Central Ohio man convicted of work comp fraud

Employment scheme implicates girlfriend

A Lancaster man must pay the Ohio Bureau of Workers’ Compensation nearly $7,000 in restitution after pleading guilty to workers’ compensation fraud Monday for a scheme that could land his girlfriend in court as well.

Charles Malone, 43, worked for a heating and air conditioning company for six months in 2016 while simultaneously collecting injured worker benefits from BWC. To hide his employment, he duped his employer into issuing his paychecks to his girlfriend in her name.

“He gave his employer a plausible explanation, and they fell for it,” said Jim Wernecke, director of BWC’s special investigations department. “As for the girlfriend, she could also face charges for her role in helping Mr. Malone defraud our agency.”

A judge in the Franklin County Court of Common Pleas sentenced Malone to 180 days in jail, the maximum for a first-degree misdemeanor. He then suspended the jail sentence for five years of community control (probation) under the condition that Malone maintains employment and pays BWC $6,879 in restitution.

In other fraud news, a Cleveland-area man pleaded guilty on Monday to a first-degree misdemeanor charge of workers’ compensation fraud after BWC investigators discovered him operating his sports video business while collecting disability benefits.

A Franklin County judge ordered Kyle E. Goodwin, 47, of Westlake, to pay BWC $2,978 in restitution. He sentenced Goodwin to 180 days in jail (suspended) and 12 months of community control.

Acting on a tip, BWC investigators found Goodwin continued working for his business, OhioSportsNet LLC, in 2016 and 2017 after he claimed to be temporarily totally disabled. They found he earned $9,025 obtaining, editing and producing videos for various high school sports teams, sports clubs and high school athletes.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

BWC secures three convictions in January

Two for work comp fraud, one for lapsed coverage

A funeral home worker and two cleaning company owners owe the Ohio Bureau of Workers’ Compensation $30,000 after pleading guilty to workers’ compensation fraud or related charges in January, the bureau’s first convictions of the new year.

“It’s thanks to honest citizens who report suspected fraud that we’re able to investigate many of our cases and stop this criminal activity in its tracks,” said Jim Wernecke, director of BWC’s special investigations department (SID). “The money we recover from people trying to cheat our system will go where it rightfully belongs — taking care of injured workers and helping employers create safer workplaces across this state.”

Those convicted include:

Oran Lewis of Columbus, Working and Receiving — Acting on a tip, investigators surveilled Lewis and uncovered evidence proving he worked for two funeral homes as a funeral procession escort on multiple occasions while collecting injured worker benefits from BWC.

Lewis pleaded guilty on Jan. 24 to one count of workers’ compensation fraud, a fifth-degree felony. He was sentenced to 180 days in jail, which was suspended for one year of community control (probation). He must pay $10,442 in restitution to BWC.

Amanda Joy Klapp of Hudson, Ohio, dba Amanda Joy Cleaning Company LLC, Under Reporting Payroll — BWC’s employer fraud team received an anonymous allegation that Klapp was operating her business without workers’ compensation coverage. Agents discovered that Klapp had employees when she opened her business in 2013, but she didn’t secure BWC coverage until 2015. She then intentionally under-reported her payroll to avoid paying a higher premium. When she stopped paying her premiums and her policy lapsed, she attempted to take out a new policy using her husband’s name to avoid paying the balance owed on her original policy.

Klapp pleaded guilty Jan. 9 to three counts of workers’ compensation fraud, all first-degree misdemeanors, in Stow Municipal Court in Summit County. A judge sentenced her to 180 days in jail with 150 days suspended and ordered her to serve 30 days of house arrest. The judge fined Klapp $500 on each count, then suspended half the total. The judge ordered Klapp to bring her workers’ compensation coverage into compliance within 30 days and to pay $14,000 in restitution to BWC.

Robert Settlemoir of Columbus, dba Pro Clean Carpet and Upholstery, Lapsed Coverage — Investigators found Pro Clean Carpet and Upholstery had been operating since 2011 without workers’ compensation coverage. BWC attempted to work with Settlemoir to bring his policy into compliance, but Settlemoir failed to take the necessary steps.

Settlemoir pleaded guilty on Jan. 25 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, suspended for two years of community control. Conditions of community control are that Settlemoir obtain employment and pay restitution of $5,482 to BWC.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

BWC spotlights employers’ workplace safety ingenuity

By Erik Harden, BWC Public Information Officer

At BWC, we’re constantly amazed at the innovative ideas employers have for tackling workplace hazards. To spotlight these employers, their ingenuity and their commitment to workplace safety, we sponsor our annual Safety Innovation Awards.

We created the program to recognize innovations that result in risk reduction, cost savings, and potential application to other workplaces, industries or operations. Innovations can range from a newly–created piece of equipment, tool, process or method to an existing one that an employer has improved or uses in a new or creative way.

After careful consideration of dozens of applications and visits to the sites of eight semifinalists, we are pleased to announce the following employers as the four finalists for the 2018 Safety Innovation Awards.

MPW Industrial Services (Hebron) – M1-RV crawler
A remote-controlled vacuuming system that cleans clarifier tanks; it eliminates employee exposure from hazards of entering and cleaning clarifier tanks

Navistar (Springfield) – Cab destructive weld tear down
An articulating arm that holds a worker’s pneumatic tool during weld tear down of truck cabs; it reduces the potential of falling, bad postures and awkward positions due to high reaction forces on employees during the process

Ramco Electric Motors (Greenville) – Aluminum die-casting automated biscuit return
A conveyor system that delivers aluminum die-casting byproducts (aka “biscuits”) from the casting machine back to the 1,300-degree liquid aluminum bath; the system eliminates the exposures of an individual performing the task of dropping the biscuits back in the crucible

Terracon Consultants Inc. (Cincinnati) – YM3000 pin puller
A redesigned T-handle that is adjustable in height and allows employees to remain standing when pulling 28-inch pins (used for soil density readings) from the ground; it decreases the potential of back or wrist strains from pin pulling, helps reduce fatigue and increases productivity

The four finalists will present their innovations to a three-judge panel and the public at our Ohio Safety Congress & Expo 2018 (OSC18) in Columbus on March 7-9.

The panel of independent judges will select the winners using a number of criteria, including risk reduction, innovation, return on investment, potential for other employers to use the innovation and presentation quality. OSC18 attendees can cast a vote for their favorite innovation to determine the recipient of The People’s Choice award.

We will present the awards and monetary prizes during a ceremony at OSC18. However, the real winners are the employees of these companies. Innovations like the ones listed above help workers stay safe and healthy, increase productivity and morale, and produce long-term cost savings.

Working while receiving?

By Jeff Baker, Program Administrator, BWC Special Investigations Department

Working while receiving benefits is one of the most common types of fraud our investigators uncover. In fiscal year 2017, 57 out of 133 criminal convictions were claimants working while receiving lost time benefits to which they were not entitled.

Working while receiving is one of the most obvious and flagrant abuses of the system. It is particularly regrettable since the claimants were, at one time, truly injured and entitled to workers’ compensation benefits.

We make every effort to ensure that each claimant knows the well-established rules. The fraud warning messages are clear, explicit and conspicuously placed on forms. For example, a fraud warning message (pictured below) appears on the BWC form to be signed by a claimant to request temporary total lost time benefits.

Fortunately, the vast majority of claimants return to work when they are able and notify BWC that they intend to do so. They understand and accept that their lost time benefits achieved their essential purpose – they provided compensation while the claimant temporarily could not work and was recuperating from an accident, illness or injury.

No matter how clever an individual may be, if he or she commits the crime of returning to work while receiving workers’ compensation benefits, the tell-tale signs remain. Rest assured, we are looking for, investigating, and prosecuting these cases. They will lose their lost time benefits and perhaps their freedom as well.

Making a better Ohio with health and wellness

By Erik Harden, BWC Public Information Officer

Improved health and wellness leads to a better quality of life in all aspects of our lives, including the workplace.

Living a healthy, balanced life can help prevent injury or help workers recover more quickly if they are hurt on the job. That’s why we’re launching Better You, Better Ohio!™ – a program designed to provide health and wellness resources and services to workers who work for small Ohio employers (50 or fewer workers) in high-risk industries*.

Better You, Better Ohio! takes the stress out of implementing or joining a workplace wellness program thanks to a simple, paperless sign-up process for workers and no costs for the employee or employer. The program offers:

  • Health and wellness awareness, education and training;
  • Health assessments and biometric screenings for better understanding of their health and well-being;
  • A member engagement website that allows them to develop health plans and track their progress to achieve their goals;
  • A state-of-the art mobile app for creating weekly action plans and getting health tips;
  • Digital coaching to help them on their journey to better health.

Why we’re offering Better You, Better Ohio!

Ohio, like much of the nation, is facing major health challenges driven primarily by obesity, aging and the rise in chronic diseases (i.e. diabetes and cardiovascular diseases). As of 2017, Ohio’s health ranking stood at 39th among the 50 states. These health challenges and outcomes are mostly associated with lifestyle behaviors. Individuals can improve these behaviors by using the resources and support services health and wellness programs like Better You, Better Ohio! offer.

Want to know more?

Visit our Better You, Better Ohio! webpage for additional details.

*Agriculture; automotive repair and service; construction; firefighters; health care; manufacturing; police and public safety; public employers; restaurant and food service; transportation and trucking; trash collection; wholesale and retail

Free CEUs! Register for the Medical & Health Symposium, March 8 – 9

Online registration is open for this year’s annual Ohio Workers’ Compensation Medical & Health Symposium, at the Greater Columbus Convention Center. It runs in conjunction with BWC’s Ohio Safety Congress & Expo. View brochure.

Two education opportunities available

The Provider Clinical Education track is an opportunity for health-care professionals to learn about the latest trends and evidence-based medicine. This track features leading state, national and international experts in addiction, behavioral health, chiropractic medicine, cultural diversity, orthopedic surgery, pharmacology, physical medicine and rehabilitation, psychology and total worker health.

BWC is requesting contact hours for select provider clinical educations sessions for the following licensed health care professionals:

  • Nurses;
  • Occupational and physical therapists;
  • Pharmacists;
  • Physicians (DC, DO, DPM and M.D.);
  • Physician assistants;
  • Psychologists;
  • Vocational rehabilitation (CCM, CDMS and CRC).

The Provider Staff Forum is new this year. It offers a full day (Friday, March 9 only) of education designed specifically for provider office staff related to key workers’ compensation policies and procedures. BWC recommends this portion of the symposium for office staff/administrators who are responsible for the day-to-day operations of workers’ compensation processes and workflow within a health-care system.

Register today!

  • Registration is free.
  • You need a unique email address to register.
  • Physicians and physician assistants must provide their National Provider Identifier and specialty.
  • Pharmacists must provide their Ohio license number and the National Association of Boards of Pharmacy number.
  • Be prepared to select your educational track and each session.
    • Provider clinical education (13 sessions: March 8 – 9)
    • Provider staff forum (Five sessions: March 9)
  • Visit expoplanner.com/medical for more information and to register.
  • Registration is limited.
    • 700 attendees for the Provider Clinical Education track.
    • 125 attendees for the Provider Staff Forum track.

If you have questions, call BWC’s provider contact center at 1-800-644-6292, option 0-3-0, or email medsymposium@bwc.state.oh.us. For more information, go to bwc.expoplanner.com/medical.

Funeral escort earns felony conviction for work comp fraud

Judge shows little sympathy, orders $10K in restitution

A Columbus man injured in 2014 while working as a motorcycle escort for funeral processions must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $10,400 after pleading guilty to workers’ compensation fraud Wednesday in a Columbus courtroom.

Acting on a tip, BWC investigators conducted surveillance and collected evidence proving Oran Lewis, 66, worked for two different funeral homes in 2015 while collecting disability benefits from BWC.

“It doesn’t matter if you’re driving a vehicle or doing hard labor — it’s against the law to collect disability benefits from BWC when you’re also working and making a living,” said Jim Wernecke, director of BWC’s special investigations department. “What’s more, we’re not talking about a one-time incident or occasional odd job here and there. We found Mr. Lewis performing this service 29 times between May and October of 2015.”

Lewis confessed to the crime and cooperated with BWC when he was approached by agents.

A Franklin County Court of Common Pleas judge also sentenced Lewis to 180 days in jail (suspended) and one year of probation for the fifth-degree felony.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.