The Buckeye State continues to aggressively fight workers compensation fraud.
Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer recently announced that seven individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers comp system in October 2014. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).
“BWC is the largest state-fund insurance system in the nation, and we won’t back down when it comes to workers compensation fraud,” Buehrer said. “Our Special Investigations Department has identified more than $1.6 billion in savings since it began in 1993, and continually strives to root out fraud and seek prosecution, when necessary, to preserve the State Insurance Fund.”
The following cases resulted in guilty pleas or convictions during October.
Richard Lewis III (Tampa, Florida) pleaded guilty Oct. 27 in Franklin County Municipal Court to one count of workers comp fraud, a first-degree misdemeanor, and was sentenced to 79 days of incarceration and given 79 days of credit for time served. BWC began looking into the matter after receiving a false claim allegation from an employer. Investigators found that Lewis signed a first report of injury form, alleging that he was injured while employed; he received medical treatment and prescription drugs as a result of the claim. The claim was disallowed after investigators learned he was not an employee of the business. In 2013, Lewis filed two additional false claims against another business; those were also disallowed due to a lack of employer/employee relationship.
David Martindale (Warren, Trumbull County) pleaded guilty Oct. 9 in Warren Municipal Court to one count of workers comp fraud, a first-degree misdemeanor, and was ordered to repay $5,679.64 in restitution to BWC, plus a $200 fine and court costs. BWC began investigating after receiving an allegation that Martindale was working while receiving BWC benefits. Financial records and interviews showed that Martindale did return to work while receiving workers comp benefits. In addition to restitution, he was sentenced to serve 180 days in jail, which was suspended for five years of probation. If he violates the terms of his probation, Martindale will serve the jail time.
Russell Woelfel (Miamisburg, Montgomery County) pleaded guilty Oct. 23 in Columbus Municipal Court to workers comp fraud, a first-degree misdemeanor. He appeared in court with a check for $1,015.76 for investigative costs, and had previously repaid his restitution of $2,621.26 to BWC. BWC identified that Woelfel earned wages while simultaneously collecting temporary total disability benefits, and investigators found that Woelfel worked as an engineer for a construction business while collecting BWC disability benefits between May and September 2012. Since he paid for investigative costs and restitution, the judge sentenced Woelfel to pay a $250 fine plus court costs.
Phillip Sexton (Dayton, Montgomery County) pleaded guilty Oct. 20 in Dayton Municipal Court to falsification, a first-degree misdemeanor, and was ordered to pay $1,003.69 in investigative costs along with a $200 fine and $111 in court costs. BWC received an allegation that Sexton may have filed a false claim against The Humane Society of Greater Dayton, and investigators confirmed that Sexton was never employed by the organization.
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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