Columbus, OH – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer recently announced that 11 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in May 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).
“Two cases this month highlight the value of the work of the intelligence unit within our Special Investigations Department, which exchanges data with other state agencies to root out fraudulent activity,” Buehrer said. “They also uncover potential false claims, diversion of prescription drugs, medical billing fraud and unpaid workers’ compensation premiums.”
The following is a sampling of cases that resulted in guilty pleas or convictions during May:
Tim Wyse, Felicia Braggs-Wyse and Sarah Washtak doing business as Wyse Enterprise Inc. (Toledo, Lucas County), pleaded guilty recently in the Lucas County Court of Common Pleas in connection with lapsed workers’ compensation coverage, dishonored payments and altering a BWC coverage certificate. Co-owner Tim Wyse, of Toledo (Lucas County), pleaded guilty April 27 to two counts of workers’ compensation fraud, both fifth-degree felonies. Co-owner Braggs-Wyse, of Toledo (Lucas County), pleaded guilty the same day to passing bad checks, a first-degree misdemeanor. Business secretary Washtak, of Maumee (Lucas County), pleaded guilty May 11 to workers’ compensation fraud, a first-degree misdemeanor. Investigators received two allegations about the business. The collections department reported that a check written for a premium payment was returned for non-sufficient funds, which caused the employer’s policy to lapse. Agents provided Wyse with instructions on how to reinstate the company’s workers’ compensation policy, but Wyse failed to take steps toward becoming compliant. An allegation that the employer passed a false BWC certificate of coverage was also received. Braggs-Wyse said she generated the dishonored check, and Washtak admitted to falsifying and providing the workers’ compensation coverage certificate. Wyse was ordered to pay $13,277.59 in restitution and sentenced to three years of community control. Braggs-Wyse was ordered to pay $13,277.59 in restitution and is scheduled for sentencing on June 18. Washtak was not ordered to pay restitution and is scheduled for sentencing on June 25.
David Story doing business as Story Equipment & Repair (Wayne, Wood County) was convicted and sentenced May 8 in the Bowling Green Municipal Court on one count of failure to comply, a second-degree misdemeanor. BWC fraud investigators received a referral about Story’s business, Story Equipment & Repair in Wayne, in 2012 from the agency’s employer compliance department. Story entered into a payment plan for premiums owed, and that investigation was closed. In 2014, SID used data to identify lapsed employers and discovered that Story defaulted on his payment plan, failed to report payroll for his business and did not pay related premiums to BWC. Investigators found that the payroll information he withheld resulted in an additional $6,969.62 in premiums due. Story was sentenced to five years of probation and was ordered to pay $125 in court costs. He was also ordered to pay a $750 fine and sentenced to 90 days of incarceration, which were both suspended as long as he continues making payments.
Douglas Vastine (Milford, Clermont County) pleaded guilty May 20 in the Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a first-degree misdemeanor, and one count of forgery, a fifth-degree felony. BWC received an allegation that Vastine may be falsifying his job searches submitted to the BWC for disability benefits. Investigators found that he falsified job searches to qualify for living maintenance wage loss benefits between January and April 2013. Vastine received more than $6,000 in benefits he would otherwise been ineligible to receive. Investigators also found Vastine submitted false travel reimbursement forms to BWC, resulting in approximately $900 of improper payments. Vastine is scheduled to be sentenced July 10.
Vincent Biasella (formerly of Clinton, Summit County) was convicted May 15 in the Franklin County Court of Common Pleas for working while receiving workers’ compensation benefits. Biasella, who currently resides in Cape Coral, Florida, previously pleaded guilty in March to one count of workers’ compensation fraud, a fourth-degree felony. A data cross-match with the Ohio Department of Job and Family Services indicated that Biasella was employed while receiving compensation for a 2009 workplace injury. An investigation conducted by SID confirmed Biasella was employed by a yacht club and a boat club in Florida between February 2011 and June 2013 while receiving temporary total disability benefits. Injured workers are not permitted to work while receiving this type of benefit. Biasella was sentenced to five years of community control and ordered to pay BWC $93,683.57 in restitution. He could face up to 18 months in prison, if he fails to abide by the terms of the probation.
Rick Hamed, doing business as MZM Transport, Inc. (Cleveland, Cuyahoga County) pleaded guilty May 12 in the Cuyahoga County Court of Common Pleas to one count of passing bad checks and one count of workers’ compensation fraud, both first-degree misdemeanors. SID received an allegation from BWC’s employer compliance department after MZM Transport Inc. failed to reinstate its workers’ compensation coverage, or repay BWC for a payment returned due to non-sufficient funds. SID’s employer fraud team contacted Hamed and discussed the issue. Agents provided Hamed with the necessary forms to reinstate his workers’ compensation coverage, but he failed to file payroll reports and pay premiums for three reporting periods between 2012 and 2013. Hamed also failed to repay the dishonored payment. Hamed is scheduled to be sentenced June 18.
Cymande McFarland (Cleveland, Cuyahoga County) pleaded guilty May 6 in the Franklin County Court of Common Pleas to one count of theft, a fifth-degree felony. SID’s intelligence unit identified through a data cross match with ODJFS that McFarland was possibly working while receiving BWC disability benefits. Investigators found that McFarland worked at a factory and receiving BWC benefits between April 2013 and April 2014. McFarland is scheduled to be sentenced on June 18.
Source: Ohio BWC SID