Workers' Comp Fraud Blotter – March 20, 2014
Orthopedic Surgeon Who Did 20 Surgeries a Day Will Now Set Both Feet In Prison (NY) – Dr. Spyros Panos has been sentenced to 54 months in federal prison for operating a fraud scheme that cheated Medicare, the New York State Insurance Fund, and numerous private health insurance providers out of over $2.5 million. Panos was a board certified orthopedic surgeon who often performed as many as 20 or more surgical procedures in a single day. Panos overbilled for open surgeries that he actually performed arthroscopically, overbilled for certain techniques and procedures that he did not do but instead used cheaper techniques and procedures, overbilled for removal of loose body tissues that were smaller than he billed for or were not removed at all, and when caught, he claimed that the billings were simply clerical errors. Read more
Disabled Carpenter Was Able To Hammer Away For Four Years (OH) – William Mcie has pled guilty to workers' compensation fraud for working while receiving workplace injury benefits. Mcie worked as a self-employed carpenter between May 2008 and September 2012, while he was concurrently receiving temporary total disability benefits. Read more
Workers’ Compensation Violation Halts Construction of Restaurant (CT) – The Connecticut Department of Labor has issued stop-work orders on the construction of a Ted’s Montana Grill because a contractor on the project, Hayford Builders LLC, was paying its employees in cash in order to avoid workers’ compensation and payroll taxes. Read more
Driver Was Overpaid More Than $100,000 While He Was Trucking Along (OH) – Lonnie Mace will be sentenced next month on a charge of felony workers’ compensation fraud. While receiving permanent total disability benefits, Mace was working as a commercial truck driver for a trucking company. His double-dipping was discovered as a result of a PUCO safety inspection of a truck that he was driving. Read more
Cab Company Misclassified Drivers and Mechanics In Order To Avoid Workers’ Compensation Insurance (NY) – William Boyar and Steven Youngren, the owners of Call A Cab, have been indicted by a grand jury on charges of workers’ compensation and insurance fraud. They are accused of failing to pay $130,000 in premiums by misclassifying their drivers and mechanics. Instead, they only paid $900 in workers’ compensation insurance on their clerical employees. Read more
Scrapping Junk Vehicles For Cash While On Disability (OH) – Joshua Collmar, who is currently in prison on an unrelated charge, has been sentenced to six months in jail for felony workers’ compensation fraud. The investigators obtained evidence from scrap yards and interviewed customers, who verified that Collmar scrapped junk vehicles and was paid cash for his services, while he was also collecting temporary total disability benefits. Read more
Former Texas Association of School Boards Director Headed To Prison For Fraudulent Workers’ Compensation Claims (TX) – Herman Wilks, the former Department Director of Workers’ Compensation Claims Administration for the Texas Association of School Boards, has been sentenced to 5 years in prison and ordered to pay $1 million in restitution. Wilks’ duties included the supervision of setting up member school districts' workers' compensation claims, adjudicating medical bills, and carrying out utilization, management and pre-authorization functions. Wilks submitted fraudulent workers’ compensation claims on behalf of Medco Implantable Supply, a dummy company he created for the sole purpose of carrying out his fraudulent scheme. He spent the $500,000 he stole on clothes, trips and fine hotels and cigars. Read more
College Student Who Dropped Classes Ordered To Repay Workers' Compensation Death Benefits Or Go To Jail (OH) – Adam Osterman has pled guilty to workers’ compensation fraud and must pay restitution of $59,213.83 or spend 8 months in jail. As the son of a worker killed on the job, Osterman was eligible to receive death benefits while enrolled in college. For two years he claimed that he was attending classes, while he actually either did not attend or dropped the classes. His scam was uncovered after he bragged about receiving the death benefits while dropping his college classes. Read more
Disabled Man Plowed and Shoveled Snow (CT) – Michael Ryan has been charged with workers’ compensation fraud for double-dipping. While Ryan was allegedly totally disabled and unable to work because of an injury he suffered while employed at a glass business, he was actually working, plowing and shoveling snow. Read more
Ohio Double-Dipper Fled To Florida To Avoid Arrest Warrant (OH) – Concrete installer John Neeley has pled guilty to workers’ compensation fraud after he was caught on video working while he was supposed to be recovering from a workplace injury. While collecting disability benefits, investigators discovered that Neeley performed concrete installation jobs for several customers. When he learned of the charges and arrest warrant against him, Neeley fled to Florida, but he was soon arrested on unrelated charges in Florida and extradited back to Ohio. Read more
Owner Of Masonry Company To Pay $806,020 Restitution To Workers’ Compensation Insurer (TX) – As a result of his guilty plea to workers’ compensation fraud-related charges, Howard Whiddon, the owner of Whiddon Masonry & Stucco, Inc., has been ordered to repay $806,020 to Texas Mutual Insurance Company. During a four year period, Whiddon intentionally misrepresented the operations and payroll of a related company, Veranda Masonry, Inc. Read more
Asbestos Abatement Company Owner Indicted For Hiding Payroll In Workers’ Compensation Fraud Scheme (MA) – Kruy Kroch, the owner and operator of MK Environmental, Inc., an asbestos abatement company, has been indicted on charges that he failed to accurately report his total payroll and number of employees and under-stated the number of jobs associated with his business to avoid paying thousands of dollars in insurance premiums. Based upon his payroll reports, Kroch was granted the minimum workers’ compensation premium rate on his policy, even though he actually employed up to 30 workers, with at least four being full-time employees. Read more
Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations.
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