Workers’ Compensation Fraud Defense Lawyer in Cincinnati, OH

Ohio Revised Code § 2913.48 makes it a crime to defraud or facilitate fraud with the intent to receive workers’ compensation benefits to which you are not entitled.

The Ohio Bureau of Workers’ Compensation is responsible for underwriting companies’ insurance coverage for work-related injuries and illnesses. This group handles all medical and lost-time claims, and they routinely investigate cases of suspected workers’ compensation fraud. If this group suspects you are committing fraud, it will pursue you. 

When you look for someone to defend you against possible charges, consider hiring a lawyer with experience. Joslyn Law Firm has a proven track record of success. We have handled more than 20,000 criminal cases in Ohio, including people of Cincinnati who have been accused of workers’ compensation fraud.

Our legal team is deeply familiar with local and state courts, from the judges and courtroom staff to prosecutors and probation officers. This familiarity gives us the edge when fighting for the best outcomes in our clients’ cases. 

Lawyer for Workers’ Compensation Fraud in Cincinnati, OH

Ohio laws are strict about workers’ compensation claims, and courts do not take cases of workers’ compensation fraud lightly. These offenses can be charged as anything from a misdemeanor to a felony, depending on the amount of money you are accused of defrauding.

There are serious penalties for this crime, including possible jail time. You will want someone by your side who has demonstrated their skills in a criminal courtroom.

We Build Your Case with Experience 

Principal Attorney Brian Joslyn is one of Ohio’s most skilled and recognized criminal defense lawyers. The National Academy of Criminal Defense Lawyers named Joslyn one of the 10 best criminal attorneys in the state. Columbus CEO Magazine heralded him as a “Top Lawyer,” and the esteemed Super Lawyers rating service designated Joslyn a “Rising Star.”

Furthermore, one of our associate attorneys worked as a former Hamilton County Assistant Prosecuting Attorney, and he brings to your case firsthand knowledge of how prosecutors think. Another associate attorney brings his passion for defending the accused—a passion he applied in his five years of working at the Franklin County Public Defender’s Office

We Build Your Case with Knowledge

Our team knows all the forms of workers’ compensation fraud and how to defend against these charges—starting with the possibility that the “fraud” you are accused of committing was a simple mistake. With the right strategy, we could have your case dismissed or at least work to have the charges against you reduced.

It is a matter of knowing Ohio’s laws and criminal justice system. Brian Joslyn’s expertise in these areas has prompted local and national media—from newspapers like The Plain Dealer and The Columbus Dispatch to such affiliates as 6 ABC, 4 NBC, 10 WBNS, and 28 FOX—to view him as their go-to source for any stories they are researching on criminal law.

Let our team at Joslyn Law Firm team put our knowledge and experience to work for you. We care about the outcome of your case and preserving your dignity throughout this process. Our every effort goes into protecting your rights as a criminal defendant. Call us today for a free evaluation of your case: (513) 399-6289.


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Cincinnati Workers’ Compensation Fraud Information Center


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Workers’ Compensation Fraud in Cincinnati

The idea behind workers’ compensation is simple. If you sustain an injury or illness while you are working within the scope of your employment, you can file a claim for workers’ compensation benefits. These benefits may include a portion of your lost wages, coverage of your medical expenses, and sometimes even permanent disability benefits. 

If you intentionally act in a way to receive workers’ compensation benefits that you do not deserve under the terms of Ohio law, you could be found guilty of workers’ compensation fraud. 

It is not uncommon for people accused of this crime to not even be aware that they are committing an offense. Ohio law accounts for many forms of workers’ compensation fraud, each of which comes with its own consequences for anyone convicted of this financial crime

As per Ohio Revised Code § 2913.48, you are guilty of workers’ compensation fraud if you do any of the following:

  • Receive workers’ compensation benefits to which you are not entitled
  • Make or facilitate the presentation of a false statement so that you can get workers’ compensation benefits
  • Conceal, falsify, alter, remove, or destroy evidence required to establish a claim’s validity
  • Conspire to defraud the Ohio Bureau of Workers’ Compensation or a self-insuring employer with a false workers’ compensation claim
  • Falsify manual codes, payroll, classification of employees, number of personnel, paid compensation to misrepresent premiums or assessments you, as an employer, owe the Bureau
  • Falsify or create a workers’ compensation certificate to misrepresent coverage
  • Fail to secure workers’ compensation coverage in order to defraud the Bureau

How Workers’ Compensation Fraud Is Charged in Cincinnati 

Typically, workers’ compensation fraud is charged as a first-degree misdemeanor, with the following exceptions:

  • Fifth-degree felony: defrauded amount is between $1,000 and $64,999
  • Fourth-degree felony: defrauded amount is between $75,000 and $149,999
  • Third-degree felony: defrauded amount is more than $150,000

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Penalties for Workers’ Compensation Fraud in Ohio

If a court convicts you of workers’ compensation fraud, you will face serious penalties. The actual penalties and punishment for this crime depend on how the offense is classified, as follows: 

  • First-degree misdemeanor: Up to 180 days in prison and/or up to $1,000 in fines
  • Fifth-degree felony: Six to 12 months in prison and/or up to $2,500 in fines
  • Fourth-degree felony: Six to 18 months in prison and/or up to $5,000 in fines
  • Third-degree felony: nine to 36 months in prison and/or up to $10,000 in fines

Following a conviction, you would also have to pay the costs of investigating and prosecuting the case against you.


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Defenses Against Workers’ Compensation Fraud in Hamilton County

Ohio holds its prosecutors to the high legal standard of proving your guilt beyond a reasonable doubt. This means the prosecution must show that you committed workers’ compensation fraud, facilitated fraud, or acted with intent to commit this fraud. 

If the prosecution fails in this capacity—with intent being an integral component of their case—the court could dismiss the charge against you and drop your case. 

How We Can Argue Your Defense

When you hire Joslyn Law Firm to defend you against charges of workers’ compensation fraud, we will gather and preserve evidence to support your claim. Our defense strategy could be to prove the legitimacy of your workers’ compensation claim or to establish that you mistakenly—and without intent to defraud the bureau—acted in the manner that flagged your behavior as fraudulent. 

Toward this end, our legal team can:

  • Interview witnesses
  • Obtain photos and videos that substantiate your claim
  • Gather all the medical records related to your injury or illness

 


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Additional Resources for Workers’ Compensation Fraud in Ohio 

Ohio Bureau of Workers’ Compensation (BWC)

This agency provides compensation and medical benefits for employees who sustain an injury or illness while working within the scope of their employment. The website gives you access to information regarding your rights as an injured worker. You can also file a claim on the site and apply for coverage or find a provider. Finally, the site provides the information and means for reporting fraud.

Ohio Revised Code § 2913.48

This section of the Ohio Revised Code defines the offense of workers’ compensation fraud. Read this page to learn the various actions that Ohio interprets as fraudulent. The text also defines the various terms used throughout the code.

Ohio Attorney General - Workers’ Compensation

The Workers’ Compensation Section of the Ohio Attorney General’s Office gives legal advice and counsel to the Ohio Bureau of Workers’ Compensation. Visit this page to learn the history of workers’ compensation, the types of funds that the BWC administers, and examples of the various types of workers’ compensation, including temporary total disability, permanent total disability, wage loss compensation, and percentage of permanent partial disability.

U.S. Department of Labor

If you are a federal worker or the dependent of a federal worker, you can visit this page to learn about the four major disability compensation programs that the U.S. Department of Labor’s Office of Workers’ Compensation Programs administers. 

The page also provides links to other groups, including the Federal Employees’ Compensation Program, Longshore and Harbor Workers’ Compensation Program, Federal Black Lung Program, and Energy Employees Occupational Illness Compensation Program.

Hamilton County Human Resources

This page provides vital information about the workers’ compensation program for Hamilton County employees. Visit this link to access forms and to learn about your rights and responsibilities as a Hamilton County employee. You can also link from here to the Hamilton County Workers’ Compensation Handbook and read the Hamilton County Policy and the Ohio Revised Code, both of which prevail in the case of discrepancies in the handbook.

 


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News About Workers’ Compensation Fraud in Ohio 

June 11, 2021

“Real Estate Agent Owes BWC Over $151K After Fraud Conviction”

The Ohio Bureau of Workers’ Compensation (BWC) reports that a Columbus, Ohio, real estate agent and broker will owe more than $151,000 after pleading guilty to fourth-degree felony workers’ compensation fraud. According to the BWC, David L. Garner received disability benefits and all the while was working.

An investigation revealed the man’s misrepresentation of facts and withholding of his activities so that he could collect benefits to which he otherwise would not have been entitled. A Franklin County judge placed the man on community control for three years. If he violates the terms of his community control, he could serve a suspended 18-month prison sentence.

March 12, 2021

Ohio BWC: 7 Fraud-Related Convictions Secured in February, Including Dayton Doctor

2 News reports that the Ohio Bureau of Workers’ Compensation (BWC) obtained seven conviction cases in February. One case involved a Dayton doctor who ran a pill mill. The BWC uncovered Dr. Morris Brown’s involvement in an opioid ring. He was sentenced to two years in prison.

Another workers’ compensation fraud case involved the owner of a Medina massage parlor. Yulian Fu was found to be running his massage parlor business without BWC coverage. He pleaded guilty to the fifth-degree felony count of workers’ compensation fraud and was sentenced to three years discretionary post release control. Several other cases are detailed in the article.

November 8, 2020

“Retired Canton Police Officer Pleads Guilty to Workers’ Compensation Fraud, Ordered to Pay $89,000”

FOX 8’s article about retired Canton Police Officer James Blaine says he is breaking the law by collecting workers’ compensation benefits while he operates his landscaping business. According to an undercover agent, Blaine had been receiving permanent total disability benefits for a back injury resulting from a work accident. 

The article shows video of Blaine actively doing his landscaping work. This footage, combined with a comparison of state computer records, seem to substantiate the claim of Blaine’s “double dipping.” He pleaded guilty to a charge of workers’ compensation fraud. Penalties include paying the BWC $89,000 and paying for the cost of the undercover investigation.

November 1, 2019

Cincinnati Woman Convicted of Workers' Comp Fraud

The Ohio Bureau of Workers’ Compensation (BWC) reported to ABC 6 that Michelle D. Smith pleaded guilty to workers’ compensation fraud, a fifth-degree felony. According to the news coverage, Smith lied about her disability status, receiving more than $40,000 in disability while she ran two businesses.

The BWC discovered records showing that Smith was working 35 hours per week, which raised a red flag about her “permanently and totally disabled” condition. A Franklin County judge ordered Smith to repay the amount. She will serve five years’ probation.

October 6, 2020

Hamilton Pain Clinic Owner Sentenced to 10 Years in Prison

Nilesh Jobalia, the owner and operator of a Hamilton pain clinic, was given a 10-year prison sentence and ordered to pay over $2 million in restitution to the Bureau of Workers’ Compensation, Medicare, and Medicaid, Local 12 WKRC reports. 

Jobalia prescribed fentanyl, methadone, oxycodone, morphine, and other drugs to her patients without their having even seen a physician. In a single customer case, Jobalia manipulated $450,000 in BWC payments for unneeded drugs. The article claims he was the source of more than $2 million in false claims. 


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Frequently Asked Questions About Workers’ Compensation Fraud in Hamilton County 

Q. Can I Go to Jail for Workers’ Compensation Fraud in Ohio?

Yes, you could serve a prison term of up to three years for workers’ compensation fraud in Ohio. The actual sentence would be based on the amount of money you allegedly defrauded.

Q. Is Workers’ Compensation Fraud a Misdemeanor in Cincinnati?

Generally, workers’ compensation fraud is considered a first-degree misdemeanor, according to Ohio statutes. However, in certain circumstances, the offense would be charged as a felony of the fifth, fourth, or even third degree, depending on how much money you allegedly defrauded.

Q. What Are Some Examples of Workers’ Compensation Fraud?

According to Ohio law, there are many ways in which an individual or employer can be guilty of workers’ compensation fraud. If an employer misclassifies an employee to get out of paying workers’ compensation insurance, if an employee uses benefits to pay for a fake illness or injury, or if an employee exaggerates an injury or illness to collect benefits, they could be charged with workers’ compensation fraud. 

Q. What Is Workers’ Compensation Fraud?

Ohio Revised Code § 2913.48 defines workers’ compensation fraud as occurring when a person knowingly and with purpose to defraud receives workers’ compensation benefits to which they are not entitled, makes false statements to get benefits, falsifies or destroys records that play a role in validating a claim, conspires to defraud the bureau, falsifies personnel information needed to determine compensation premium or assessment, alters a workers’ compensation certificate, or fails to secure maintain workers’ compensation coverage.

Q. Do I Have to Pay a Fine for Workers’ Compensation Fraud?

If you are convicted of workers’ compensation fraud, you face penalties of jail time and/or fines. The fines for this offense range from $1,000 to $10,000, depending on the amount of money you allegedly defrauded. 


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Cincinnati Workers’ Compensation Fraud Defense Lawyers

If you have been charged with workers’ compensation fraud in Cincinnati, a lawyer from Joslyn Law Firm could begin to develop your legal defense strategy. Our team of criminal defense attorneys has established themselves as lawyers who get results for people who stand accused of white-collar crimes in Cincinnati.

We will fight to protect your rights and work to achieve the best outcome for your case. Contact Joslyn Law Firm today for a free consultation: (513) 399-6289.


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