Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Steve Buehrer announced recently that 10 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio's workers compensation system in June 2015. These court actions are the result of investigations conducted by BWC's Special Investigations Department (SID).
"Whether it's an employer failing to pay workers comp premiums, a medical provider doling out prescriptions without evaluating patients, or claimants secretly working while improperly receiving disability benefits, BWC does not take workers compensation fraud lightly," Buehrersaid."Funds that are recovered thanks to SID's efforts are returned to the State Insurance Fund to care for injured workers who are truly injured, and to keep employer premiums as low as possible."
The following is a sampling of cases that resulted in guilty pleas or convictions during June:
Tina Trill, doing business as TEP Bedding Group Inc. (Orwell, Ashtabula County), pleaded guilty June 1 in the Ashtabula County Court of Common Pleas to one count of obstructing official business, a second-degree misdemeanor. BWC's employer fraud team received an allegation from the agency's collections department that the employer submitted a workers compensation premium payment that was dishonored by the bank, and the policy lapsed. The employer submitted outstanding payroll reports, but didn’t make any other attempts to bring the policy into compliance with the law. Trill paid $12,000 in restitution to BWC.
James Crist, of Middletown (Butler County), pleaded guilty and was sentenced June 2 in Middletown Municipal Court on one count of workers compensation fraud, a first-degree misdemeanor. A BWC employee alerted SID that Crist was difficult to contact during the day and that machinery was sometimes heard running in the background during telephone calls. Investigators found that Crist returned to work for his own business, Crist Construction LLC, while collecting temporary total disability benefits from November 2010 to August 2011. Claimants are not permitted to work while receiving this type of benefit. Crist paid $21,579 in restitution before entering his plea in court, and paid $4,155.07 to cover the fraud investigation costs on the same day he appeared in court. He was given a suspended sentence of 180 days in jail and was also fined $500.
Laurie Nesit, of Akron (Summit County), pleaded guilty June 8 in the Franklin County Court of Common Pleas to one count of workers compensation fraud, a fifth-degree felony. BWC became aware through a data cross-match with the Ohio Department of Job and Family Services that Nesit received wages and temporary total disability benefits from BWC during the same time period. Claimants are not permitted to work while receiving this type of benefit. Investigators found that Nesit returned to work as an inspector for two businesses from April to May 2013, and from July 2013 to January 2014, while receiving temporary total disability benefits. In August 2014, an Industrial Commission hearing officer issued an order finding an overpayment of BWC benefits for those time periods. The hearing officer also issued a finding of fraud relative to the declared overpayment. Nesit was sentenced to serve 11 months in jail, which was suspended for five years of community control. She was ordered to pay $23,847 in restitution to BWC and ordered to maintain employment.
Melony Belcher, of Toledo (Lucas County), was granted into a criminal diversion program June 17 in the Lucas County Court of Common Pleas. SID received an allegation through BWC's fraud hotline that Belcher may have returned to work while collecting workers compensation benefits from her self-insured employer. Investigators discovered that Belcher returned to work from February to April 2014 as a full-time elder assistant for a Monclova business while collecting temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit. In addition to the criminal diversion program, which she must remain in for two years, Belcher was ordered to repay $2,696.70 in restitution to the self-insured employer.
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: kstack@reduceyourworkerscomp.com.
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