The efforts of several individuals to defraud Ohio’s workers compensation system recently came up dry.
Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer recently reported eight individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers compensation system in November.
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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.
“The actions of these individuals are all illegal and our special investigations department is doing an outstanding job of conducting investigations to return dollars to the State Insurance Fund,” said Buehrer.
Following is a sampling of the cases that resulted in a guilty plea or conviction during November:
Mark Owens (Warren, Trumbull County) pleaded guilty Nov. 18 in the Franklin County Court of Common Pleas to a misdemeanor count of theft for working while receiving benefits. SID opened the case against Owens after performing a cross match with the Ohio Department of Job and Family Services that indicated he was possibly working while receiving temporary total disability benefits. Agents obtained employment records and found that Owens returned to work on a regular basis for a temporary agency as a general laborer from January 2011 through March 2012. Owens was sentenced to 38 days in jail, given credit for the eight days he already served, and the remaining time was suspended for three years of community control. As a condition of community control, Owens was ordered to pay $6,121.59 in restitution to BWC. He paid $800 at sentencing to begin his repayment.
Timothy Hunter (Columbus, Franklin County) pleaded guilty Nov. 20 to one misdemeanor count of workers comp fraud for working while receiving benefits. SID performed a cross match with the Ohio Department of Job and Family Services that indicated Hunter had received wages from The Kroger Company during the same period he received temporary total benefits from BWC. The investigation found Hunter knowingly worked for The Kroger Company during the same period he received benefits and failed to notify BWC or his physician of his employment. Hunter was sentenced to 30 days in jail suspended for six months of community control. He must also pay restitution in the amount of $2,088.
Michael Bassinger, dba Freight Lease Inc., (Elida, Allen County) was convicted of one count of failure to comply for operating his business without the required workers comp insurance coverage. SID opened the case after BWC’s employer compliance department tried multiple attempts to assist Bassinger with bringing his policy into compliance. Investigators interviewed Bassinger, who stated he knew he was in violation of state law and wished to get back into compliance. Bassinger submitted payroll reports and made a few sporadic payments, but never entered into a payment plan that would allow reinstatement of his policy. The case was referred to the Lima Municipal Court. Bassinger testified that he agreed to a payment plan with the Ohio Attorney General’s Office to reinstate his policy. He presented a copy a treasurer’s check in the amount of $50,000 to be used as a down payment, followed by $2,500 monthly payments. Bassinger was convicted of a misdemeanor count of failure to comply, fined $150 plus court costs and ordered to comply with his established payment plan. Judge Workman advised Bassinger that he would lose his freedom if he did not comply with the sentencing.
John Monday AKA John Turner (Cincinnati, Hamilton County) pleaded guilty in the Franklin County Court of Common Pleas Nov. 5 after he was found working as a janitor while receiving benefits, a job he got using a fake ID. SID learned that Monday, under his alias of John Turner, sought after hour’s treatment for pain from a physician at the Spine Institute, where he worked as a janitor. He told this physician that he already had a physician who treated him for injuries related to a previous workers comp claim. Monday then stated his intention to change physicians and supplied his medical records to the physician who treated him after hours. Monday later realized the records were under his real name, John Monday, and asked the office not to file the most recent visit with BWC because he was not supposed to be working. SID later learned that Monday worked as a janitor at the Cincinnati Spine Institute since 1990 while receiving permanent total disability and disabled workers’ relief fund benefits. Monday used an Ohio driver’s license and a state Identification card under the name John Turner in order to obtain employment at the Spine Institute while on workers comp. Monday was found guilty of one felony count of workers comp fraud and the judge proceeded immediately to sentencing. Monday was ordered to pay restitution of $105,169.23, in addition to court costs and $3,692.84 for investigative costs. He was also placed on community control for five years under the conditions that he has no new convictions, and establishes an income within 60 days. If Monday violates the terms of his community control, he will serve 18 months in prison.
Elvin Hamilton (Dayton, Montgomery County) pleaded guilty to one felony count of workers comp fraud on Nov. 22 in Franklin County Common Pleas Court for working while receiving benefits. SID initiated an investigation after receiving an allegation from a BWC claims service specialist that Hamilton may have a photography business. The investigation found Hamilton was operating Hamilton Photography taking pictures for companies, athletic organizations, government entities and private individuals while he concurrently received temporary total benefits between July 2010 and March 2013. Agents conducted surveillance and undercover operations resulting in video evidence of Hamilton’s activities. The judge placed Hamilton on community control for five years, conditions are that he obtain/maintain employment and have no new convictions. Hamilton was ordered to pay restitution of $63,196.35 to the BWC and transferred his supervision to Greene County. If Hamilton violates the terms of his community control, he will serve six months at a State prison.
Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com. Contact: [email protected].
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