Markhoff & Mittman Blog

How doctors cheat the NY workers’ comp system

This month’s arrest of a Brooklyn doctor on charges of insurance fraud highlights a little known source of fraud in the worker’s comp system: doctors.  That’s right, the very same doctors responsible for treating sick and injured workers are stealing money from the system – billions of dollars every year according to some.

The Brooklyn doctor was caught when workers’ comp judges complained that his billing practices were suspicious.  Investigators followed up, and sure enough they found evidence of a major fraud scheme.  But this is just a drop in the bucket: how many other doctors are cheating workers out of benefits that they deserve for serious injuries sustained on-the-job?

There are a number of ways that doctors can defraud the system:

• Performing not-so-independent medical exams on injured workers where no matter the type of injury the doctor submits insurance paperwork stating that the worker is ok to work.
• Filling out medical exam paperwork and minimizing the injures that a worker has suffered so the insurance company doesn’t have to pay as much to a worker
• Billing insurance companies for medical exams that they didn’t perform (the Brooklyn doctor did this two ways: he billed insurers for more patient exams than one doctor could perform in a day and also billed for exams he supposedly performed while he was in fact out of the country).

But let’s be honest here: doctors are not alone in defrauding the system.  Insurance companies themselves have a hand in much of the fraud committed by doctors, as they are the ones who will ‘doctor shop’ – they will seek out doctors willing to minimize workers’ injuries on paper so they can save money.

Don’t try to tackle this dirty system by yourself.  If you have been injured on the job, please contact the attorneys at Markhoff & Mittman today for help fighting back.