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.

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.

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.

Cleaning company owner soils record with fraud conviction

Northeast Ohio woman to serve house arrest, pay $14K restitution

The owner of a Hudson, Ohio, cleaning business must serve 30 days under house arrest and pay $14,000 in restitution to the Ohio Bureau of Workers’ Compensation after pleading guilty to workers’ compensation fraud Jan. 9.

Amanda Joy Klapp, owner of Amanda Joy’s Cleaning Company, also must bring her BWC coverage into compliance within 30 days and pay $750 in fines.

“Our agents found Ms. Klapp trying to cheat BWC in a number of ways,” said Jim Wernecke, director of BWC’s special investigations department. “She 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. And 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.”

Appearing in Stow Municipal Court in Summit County, Klapp pleaded guilty to three first-degree misdemeanor counts of workers’ compensation fraud and was fined $500 on each count. The judge suspended half of the fines and 150 days of a 180-day jail sentence, ordering the remaining 30 days to be served under house arrest.

In other news, the bureau secured three fraud-related convictions in December, bringing the total number of convictions in calendar year 2017 to 130.

Eric Payne of Hamilton, Ohio, pleaded guilty Dec. 13, in the Franklin County Court of Common Pleas to a fifth-degree felony count of workers’ compensation fraud after BWC agents found him working as a home and building inspector while collecting $8,126 in temporary total disability between February and August 2015. Sentencing is scheduled for Jan. 23.

David Proffitt of Plain City, Ohio, pleaded guilty Dec. 12 to a first-degree misdemeanor count of workers’ compensation fraud after investigators found him working as a golf coach while collecting BWC benefits. A Franklin County judge declined to sentence Proffitt or order restitution.

Beth Amirault of Dublin, Ohio, dba A Place to Grow, pleaded guilty Dec. 5 to a second-degree misdemeanor count of failure to comply after investigators found she had been operating her child care center without work comp coverage since 2005. Amirault initially cooperated with BWC to bring her policy back into compliance, then failed to follow through on her reinstatement plan. A Franklin County judge sentenced her to 90 days in jail (suspended), two years of probation and ordered her to pay fines and court costs.

To report suspected workers’ compensation fraud, visit bwc.ohio.gov or call 1-800-644-6292 and select option “0”, then option “4”.

Top 5 posts of 2017

It’s been a busy year on the Ohio BWC blog!

In 119 posts, we covered topics ranging from safety during a solar eclipse to preparing for an active aggressor situation. In between were fraud updates and safety tips from our experts.

Thanks to all of our readers, and those who shared our links and left comments!

Here are the posts you read the most in 2017:

  1. Don’t look at the sun and other not-so-obvious tips!
  2. Foul! Bowling coach crosses the line, commits work comp fraud
  3. Don’t be shocked or surprised – use lockout/tagout
  4. Working hard in the yard? Remember these safety tips
  5. Are you prepared for an active aggressor incident?

We’re looking forward to another busy year of blogging in 2018.  For now, we wish you all a very Happy New Year!

Five Northeast Ohioans convicted of work comp fraud

Four claimants and one employer from northeast Ohio were sentenced in November for defrauding the Ohio Bureau of Workers’ Compensation (BWC).

The cases bring the year’s total convictions for BWC’s special investigations department (SID) to 121.

“BWC is in the business of caring for injured workers and promoting safe workplaces, not doling out thousands of dollars to cheaters,” said SID Director Jim Wernecke. “We’ll return these funds to where they belong and turn our attention to others working the system to avoid paying their share or to collect payments they don’t deserve.”

Among those convicted last month:

Geoffrey Cigany, of Chardon, Ohio, pleaded guilty Nov. 8 to a first-degree misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. An anonymous allegation led to an investigation that found Cigany worked as a handyman/carpenter for WC Gotts Holdings, Inc. while receiving benefits between March 2014 and September 2014. Cigany paid restitution in full in the amount of $8,499. A Franklin County judge ordered Cigany to pay a fine and waived court costs.

Harvey Short, dba ASAP Transport, of Garfield Heights, Ohio, was convicted Nov. 16 of a second-degree misdemeanor count of failure to comply for falsifying his workers’ compensation certificate of coverage. The certificate raised suspicion after Short provided it to a local company as proof of coverage because it showed a different policy number than the one he provided the prior year. Short admitted to falsifying the certificate and was ordered by a Garfield Heights Municipal Court judge to pay restitution of $150 and court fees.

Laitanya Dinkins, of Euclid, Ohio, pleaded guilty Nov. 2 to a first-degree misdemeanor count of workers’ compensation fraud for working while receiving BWC benefits. A database cross match with the Ohio Department of Job and Family Services tipped investigators off that Dinkins returned to work as a home health aide while receiving BWC benefits. A Franklin County judge sentenced Dinkins to 90 days in jail (suspended) and three years of community control. She was also ordered to pay restitution of $3,716.

Christopher Gattarello, of Lyndhurst, Ohio, pleaded guilty Nov. 22 to a fifth-degree felony count of workers’ compensation fraud for working while receiving benefits from BWC. The investigation began after a claims representative noted construction noise in the background during every phone conversation with Gattarello about his injury claim. Investigators found Gattarello, the owner of several Cleveland-area garbage-hauling companies, returned to work as a driver/heavy equipment operator. Gattarello was sentenced in a Franklin County courtroom to 186 days in jail with credit for time served. He was already serving 57-months in prison on federal charges of money laundering and violating the Clean Air Act. Read more about his case and view surveillance video here.

Timothy S. Lumsden, of Avon Lake, Ohio, pleaded guilty to a fifth-degree felony count of workers’ compensation fraud for working while receiving BWC benefits. Acting on a tip in 2015, BWC investigators determined Lumsden had returned to work as an independent carpenter at the Federal Knitting Mills Building in Cleveland while collecting temporary total disability benefits. A Franklin County judge ordered Lumsden to pay BWC $5,385 in restitution. He also sentenced Lumsden to 11 months in jail (suspended) and community control for three years.

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