From the Philadelphia Inquirer:
... Federal prosecutors Friday unsealed an indictment charging a Wynnewood doctor with Social Security fraud.
Frederick Douglas Burton, 67, of the Burton Wellness & Injury Center on City Avenue in Wynnewood, has been charged with two counts of mail fraud and attempted mail fraud.He is accused of defrauding the Social Security Administration by signing and sending letters on behalf of another doctor, Dennis Erik Fluck Von Kiel, of Lehigh County.
The two letters, sent in the fall of 2013 to a law firm that helps clients obtain Social Security disability benefits, falsely contended that Burton had been treating Von Kiel for about seven years, and that Von Kiel suffered from post-traumatic stress disorder and was unable to work, according to the U.S. Attorney's Office in Philadelphia. ...
6 comments:
Lehigh County is served by either the Wilkes Barre or Elkins Park ODAR. Sounds like a weak case for disability if they were relying on letters about PTSD from 7 years prior from a dctor that doesnt specialize in psych treatment.
Ah, the fraud investigations pay off. Perhaps there actually are claimants committing fraud after all.
Of course there are people committing fraud, no one has ever doubted that there are. This issue is whether it is rampant or at least occurring at such a level as to paint all claimants and reps as being frauds. Anecdotal cases certainly support the first part but not the second.
I guess that if 'disability deniers' can cite anecdotal 'evidence,' I guess that I can cite the opposite. I'm now closing out my SSDI/SSI practice after 26 years and what must be a few thousand cases (I've never attempted to count). Especially in the last 10 years, I've rejected about 25-30% of all the claimants who came to me seeking representation (the biggest reason has been that they could not afford medical treatment to document their impairments which do appear to be legitimate). While I've always represented my clients zealously, I've tried to maintain my credibility with ALJs, so I have never knowingly accepted a case in which I could detect ANY fraud whatsoever. During these years, I have only seen 7-8 cases which I believed to be COMPLETELY fraudulent. Surprise--the majority of claimants whose claims I believed were COMPLETELY or had AN ELEMENT OF FRAUD were those submitted by retired law enforcement officers.
Compared with several thousands of honest claimants, these cases ARE mere drops in the bucket. While some ignorant but sympathetic physicians will write factually lacking letters supporting their patients' weak disability claim, I've never seen a case of a physician perpetrating an attempted fraud--in fact, I've seen numerous cases here in western North Carolina in which physicians have purposely entered statements in treatment records offering their subjective opinions that claimants were NOT disabled, despite lab reports and imaging evidence or other "objective" evidence which strongly supported the presence of severe impairments.
1:01 PM wrote:
"While some ignorant but sympathetic physicians will write factually lacking letters supporting their patients' weak disability claim, I've never seen a case of a physician perpetrating an attempted fraud--"
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I would argue that the sympathetic physicians do even more damage than the fraudulent ones. When so many physicians are willing to provide unsupported or even contradictory opinions (they really have nothing to lose by doing so), it casts a negative light on medical source statements in general. I realize that it can be difficult to get doctors to complete detailed assessments, but the solution should not be for them to arbitrarily check boxes indicating that the patient will require frequent breaks and needs to miss four or more days of work per month.
@12:36, this is 1:01. Perhaps I was not clear enough of what type of letter these sympathetic physicians were writing. I am not speaking of having the physician complete Form-1151-U4, Medical Source Statement, but the letter perhaps solicited by the patient/claimant upon application for benefits that essentially says nothing more than "In my opinion, he's disabled." In the next town, there was a rheumatologist (now retired) who was so truly sympathetic for his patients that he would always write those letters. As far as his credibility, 12:36, you are correct in that the ALJs who saw his letters most frequently simply disregarded his medical opinions, even when his treatment notes were supportive.
However, as I did state, more of the treating physicians in Western North Carolina appear to have a negative attitude toward ANYONE receiving disability benefits. Perhaps this is because of their ignorance of SSA's requirements or the prevailing public attitude here that "there's always something that anyone can do." [For 8 hours every day, without accommodations?] Because I have always seen so many physicians who will insert negative comments regarding disability in records, I have always warned my clients to NOT TELL their doctor that they're applying for benefit until such time as we know that the doc is affirmatively supportive.
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