Nearly $1 million owed BWC in employer fraud case

Cleveland-area business owner convicted of fraud Monday

A northeast Ohio business owner owes the Ohio Bureau of Workers’ Compensation nearly $1 million in restitution following his conviction Monday in Cleveland on workers’ compensation fraud charges.

Robert E. Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud after refusing to cooperate with BWC to bring his lapsed policy into compliance.

“Mr. Fitz owes at least $965,000 in unpaid premiums and for the costs of injured worker claims that occurred while his policy was lapsed,” said BWC Administrator/CEO Stephanie McCloud. “If he had just followed the law and paid his premiums, he wouldn’t be in this trouble today.”

At his conviction hearing in the Cuyahoga County Court of Common Pleas, Fitz agreed to work with BWC and the Ohio Attorney General’s Office to provide his company’s financial reports and enter a reinstatement payment plan prior to his sentencing date of Nov. 4.

According to BWC’s Special Investigation Department, Fitz’s BWC policy has been lapsed since Sept. 1, 2003. Since then, BWC has picked up the costs on 43 injury claims, including five since 2014.

In other fraud news, a northeast Ohio man must pay BWC nearly $79,000 in restitution after pleading guilty to a fifth-degree felony charge of workers’ compensation fraud Tuesday in a Franklin County courtroom.

Ronald J. Dorfeld of Brunswick, Ohio, must pay BWC $78,957 and serve five years of probation in lieu of a nine-month jail sentence for working while collecting BWC disability benefits.

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

Special investigations department concludes FY 2019 with impressive results

By Jim Wernecke, Director, BWC Special Investigations Department

It’s getting harder and harder for the criminally minded to rip off BWC and the State Insurance Fund and get away with it.

That was the message I took to BWC’s board of directors Thursday afternoon when I presented the board with the Special Investigations Department’s annual report for FY 2019, which closed June 30. The report details another impressive year of our department’s efforts to deter, detect, investigate, and prosecute workers’ compensation fraud.

Here are some highlights in what was our 26th year as a department:

  • We closed 1,732 fraud cases, 7% more than in 2018.
  • We secured 101 convictions of claimants, employers, and health care providers who defrauded our agency.
  • For every dollar we spent on our efforts, we saved the state fund nearly $5.
  • We reduced our investigation time per case by 2.9 days on average, to 189 investigative days, our lowest number on this measure since 2005.
  • All told, we saved the state fund $65.1 million in 2019, an 8 % increase over 2018’s numbers.

We couldn’t have achieved this success without the 119 dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law.

In 2019, our investigative teams continued to work closely with the law enforcement community at the local, state, and federal levels. We collaborated on several investigations, including cases involving physicians running pill mills in Ohio and surrounding states.

In addition, our teams joined other state and federal investigators participating in the Document and Benefit Fraud Task Force, the Ohio Medicaid Prescription Program Integrity Group, and the Pill Mill Coordination team for the Ohio Attorney General’s Medicaid Fraud Control Unit.

As we commence our 27th year in FY 2020, we remain united in our commitment to protecting the State Insurance Fund for injured workers and the Ohio workers and employers it serves. We join our colleagues throughout this agency in delivering the people of this state the world-class workers’ compensation system they deserve.

Former deputy sheriff owes BWC $235K for workers’ comp fraud

Zanesville man earns felon status after Monday’s conviction

A Zanesville man and former county deputy sheriff must reimburse the Ohio Bureau of Workers’ Compensation nearly $235,000 in restitution following his felony conviction for workers’ compensation fraud Monday in a Franklin County courtroom.

A judge ordered Gregory A. Fitzer, 56, to pay BWC $211,536 in restitution and $23,187 in investigative costs after Fitzer pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud. She also ordered the former Muskingum County deputy sheriff to serve four years of probation in lieu of a year in jail.

“Our investigators found Mr. Fitzer knowingly and with fraudulent intent deceived our agency and his physicians in order to receive disability benefits,” said BWC Administrator/CEO Stephanie McCloud.

Acting on a tip, BWC’s Special Investigations Department discovered Fitzer worked as a process server and investigator for several law firms in and around Zanesville from January 2007 to March 2016 while collecting disability benefits from BWC. The investigation, which included surveillance, multiple interviews and a review of bank and employment records, also found he worked as a truck driver and laborer for a local retailer.

In other fraud news:

BWC secured eight fraud-related convictions in August, bringing 2019’s total to 63. They include a Central Ohio nurse practitioner convicted on health care fraud charges.

BWC assisted in the investigation that led to the Aug. 30 sentencing of nurse practitioner Amy Wood-Kirk of Grove City and fiancé Ryan Edney on one count of conspiracy to commit health care fraud. Amy Wood-Kirk prescribed large quantities of medications, including prescriptions for compounded pain cremes, outside acceptable medical standards for the personal profit of herself and Edney.

The U.S. District Court for the Southern District of Ohio sentenced Wood-Kirk to five years of probation and ordered her and Edney to repay Medicaid, TriCare, and Medical Mutual of Ohio $751,809 in restitution. Wood-Kirk was also sentenced to 180 days home confinement.

In order of most recent court appearance, other August convictions include:

Jim Hesler, dba Robert’s Roofing, Batavia, Ohio
Hesler was found guilty Aug. 23 in Clermont County Common Pleas Court on two counts of workers’ compensation fraud, both fifth-degree felonies. BWC investigated Hessler after learning he had not been reporting his payroll to the agency and several injury claims had been filed.

Investigators found his business was still in operation. Sentencing is scheduled for Oct. 8, at which time a judge may determine the amount of restitution owed BWC.

Eric Johnson, Akron, Ohio
Johnson pleaded guilty Aug. 22 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while receiving disability benefits. Prior to entering the plea, Johnson deposited full restitution of $1,062 at the clerk of court’s office.

Gregory White, dba White’s Auto Care LLC, Lorain, Ohio
White pleaded no contest Aug. 22 to one count of failure to comply, a second-degree misdemeanor, for not reinstating his BWC policy while operating his business. A second count was dismissed as White had brought his BWC account current prior to court. White was ordered to pay court costs of $167.

Everett Ferryman, Marysville, Ohio
Ferryman pleaded guilty Aug. 21 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC discovered him working as a truck driver and receiving cash “under the table” while receiving BWC disability benefits. The court sentenced him to a term of probation not to exceed five years but could terminate sooner upon payment of $22,851 in restitution. The court also imposed a suspended sentence of 12 months in prison.

Tammy Hill, Jackson, Ohio
Hill pleaded guilty Aug. 12 in Jackson County Municipal Court to theft by deception, a first-degree misdemeanor, after BWC found her cashing BWC benefit checks belonging to an injured worker. A judge ordered Hill to serve up to five years of probation, complete 500 hours of community service, 180 days in jail (suspended), and pay a $100 fine and court costs within 12 months.

Paul Gall, dba Sun Masters, Brooklyn Heights, Ohio
BWC found Gall had been operating his business, Sun Masters LLC, without BWC coverage since March 2014. In lieu of conviction, Gall entered a payment plan with the Ohio Attorney General’s office after making a down payment of $12,000 toward his $44,000 balance.

Robert McWhorter, New Albany, Ohio
McWhorter pleaded guilty Aug. 7 to one count of workers’ compensation fraud, a fifth-degree felony, after BWC found him working for his landscaping company while receiving BWC disability benefits. A judge ordered McWhorter to pay $9,888 in restitution to BWC and serve one year of probation in lieu of a 6-month jail sentence.

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

Ohio trucker, others convicted of workers’ comp fraud

Marysville man kept truckin’ while collecting disability benefits

A Marysville truck driver was convicted of workers’ compensation fraud Wednesday after the Ohio Bureau of Workers’ Compensation discovered he continued to work while collecting BWC benefits for a workplace injury he suffered more than a decade ago.

Everett Ferryman, 46, pleaded guilty in a Franklin County courtroom to a fifth-degree felony count of workers’ compensation fraud. The judge ordered Ferryman to pay BWC $22,851 in restitution and serve probation for five years or until restitution was paid, whichever came first. She also imposed a suspended sentence of a year in prison.

“The law is clear — our benefits are for workers who are truly injured,” said BWC Administrator/CEO Stephanie McCloud. “They’re not a support system for people trying to cheat BWC and Ohio employers.”

Acting on a tip in 2017, BWC’s Special Investigations Department found Ferryman working as a truck driver while collecting BWC benefits from at least March 27, 2017, to Oct. 31, 2017. He was injured as a truck driver in May 2008 and had received temporary disability benefits from BWC periodically since then.

In other news
The owner of a Central Ohio landscaping company was ordered to pay BWC $9,888 in restitution Aug. 7 after investigators found he continued to work for his company while collecting BWC benefits for nearly a year and a half.

Robert J. McWhorter of New Albany pleaded guilty to a fifth-degree felony count of workers’ compensation fraud in a Franklin County courtroom. A judge sentenced McWhorter to one year of probation in lieu of six months in jail. He has paid his restitution in full.

Also in recent news, BWC’s Special Investigations Department secured five fraud-related convictions in July, bringing total convictions for calendar year 2019 to 54. Those convicted include:

James Coon of Akron, dba James Coon Construction
Coon pleaded guilty to involuntary manslaughter July 24 after one of his workers fell to his death in late 2017. He also pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud.

BWC found Coon lacked workers’ comp coverage when his employee died and that he repeatedly lied about his business over the years to minimize his premiums or avoid paying them altogether. Sentencing is scheduled for Sept. 6.

Jacci Richards of Toledo/dba Acorns to Oaks
Richards pleaded no contest but was found guilty July 16 to a second-degree misdemeanor charge of failure to comply after BWC found her operating a now-closed day care center without workers’ compensation coverage. A judge ordered her to pay $99 in court costs.

R. Gregory Lawrence of Euclid, dba Lakeshore Coffee House Inc.
BWC found Lawrence was operating Lakeshore Coffee House Inc. with lapsed BWC coverage. Lawrence pleaded guilty July 11 in Euclid Municipal Court to two counts of disorderly conduct, both minor misdemeanors. Lawrence was fined $200. Prior to the court date, Lawrence paid the balance he owed BWC and brought his policy into compliance.

Scott Laird of Cambridge
Laird pleaded guilty July 10 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working while collecting BWC benefits. A judge ordered Laird to pay BWC $3,113 in restitution and sentenced him to two years of probation in lieu of 90 days in jail.

Cynthia Gribble of New Philadelphia
Gribble pleaded guilty July 1 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found her working as a home health care aide while collecting BWC benefits. A judge ordered her to pay BWC $7,328 in restitution and serve six months of probation in lieu of 90 days in jail.

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

BWC reports 4 fraud-related convictions in June

Four Ohioans were convicted for workers’ compensation fraud or related charges in June, including a Springfield man who must reimburse the Ohio Bureau of Workers’ Compensation (BWC) more than $13,000 after investigators found him working two jobs while collecting disability benefits.

Clark A. Howard pleaded guilty June 18 to a fifth-degree felony count of workers’ compensation fraud after BWC investigators discovered him working for a pizza shop in London, Ohio, and as a machine press operator for another business. A Franklin County judge ordered Howard to pay BWC $13,518 in restitution.

“We’re here to support injured workers as they try to get back to work and back to life, not supplement the income of able-bodied people cheating our system,” said BWC Administrator/CEO Stephanie McCloud.

The judge also sentenced Howard to 30 months of community control (probation) in lieu of a year in jail.

Other June convictions include:

Ben Patterson of Xenia, Ohio, dba C&B Landscaping
Patterson pleaded guilty June 25 to one count of failure to comply, a second-degree misdemeanor, for operating his landscaping company without BWC coverage since 2009. Investigators worked with Patterson to reinstate coverage, but Patterson failed to establish a payment plan.

Patterson paid all outstanding BWC premiums, related fees and interest on June 24, the day before his court hearing. A Xenia Municipal Court judge fined him $150 and court costs and sentenced him to 90 days in jail, suspended upon the condition he not have a similar offense for five years.

Patricia Simon of Columbus, Ohio
Simon pleaded guilty June 18 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC determined she intentionally submitted a false statement to support her claim for workers’ compensation benefits. A Franklin County judge ordered her to pay a $250 fine and $128 to BWC for investigative costs.

Lori Hines of Waynesfield, Ohio, dba Marshall’s Hydraulic Services
Hines pleaded guilty June 7 to one count of failure to comply, a second-degree misdemeanor, after BWC found Marshall’s Hydraulic Services operating without BWC coverage since January 2017.

An Auglaize County Municipal Court judge sentenced Hines to a year of non-reporting probation, a 90-day suspended jail term and a $100 fine. Hines subsequently paid her BWC balance in full and the company’s coverage was reinstated.

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

Toledo contractor owes BWC $57K following fraud conviction

Lapsed policy, refusal to cooperate costs Holland man

By Tony Gottschlich, BWC Public Information Officer

A Toledo-area contractor owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $57,000 in restitution after pleading guilty to workers’ compensation fraud in a Toledo courtroom last month.

Eric L. Hughes, 53, of Holland, pleaded guilty to a fourth-degree felony charge of workers’ compensation fraud May 19 after failing to renew his BWC policy despite repeated attempts by the agency to bring him into compliance. A Lucas County judge ordered Holland to pay BWC $56,959 in restitution and serve three years of community control (probation).

“Ducking his legal obligation to protect his workers clearly didn’t pay for Mr. Hughes,” said BWC Administrator/CEO Stephanie McCloud. “He could have resolved this issue fairly easily when we first contacted him in 2017, and we would have given him a payment plan to boot. Now he’s got a $57,000 debt and a felony record.”

According to BWC’s special investigations department, Hughes worked as a handyman and general contractor on residential and commercial buildings, usually with just one employee. But after securing a sizable contract to replace a roof on a fire-damaged building in 2017, he hired a crew of eight to 10 workers and started the job while his BWC policy was still lapsed. The company that hired Hughes later fired him after learning of the lapse.

A BWC audit in 2018 determined Hughes owed the agency nearly $57,000 in past premiums, based largely off his payroll for the time he worked on the roofing job.

In other news, a Springfield man must pay BWC $13,518 in restitution after agency investigators found him working in a machine shop and at a restaurant while collecting BWC benefits.

Clark Howard, 35, pleaded guilty Tuesday to a fifth-degree felony count of workers’ compensation fraud in a Franklin County courtroom.

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

BWC secures six convictions in May

Five Ohio workers and one business owner were convicted in May on workers’ compensation fraud and related charges.

The six convictions raise BWC’s total convictions for the 2019 calendar year to 38.

“When people cheat the BWC system, they are cheating the employers and hard-working Ohioans across this state who play by the rules,” said BWC Administrator/CEO Stephanie McCloud. “Congratulations to our special investigations department for stopping this fraudulent behavior.”

In order of most recent case, those convicted include:

Bruce Collier of Chardon, Ohio
BWC investigators found Collier working as a self-employed travel agent/owner of Travel Specialist Group while receiving BWC benefits. Collier pleaded guilty May 21 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to pay BWC $12,487 in restitution, which he paid at the time of sentencing.

James Nichols of Cleveland, Ohio
BWC investigators found Nichols working as a janitor and office manager while collecting BWC benefits. Nichols pleaded guilty May 13 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 150 days in jail, suspended for two years of community control. He was ordered to pay BWC $3,525 in restitution. He made a $1,000 payment at sentencing.

Deborah Rosenlieb of Cuyahoga Falls, Ohio
Rosenlieb pleaded guilty May 9 in Summit County Common Pleas Court to workers’ compensation fraud, a fourth-degree felony, after investigators found her collecting her late father’s BWC benefits for two years. A judge ordered her to pay BWC $29,418 in restitution and serve two years of community service.

Jesse Lemaster, dba Lemaster Tree Care, Springfield, Ohio
Lemaster pleaded guilty May 8 to two counts of failure to comply, both second-degree misdemeanors, for operating his business without a valid BWC policy. He was sentenced to 30 days in jail on each charge, which was suspended pending a July 10 hearing, at which time he is to prove to the court he has valid workers’ compensation coverage.

Natasha Mitchum of Youngstown, Ohio
Mitchum pleaded guilty May 2 in Franklin County Common Pleas Court to workers’ compensation fraud, a first-degree misdemeanor, after BWC found her working as a call center employee/customer service representative while receiving disability benefits. She was sentenced to 180 days in jail, suspended for three years of community control, and ordered to pay BWC $1,863 in restitution.

John Griggy of Canton, Ohio
Griggy pleaded guilty May 1 to one count of workers’ compensation fraud, a first-degree misdemeanor, after BWC found him working as a self-employed electrician while receiving BWC benefits. Prior to sentencing, Griggy paid BWC full restitution in the amount of $54,220.

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

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