Columbus, OH – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer recently announced that 13 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in February 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).
“Several allegations this month were generated by the Special Investigations Department’s intelligence unit, which reviews BWC data for potential red flags,” Buehrer said. “Their efforts help uncover potential fraud by claimants, medical providers and employers.”
The following is a sampling of cases that resulted in guilty pleas or convictions during February:
Bonnie Gajoch (Elyria, Lorain County) was entered into the Franklin County Prosecuting Attorney’s Diversion program Feb. 6 for 24 months to pay $14,944.40 in restitution to BWC. SID’s intelligence unit initiated an allegation after a data cross match showed that Gajoch was possibly working while collecting BWC disability benefits. Investigators found that Gajoch returned to work as a nurse at an assisted living community while receiving temporary total disability benefits between May and September 2012. Investigators also found Gajoch continued operating her own home health care business, Vital Angels, beginning in June 2012 while receiving temporary total benefits. Injured workers are not permitted to work while receiving this type of benefit. A picture of Gajoch is available here.
Jacqueline Horn doing business as J&J Enterprise Services (Independence, Cuyahoga County) pleaded guilty as part of a plea deal Feb. 23 in Cuyahoga County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor. BWC received an allegation that Horn, owner of Jackie & Jackie Enterprise Services, may have submitted false BWC coverage certificates to the Broadview Heights Building and Zoning Department. Investigators found that Horn was responsible for altering or falsifying nine BWC certificates of coverage between 2006 and 2012. Horn used the false certificates to complete a requirement for conducting business within the city. She accepted full responsibility when interviewed by investigators. Horn was fined $500 and was ordered to pay court costs.
Carman Gargano doing business as C&C Investors (Cleveland, Cuyahoga County) pleaded no contest as part of a plea deal Feb. 18 in City of Cleveland Municipal Court to one count of workers’ compensation fraud, a first-degree misdemeanor. SID’s intelligence unit identified that C&C Investors, doing business as the Pit Stop Doughnut Shop, had again let its coverage lapse. Gargano worked with investigators to bring coverage back into compliance, but the Pit Stop’s policy lapsed again in 2011. Gargano failed to take necessary steps to come back into compliance with the law. Gargano was sentenced to 180 days of incarceration, which was suspended, and was placed on five years of probation. Gargano must follow through with a payment plan and reinstate the workers’ compensation policy for the business, or else the suspended incarceration could be imposed.
Cora Beach (Springfield, Clark County) pleaded and was found guilty Feb. 26 in Franklin County Court of Common Pleas of one count of workers’ compensation fraud, a fifth-degree felony. SID identified that Beach was possibly receiving wages while collecting BWC disability. Investigators found that Beach worked for a Dayton printing company while collecting more than $9,000 in temporary total disability between January and April 2013. A pre-sentence investigation was ordered, and sentencing was set for April 23.
Paul Smith (Jackson Center, Shelby County) pleaded and was found guilty Feb. 17 in Franklin County Court of Common Pleas of one count of workers’ compensation fraud, a fifth-degree felony. A data cross match showed that Smith was possibly working while collecting BWC disability benefits, and investigators found that he was working as a restaurant cook between March and July 2013 while collecting more than $4,000 in temporary total disability benefits. A pre-sentence investigation was ordered and sentencing was set for April 2.
Source: Ohio BWC