For immediate release: March 15, 2016
BWC investigations result in 17 workers' comp fraud convictions in February
Columbus - Ohio Bureau of Workers' Compensation (BWC) Administrator/CEO Steve Buehrer announced today that 17 individuals were convicted of, or pleaded guilty to,
charges related to defrauding Ohio's workers' compensation system in February 2016. These court actions are the result of investigations conducted by BWC's Special
Investigations Department (SID).
"The outstanding work of our investigators resulted in an impressive number of cases coming to a close in February," said Buehrer. "From one medical provider
who fraudulently billed BWC to several employers who didn't pay their premiums, and claimants who continued working while on workers' comp, we see examples of the many
types of fraud our investigators must chase each day."
The following are a sampling of cases that resulted in guilty pleas or convictions during February:
>Mark Scanlon, DC (Cincinnati, Hamilton County) pleaded guilty to four counts of workers' compensation fraud and one count of theft, all first-degree
misdemeanors, in the Franklin County Court of Common Pleas on Feb. 29 for billing for services not rendered. Scanlon was a chiropractor and owner of Progressive
Rehab Center in Butler County. The allegation involved Scanlon's fraudulent billing practices including false office notes for dates of service in which patients
did not show up or services were not provided. This included creating fee slips with false information for the purpose of billing the managed care organization
contracting with BWC. His conduct allowed him to receive reimbursement for services he did not perform or for services that did not occur. SIDâ€™s health care
provider team worked with the Ohio Department of Insurance in investigating Scanlon. Scanlon was ordered to pay $40,000 in restitution, which he paid to the
Clerk of Courts prior to his plea, and to voluntary de-certify himself as a BWC provider.
Robert Daniels (Pickerington, Fairfield County) pleaded guilty to one count failure to comply with the law, a second-degree misdemeanor, on Feb. 11 in the
Franklin County Court of Common Pleas for operating his business without workers' compensation insurance coverage. SID opened an investigation into Daniels
and his business, Ohio Sound, after receiving a referral from BWC's Collections Department, which received three dishonored checks over a six month period
for a policy that had been lapsed for several years. Daniels also underreported payroll during two payroll periods and failed to report the payroll for a third
payroll period. He was sentenced to community control for two years and was also ordered to perform 100 hours of community service within 90 days. He will
serve 90 days in jail if he violates any terms of his community control.
Norman Beight, dba New Waterford Enterprises, Inc. (New Waterford, Columbiana County) appeared in the Columbiana County Court of Common Pleas on Feb. 12 for
operating his business with lapsed coverage. SID received a referral from BWC's Employer Compliance Department (ECD) indicating Norman D. Beight (Denny) and Judith
A. Beight (Judy), owners of New Waterford Enterprises Inc., dba Vittle Village, were operating a business without the required workers' compensation insurance
coverage. The ECD attempted several times to get the Beights into compliance prior to referring the case for investigation. During interviews, they both stated
they would work toward becoming compliant but neither complied with agents' request to submit payroll reports or payroll information and enter into a reinstatement
payment plan. Denny Beight was convicted of one misdemeanor count of workers' compensation fraud on Feb. 12, with a dismissal of charges against Judith Beight as
part of a plea deal after the couple became compliant and had their policy reinstated. Denny Beight was placed on probation and ordered to remain current on his
BWC premiums. The court will review the matter on August 19, 2016 with intention of releasing him from probation if he is still current.
Jeffrey Kobosky, dba Elegant Landscape (Stow, Summit County) pleaded guilty to a second-degree misdemeanor count of workers' compensation fraud on Feb. 22
in the Summit County Court of Common Pleas for operating his business with lapsed coverage. SID opened an investigation after receiving a referral from an anonymous
source regarding coverage status for Kobosky/Elegant Landscape. Kobosky had submitted a bid for a job but was told he must have BWC coverage. After advising that
he was working under another company and wouldn't need to provide a certificate for his company, Kobosky was informed he would have to resubmit his bid on the
new company's letterhead and provide its BWC policy number for verification. Kobosky filed for a new policy on BWC's website under his name to avoid the debt
he had compiled under his company's name. Agents interviewed Kobosky regarding the lapsed policy and the additional application he completed under his name.
Kobosky explained to agents his accountant told him he could complete another application under his name to continue to work. The accountant explained in an
interview that he never told Kobosky to apply for another policy and actually advised against it. Kobosky paid restitution in full in the amount of $5,724.48.
Douglas Fay and Laurel Seiner, dba Fay Crushing and Stone LLC (Lima, Allen County), entered into a diversion program on Feb. 11 after pleading guilty to
charges related to operating their business without workers' compensation insurance coverage. BWCâ€™s Employer Fraud Team (EFT) received information from the BWC
Collections department advising that two premium payments for Douglas Fay's business; Fay Crushing and Stone LLC, had been returned for non-sufficient funds,
resulting in the BWC coverage policy lapsing. Fay had previously been investigated by the EFT for non-compliance with his BWC coverage. Fay was interviewed by
agents and admitted he knew the payments were no good, and signed a bad check letter of acknowledgment. Approximately two weeks later, EFT found Laurel Seiner
had submitted a BWC application for coverage pertaining to a stone crushing business in which she listed herself as the sole owner. Agents interviewed Seiner
and learned she was the secretary and bookkeeper for several of Fay's businesses, including Fay Crushing & Stone LLC. Seiner listed there were no other policies
associated with her business. Agents interviewed seiner and she stated Fay was now her employee. When questioned, Seiner initially denied conspiring with Fay to
open a new policy in order to get a valid certificate. Seiner admitted Fay approached her and asked her to open a policy in her name because his policy was not
in good standing and he needed a valid BWC certificate. Seiner pleaded guilty to one count of tampering with records, a third-degree felony. Seiner was sentenced
to three years post release control, and ordered to pay $8599.72 in restitution. Fay pleaded guilty to one count of tampering with records, a third-degree felony,
one count of workers' compensation fraud, a fifth-degree felony; and one count of passing bad checks, a fifth-degree felony. Fay was sentenced to five years post
release control, and ordered to pay $14,448.92 in restitution.
Jackie Dalton (Dalton, Wayne County) pleaded guilty on Feb. 26 to one count of workers' compensation fraud, a first-degree misdemeanor, for working while
receiving benefits. SID's Intelligence Unit identified Dalton as working while receiving BWC disability benefits through a cross match with the Ohio Department
of Job and Family Services. The investigation found that Dalton had been employed by five businesses while receiving temporary total disability benefits. Agents
obtained payroll and employment documentation for Dalton and he admitted in an interview he had worked for these businesses. Dalton was sentenced to 180 days
in jail, suspended for three years of community control.
Bruce Wilcox (Cincinnati, Hamilton County) pleaded guilty on Feb. 25 in the Franklin County Court of Common Pleas to a fifth-degree felony charge of
workers- compensation fraud for working while receiving benefits. SID identified a potential conflict after the Ohio Department of Jobs and Family Services
reported Wilcox was earning wages while he was collecting permanent total disability. The investigation revealed that Wilcox was working as a consultant for
Bavarian Trucking Company and as a Kentucky sales representative for AZO Services Inc. Wilcox worked for a period of five years while collecting the benefits from
BWC. He was sentenced to community control for five years of basic supervision on conditions that he obtain/maintain employment and have no new convictions.
Wilcox was also ordered to pay $97,203.62 in restitution to BWC. He will serve seven months at Ohio Department of Rehabilitation and Correction if violates the
terms of his community control. Wilcox made an initial $25,000 payment towards restitution to the Franklin Clerk of Court's office after his sentencing.
David Wallace (Columbus, Franklin County) pleaded no contest and was found guilty of a first-degree misdemeanor count of workers' compensation fraud in the
Franklin County Court of Common Pleas on Feb. 23 for working while receiving benefits. SID initiated an investigation after receiving an allegation that Wallace
was running a pest control business while receiving disability benefits. The investigation found evidence proving Wallace was the owner/operator of Discount Pest
Control, and was actively working as the sole employee while intentionally concealing his activities from BWC in order to continue receiving benefits. Wallace was
ordered to pay $10,000 in restitution and was sentenced to 180 days in jail, suspended for 60 months of Community Control.
David Milcinovic (Cleveland, Cuyahoga County) pleaded guilty to a first-degree misdemeanor count of workers' compensation fraud on Feb. 9 in the Franklin
County Municipal Court for working while receiving benefits. SID opened an investigation into Milcinovic after a cross-match with Ohio Department of Job and
Family Services indicated the Polish National Alliance reported wages for him during a period of time he was receiving workers' compensation benefits. The
investigation confirmed Milcinovic continued employment as the Vice President of Union of Poles and Board Member of the Polish National Association while he was
receiving temporary total disability benefits for a workplace injury. Milcinovic had already prepaid the entire restitution in the amount of $42,911.73 to the
Bureau of Workers' Compensation. He was ordered to pay a fine of $250, plus court costs.
Olivia Robinson (Columbus, Franklin County) pleaded guilty to a first-degree felony count of attempted workers' compensation fraud on Feb. 16 in the Franklin
County Municipal Court for working while receiving benefits. SID received an allegation that Robinson owned a cleaning company and was cleaning offices and residential
homes while she was receiving workers' comp for a workplace injury. The investigation confirmed she was owner of All Points Cleaning and had been cleaning offices for
regular and repeat customers over a period of several years. Investigators also found Robinson was concurrently employed with Bridgewater Banquet Center, and that she
intentionally misrepresented and withheld her employment with both companies in order to continue collecting BWC benefits. Robinson was ordered to pay $26,737.47 in
restitution to BWC. She was also sentenced to eight months in the Ohio Department of Rehabilitation and Correction, suspended on the condition that she successfully
completes five years of community control.
To report suspected workers' compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.
Check out our latest cases at ohiobwcfraud.wordpress.com and
view BWC's workers' comp fraud awareness video on YouTube.
Follow BWC on Twitter.
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