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.

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.

Akron business owner convicted of manslaughter, workers’ comp fraud

Company has history of worker injuries, noncompliance with BWC

The owner of an Akron construction company pleaded guilty to involuntary manslaughter July 24 after one of his workers fell to his death in late 2017.

James D. Coon, the owner of James Coon Construction, also pleaded guilty in a Summit County courtroom to a fourth-degree felony charge of workers’ compensation fraud. Investigators with the Ohio Bureau of Workers’ Compensation (BWC) found Coon lacked BWC coverage when his employee died and that he repeatedly lied about his business to minimize his premiums or avoid paying them altogether.

“This tragic case underscores the critical importance for workplace safety protocols and workers’ compensation insurance,” said BWC Administrator Stephanie McCloud. “Our investigation found Mr. Coon willfully and deliberately disregarded his responsibilities under the law, and now several lives are devastated by it.”

Gerardo “Jerry” Juarez Sr., a 39-year-old married father of five, died Nov. 4, 2017, at the scene of his fall. It was his second day on the job. The federal Occupational Safety and Health Administration notified BWC of the accident four days later.

According to BWC’s special investigations department, Juarez was working on a sloped roof of a 3-story apartment complex without a fall protection device when he slipped and fell 25 feet to his death. Among the investigation’s findings:

  • Two other Coon employees were injured in falls prior to Juarez’s death, also during a time when Coon lacked BWC coverage.
  • Coon told BWC he no longer operated his business. But in March 2018 — five months after Juarez’s death — agents observed six Coon employees at a worksite tearing shingles from a roof. They had no safety equipment.
  • Coon consistently reported to BWC over the years of having no employees. A BWC audit found nearly $286,000 in payroll to employees from July 1, 2009 through July 1, 2018.

Coon owes BWC $303,152 to date for unpaid premiums and claims costs for workers injured during a policy lapse. His conviction for involuntary manslaughter, a third-degree felony, is punishable by a maximum five years in prison and a fine of up to $10,000. Sentencing is set for August 21.

BWC safety services and grants: BWC offers free safety consultations and grant dollars to assist employers with the purchase of equipment that improves workplace safety. For more, visit bwc.ohio.gov and click on the Safety & Training link.

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

BWC secures 7 fraud convictions in April

Fraudsters ordered to pay BWC nearly $107,000 in restitution

The Ohio Bureau of Workers’ Compensation secured seven fraud convictions in April, all workers who were discovered working for a living while collecting disability benefits from the agency.

Those convicted were ordered to pay BWC a combined total of $106,995 in restitution.

“We look forward to recouping those dollars so they can serve a legitimate purpose – taking care of injured workers,” said BWC Administrator/CEO Stephanie McCloud.

In order of most recent court appearance, those convicted in April include:

Clinton Walker of Cincinnati, Ohio
Walker pleaded guilty April 25 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. He was ordered to pay BWC $9,831 in restitution and $3,600 in investigative costs. He provided a cashier’s check to BWC at his hearing for the full amount.

Ernest Thomas of Boardman, Ohio
Thomas pleaded guilty April 23 to one count of workers’ compensation fraud, a first-degree misdemeanor. He was sentenced to 180 days in jail, which was suspended for six months of probation, and ordered to pay a $500 fine and court costs. Thomas paid restitution and investigative costs totaling $10,605 to BWC at the time of his plea.

Michael D. Myers of Lebanon, Ohio
Myers pleaded guilty April 22 to a fifth-degree felony charge of workers’ compensation fraud in Franklin County after BWC found him working while collecting disability benefits in 2016 and 2017. A judge ordered Myers to pay BWC $45,338 in restitution, perform 25 hours of community service and serve one year of probation in lieu of six months in prison.

Antonio Daniels of Streetsboro, Ohio
Daniels pleaded guilty April 17 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found him working as an industrial assembler while collecting BWC benefits. A Franklin County judge ordered Daniels to pay BWC $6,409 in restitution and serve five years of probation in lieu of 30 days in jail.

Kristin Stuhldreher of Youngstown, Ohio
Stuhldreher pleaded guilty April 16 to a fifth-degree felony count of workers’ compensation fraud after investigators found her working as a restaurant manager while collecting BWC disability benefits. A judge ordered her to pay BWC $18,239 in restitution and serve five years of probation.

Amanda Treadway of Reynoldsburg, Ohio
Treadway was ordered to pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC discovered Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.

Antoine Harris of Cincinnati, Ohio
Harris was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3 after BWC found him working as a truck driver while collecting disability benefits. Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.

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

Ohio woman keeps BWC benefits alive after father dies

Owes BWC more than $29,000 after fraud conviction

A northeastern Ohio woman pleaded guilty May 9 to workers’ compensation fraud after investigators with the Ohio Bureau of Workers’ Compensation (BWC) found her collecting her father’s benefits for more than two years after he died.

Deborah Rosenlieb of Cuyahoga Falls pleaded guilty to the fourth-degree felony in the Summit County Common Pleas Court, where a judge ordered her to pay BWC $29,418 in restitution. The judge also ordered Rosenlieb to serve two years of community service.

“Ms. Rosenlieb’s father was receiving death benefits on behalf of his late wife, but when her father died in January 2016 she didn’t let us know,” said BWC Administrator/CEO Stephanie McCloud. “She knew she wasn’t entitled to these benefits, but she used them for personal expenses until we learned of her scheme in April 2018.”

In other news:

A Cleveland man must pay BWC $3,525 in restitution after pleading guilty Monday to a misdemeanor count of workers’ compensation fraud after BWC found him working as a maintenance technician and office manager while collecting disability benefits.

James Nichols, 57, also must serve two years of probation and pay court costs. He paid $1,000 toward his restitution prior to entering his guilty plea in the Franklin County Common Pleas Court.

A Youngstown woman pleaded guilty May 2 to a misdemeanor count of workers’ compensation fraud after BWC found her working for a call center while collecting disability benefits.

A Franklin County judge ordered Natasha Mitchum, 42, to pay BWC $1,863 in restitution and serve three years of probation.

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

Southwest Ohio man guilty of workers’ comp fraud

Lebanon man owes BWC more than $45,000 in restitution

A Lebanon man owes the Ohio Bureau of Workers’ Compensation (BWC) more than $45,000 after pleading guilty April 22 to workers’ compensation fraud.

Michael Dwayne Myers, 49, pleaded guilty to the fifth-degree felony in the Franklin County Court of Common Pleas after BWC found him working for a Lebanon fire and water damage restoration company while collecting disability benefits in 2016 and 2017.

“The State Insurance Fund is for workers who are truly injured and need benefits to survive, not for people looking to unlawfully double dip and pad their income,” said BWC Administrator/CEO Stephanie McCloud.

A judge ordered Myers to pay BWC $45,338 in restitution, perform 25 hours of community service and serve one year of probation in lieu of six months in prison.

In other news:

A Cincinnati man was ordered to pay BWC $13,432 in restitution after pleading guilty to a first-degree misdemeanor count of workers’ compensation fraud Monday.

A Franklin County judge ordered Clinton Walker to pay $9,831 in restitution for benefits he received while working for several employers from 2012 to 2015. Walker also must pay $3,600 in investigative costs. He provided a cashier’s check to BWC at his hearing for full restitution.

A Mahoning County man pleaded guilty April 23 to a first-degree misdemeanor count of workers’ compensation fraud after BWC investigators found him working as a maintenance technician while collecting BWC benefits.

A county judge sentenced Ernest Thomas to six months of community control (probation) and ordered him to pay a $500 fine and court costs. Thomas paid restitution and investigative costs totaling $10,605 to BWC at the time of his plea.

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

Ducking workers’ comp coverage costs Mansfield freight hauler $144K

The owner of a Mansfield freight hauling and trucking company must pay $144,400 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) following his sentence Monday for his conviction on four felony charges related to workers’ compensation fraud.

A Richland County judge also ordered Robert Tate, owner of Elite TNT Enterprises, to serve two years of probation for his conviction Feb. 20 on two counts of workers’ comp fraud, fourth-degree felonies, and two counts of tampering with records, third-degree felonies. Tate must bring his BWC policy into compliance with state law and pay the agency $137,447 in unpaid policy premiums and $6,953 for the costs of its investigation.

“We reached out to Mr. Tate several times to follow the law and protect his employees with workers’ compensation coverage, but he chose to ignore us and it cost him,” said BWC Administrator/CEO Stephanie McCloud.

BWC’s special investigations department discovered in 2017 that Tate was operating his business without BWC coverage. After several attempts to work with Tate, agents subpoenaed bank records and audited his business, finding Tate under-reported his payroll over several payroll periods in an attempt to lower the amount he owed the agency. They also found he falsified new applications for BWC coverage by failing to list previous policies with the agency and he under-reported the number of workers he employed.

In other news:

  • A Reynoldsburg woman must pay BWC $5,010 in restitution after pleading guilty April 4 to a misdemeanor count of workers’ compensation fraud. BWC investigators discovered Amanda Treadway working as a swimming pool attendant at a condominium complex in 2017 and also as a phlebotomist while collecting BWC disability benefits.
  • A Cincinnati man found working as a truck driver while collecting BWC disability benefits was convicted of a fifth-degree felony charge of workers’ compensation fraud April 3. Antoine Harris paid BWC $7,963 in restitution prior to his guilty plea. A judge subsequently terminated Harris’s sentence of one month of probation.
  • A Cleveland Heights woman found working as a restaurant hostess while collecting BWC disability benefits pleaded guilty to a misdemeanor count of workers’ compensation fraud March 28 in Franklin County Municipal Court. A judge ordered Morgan Hines to pay BWC $4,089 in restitution, $88 in court costs and a $250 fine. The judge also sentenced her to two years of probation.

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

Employer compliance supervisor is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An employer compliance supervisor in the Cincinnati Service Office received the 2018 Fraud Finder of the Year award Feb. 21 from BWC’s special investigations department (SID).

The supervisor received the award for alerting SID to a case in which an employer failed to report payroll and failed to respond to multiple attempts to schedule a premium audit. An investigation by the SID employer fraud team revealed the employer was operating without coverage. The referral resulted in the identification and recovery of $316,103 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud in its tracks and save the BWC system hundreds of thousands of dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources needed to create safe workplaces in Ohio and to care for those who are legitimately injured on the job.”

The BWC employee, who supervises field staff members assigned to the BWC employer compliance department, said he was honored to receive the award.

“I am truly honored to be recognized for simply doing my job and trying to do my part, while seemingly small, to safeguard the State Insurance Fund,” the employee said. He offered the following advice to any BWC employee who suspects fraud: “Trust your gut.”

SID received 3,150 allegations of fraud in 2018. About a fifth of those 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 the BWC system. During 2018, SID closed 381 cases referred by 169 BWC employees. The investigations resulted in 192 “founded cases” (the original allegation was proven true) and identified $3.1 million in savings to the BWC system

To show their appreciation, SID leaders conducted a thank-you tour and red-flag training from November through February, presenting Fraud Finder Award certificates to BWC employees in service offices across Ohio.

“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.

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