OH BWC Investigations Result in 4 Workers' Comp Fraud Convictions in January
Columbus, OH (WorkersCompensation.com) - Ohio Bureau of Workers' Compensation (BWC) Administrator/CEO Steve Buehrer announced today that four individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio's workers' compensation system in January 2016. These court actions are the result of investigations conducted by BWC's Special Investigations Department (SID).
"A recent case in which two individuals stole the identity of a deceased claimant shows that some people will go to great lengths to scam the system," said Buehrer. "They are a clear reminder why we continue our efforts to protect the dollars employers pay to support Ohio's injured workers in their time of need."
The following are cases that resulted in guilty pleas or convictions during January:
Consuelo "Connie" Griffin and David Lusk (Cincinnati, Hamilton County) both pleaded guilty Jan. 14 in the Hamilton County Court of Common Pleas to counts of theft after they were discovered cashing BWC benefit checks for an injured worker who had died. SID opened an investigation after receiving an allegation from BWC's claims department, which was unable to contact an injured worker receiving permanent total disability for a workplace injury. The claims department reported that worker's phone was disconnected. The investigation found that while the injured worker passed away in June 2014, the BWC checks that were mailed to his home continued to be cashed. Griffin and Lusk lived in the same apartment complex as the deceased and when he was hospitalized, Griffin signed a power of attorney document giving her control over his finances. Griffin also had the injured worker's mail forwarded to her address and the pair moved into his apartment when he was hospitalized. Griffin confessed to signing Harrell's name on the checks and cashing them. Griffin also took money out of his bank account while he was ill and wrote checks from his account to herself for cash. His account was soon closed because Griffin and Lusk spent all the money and failed to pay any of his nursing home expenses. Lusk pleaded guilty to count of theft and one count of theft from the elderly, both fifth-degree felonies. Griffin also pleaded guilty to two counts of theft, both fifth-degree felonies. The court sentenced them to 10 months in jail, suspended, and ordered them to repay restitution of $5,072.62. They also received three years of probation.
Michelle Green (Columbus, Franklin County) pleaded guilty Jan. 13 in the Franklin County Court of Common Pleas to attempted workers' compensation fraud, a first degree misdemeanor, for working while receiving benefits. SID's Intelligence Unit received data from the Ohio Department of Job and Family Services (ODJFS) that indicated Green had received wages while receiving BWC benefits. The investigation confirmed Green was employed with Good Hands Home Health Care Service in Columbus. Evidence obtained during the course of the investigation also showed that she intentionally misrepresented and withheld her employment in order to continue collecting benefits. She was ordered to pay restitution in the amount of $1,899.99 and $100 in court costs.
Randy Gates, dba Gator's Auto Repair and Towing (Caledonia, Marion County) pleaded no contest on Jan. 21 in the Marion Municipal Court to a second-degree misdemeanor count of failure to comply for operating his business without workers' compensation insurance coverage. BWC's Employer Fraud Team (EFT) identified that Gates continued to operate his business, Gator's Auto Repair and Towing, without valid BWC coverage after two previous investigations for the same issue. He had been previously referred for prosecution in 2005 for failure to comply for operating a business without the required BWC coverage. The EFT attempted to work with this employer to become compliant with state law but Gates refused to submit completed outstanding payroll reports in an effort to calculate accurate premiums owed. The employer also failed to attempt to pay his balance with the BWC. On January 21, 2016, Gates entered a plea of no contest to failure to comply, a second-degree misdemeanor. Gates received a 180-day jail sentence which was suspended, and was ordered to pay fines and court costs. Gates currently has an estimated balance due of approximately $36,000 and is working with the BWC to submit outstanding payroll reports for calculation of exact premium due.
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