Office manager sentenced to pay back over $30K

Crystal Posey was found guilty of one count of workers’ compensation fraud and must pay back $30,278.61 to the Bureau of Workers’ Compensation (BWC). BWC’s Special Investigations Unit (SIU) found Crystal Posey began working as an office manager for a chiropractic clinic in 2015 and was still employed at the end of the investigation. Evidence collected proved Posey knowingly, and with fraudulent intent, worked while simultaneously collecting BWC disability benefits to which she was not entitled.

Posey pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony. Posey was sentenced to eight months incarceration, suspended, and placed on non-reporting probation for five years. Should Posey violate the terms of her probation, she will be subject to a suspended sentence of eight months in jail.

“Our Special Investigations Department continues to do a fantastic job,” Administrator/CEO Stephanie McCloud said. “By shutting down fraud, this team helps ensure the funds are there for Ohio’s injured workers and employers.”

In other news:

Jason Strzala, dba Goodfellas Plumbing and Drain Inc                               

The Special Investigations Department received a referral from the BWC Employer Compliance Department after Jason Strzala, owner of Goodfellas Plumbing and Drain, failed to cooperate with the compliance officer and continued to operate without BWC coverage. The Employer Fraud Team made further attempts to assist Strzala with reinstating the policy; however, he failed to take the steps necessary to reinstate coverage on the policy.

On September 1, 2021, Strzala pleaded no contest and was found guilty in Parma Municipal Court on two (2) counts of failure to comply, both second-degree misdemeanors. Strzala was sentenced to 60 days in jail, suspended.

Jennifer Soich-Zecher

The Special Investigations Department received an anonymous call to report Jennifer Soich-Zecher working while concurrently receiving BWC benefits.

The Northeast Region SIU’s investigation found Soich-Zecher was employed as a cashier and customer service associate with Walmart and Dollar Tree while collecting BWC disability benefits. The investigation identified that Soich-Zecher worked and received benefits between February and August 2019 and confirmed that she knowingly and with fraudulent intent was working while collecting BWC disability benefits to which she was not entitled.

On September 9, 2021, Jennifer Soich-Zecher pleaded guilty in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. Soich-Zecher was sentenced to five years community control, 180 days jail (suspended) and ordered to pay restitution in the amount of $2,191.45.

Davida Taylor

The Special Investigations Department opened an investigation after it identified Davida Taylor potentially earned wages during time periods she had received BWC disability benefits.

The Northeast Region SIU’s investigation found Taylor maintained employment as a Clinical Technician/Patient Care Nurse Assistant with the Cleveland Clinic while concurrently collecting BWC disability benefits. The investigation identified that Taylor worked and received benefits between March and August 2019.

Davida Taylor pleaded guilty in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fifth-degree felony. Taylor was sentenced to non-reporting probation for four years and ordered to pay restitution of $12,206.16 to the BWC. If Taylor violates the terms of her probation, she is subject to a suspended sentence of nine months in jail.

Former doctor sentenced to pay back over $500K

Former New Albany doctor, Khaled Amr, admitted to staging a break-in at his Columbus practice for a fraudulent insurance claim and running a pill mill. Amr was sentenced to spend five years on probation and ordered to forfeit more than a half-million dollars.

Amr was arrested in 2019 at his home, where he was found hiding in a closet. According to court records, Amr was operating a pill mill out of his practice, Columbus Pain Specialists, for more than seven years. Amr was selling Oxycodone in exchange for financial kickbacks and staged a break-in at his practice to make a fraudulent insurance claim, resulting in more than $1 million being paid to him.

He will be ordered to surrender his medical license and DEA license as part of the terms of his probation. He also was ordered to pay a $5,000 fine and forfeit more than $524,000 that were proceeds of his criminal behavior.

In other news

On August 9, 2021, Lisa Buckner pled guilty to one count of workers’ compensation fraud, a misdemeanor of the first degree. Buckner returned to work at Fayette County Community Action, however, she had not reported this employment to the Bureau of Workers’ Compensation (BWC) and continued to receive disability benefits.

The investigation confirmed that Buckner knowingly and with fraudulent intent was working while simultaneously collecting BWC disability benefits to which she was not entitled. Restitution of $5,119.82 had previously been paid in full through a lump sum settlement.  A Fayette County judge accepted Buckner’s guilty plea, ordered one day in jail, gave her one day jail time credit, and closed the case for time served.

Robert Swartz, dba Bamboo Relaxing Massage

The Special Investigations Department received an allegation from the Ohio Investigative Unit regarding Robert Swartz, owner of Bamboo Relaxing Massage. Swartz came under scrutiny by a task force investigating illegal activities at massage parlors. BWC investigators joined the Ohio Investigative Unit and other federal, state and local agencies in a joint investigation. It was discovered Swartz was operating his business without BWC coverage.

On July 15, 2021, Robert Swartz pleaded guilty in Cuyahoga County Common Pleas Court to one count of workers’ compensation fraud, a fifth-degree felony. On the workers’ comp fraud charge, Swartz was sentenced to five years of community control and restitution ordered in the amount of $1,156.56 to BWC.

As part of the task force investigation, Swartz also pleaded guilty to engaging in pattern of corrupt activity, promoting prostitution, grand theft, and practicing medicine without a license.

Cynthia Whitner

The Special Investigations Department opened an investigation after it’s Intelligence Unit identified Cynthia Whitner had potentially earned wages during periods she received BWC disability benefits. The investigation found Whitner knowingly and with fraudulent intent was hired and worked for I-Force while simultaneously collecting BWC disability benefits to which she was not entitled.

On July 14, 2021, Whitner pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. Whitner was found guilty and, at the defendant’s request, deferred sentencing until September 23.

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

Workers’ comp fraud lands cheaters costly penalties

Convicts include Central Ohio doc ordered to pay $71K to BWC

Four Ohioans convicted or sentenced for workers’ compensation fraud in April include a Central Ohio physician who unlawfully distributed controlled substances and overbilled the Ohio Bureau of Workers’ Compensation (BWC).

On April 15, U.S. Judge Michael Wilson of the Southern District of Ohio ordered Kedar Deshpande, MD, to pay $117,122 in restitution, including $70,957 to BWC. The judge also sentenced Deshpande to three years of supervised release, 12 months of which is to be served under home detention, for felony counts of unlawful distribution of controlled substances and false statements relating to health care matters.

“Our Special Investigations Department found Dr. Deshpande upcoded patient office visits by falsely representing the level of examination he performed on our injured workers so he could receive inflated reimbursement from BWC,” said BWC Interim Administrator/CEO John Logue. “Congratulations to our investigators for their work on this important case and for bringing three other fraud cases to a close last month.”

Deshpande is the former owner and operator of the now-closed Orthopaedic & Spine Center, which had three locations in Central Ohio. A multi-jurisdictional task force of state and federal authorities found Deshpande pre-signed blank prescriptions for unqualified and non-licensed staff to complete and dispense to patients in his absence. The staff would fill-in the prescriptions with Schedule II controlled substances before dispensing to patients. The staff would mostly dispense the pre-signed prescriptions when Deshpande was on vacation, arrived late to the office, or was otherwise not at the clinic.

Other April fraud cases include:

William Knox of Athens, Ohio

Knox pleaded guilty April 7 in the Franklin County Common Pleas Court to one count of workers’ compensation fraud and one count of forgery, both fourth-degree felonies. Knox was sentenced to community control for five years and ordered to pay BWC restitution of $131,752.

BWC investigators found Knox inflated his weekly income from his employer of record so he could be paid at a higher weekly rate of compensation from BWC.

Tanya Houston of Shaker Heights, Ohio

A Franklin County judge ordered Houston 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 on April 7. BWC discovered Houston working while collecting injured-worker benefits.

Frank Phillips of Hamilton, Ohio

Phillips pleaded guilty April 26 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. He was ordered to pay BWC $12,588 in restitution and serve five years on community control.

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

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.