The effort to continuously crack down on workers compensation fraud suspects in the Buckeye State saw more positive results in May.
Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer recently announced that 14 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers comp system in May 2014. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID), which works to deter, detect, investigate and prosecute workers compensation fraud.
“BWC is committed to carefully managing the money employers pay in premiums to protect their workforce,” said Buehrer. “Putting an end to fraud and prosecuting those who break the law helps protect those employer dollars and ensure they’re available to support Ohio’s injured workers in their time of need.”
The following case information represents a sampling of cases that resulted in guilty pleas or convictions during May:
Gerald Whitacre (Upper Sandusky, Wyandot County) pleaded guilty May 15 in Franklin County Court of Common Pleas to one felony count of workers comp fraud for falsifying wage statements. After conducting an employer audit, a BWC employer service specialist reported a suspicion that Whitacre may have falsified wage statements from a trucking company in Upper Sandusky to obtain increased workers’ compensation benefits. Investigators found that Whitacre altered his pay stubs to lower dollar amounts and submitted them to BWC to qualify for working wage loss disability benefits. He underreported his payroll to BWC on 41 wage statements, and if he had accurately reported his earnings, he would not have been entitled to the benefits he received. Whitacre was sentenced to 12 months of incarceration, suspended for five years of community control. Conditions of Whitacre’s community control include paying $22,468.81 in restitution to BWC, obtaining viable employment, paying court costs and not having any new convictions. If he violates the terms of community control, Whitacre will serve 12 months of incarceration.
Garry Frederick, dba Top Notch Diner (Cortland, Trumbull County) pleaded no contest May 7 to charges related to a dishonored check for his premiums payment. Frederick, owner of Topnotch Diner, was convicted in 2010 for attempting to pass a bad check to BWC for a premium payment of his company. In March 2011, Frederick reinstated his coverage; however, it lapsed in September 2011 after Frederick submitted another check to BWC that was returned due to non-sufficient funds. Frederick subsequently submitted two additional checks to the BWC that were returned due to non-sufficient funds. Topnotch Diner continued to operate without workers comp coverage. Agents met with Frederick on multiple occasions and attempted to have Frederick repay the dishonored payments. However, Frederick failed to comply and make payment. Frederick was ordered to pay the fine and court costs for each of the three misdemeanor counts. He entered a payment plan with Attorney General’s Office.
Sean Merritt (Cincinnati, Hamilton County) pleaded guilty May 27 in the Franklin County Court of Common Pleas to one misdemeanor count of workers comp fraud for working while receiving benefits. SID initiated an investigation after identifying that Merritt had employment wages reported to another state agency during a period he was receiving BWC disability benefits. The investigation found that Merritt returned to work at My Brother’s Keeper, Therapeutic Home for Youth, Inc. in Cincinnati as a caretaker while collecting temporary total disability from a work related injury. Merritt was sentenced to pay $6,789.07 in restitution, which he had already paid prior to the court date. The judge also sentenced Merritt to one day in jail, which was suspended for time served.
Tina Contini (Wapakoneta, Auglaize County) pleaded guilty May 6 in the Franklin County Court of Common Pleas to one misdemeanor count of workers comp fraud for working while receiving benefits. SID identified through a state agency cross match that wages were being reported for Contini while she was collecting temporary total disability benefits. The investigation found Contini returned to work as a sales manager at MT Business Technologies, Inc., an office equipment company. Contini was sentenced to 60 days, suspended for 24 months of community control. The judge also ordered Contini to pay restitution of $4,496.34 to BWC, as well as court costs. The court ordered non-reporting probation that will be terminated upon payment of restitution in full.
Tameka Hines (Dayton, Montgomery County) pleaded guilty May 8 in the Franklin County Court of Common Pleas to a misdemeanor count of attempted workers comp fraud for working while receiving benefits. SID received an allegation that Hines may be working. The investigation found that Hines returned to work as an independent contractor for Hooper Holmes, performing physical examinations for life insurance policy applicants. She worked between December 2012 and February 2013 while collecting temporary total disability from BWC. Hines has settled her claim and restitution of $4,949.11 has been recouped. The judge also fined Hines $250 and ordered her to pay court costs.
Randy Hartman (Rudolph, Wood County) pleaded guilty May 19 in the Franklin County Court of Common Pleas to one misdemeanor count of workers comp fraud for submitting false wage statements. SID received an internal allegation after a BWC representative noticed Hartman was not submitting paystubs with his wage statements in order to obtain disability benefits. The investigation found that Hartman submitted false wage loss statements to BWC to obtain living maintenance wage loss benefits. Hartman was fired from his legitimate job but continued to submit 22 wage statements to BWC in order to conceal he was no longer employed with Downtown Sports Bar and Grill in Bowling Green. Hartman was sentenced to 150 days in jail, suspended for two years of community control. Hartman was ordered to pay restitution to BWC in the amount of $4,682.84 and obtain no new convictions.
Michael Madigan (Wintersville, Jefferson County) pleaded guilty May 8 in Franklin County Municipal Court to a misdemeanor count of workers comp fraud, for working while receiving benefits. SID received an allegation that Madigan was operating a firearms business while receiving multiple types of benefits from the BWC. Investigators reviewed the bank records of the firearms business. Activity in the account showed sales of firearms and some checks were written directly to Madigan. An audit report of the business indicated that Madigan was the primary person selling the firearms. The investigation conducted by the SIU confirmed that Madigan knowingly owned and operated the business, and earned income while he was receiving benefits from the BWC. Madigan was ordered to pay $14,801.78 in restitution to the BWC, and court costs.
Rita Lynch (Strongsville, Cuyahoga County) pleaded guilty May 21 to a misdemeanor count of theft for working while receiving benefits. SID received an allegation that BWC’s Cleveland Service Office had received numerous telephone calls stating that a claimant, Rita Lynch, was listing BWC as her employer on credit applications. Lynch stated to agents that she had reported BWC as her source of income when applying for credit, but had not represented herself as an employee. Prior to the interview of Lynch, agents discovered that Lynch worked as a Telemarketer for Dial America. Lynch initially denied working but when confronted, acknowledged she returned to work while receiving Living Maintenance Benefits. Records confirmed Lynch, who was working closely with rehabilitation case managers, provided a false return-to-work date to BWC and repeatedly failed to advise her case managers that she had already returned to work. Lynch was sentenced to 180 days in prison, gave her credit for 10 days she already served, and suspended the balance for a term of five years of community control. As a condition of her community control, Lynch is to repay the BWC $4,854 in restitution.
Ronald G. Larlham, dba RGS Automotive (Ravenna, Portage County) pleaded guilty May 12 in Ravenna Municipal Court to one misdemeanor count of workers comp fraud for operating his business with lapsed coverage. BWC’s Compliance Department found that Ronald G. Larlham, was operating his Portage County business (RGS Automotive) while its BWC coverage had lapsed. The case was referred to the Employer Fraud team after Larlham failed to work with the BWC Compliance Department to bring his policy back into compliance. Agents made several attempts to work with Larlham in order to bring his business into compliance with state law; however, Larlham failed to comply with BWC’s requests. Larlham was sentenced to 180 days in jail with 179 day suspended and credit for one day served and was ordered to pay restitution to the BWC for $3,503.14 which is to be monitored by the Adult Probation Department and paid through the Office of the Ohio Attorney General.
Valencia R. Daniels (Columbus, Franklin County) pleaded guilty May 8 to a misdemeanor count of workers comp fraud for filing a false claim. SID received an allegation that Daniels filed a false claim against Friendly Transportation Services alleging she was injured while working. However, Friendly Transportation Services indicated Daniels was never an employee. Friendly Transportation Services acknowledged that Daniels had applied for employment with their company but was never hired. The investigation found Daniels was never hired by or employed by the company. Daniels’ BWC claim was ultimately denied by the Ohio Industrial Commission. Daniels was ordered to pay a $150 fine and court costs were waived.
Joseph Garcia, dba A Expert Rooter, Inc. (Cincinnati, Hamilton County) was convicted May 8 of disorderly conduct after he was found operating his business with lapsed coverage. SID received an allegation that Garcia continued to operate his business, A Expert Rooter Inc., although his workers comp coverage had lapsed. The case was referred to the Employer Fraud team after Garcia failed to work with the BWC Compliance Department to bring his policy back into compliance. Garcia failed to comply with the agents’ continued requests to bring his business back into compliance. He also issued a payment to BWC that was dishonored by the bank due to insufficient funds. Garcia was present in court for a bench trial and provided EFT agents with money orders totaling the current balance due on his policy. In addition, Garcia was advised he would need to bring the business policy back into compliance with State law.
Ricky Gantz (Elyria, Lorain County) pleaded guilty May 9 to one misdemeanor count of workers comp fraud for working while receiving benefits. SID received an allegation from indicating Gantz was playing in a Beatles tribute band while receiving Temporary Total Disability benefits. The investigation found Gantz continued sustained remunerative employment, as a musician, with John F. Gilbert III, DBA Abbey Road Band, between April 2012 and August 2013. The Industrial Commission of Ohio found Gantz overpaid $13,277.24. On the day of the hearing, Gantzâ’s attorney provided the SIU with a check for the complete overpayment amount. Gantz was fined $120 and ordered to pay court costs.
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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