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Law Educator, Esq.
Law Educator, Esq., Consultant
Category: Fraud Examiner
Satisfied Customers: 111515
Experience:  24+ years law enforcement. Licensed Attorney.
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In short, in the past year my personal investigation of a

Customer Question

In short, in the past year my personal investigation of a less than scrupulous WC IME/treating Physician was investigated, and charged with Medicare fraud and had his medical licenses revoked in 3 states, as he was a "pain management specialist and active
(Anathesiologist) consultant as an expert witness as a forensics expert ("gun for hire!") representing the insurance carrier and respondents ("Dis-spondents"). This alleged medical professional was participating in fraudulent activities with his patients, and I was one one of these patients being seen for a WC related issue. I also believed he was taking part in WC patient fraud to which I had alerted my WC hired attorney and I was not taken seriously. I had tried to report his actions in this matter and it was basically not taken seriously. I suffered a Spinal cord injury which has drastically altered my life in compromising my health in several areas, and causing me and my family Financial hardships. The injuries I received in my MVA resulted in multiple invasive spine surgeries with instrumentation, and additional serious issues not acknowledged. I had contacted my attorney three times this past April, and to no avail? No call back. Currently my case has been considered closed do to the time element in which to appeal. I have been screwed over, maligned by IME, and WC treating physicians and wish to expose all those involved to include the alleged treating professionals, respondents, and employer. I have much information that has been totally ignored. If you can assist me in any way, that would be very much appreciated.
Cordially, Xxxxxxxx X. Xxxxxxxx 11/11/2015
Email:***@******.***
Phone#: xxx xxx xxxx
Submitted: 1 year ago.
Category: Fraud Examiner
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only. Most of these IME's are QUACKS, they are doctors who fall into two categories. First the one who will say whatever the insurance companies want and they do not examine the patient and most times never read the file either. Second, there is a group who will over treat patients to suck up as much insurance money as they can and will even charge insurance for treatment not really received. If the doctor has committed malpractice, then in order to pursue him for that malpractice you need to go to be seen by another doctor and that doctor has to write a report to attach to any complaint you file in court that the conduct of the doctor was below the reasonable standard of care.The malpractice claim against the doctor is really your only case here if the doctor is not properly treating you. You can also file a complaint to the state medical board, but all they can do is take action against his license.If you believe the doctor is committing insurance fraud, you can report him to the state insurance commission and also the state attorney general, since they can investigate the criminal aspects of your fraud claims..

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