Three Ohio businesses plead in work comp fraud cases

Two owners owe a combined $78K in back premiums

Two business owners from Bellefontaine, Ohio, that owe approximately $78,000 in back premiums to the Ohio Bureau of Workers’ Compensation can avoid fines and jail time if they bring their BWC policies back into compliance later this year, a municipal judge ruled June 12.

“Letting your workers’ compensation coverage lapse is a serious matter that puts employees and businesses at risk for potentially staggering medical costs and related expenses,” said Jim Wernecke, director of BWC’s special investigations department. “We tried to work with these owners, but they ultimately didn’t do what they needed to do to avoid criminal charges.”

Jason Brown, the owner of the trucking company Bolts Carriers LLC in Bellefontaine, pleaded no contest to two second-degree misdemeanor counts of Failure to Comply after BWC found he defaulted on a reinstatement payment plan in September 2015. Prior to sentencing, Brown paid approximately $1,900 toward his balance of more than $55,000. He has until Dec. 12 to bring his policy into compliance or he could face 20 days jail and a $450 fine on each of the two charges.

In a separate case, the owner of a boat canvas shop in Bellefontaine whose policy lapsed 18 years ago has until Sept. 1 to bring the company’s policy into compliance. One week prior to sentencing, Desee McIntosh of Custom Canvas remitted a $1,000 payment toward his balance of more than $23,000. He pleaded no contest to three second-degree misdemeanor counts of Failure to Comply. He faces 30 days in jail and $450 in fines for each count.

In other news, the owner of The Gyro Spot Bar & Grill in Parma, Ohio, pleaded guilty Tuesday to one count of Attempted Workers’ Compensation Fraud, a second-degree misdemeanor, after BWC found his business lacked workers’ comp coverage.

As BWC agents worked with owner John Triskett to bring his business into compliance, they found he intentionally under-reported his payroll and used other inaccurate information to keep his policy payments significantly less than the amount he actually owed.

A judge sentenced Triskett to 30 days in jail (suspended), six months of probation and ordered Triskett to pay a $100 fine and $1,140 in restitution to BWC.

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

Eight Ohioans plead to work comp fraud-related charges in May

The eight Ohioans who pleaded guilty and no contest in May to fraud-related charges against the Ohio Bureau of Workers’ Compensation (BWC) include a homicide suspect, a Cincinnati bus driver who collected disability benefits while working two other jobs, and a health care provider who billed BWC for work his company didn’t perform.

“Our convictions in May illustrate a range of fraud types that we see at BWC, some more serious than others,” said Jim Wernecke, director of BWC’s special investigations department. “But regardless of severity, we approach each case with equal determination to find the truth, prosecute the guilty and reclaim funds that support injured workers and create safer workplaces in our state.”

The cases, in order of most recent court date, include:

Samantha Coleman, Cincinnati — Working and Receiving
Coleman was working as a bus driver for the Southwest Ohio Regional Transit Authority (SORTA) when she was injured on the job in November 2015. While collecting disability benefits from SORTA, she continued to work her other two jobs as a tax preparer and security guard.

Coleman pleaded guilty May 30 in Hamilton County to one count of worker’s compensation fraud and one count of theft, both fifth-degree felonies. She was placed in the county’s diversion program because she had no prior record. Over the next year, she must reimburse SORTA $7,088, complete 120 hours of community service and participate in a counseling program.  If she successfully completes these requirements the case will be dismissed and she will not receive a conviction.

Bryan Gentry, Canal Fulton — Tampering with Records
Gentry pleaded guilty to a third-degree felony count of Tampering with Records after SID determined he created a phony BWC certificate of coverage to secure a tree-trimming job in Stark County. The judge sentenced him to a year in prison, to be served concurrently with a three-year term for assault and receiving stolen property.

Gentry, who’s imprisoned in Richland Correctional Institution in Mansfield, is also a suspect in the 2017 killing of a Stark County man who was romantically involved with Gentry’s girlfriend.

Gabriella Benkovits, Lakewood — Working and Receiving
Benkovits pleaded guilty May 22 to a first-degree misdemeanor count of workers’ compensation fraud after BWC found her working as a bartender while collecting disability income. She must pay BWC $7,595 in restitution and serve two years of probation.

Jeffrey Guerin, Willoughby Hills — Services Not Rendered
Guerin pleaded guilty in a Franklin County court to a first-degree misdemeanor count of workers’ compensation fraud. BWC found him billing the agency for work his now-defunct company, PT Plus in Willoughby Hills, did not perform. Guerin paid $7,154 in restitution to BWC and agreed to leave the BWC network of providers.

Carolyn Tibbetts, Toledo — Lapsed Coverage
Tibbets, the owner of Little Explorers Toledo Learning Center, pleaded no contest May 17 to three charges of failure to comply after investigators found her operating her child care center without BWC coverage. Tibbets worked with BWC to bring her businesses into compliance, but she failed to continue payments on a balance of more than $12,000. The charges are second-degree misdemeanors.

A judge referred her case to Lucas County’s probation department to be considered for its Alternatives Program. No further court action will be taken against Tibbetts if she’s accepted into the program.

Marshall Winn IV, Niles — Working and Receiving
Winn, a truck driver from northeast Ohio, pleaded guilty May 14 to a fifth-degree felony count of workers’ compensation fraud after investigators found him working while collecting disability benefits. A Franklin County judge sentenced him to five years of probation in lieu of nine months in prison and ordered him to pay BWC $12,450 in restitution and court costs.

Brooke Mobley, Dayton — Working and Receiving
Mobley pleaded guilty May 9 in Franklin County to one count of theft, a first-degree misdemeanor, after investigators found she had returned to work as an office worker while collecting disability benefits from BWC. A judge fined Mobley $200 plus court costs in lieu of a 60-day jail sentence. Mobley paid BWC $5,455 in restitution prior to her sentencing.

Judith Barlock, Parma — Lapsed Coverage
Barlock, the owner of Chase Professional Transport, failed to bring her company back into compliance after BWC discovered her policy had lapsed. She pleaded guilty May 2 to one count of failure to comply, a second-degree misdemeanor. A judge sentenced her to 90 days in jail (60 days suspended) and five years of probation. The court deferred the balance of jail time and $750 of her fine until a June 20 probation review. The amount of restitution owed BWC will be determined at that review.

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

Ohio murder suspect defrauds state work comp bureau

Northeast Ohio tree trimmer falsified coverage certificate

One month after his alleged role in murdering his girlfriend’s other lover in February 2017, Bryan T. Gentry created a phony proof-of-coverage certificate from the Ohio Bureau of Workers’ Compensation (BWC) to land a tree-trimming job and avoid paying for actual coverage.

The Stark County man’s handiwork earned him a one-year prison sentence May 24 when a Summit County judge found him guilty of tampering with records, a third-degree felony. On the same day, the judge also found Gentry, 27, of Canal Fulton, guilty for the second-degree felonious assault of an Akron man last year, a crime apparently unrelated to his BWC case or to one involving a deadly love triangle.

“It seems our case might be the least of Mr. Gentry’s legal troubles right now, but we can’t let unrelated crimes stop us from doing our job,” said Jim Wernecke, director of BWC’s special investigations department. “Our job is to deter, detect and prevent worker’s comp fraud. We don’t let anyone slide.”

The judge gave Gentry three years in prison for the assault charge, to be served concurrently with his sentence for tampering and still another prison sentence he earned in December for receiving stolen property. Police tracked Gentry down last year after finding his mail in a stolen truck.

In the BWC case, Wernecke said a customer of Gentry’s tree service contacted the agency last summer after he suspected Gentry’s BWC certificate wasn’t legitimate. Two clues tipped off the customer, an insurance salesman: The certificate lacked a policy number, and Gentry noted a policy period of one day, “3/10/2017 through 3/10/2017.” BWC’s practice is to note a full policy year, such as 07/01/2016 through 06/30/2017.

BWC agents determined Gentry doctored a relative’s certificate to look like his own so he and his six workers could get the job. Agents interviewed Gentry on Jan. 31 at the Lorain Correctional Institution in Grafton, Ohio, where he lied and denied forging the certificate, but was “soft-spoken and very well-mannered” while doing it, they said.

Two days later, Gentry’s life got more complicated. Acting on a tip from Gentry’s girlfriend, Stark County authorities recovered the body of 25-year-old man from the backyard of his Massillon home. They found him in a plastic tote, encased in concrete and buried six feet below ground.

For more on that case, see these articles in the Massillon Independent and People magazine.

Gentry has since been relocated to the Richland Correctional Institution in Mansfield.

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

Case update: Ohio doctor sentenced to 5-year prison term

Dr. Timothy Manuel, a Highland County physician who improperly prescribed opioids to injured workers, was sentenced Thursday to five years in prison and ordered to pay $12,060 in restitution to BWC.

Manuel, 59, was the subject of a joint investigation by BWC and the Ohio Board of Pharmacy that found he prescribed large amounts of medically-unnecessary oxycodone to numerous patients while working as a doctor at Hillsboro Urgent Care in southwestern Ohio. He also billed BWC for medical services that weren’t provided.

Manuel was taken into custody following his sentencing in the Highland County Court of Common Pleas. Read more on the case in this Hillsboro Times Gazette article.

Youngstown auditor is BWC’s Fraud Finder of the Year

By Jeff Baker, Program Administrator, BWC Special Investigations Department

An external auditor in the Youngstown Claims Office received the 2017 Fraud Finder of the Year award May 22 from BWC’s special investigations department (SID).

The auditor, who does not want to be identified given the sensitive nature of his job, 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 that most of the employer’s Ohio employees were reported to ODJFS, but not to BWC. The referral resulted in the identification and recovery of $804,352 in savings to the state insurance fund.

“Thanks to this employee’s vigilance and timely referral, we were able to stop fraud and save the BWC system nearly a million dollars,” said SID Director Jim Wernecke. “Our success in uncovering fraud protects resources we need to take care of injured workers, create safe workplaces and provide the best service possible to employers at affordable rates.”

The auditor, who handles employer policy underwriting and premium audits, said he appreciates the recognition and is glad he could help.

“This is why we do what we do,” he said. “After spotting a red flag in this case, I dug a little deeper and found more red flags. Persistence paid off, and it’s a good thing, because this kind of behavior drives up our costs and hurts all the honest players in our system.”

SID received 2,320 allegations of fraud in 2017, with about a fourth of those coming from BWC personnel around the state — claims representatives, employer representatives and others who suspect illicit behavior on the part of injured workers, employers, health care providers or others connected to the BWC system. During 2017, SID closed 311 cases referred by 158 BWC employees. The SID investigations found fraud in 146 of the 311 cases and generated $2,724,426 in identified savings.

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

“We encourage all BWC employees 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) or visit www.bwc.ohio.gov.

Cleveland bartender’s Facebook post exposes work comp fraud

Restaurant worker owes BWC nearly $7,600

A Cleveland bartender must repay the Ohio Bureau of Workers’ Compensation $7,595 after pleading guilty Tuesday to workers’ compensation fraud.

In addition to restitution, Gabriella Benkovits, 26, of Lakewood, must serve two years of probation for the first-degree misdemeanor, a judge in the Franklin County Court of Common Pleas ruled.

“The company managing Ms. Benkovits’ medical claim for her 2012 work injury alerted us that they found a Facebook post indicating she was working as a bartender in Westlake,” said Jim Wernecke, director of SID’s special investigations department. “Our investigation revealed she worked at three different establishments from July 2015 to February 2016 while collecting disability benefits she wasn’t entitled to.”

Wernecke said Benkovits deliberately concealed her employment from BWC, her physicians and other parties officially involved in her injury case.

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

1,000 Fraud Hotline calls in 6 months!

By Jeff Baker, Program Administrator, BWC Special Investigations Department

We have received 1,000 calls since we launched our new Fraud Hotline system six months ago during International Fraud Awareness Week 2017. That’s 167 calls a month, a little more than seven a day, or one nearly every working hour!

In our November 14, 2017 blog, we noted that calling the BWC Fraud Hotline is the most interactive and direct way for you to report an allegation of fraud. Our hotline puts you in direct contact with an agent in our Special Investigations Department, one ready and willing to listen to your concerns. (Under our old system, you reached a representative in BWC’s Customer Contact Center.)

Our hotline agents have years of investigative knowledge, skills and experience securing the essential information from sources. Whether the fraud hotline agent is Connor, Jake, Jeff, Karen, Karie or Loryn, or any of our 25 fraud analysts assigned to our special investigations unit statewide, callers know within seconds that they have reached a committed, respectful professional.

You, the general public, are essential in helping us fight fraud, waste, and abuse in workers’ comp. We are celebrating our 25th year since the creation of our Special Investigations Department in 1993 and thousands of our closed, founded cases started with a call to our Fraud Hotline.

Just last month, for example, the convictions of Rodney Alberino, James Harris and Donna Steele were each the result of just such a call.

If you’re concerned about the alleged fraudster discovering your identity, rest assured. Your identity may remain either anonymous or confidential, depending on your preference. In addition, you don’t need to prove any facts or even have 100 percent confidence in your suspicion. You need only to suspect that fraud may have occurred or continues to occur. We’ll take care of the rest.

We look forward to hearing from you, so give us a call at 1-800-644-6292 if you suspect fraud. We will conduct the investigation and determine the facts. Together, we are successfully combatting workers’ compensation fraud in Ohio – one call at a time.

Thank you for your support!