Did This Medical Witness Defraud Thousands of Worker's Compensation Claims? (UPDATED)

Categories: Labor, Medicine

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A medical expert regularly employed by insurance companies to undercut workers' compensation claims lied about how extensive his exams were. Despite the potential for perjury charges, Dr. Michael Katz is still working. Welcome to this installment of Craven Abuses by the Healthcare Industry, Part 1 Milion.

The story starts back in April at a Queens Supreme Court hearing assessing whether laborer Manuel Bermejo workers' comp claim from a fall was denied due to malpractice at the hands of a New York City medical resident. The case names Amsterdam & 76th Associates, LLC, Ibex Construction, LLC and Marble Techniques, Inc., as defendants.

The defense hired Dr. Katz to refute the claim. In his expert testimony Katz claimed that his examination lasted for 20 minutes. Little did the insurance company know, the plaintiff's lawyer had a secret recording of the exam, showing that it lasted exactly one minute and 56 seconds.

According a court transcript obtained by New York Personal Injury Law Blog (you gotta love the Internet), Bermejo's lawyer secretly recorded the exam--Bermejo's second--because he believed Katz lied about the length of the first exam, which Katz said lasted a whopping 45 minutes. The admission of the recording forced presiding Judge Duane Hart to declare a mistrial.

When the Voice contacted Katz regarding his role in the case, he vehemently denied being a "shill" for insurance companies, and insisted he was siding with the city hospital "for the children."

"Every erroneous payment made by The City of New York costs thousands of deserving children a decent education," he says.

Katz also explains that "my review was based on an extensive review of records and the issue was not the clinical exam which was abnormal but causality. Causality references the literature, the mechanism of injury and extensive clinical experience," meaning that the relevant parts of the exam would not have necessarily been physical.

Katz has a history of extremely short exam times and at least one prior challenge to his examinations in court. He also did not appear for a hearing Judge Hart called on Monday to assess the extent of Katz's possible perjury.

Katz is a professional expert witness. He has performed thousands of these procedures, meaning there could be thousands of workers who were defrauded out of their worker's comp. Katz, for his part, feels he is being persecuted.

"This was an assassination attempt against me to obtain outsize settlements with little expenditure of effort," he says.

(h/t: New York Personal Injury Blog)

Update: In a previous version, the post listed the New York City Health and Hospitals Corporation as a defendant. In fact, the plaintiff had already discontinued the suit against NYCHHC before the events surrounding the mistrial.

Send your story tips to rbrooks@villagevoice.com.





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3 comments
SuperNewf1
SuperNewf1

"LOWBALLING" is an insurance fraud no matter who does it. Unfortunately government and injured workers made a mistake in 1915 in New York by accepting Worker's Compensation Insurance. The "Exclusive Remedy" is just a way for large dangerous corporations such as mines, railways, Police, Military, etc. to dishonor their pledge to provide injured workers with medical care and wage loss if injured on the job. Unknown to injured workers when they accept workers compensation benefits is they don't just lose the right to sue their employer, they also lose their medical and legal rights. How can any seriously injured worker get well and back to work if they have to appeal and appeal and appeal to the criminals who already know the patient is disabled from employment and deserving of workers compensation payments? There is a very large number of "injured workers" who have died as a result of these Workers Compensation Boards. How can you get justice when every appeal IS the crime. Quite simply, workers compensation insurance is the fraud of the century. Forced onto taxed subsidized welfare, food stamps, no medical care, losing all possessions and savings, slandered, called a fraud and a malingerer because doctors like the above have another hidden agenda. It is not the kiddies he worries about, it is his big fat salary/bonus/perks,etc. etc. etc.. Otherwise he would not be forcing the wives and children of injured workers to suffer with nothing to eat and no shelter. Homes broken and destroyed.. This system must be changed. for all our sakes. 

tybeejody
tybeejody

Even more disgusting for the injured worker(s) is the fact that Worker's Compensation is a NO-Fault insurance. The injured have absolutely no recourse in defending themselves civilly (in a civil court) because they must follow the laws set out by federal/state WC laws. Many workers that are severely injured run out of their indemnity payments (66.66% of base salary) way before they have been deemed "healed".

In the state of Florida, an injured worker ONLY receives 104 weeks of payments, after that nothing. What is an injured worker to do? They have absolutely no recourse to sue when they are injured and to add insult to injury... no income.
The whole system is a racket to those that are truly injured.

tybeejody
tybeejody like.author.displayName like.author.displayName 2 Like

Of course all of this is a "racket". These Doctor's get paid more by the insurance companies to see these injured Worker's Compensation patients and issue a diagnosis a lot more than they get from a "regular" patient.
$$$ is very enticing. 

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