Convicted of fraud, nurse ordered to pay BWC $23K in restitution

Felony conviction for Shaker Heights woman

A Cleveland-area nurse was ordered to pay the Ohio Bureau of Workers’ Compensation (BWC) more than $23,000 in restitution April 7 after BWC discovered her working while collecting injured-worker benefits.

A Franklin County judge ordered Tanya Houston, 46, of Shaker Heights to pay $23,489 to BWC and serve five years of probation in lieu of a one-year prison sentence after she pleaded guilty to a fifth-degree felony count of workers’ compensation fraud.

“We’re here to provide compensation for people who can’t work because of an on-the-job injury, not supplement the income of fraudsters cheating our system,” said BWC Interim Administrator John Logue. According to BWC’s Special Investigations Department, Houston was working as a therapeutic program nurse when she injured herself in June 2019. As she collected disability benefits from BWC for the injury, she continued to work for a second employer without informing BWC, the employer where her injury occurred, or her physician and other treatment providers.

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

Former police officer convicted for workers’ comp fraud

North Canton man owes BWC $89,000

A retired police officer for the city of Canton pleaded guilty to workers’ compensation fraud Thursday after the Ohio Bureau of Workers’ Compensation (BWC) discovered him working two jobs while claiming to be permanently disabled.

James H. Blaine of North Canton must pay BWC $66,481 in restitution and $23,000 in investigative costs after pleading guilty to the fourth-degree felony charge through a bill of information hearing in the Stark County Court of Common Pleas. A judge also ordered Blaine to serve three years of probation, obtain a full-time job, and provide 100 hours of community service.

“If you’re working two jobs, you’re clearly not permanently disabled,” said BWC Administrator/CEO Stephanie McCloud. “Kudos to our investigators for detecting this fraud and putting a stop to it.”

BWC’s Special Investigations Department discovered Blaine working as a security guard for a private company in late 2017 and operating his own landscaping business while collecting permanent total disability benefits for an injury he suffered while working for a salt company. His fraudulent activity is unrelated to his former job as a police officer in Canton, where he retired in 1997, according to city records.

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

Fayette County man owes $141,000 after second fraud conviction

Ohio BWC releases latest fraud convictions

A Washington Courthouse man pleaded guilty to felony workers’ compensation fraud Oct. 5 for working while receiving more than $141,500 in benefits from the Ohio Bureau of Workers’ Compensation (BWC).

Jeffrey Janson, 70, pleaded guilty to the fourth-degree felony in Franklin County Common Pleas Court. A judge sentenced him to six months in jail, suspended for three years of probation, and ordered Janson to pay restitution of $141,578 to BWC. Janson was previously convicted of felony workers’ compensation fraud in July 2010.

“Most people learn a lesson after a conviction for workers’ compensation fraud,” said BWC Administrator/CEO Stephanie McCloud. “Obviously that’s not the case with Mr. Janson, who tempted fate again and was caught a second time by our investigators.”

BWC’s Special Investigations Department discovered Janson working as a semi-truck driver while receiving benefits for a workplace injury. Further review of his bank records proved he was, in fact, working for four additional employers during the same time period.

In other news, BWC secured five fraud-related convictions in September, bringing its 2020 calendar year total to 57. They include a case involving a Logan County man receiving benefits while coaching high school sports teams.

BWC investigators found Dennis Martin, of Bellefontaine, working as varsity baseball coach and as an assistant coach for girls varsity basketball at Botkins High School from Oct. 27, 2017 to May 7, 2018. During this same time, Martin was collecting disability benefits from BWC. A judge credited Martin for time served and terminated the case. Martin has paid restitution of $7,082 to BWC.

On Sept. 23, Jessica Holston, of Dayton, pleaded guilty to misdemeanor theft in Franklin County Common Pleas Court for collecting more than $3,200 in disability benefits from BWC while working as a home health aide for Wellcare Home Health from March 13, 2017 to May 30, 2017. A judge sentenced Holston to 180 days in jail, suspended for three years of probation, and ordered her to pay $3,242 in restitution to BWC.

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

 

Video surveillance exposes Sidney couple’s scheme to defraud BWC

Agency closes 11 cases in June, July

The Ohio Bureau of Workers’ Compensation (BWC) closed 11 cases involving workers’ compensation fraud and related charges in June and July, bringing total convictions for BWC to 47 for calendar year 2020.

“Workers’ compensation fraud can happen anywhere in Ohio,” said BWC Administrator/CEO Stephanie McCloud. “That’s why we have dedicated investigators in every corner of the state to uncover folks — whether they’re employers, injured workers or medical providers — who try to cheat the system.”

Among the June cases is a Sidney, Ohio, couple sentenced on felony charges related to workers’ compensation fraud after a BWC investigation found the husband mowing lawns, using a snow blower, and chopping wood while claiming to be permanently and totally disabled from work.

A Shelby County judge sentenced David Juillerat on June 8 to five years of probation in lieu of jail time and a fine of $1,000 for his conviction on a reduced charge of attempted tampering with records, a fourth-degree felony. Juillerat’s wife, Wendy Juillerat, was sentenced three days earlier on a similar charge, attempted complicity to tampering with records, also a fourth-degree felony. A judge sentenced her to five years of probation in lieu of jail time and to pay court costs.

David Juillerat applied to BWC in 2018 for permanent total disability benefits, claiming a work injury left him unable to drive a car or walk without the assistance of a walker. Acting on a tip that he might be faking his injury, agents with BWC’s Special Investigations Department surveilled David for several weeks in 2019. They filmed him on multiple occasions entering and leaving medical offices with a walker. Away from a medical office, however, agents filmed him walking, shopping, working on his car, chopping wood, and other activities, all without the use of a cane or walker.

As for Wendy Juillerat, agents say she admitted to helping her husband complete his application for permanent total disability and accompanied him to numerous doctor’s appointments in which she would exaggerate his physical limitations in order for the disability to be granted.

Based on BWC’s investigation, David Juillerat’s application for disability benefits was denied in late 2019, saving BWC an estimated $233,668 in benefits over the projected life of the claim.

Other cases in June and July include:

Joseph Ferguson of Toledo

Ferguson pleaded guilty July 24 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor, after a BWC investigation revealed he was working as a web development supervisor while receiving benefits from BWC from October 2017 to January 2018. The judge sentenced Ferguson to five years of community control and ordered him to pay restitution of $6,473 to BWC. If he violates the terms of his community control, he will serve 60 days in jail.

Ruth Asamoah of Columbus

On July 13, Asamoah pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. BWC investigators found Asamoah worked for eight employers, performing the same or similar jobs she was doing when she was injured. A Franklin County judge ordered her to pay $15,020 in restitution and sentenced her to an 11-month jail sentence, suspended for five years of probation.

Jeffrey Berkley of Taylor, Michigan

BWC investigators found Berkley working as a driver, transporting cars around the Midwest, while receiving BWC benefits from July 2014 to September 2014. On July 7, Berkley pleaded guilty in Franklin County to one count of workers’ compensation fraud, a first-degree misdemeanor. The judge sentenced him to a 12-month suspended jail sentence and ordered him to pay restitution of $2,668 to BWC. Berkley paid the full amount of restitution to the clerk of courts prior to the plea.

Marguerite Cervantes of Perrysburg

Cervantes pleaded guilty July 2 to one count of workers’ compensation fraud, a fifth-degree felony, in the Franklin County Court of Common Pleas. A BWC investigation revealed Cervantes had returned to work as a clinical nurse from April to October 2016 while collecting temporary total disability benefits. The judge sentenced her to an 11-month suspended jail sentence, five years of probation, and ordered her to pay restitution of $16,885.

Angela Berardelli of North Canton

A BWC investigation revealed Berardelli was working at a restaurant while receiving BWC benefits from January 2016 to June 2017. On June 30, Berardelli pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. She received a sentence of 90 days in jail suspended for 12 months of community control. The judge ordered Berardelli to pay restitution of $10,194 to BWC. She made a payment of $6,500 at the time of plea.

Patricia Black of Cincinnati

Black pleaded guilty June 16 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony. An investigation by BWC found Black working as an office cleaner while receiving BWC benefits from January 2018 to October 2018. Black was ordered to pay $18,407 in restitution and sentenced to 12 months in prison, suspended for three years of non-reporting community control.

To report suspected workers’ compensation fraud, call 1-800-644-6292 (Option 4, Option 0, Option 1) or visit bwc.ohio.gov.

Dayton claims representative is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

A claims service specialist (CSS) in our Dayton Service Office is our 2019 Fraud Finder of the Year award winner.

We can’t name the employee because we don’t publicly identify our fraud tipsters, but this longtime BWC veteran tipped us off about a claimant collecting disability benefits after going to prison for shooting a SWAT officer.

“Thanks to this employee’s actions, we were able to save the BWC system more than $2 million,” said Jim Wernecke, director of our Special Investigations Department (SID), referring to the estimated cost over the life of the claim.

With characteristic humility, the CSS, who referred five other allegations to SID during fiscal year 2019, said, “I was just doing my job.”

About a fourth of the nearly 3,000 fraud allegations we received in fiscal year 2019 came from BWC personnel around the state. These included claims representatives, employer representatives, and others who suspected illicit behavior on the part of injured workers, employers, health-care providers or others connected to Ohio’s workers’ compensation system. Our investigations led to an estimated $5.9 million in savings to the BWC system.

“We encourage all BWC employees and the general public to contact us immediately if they suspect fraudulent behavior in our system, even the slightest hint of it,” said Director Wernecke. “We will conduct a thorough investigation, and the sooner we get started, the better.”

To report suspected cases of workers’ compensation fraud, call 1-800-644-6292 (then select option 0, option 4, option 1) or visit www.bwc.ohio.gov.

Ohio business owners owe more than $800K following fraud-related convictions

Three Northeast Ohio men owe the Ohio Bureau of Workers’ Compensation (BWC) more than $800,000 after investigators discovered they were operating their businesses without workers’ compensation coverage.

“These business owners learned the hard way they cannot operate their business without workers’ compensation coverage, and now they owe us hundreds of thousands of dollars,” said BWC Administrator/CEO Stephanie McCloud. “I’m pleased our investigators stopped these employers from continuing to break the law and cheat our system.”

William H. Foster III

William H. Foster III, owner of American Construction Group LTD, pleaded guilty Feb. 11 in a Summit County courtroom to a second-degree misdemeanor of obstructing official business after failing to work with BWC to reinstate his policy. A judge sentenced Foster to credit for time served in jail and to follow the payment agreement he made with the BWC and the Ohio Attorney General’s Office to reinstate his policy. Foster owes BWC more than $360,000 in past premiums and penalties.

Paul “Bob” Collier Jr.

In Stark County, Paul “Bob” Collier Jr. and Miklos Fioretto pleaded guilty on Jan. 17 and Feb. 5, respectively, to a fourth-degree felony charge of workers’ compensation fraud for failing to maintain coverage on their East Sparta, Ohio, business.

Investigators discovered that Fioretto and Collier changed the name of their pallet manufacturing business to avoid paying past premiums and penalties associated with the business.

Both men were sentenced to three years of community service. A condition of probation is to pay BWC restitution of $458,125.

In other news: A Columbus woman was ordered to pay BWC $6,941 in restitution on Tuesday after pleading guilty to a first-degree misdemeanor charge of workers’ compensation fraud.

BWC investigators discovered Jamia Smith, 39, working for a staffing firm while concealing that information from BWC to continue collecting disability benefits. A judge also sentenced Smith to three years of probation in lieu of six months in jail. To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit www.bwc.ohio.gov.

Fraudulent billing leads to occupational therapist’s conviction

Agency secures 6 fraud-related convictions in December   

A northeast Ohio occupational therapist was convicted last month for felony workers’ compensation fraud for billing the Ohio Bureau of Workers’ Compensation (BWC) for treatment services she did not provide to patients.

Susanna Kagalitskaya Freedman, of Euclid, pleaded guilty Dec. 17 in a Cuyahoga County court to a fifth-degree felony count of workers’ compensation fraud. The judge sentenced her to five years of probation and a $2,500 fine. Additionally, Freedman was permanently decertified to treat BWC patients for claim-related injuries.

“As an agency, we expect providers to give superior care and service to injured workers,” said BWC Administrator/CEO Stephanie McCloud. “This particular provider obviously did not meet the standard of care injured workers deserve and she cheated our system.”

Numerous red flags in Freedman’s billing practices and treatment notes sent to BWC prompted BWC’s Special Investigations Department (SID) to initiate an investigation starting in October 2017. Investigators discovered Freedman was falsifying documents, indicating services had been rendered when they had not. BWC would then pay for the substandard care based on the falsified information Freedman provided.

SID secured five other fraud-related convictions in December, bringing calendar year 2019’s total to 94.

Jeffrey Jakob of Toledo
Jakob pleaded guilty Dec. 31 in Toledo Municipal Court to one count of failure to comply, a second-degree misdemeanor, after BWC found he was operating his business, J.A. Jakob Marine Contracting, with lapsed coverage since March 2015. BWC agents made multiple attempts to assist Jakob in getting his coverage reinstated, but he failed to do so. The judge ordered him to one year of probation and to comply with a reinstatement payment plan with the Ohio Attorney General’s office. He must also remain current on installment payments to BWC.

Harold Brown of Bellefontaine
Brown pleaded guilty Dec. 23 to three second-degree misdemeanor charges of failure to comply for running his business, Brown’s Lawn & Tree Service, without workers’ compensation coverage. BWC investigators discovered his BWC policy had been lapsed since September 2010. Brown received 30 days in jail (suspended), a $250 fine, and was ordered to make regular payments to BWC and the Attorney General until a reinstatement payment plan was paid in full. The current amount due on Brown’s BWC policy is approximately $133,000.

Marie Olinger of Delta
On Dec. 17, a Franklin County judged ordered Olinger to three years of community control for working while receiving more than $2,800 in disability benefits from BWC. The investigation found Olinger had returned to work at the Dental Center of Northwest Ohio between January and March 2017 while receiving temporary total disability benefits.

Rodney Filibeck of Mansfield
Filibeck pleaded guilty Dec. 16 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. After receiving an anonymous tip, BWC investigators determined Filibeck was working construction jobs while receiving BWC disability benefits between September 2016 and June 2017. The judge handed down a 60-day jail sentence, suspended for 12 months of community control and ordered him to pay $2,519 in restitution to BWC.

Deangelo Speed of Shaker Heights
Speed pleaded guilty Dec. 2 in a Franklin County courtroom to a fifth-degree felony count of workers’ compensation fraud. BWC agents found Speed working as a truck driver while collecting BWC benefits from Oct. 20, 2015, through Jan. 27, 2017. The judge ordered Speed to pay BWC $7,599 in restitution and court costs by March 2, 2020. The judge also sentenced Speed to a six-month jail sentence, suspended for six months of probation.

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

Northeast Ohio business owners owe BWC nearly $1.3 million following fraud convictions

Two northeast Ohio businessmen must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $1.3 million in restitution following their recent convictions on multiple fraud charges in separate, unrelated cases.

“We look forward to recouping these dollars and directing them where they belong — taking care of injured workers, creating safe workplaces, and giving employers excellent coverage and service,” said BWC Administrator/CEO Stephanie McCloud.

Sentenced Monday in a Cuyahoga County courtroom, Robert E. Fitz must pay BWC $961,956 in monthly installments and serve five years of probation for his Sept. 30 conviction on a fourth-degree felony charge of workers’ compensation fraud.

Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, had refused to cooperate with BWC to bring his lapsed policy into compliance, leaving the agency to pick up the costs on 43 injury claims since 2003, five in the last five years.

On Oct. 21 in Stark County, a judge ordered an Alliance man to pay BWC $300,230 in restitution after BWC found him defrauding the agency in multiple ways, including working at two businesses he owned while collecting workers’ compensation for work injuries he claimed left him permanently and totally disabled.

Roger L. Kale, Jr., 51, also must serve five years of probation and perform 100 hours of community service. BWC’s Special Investigations Department also found the following:

  • To establish his compensation rate for his 2009 workplace injury, Kale reported wages for himself that were higher than what he reported on his BWC payroll reports for all of his employees combined.
  • Kale operated A-1 Brosch Tree Service without workers’ compensation coverage required by Ohio law.
  • Kale under-reported his payroll and misclassified his employees to lower the cost of his BWC premiums.
  • Kale presented clients an altered BWC certificate of coverage to make it appear his business had coverage when it did not. One client reported Kale to BWC.

Video obtained from the Ohio State Highway Patrol shows Kale operating a tow truck while claiming to be permanently disabled.

Kale pleaded guilty to one count of tampering with records, a fourth-degree felony; three counts of workers’ compensation fraud, all fourth-degree felonies, and two first-degree misdemeanor charges of workers’ compensation fraud.

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

Cincinnati caterer convicted of workers’ comp fraud

Woman ran catering business while collecting disability benefits

A Cincinnati woman claiming to be permanently disabled from work owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $41,000 after her felony conviction Oct. 24 for workers’ compensation fraud.

Michelle D. Smith, 57, pleaded guilty to the fifth-degree felony in the Franklin County Common Pleas Court after BWC discovered she owned and ran two businesses, Expression Unique LLC and Later in Life Brides, while collecting BWC benefits for workers deemed permanently and totally disabled.

“Our Special Investigations Department found records indicating Ms. Smith worked 35 hours per week at her businesses,” said BWC Administrator/CEO Stephanie McCloud. “I don’t think that meets anyone’s definition of ‘permanently and totally disabled,’ let alone BWC’s.”

Smith, who was injured on a job in 2000, declined through her attorney to be interviewed by BWC investigators about her case. Investigators gleaned much of their evidence from customer interviews and a catering contract Smith had with the city of Cincinnati.

A Franklin County judge ordered Smith to pay BWC $40,873 dollars in restitution and serve five years of non-reporting community control (probation). If she violates her probation, she must serve a year in prison.

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

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.