Columbus, OH (WorkersCompensation.com) - A northeast Ohio truck driver on injured workers' benefits since 1993 is on the hook for $17,000 after pleading guilty to workers' compensation fraud Tuesday in the Franklin County Court of Common Pleas.
Ohio Department of Health (ODH). Furthermore, ODH indicates 4 to 5 Ohioans die daily due to drug overdose, which includes both illegal and prescription drugs.
Ohio is not alone as this is a national epidemic. Dr. Danesh Mazloomdoost, a Johns Hopkins University graduate and medical director of Pain Management Medicine in Lexington, Kentucky, notes in a recent article that over the last decade “opiate overdoses have killed more than 125,000 Americans.” That's twice the number of Americans killed during the Vietnam War. Even more startling is his reference to the fact that “for every opiate overdose, there are 825 recreational opiates users at risk for addiction or overdose.”
Through our investigations, we've found that people addicted to prescription medicine may commit crimes. A few weeks ago, we released an investigation summary about a man who was sentenced for receiving opioids from multiple doctors.
Deception to obtain, often called doctor shopping, is a crime where a person attempts to conceal their addiction by seeing multiple doctors to obtain prescriptions for the same or similar drugs.
Addicts may fake injuries and go to an emergency room just to get a few days' worth of narcotic drugs. To further conceal their doctor shopping, people sometimes use multiple pharmacies in an attempt to avoid any questions about the volume or frequency of filling their prescriptions. These illegal actions result when either the person is abusing the drugs by taking more than prescribed or diverting/trafficking the drugs for money.
In response to these trends, BWC made several changes to its pharmacy program over the past several years, including implementation of a medication formulary, standardized drug utilization reviews and a lock-in program to limit doctor and pharmacy shopping. These efforts have resulted in opiate doses dropping 10.9 million since 2010 and drug cost savings of more than $20 million since 2011.
BWC's Special Investigations Department (SID) has also amped up its efforts to detect fraudulent activity of drug seekers and of medical providers overprescribing prescription painkillers.
Opioids are “remarkable drugs” and “the best way to relieve excruciating pain in the short run after injury or surgery,” according to Webility Corp., which partnered with BWC to develop and test new ways to communicate and provide assistance to injured workers, all with the goal of quicker recovery and return-to-work outcomes.
When taken regularly for months or years, however, they can cause more harm than good.
“With prolonged everyday use, they have actually worsened pain and disability for many people who should have been able to resume a relatively normal life,” according to a Webility Corp. brochure.
Fortunately, most doctors hold the care of their patients as their highest priority. However, there are those who are concerned only with enriching themselves by feeding the drug habits of their patients. Examples of this are all too prevalent and all too recent. Consider this mother's reaction to her son's death here and what happened to the responsible doctor, Terry Dragash here. Like doctor shopping, conspiracy to distribute drugs is another crime SID takes very seriously.
Even as SID seeks out those who improperly use or distribute prescription medications, we understand opioids are often a legitimate part of an injured worker's treatment and recovery plan. That's why BWC strongly encourages injured workers to talk through the pros and cons of starting an opioid treatment program, and ask as many questions of their physicians as possible. When it comes to opioids, asking questions is crucial, and an open and frank conversation with your physician will help you determine the best course of action.
SID's fraud investigators and analysts see the effects of long-term prescription opioid use, and others do, too. The Ohio Department of Health has launched Prescription for Prevention, a campaign to combat the epidemic of prescription drug overdose and abuse. Learn more about that campaign here.
" data-image-title="Prescription Drug Awareness: Stay Informed, Take Control" data-image-meta="" data-comments-opened="1" data-orig-size="" data-orig-file="" data-permalink="https://ohiobwcfraud.wordpress.com/?p=2237" data-attachment-id="2237" />William Seckler, 54, of the village of Andover in Ashtabula County, must pay the Ohio Bureau of Workers' Compensation (BWC) $14,520 in restitution and $2,530 in investigative costs for working while receiving permanent total disability benefits. A judge also ordered Seckler to serve 180 days in jail, suspended, and four years of community control for the first-degree misdemeanor.
Seckler was employed as a full-time truck driver at the time of his injury in 1993. Acting on a tip, BWC's Special Investigations Department (SID) started looking at him in 2014 and found him working as a delivery driver for an Amish roofing company.
In other news, a Columbus man was convicted for workers' compensation fraud on Dec. 19 after falsifying his job search forms in order to receive non-working, wage-loss benefits from BWC.
Alfonso R. Hooper, 66, pleaded guilty to a first-degree misdemeanor count of workers' compensation fraud after SID found he falsely claimed to have applied for work at more than 40 potential employers listed on his job search forms.
A Franklin County judge sentenced Hooper to 30 days in jail, suspended, and one year of community control. The judge also ordered Hooper to pay BWC $5,000 for its investigative costs.
In a court case Dec. 30, a central Ohio man was convicted for failure to comply after BWC found he was operating four gas stations in the Youngstown area with lapsed workers' compensation policies.
Miguel Santoni (formerly of Cleveland, Cuyahoga County) pleaded guilty April 17 to a fifth-degree felony count of workers' compensation fraud for working while receiving Temporary Total Disability benefits for a prior workplace injury.
An allegation was received that Santoni filed a new workers' compensation claim while receiving disability benefits from one of his prior workers' compensation claims, according to the Ohio Bureau of Workers' Compensation (BWC) Special Investigations Department (SID). Injured workers are not permitted to work while receiving temporary total disability benefits.
Santoni was indicted in September 2011 on charges of workers' compensation fraud and theft. After the indictment, it was determined that that he was living in Puerto Rico. BWC's SID agents worked with the United States Marshals Service to coordinate his arrest. He was arrested Jan. 29 in Puerto Rico and extradited to Franklin County, Ohio.
On April 17, Santoni was convicted of the fifth-degree felony count of workers' compensation fraud. He was sentenced to serve 90 days in jail and ordered to pay restitution to the BWC in the amount of $5,140.09.
" data-image-title="Former Cleveland man extradited, sentenced for workers' comp fraud" data-image-meta="" data-comments-opened="1" data-orig-size="" data-orig-file="" data-permalink="https://ohiobwcfraud.wordpress.com/?p=1422" data-attachment-id="1422" />A judge in Niles Municipal Court convicted Muhammad Rashid, 36, of Hilliard, Ohio, on a minor misdemeanor count of failure to comply and fined Rashid $100 and court costs.
Rashid worked with BWC to become compliant with three policies, but not on the fourth. Rashid later filed paperwork with BWC stating he closed that business and paid the outstanding balance due of $2,824.