Those trying to defraud the Ohio workers compensation system are just awaiting trouble.
Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer announced recently that nine individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers comp system in November 2014. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).
“Investigating fraud is a vital part of the workers compensation business,” Buehrer said. “Identifying fraud puts dollars back into the State Insurance Fund and supports our efforts to keep premiums as low as possible.”
The following is a sampling of cases that resulted in guilty pleas or convictions during November:
Leslie Hammond (Newark, Licking County) was sentenced Nov. 21 in Franklin County Court of Common Pleas in connection with working while receiving disability benefits. In October, he pleaded guilty to one count of workers comp fraud, a fifth-degree felony. BWC received an allegation that Hammond was working while receiving benefits. Investigators conducted multiple interviews and reviewed bank records, which showed that Hammond worked as a subcontractor while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Hammond was sentenced to serve one year in jail, but that was suspended for five years of community control. As a condition of community control, Hammond must pay $71,310.82 in restitution to BWC; if this requirement is not met, he will serve the jail time.
Dianne Smoot (Columbus, Franklin County) was sentenced Nov. 6 to pay $14,598.24 in restitution to BWC after pleading guilty the same day in Franklin County Court of Common Pleas to one count of workers comp fraud, a fifth-degree felony. A data cross-match with the Ohio Department of Job and Family Services revealed that Smoot received wages during the time she received disability benefits from BWC. Investigators found that Smoot worked as a home health aide for a program sponsored by the Central Ohio Area Agency on Aging while receiving the benefits. In addition to restitution, Smoot was sentenced to six months of incarceration, which was suspended for five years of community control. Terms of community control include paying the restitution and maintaining employment.
Russell Milam (Columbus, Franklin County) pleaded guilty Nov. 12 in Franklin County Court of Common Pleas to workers comp fraud, a fifth-degree felony. BWC received two separate allegations that Milam was working while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Investigators reviewed payroll records, which showed that Milam worked as a subcontractor for a gutter company in 2010 while receiving temporary total disability. Milam was ordered to pay $3,288.24 in restitution. He was placed on community control with basic supervision for two years. Milam was also given 12 months at the Ohio Department of Rehabilitation and Correction, which was suspended as long as community control is not violated. He also had 13 days of jail time credit.
Samuel Jarrell (Marion, Marion County) pleaded guilty Nov. 12 in Franklin County Court of Common Pleas to one count of workers comp fraud, a first-degree misdemeanor. BWC received an allegation that Jarrell was working while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Investigators reviewed bank records and conducted both interviews and surveillance to prove that Jarrell was working at his family truck and auto repair business while receiving temporary total disability. Jarrell was ordered to pay $6,136 in restitution, and was also sentenced to 90 days of incarceration, which was suspended for a year of community control. Terms of his community control include paying the restitution.
Anthony Sebree (Amelia, Clermont County) pleaded guilty Nov. 14 in Clermont County Municipal Court to falsification, a first-degree misdemeanor, and was sentenced to two years of court-monitored probation. BWC received an allegation that Sebree may have filed a false claim. Investigators found that Sebree filed a claim with BWC, indicating that he was injured while working at a company in Batavia. The business provided records that showed Sebree was not employed by the company when the alleged injury occurred. Sebree confessed to investigators that he lied when he filed the claim with BWC.
Rose Marinescu doing business as Rainbow Child Day Care No. 1 (North Olmsted, Cuyahoga County) pleaded guilty to workers comp fraud and attempted theft Nov. 5 in Cuyahoga County Court of Common Pleas. Marinescu was sentenced on both charges, which are first-degree misdemeanors, the same day. This follows her 2011 conviction in Rocky River Municipal Court for failure to comply, when she was sentenced to pay $30,000 in past due workers comp premiums for her business, Rainbow Child Day Care No. 1 Inc., 24329 Lorain Road in North Olmsted. SID discovered that Marinescu defaulted on her court-ordered payment plan. Agents from the department’s employer fraud team attempted to work with Marinescu to resolve the matter, but she failed to cooperate. Marinescuwas placed on two years of community control and was ordered to repay the remainder of the restitution she owed, which totals more than $25,000. She was also fined $346.50.
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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