judge fined her $100, then suspended the fine.

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

Ohio man who kept on truckin’ convicted of workers’ comp fraud

September 8, 2017 Leave a comment

A Madison County truck driver who claimed he was permanently disabled from a work injury in 1999 pleaded guilty Wednesday to workers’ compensation fraud after investigators discovered him driving a truck again for another employer.

Michael Humble, 48, must pay $3,834 in restitution to the Ohio Bureau of Workers’ Compensation (BWC), according to his sentence Wednesday in a Franklin County courtroom. A judge also sentenced Humble to one day in jail, suspended, for the first-degree misdemeanor.

Acting on a tip, BWC’s special investigations department discovered Humble driving a truck in August 2015 for an exterior siding and roofing company while still collecting Permanent Total Disability (PTD) benefits.

Humble’s restitution is based on a time period that investigators proved he was working, not on total benefits received since his date of injury.

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

‘Blind’ man who drives, directs traffic, guilty of theft from workers’ comp agency

September 1, 2017 3 comments

Parking lot owner one of two Toledo cases in court this week

A Toledo-area man who claimed he was too visually impaired to work must pay the Ohio Bureau of Workers’ Compensation nearly $15,000 in restitution after investigators found him driving, parking cars and directing traffic at a parking facility he owns in downtown Toledo.

Tim Tokles, 60, of Holland, Ohio, must pay BWC $14,689 and serve five years probation after pleading guilty to a first-degree misdemeanor theft count Thursday in the Franklin County Court of Common Pleas.

“Mr. Tokles claimed he was permanently disabled from working due to an eye injury he suffered on the job, but our surveillance shows him working and performing multiple tasks that were inconsistent with his injury claim,” said Jim Wernecke, director of BWC’s special investigation department.

BWC’s investigation discovered Tokles operating his downtown lot outside his medical restrictions from June 19, 2012, until Aug. 31, 2013, while receiving permanent total disability benefits from BWC. When first approached by investigators, Tokles told them he couldn’t see, but they had just witnessed him driving his vehicle.

According to court records, Tokles’ disability claim includes restricted ability to read, use a computer and drive because of glare, depth perception, light sensitivity and discomfort in right eye. He also claims that several environmental conditions or elements irritate his eye, including air conditioning, cleaning materials, dust, air pollutants and wind.

In another fraud case out of Toledo this week, a maintenance man must pay BWC $18,501 in restitution and serve five years probation after investigators found him working at various apartment complexes in the Toledo area while collecting BWC benefits.

Alfred Bowlson, 44, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud on Wednesday in Franklin County. A judge warned that if Bowlson violates the terms of his probation, he will serve 11 months in prison.

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

Two Ohio restaurant owners convicted for cheating workers’ comp system

August 25, 2017 Leave a comment

Each owes BWC more than $9,400

The owner of a central Ohio restaurant must reimburse the Ohio Bureau of Workers’ Compensation (BWC) $9,406 after his former employer accused him of cheating the agency.

Mark J. Cothern, of Danville, Ohio, in Knox County, also must serve three years probation after pleading guilty Aug. 11 to one fifth-degree felony count of attempted workers’ compensation fraud in the Knox County Court of Common Pleas. Investigators found Cothern, who was injured while working for a Mount Vernon employer in 2014, was receiving BWC benefits while working at his restaurant in Danville, the Score-board Drive-in.

“We conducted multiple undercover and surveillance operations, which supported the allegation we received,” said Jim Wernecke, director of BWC’s special investigations department.

In other news, the owner of a northeast Ohio restaurant pleaded guilty Aug. 18 to a second-degree misdemeanor count of failure to comply after he refused to cooperate with BWC to reinstate his workers’ comp coverage.

Elton Rista must pay BWC for back premiums totaling $9,478 for operating his Avon Lake restaurant without workers’ compensation coverage from June 30, 2011 through Aug. 7, 2015. He was also sentenced to two years of community control.

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

BWC fraud investigators secure 6 convictions in July

August 18, 2017 Leave a comment

The Ohio Bureau of Workers’ Compensation secured seven convictions in July of employers and injured workers who attempted to cheat the agency.

The cases raise the year’s total convictions for BWC’s special investigations department (SID) to 90.

“Workers’ compensation fraud raises the cost of the system for everyone involved,” said SID Director Jim Wernecke. “I hope these latest convictions serve as a reminder to those attempting to steal from BWC: We have investigators all over the state. We will find you, bring you to justice and make you repay the funds you illicitly acquired.”

Those convicted last month include:

Robert Leonard of Niles, Ohio, and McMenamy’s LLC
A Trumbull County judge on July 31 found Leonard guilty of one misdemeanor count of attempted workers’ compensation fraud and his restaurant guilty of a fourth-degree felony count of workers’ compensation fraud. Leonard failed to comply with repeated attempts by BWC to reinstate lapsed coverage for his business, McMenamy’s LLC. Leonard paid full restitution to BWC in the amount of $13,224.

Donna Roethlisberger of Lima, Ohio
Roethlisberger, doing business as Complete Cleaning of NWO, pleaded guilty July 20 to two counts of tampering with records, both third-degree felonies, after investigators found she obtained BWC certificates of coverage under her employees’ names without their knowledge. Sentencing is scheduled for Aug. 30 in the Putnam County Court of Common Pleas.

Joseph Stewart of Titusville, Florida
Stewart pleaded guilty July 20 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found him assembling countertops, kitchen cabinets and a display case for a market in Toledo while collecting temporary total disability benefits. A judge ordered Stewart to serve five days in jail, five years of community control and to pay restitution of $4,160 to BWC.

Michael R. Strickland of Woodville, Ohio
Strickland pleaded guilty July 10 in Franklin County to one count of workers’ compensation fraud, a first-degree misdemeanor, after investigators found him delivering mail for a trucking company while collecting BWC benefits. Investigators say Strickland did not report his work activity until three months after he was off disability and had returned to work. He received no sentence.

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

Cleaning company owner soils record in workers’ comp scheme

August 11, 2017 Leave a comment

A northwest Ohio woman with lapsed workers’ compensation coverage pleaded guilty last month to felony charges of tampering with records after investigators found she obtained new coverage under her employees’ names to avoid paying her debt to the Ohio Bureau of Workers’ Compensation (BWC).

Donna Roethlisberger, owner of Complete Cleaning of Northwest Ohio, pleaded guilty to two third-degree felony counts of tampering on July 20 in the Putnam County Court of Common Pleas. Third-degree felonies carry a maximum penalty of five years in prison and a $10,000 fine.

BWC’s special investigations department (SID) opened its investigation of Roethlisberger after receiving an allegation from the Putnam County Sheriff’s Office advising it had received a complaint from a woman who used to work for Roethlisberger. The former employee told the sheriff’s office that after filing her taxes she was notified the state was not issuing her a refund because of the debt she owed BWC for her cleaning business. The woman advised she never owned a cleaning business.

BWC’s confirmed the employee’s allegation. In addition, investigators discovered Roethlisberger opened another BWC policy under a different employee’s name after she let the first fraudulent policy lapse. Roethlisberger confessed when confronted by investigators.

Ohio law requires employers to carry workers’ compensation coverage. Oftentimes, employers must produce a certificate of coverage when entering contracts with other businesses or government entities for their service.

“It’s disappointing to see employers concoct schemes like this to avoid their responsibilities under the law,” said SID Director Jim Wernecke. “We appreciate the challenges of running a business, but if an employer is falling behind on their BWC premiums, they need to call us and we’ll work with them. Cutting corners or trying to cheat the system will always cost them more in the long run.”

Roethlisberger’s sentencing is scheduled for Aug. 30.

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

Woman commits fraud seeking medical benefits through workers’ comp

August 4, 2017 Leave a comment

A Columbus woman pleaded guilty to workers’ compensation fraud this week after filing three false claims for medical benefits since 2012.

Shardette Nyarko, 36, pleaded guilty Tuesday to a first-degree misdemeanor charge of workers’ compensation fraud in the Franklin County Court of Common Pleas. A judge fined her $100, then suspended the fine.

Investigators with the Ohio Bureau of Workers’ Compensation discovered Nyarko’s false claims last year while conducting a routine review of disallowed injury claims. They found Nyarko filed a false claim in April 2016 and two in 2012. Nyarko stated in her claims that she was at work at the time of her injuries, but investigators determined she was not employed at the time she said she was injured.

When questioned by investigators, Nyarko explained that she needed medical treatment she could not afford.

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

Cheating BWC proves costly to workers, business owners

July 14, 2017 Leave a comment

A North Canton woman convicted in May of workers’ compensation fraud must reimburse the Ohio Bureau of Workers’ Compensation nearly $22,000 for collecting benefits while working as a home health aide for nearly two years.

A Franklin County judge on Wednesday also sentenced Diana S. Herrick to five years probation in lieu of an eight-month jail sentence for committing the fifth-degree felony. BWC’s Special Investigations Department (SID) found Herrick provided numerous activities for two individuals while claiming to be too injured to work, including household chores, meal preparation, cleaning and shopping.

“I cannot stress this message enough: Cheating BWC will only cost you more in the long run,” said SID director Jim Wernecke. “It could land you a significant financial debt and criminal record, as well as damage to your reputation and potential for future employment.”

On the same day in a different Franklin County courtroom, Michael Strickland of Sandusky County pleaded guilty to a misdemeanor count of workers’ compensation fraud after BWC found him delivering mail while collecting injured-worker benefits. He paid BWC $5,096 in restitution prior to his court appearance.

Ghandi Faraj

In other news, SID reported closing several criminal cases in June and one in May not previously publicized.

  • Ghandi Faraj of Lorain pleaded guilty June 30 to a first-degree misdemeanor of workers’ compensation fraud after BWC found him operating a Quizno’s restaurant without BWC coverage when one of his employees filed a claim for a workplace injury. A judge sentenced Faraj to two years of non-reporting probation and ordered him to pay BWC $10,487 in restitution and stay compliant with workers’ comp requirements.
  • Darrin Armstrong of Cincinnati pleaded guilty June 15 to a first-degree misdemeanor theft charge after SID found him using his wife’s BWC debit card multiple times after her death. The investigation found 62 transactions between December 2015 and February 2016 totaling over $4,400. A Hamilton County judge placed Armstrong on eleven months probation and ordered him to reimburse BWC $2,715.
  • Cindi Hackney of Columbus pleaded guilty June 13 to one count of failure to comply, a second-degree misdemeanor, after BWC found her operating her pizza restaurant without BWC coverage. She was ordered to pay a fine and court costs totaling $163. She also paid approximately $5,000 toward her BWC debt.
  • Richard Allison of Columbus pleaded guilty to a first-degree misdemeanor of workers’ compensation fraud after investigators found him working for five separate employers over 13 months while collecting BWC benefits. A judge on June 6 sentenced Allison to five years probation in lieu of a six-month jail term and ordered him to pay $5,149 in restitution to BWC.
  • Mohamad Awad of Toledo, doing business as Everlasting LLC, paid almost $1,000 toward his BWC balance before pleading guilty June 5 in a Toledo courtroom to failure to comply, a second-degree misdemeanor. BWC agents had previously made multiple attempts to bring Awad into workers’ compensation compliance but were unsuccessful.
  • Steve Makris of Canton paid BWC $23,943 in restitution after pleading guilty May 26 to a first-degree misdemeanor of workers’ compensation fraud. Investigators found Makris formed a new business, Eagle Industrial Painting, and collected a salary while receiving benefits from BWC.

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

Northeast Ohio man reports crime, gets arrested

June 30, 2017 Leave a comment

Stark County tree service owner convicted of work comp fraud

COLUMBUS — When James Glen Willis called police to report a theft from his vehicle in May, police made a quick arrest — of Willis himself.

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Willis, of Jackson Twp. in Stark County, apparently didn’t know there was a warrant out for his arrest for committing workers’ compensation fraud. He spent three days in jail and pleaded guilty to the first-degree misdemeanor on May 30 in the Stark County Court of Common Pleas. A judge ordered him to two years of good behavior in lieu of a 180-day jail sentence and gave him credit for three days served.

“Who knows when Mr. Willis would have faced justice had someone not broken into his truck,” said Jim Wernecke, director of BWC’s Special Investigation Department. “Not that I’m glad a crime occurred, but the warrant for his arrest was issued a year ago following his indictment by a Stark County grand jury.”

Willis, 47, is the owner of G and D Tree Service. BWC agents started looking at him in 2013 while investigating one of his employees for workers’ comp fraud. They found Willis’s BWC coverage had lapsed in March that year but he continued to operate without coverage. Willis admitted to having one part-time employee, while BWC surveillance discovered a regular crew of four to six employees.

Willis has since paid BWC $8,000 toward the balance he owes the agency.

In other fraud news, a former Toledo man convicted in May for stealing from BWC was sentenced June 23 to three years of community control in lieu of a 10-month jail sentence.

Herbert Christopher, who pleaded guilty May 4 to fifth-degree felony theft charge, also must pay BWC $32,752 in restitution in monthly payments of at least $200. BWC agents found Christopher working as a home inspector in Tennessee while receiving BWC benefits.

“Our Special Investigations Department is here to ensure our workers’ compensation system is as strong, fair and honest as it can be,” said Wernecke. “Anyone who cheats the system is just raising the costs for everyone else and taking resources needed by those who legitimately need it.”

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

BWC secures 11 convictions in May

June 16, 2017 Leave a comment

Ohioans convicted in May of workers’ compensation fraud and related charges include a Cleveland-area man serving time in a federal prison on corruption charges, a former Toledo man working as a home inspector in Tennessee and two men who claimed to be permanently disabled but were earning tens of thousands of dollars working for themselves.

“These cases demonstrate our resolve to stop workers’ compensation fraud and protect the State Insurance Fund,” said BWC Administrator/CEO Sarah Morrison. “Whether you’re in prison or working in another state, we will find you, we will prosecute you and we will recover the funds you improperly acquired so they can be used for those who are legitimately injured on the job.”

As of May 31, BWC’s Special Investigations Department had secured 64 convictions this year on charges related to cheating the workers’ compensation system. Starting with the most recent convictions, May’s cases include:

Richard Claffey of Columbus, Working and Receiving
Claffey pleaded guilty on May 31 to a fifth-degree felony charge of workers’ compensation fraud after investigators found he had collected and sold 46 tons of scrap metal during a time he purported to be disabled.  He was sentenced to five years of community control and ordered to pay $35,000 in restitution to BWC.

Abdikani Diini, dba Aarans Business Center, of Columbus, No Coverage
Diini pleaded guilty May 25 to one count of failure to comply, a second-degree misdemeanor, after investigators found his policy had lapsed shortly after he worked with BWC to reinstate it.

A judge ordered Diini to pay the full balance owed to BWC, $1,021.

Daniel McClellan of the village of Coalton, Working and Receiving
McClellan pleaded guilty May 24 to a first-degree misdemeanor charge of workers’ compensation fraud after BWC investigators found him working multiple jobs while collecting temporary disability benefits for a workplace injury he suffered as a roofer in 2009. A judge ordered McClellan to pay BWC $11,875 in restitution and $4,000 for the cost of its investigation.

Jimmie Rankin of Marion, Working and Receiving
Rankin owes BWC $160,000 after pleading guilty May 17 to a fourth-degree felony charge of workers’ compensation fraud. Rankin, who claimed to be permanently disabled, 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.

Fernando Cruz of Maineville, Working and Receiving
Cruz claimed to be permanently disabled from work while earning more than $100,000 preparing tax returns. He owes BWC nearly $57,000 in restitution after pleading guilty May 12 to a fifth-degree felony conviction for workers’ compensation fraud. A judge also sentenced him to five years of community control.

Herbert Christopher of Shelbyville, Tennessee, Working and Receiving
Christopher, formerly of Toledo, pleaded guilty May 4 in the Franklin County Court of Common Pleas to one count of theft, a fifth-degree felony, after investigators found him working as a home inspector in Tennessee. Sentencing is scheduled for June 23.

Leon Watson of Toledo, dba Leon and Terry Enterprise, Lapsed Coverage
Watson pleaded guilty May 4 to a minor misdemeanor count of failure to comply and was ordered to pay $99 in court costs. Watson made payments totaling $4,481 to the Ohio Attorney General’s office, resolving the balance due on his BWC policy and resulting in the reinstatement of the policy.

Diane Herrick of North Canton, Working and Receiving
Herrick pleaded guilty May 2 to one count of workers’ compensation fraud, a fifth-degree felony, after investigators found her working as a home health aide while receiving BWC benefits. The investigation found Herrick collecting nearly $22,000 while providing numerous activities for two individuals, including household chores, meal preparation, cleaning and shopping. A restitution hearing has been set for June 28.

Kandice Klink Jones of Columbus, Working and Receiving
Jones pleaded guilty May 1 to a fifth-degree count of workers’ compensation fraud after investigators found her working for four separate employers while collecting BWC benefits. She was ordered to pay BWC $12,938 in restitution and sentenced to five years of community control.

James Todt of Brecksville, Working and Receiving
Already serving time in prison on corruption charges, Todt pleaded guilty May 1 to a fifth-degree felony count of workers’ compensation fraud after investigators found he had collected $33,400 from BWC while working in the construction industry. He was sentenced to nine months in prison, to be served concurrently with his current sentence.

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

Bar owner ignores BWC debt, then pays after liquor agents raid bar

June 9, 2017 Leave a comment

Southwest Ohio man guilty of ‘failure to comply’

A Hamilton bar owner who refused to cooperate with the Ohio Bureau of Workers’ Compensation (BWC) over his lapsed coverage entered a repayment plan with BWC after state liquor control agents raided his bar in early April and seized cash and liquor.

The workers’ compensation coverage for Alleys on the River in Hamilton is now active and in compliance, but owner Michael E. Larkin, 53, has a criminal conviction on his record now after pleading guilty May 31 to a second-degree misdemeanor count of failure to comply. A Hamilton municipal judge fined him $150, sentenced him to two years of community control and ordered that $1,000 of the cash seized in the raid be applied to his BWC debt.

“We made several attempts to help Mr. Larkin bring his lapsed BWC policy into compliance, but he wouldn’t work with us. He didn’t even show up in court for his arraignment after we pressed charges,” said Dan Fodor, assistant director of BWC’s Special Investigations Department (SID). “We subsequently referred his case to the Ohio Liquor Control Commission because he wasn’t meeting his obligation to his employees to carry workers’ comp coverage, which is required by state law.”

The commission suspended Alleys’ liquor license in May 2016, but agents with the Ohio Investigative Unit raided the business on April 6 this year after learning it was still selling alcohol. Agents seized $2,600 in liquor proceeds and nearly 1,500 bottles and cans of beer and liquor. Larkin started his payment plan with BWC the next day, and he has since regained his liquor license.

Fodor said this case illustrates the importance of employers working with BWC to resolve their compliance issues, rather than ignoring them altogether.

“Our employer fraud team actively investigates those that try to cheat the system,” he said. “BWC offers a number of programs that could potentially lower an employer’s premiums. They just need to call and work with us, because ignoring or defying their obligations will only cost them more in the long run.”

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

Metal scrapper, business owner guilty of work comp fraud

June 2, 2017 Leave a comment

A Columbus man on disability benefits for a workplace injury must reimburse the Ohio Bureau of Workers’ Compensation (BWC) $35,000 after investigators found him collecting and selling 46 tons of scrap metal during a time he purported to be disabled.

Richard Claffey, 53, pleaded guilty Wednesday to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas. In addition to restitution, he must serve five years of community control in lieu of six months in prison.

“An anonymous source told us Mr. Claffey was ‘junking’ everyday, picking up refrigerators and stoves and driving through alleys every evening to collect metal and sell it to local scrap yards,” said Jim Wernecke, director of BWC’s Special Investigations Department (SID). “Some might call ‘junking’ more of a hobby than a profession, but we found Mr. Claffey made a living from these efforts, which disqualified him from receiving BWC benefits.”

Claffey suffered a workplace injury in 2010 while working for a landscaping company.

In other fraud news, a Carroll County business owner with lapsed BWC coverage pleaded guilty to workers’ comp fraud after failing to bring his business into compliance despite multiple efforts by BWC staff to help him do so. Investigators found the owner even changed the name of his business and applied for new coverage to avoid paying his BWC debt.

Warren Kelm, owner of Augering Technologies/Coal Auger Pro Inc.,  pleaded guilty to the first-degree misdemeanor April 20 and paid $14,515 toward the balance he owes to BWC.

“We appreciate the financial challenges of running a business, but if an employer is falling behind on their BWC premiums, they need to call us and we’ll work with them,” said SID Director Wernecke. “Cutting corners or trying to cheat the system will always cost them more in the long run.”

Kelm is now operating with proper coverage. A judge sentenced him to three years of community control in lieu of six months in jail.

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

Fraud conviction costs construction worker $16K

May 26, 2017 Leave a comment

A Jackson County man owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $16,000 after pleading guilty to fraud Wednesday in a Franklin County courtroom.

Daniel McClellan, 36, pleaded guilty to a first-degree misdemeanor charge of workers’ compensation fraud after BWC investigators found him working multiple jobs while collecting temporary disability benefits for a workplace injury he suffered as a roofer in 2009. A judge ordered McClellan to pay BWC $11,875 in restitution and $4,000 for the cost of its investigation.

“Mr. McClellan was not supposed to be working and earning income while receiving these benefits, but we discovered he had been working in construction and other trades as far back as 2012,” said Jim Wernecke, director of BWC’s Special Investigations Department.

McClellan, who lives in the village of Coalton 70 miles southeast of Columbus, was also sentenced to a year of community control in lieu of six months in jail.

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

Construction worker’s fraud scheme collapses

May 19, 2017 Leave a comment

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

May 19, 2017 Leave a comment

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.

Federal prisoner adds workers’ comp fraud to record

May 5, 2017 Leave a comment

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.