Ohio BWC Reports Convictions for Workers Comp Fraud

8 Individuals Convicted of Charges

Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer recently announced eight individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers compensation system during September.

The court actions are the result of investigations conducted by BWC’s special investigations department (SID). The department works to deter, detect, investigate and prosecute workers comp fraud.

“These cases represent two common types of fraud cases we see: employers that don’t maintain the proper workers comp coverage and injured workers obtaining employment in conflict with their benefits,” said Buehrer. “Regardless, Ohio employers and their workers should know that cases that involve any apparent fraud will be taken very seriously by our investigators – and perpetrators will be punished.”

Summary of Cases:

Lisa Hart, dba Emergency Pet Clinic, (Bedford Heights, Cuyahoga County) pleaded guilty to three felony counts of fraud for failing to obtain workers compensation insurance coverage. Hart is the owner and operator of the Emergency Pet Clinic. She purchased the business in December 1996 but never completed the BWC paperwork indicating she had made the purchase. The BWC policy lapsed in September 2003 when Hart failed to file the BWC payroll report for the first half of 2003 and pay the associated premium. BWC’s employer compliance department made multiple unsuccessful attempts to bring the business back into compliance. The department referred the case to SID’s employer fraud team. Agents attempted to interview Hart, but she either canceled meetings or did not respond. Interviews with current and former employees of the business confirmed Hart did hire employees, and some of those employees had filed injury claims during the time period the policy was lapsed. Hart was sentenced Sept. 24 to one year incarceration suspended for five years of probation. Terms of her probation include making restitution in the amount of $21,023.27, including $2,000 for investigative costs and cooperating with a BWC audit.

Mark Knose (Cincinnati, Hamilton County) pleaded guilty to one felony count of workers compensation fraud for working while receiving benefits. SID received an allegation from a third-party administrator indicating Knose may be coaching baseball. The investigation found that Ross Local Schools employed Knose as a varsity pitching coach and that the Champions of Baseball Academy in Milford employed him as a coach and scout. Both organizations employed Knose while he received temporary total compensation. Knose entered his guilty plea Sept. 19. He is scheduled for sentencing in this month in the Hamilton County Court of Common Pleas.

Michael Myers (Goshen, Clermont County) pleaded guilty in the Clermont County Court of Common Pleas to one felony count of workers compensation fraud for drug trafficking. The Clermont County narcotics task force contacted SID and informed it that Myers may be selling narcotics that BWC paid for as a result of his workplace injury claim. SID worked with the drug task force and had an informant purchase several pills, later identified as prescribed to Myers and paid for by BWC. Myers pleaded guilty Sept. 7 and was placed on probation. He must also pay court costs.

December Combs (Bellefontaine, Logan County) pleaded no contest in Bellefontaine Municipal Court Sept. 11 to charges related to fraudulently creating an online account to access her ex-husband’s claim information. SID received an allegation that Combs assumed her ex-husband’s identity to obtain information for use at child custody hearings. SID found that accusation to be true. Combs must pay a $150 fine.

Albert Harr (Tallmadge, Summit County) pleaded guilty to one count of attempted theft and one count of attempted workers compensation fraud, both misdemeanors, for failing to report wages. Harr, a highway contractor for the United States Postal Service (USPS), came under investigation by a special task force to address a trend among contractors of failing to maintain workers’ compensation coverage despite receiving funds from the USPS to purchase coverage. Investigators found that Harr hired an employee to help him operate the route driver but failed to report the employee to BWC. However, he did request and receive reimbursement from the USPS for the additional workers’ compensation costs associated with the new employee. Simply put, Harr pocketed the money instead of using it to purchase coverage with BWC. Harr was sentenced Sept. 20 to one year of probation and ordered to repay restitution in the amount of $2,237.65.

Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher www.reduceyourworkerscomp.com. Contact: [email protected].