Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Defense Base Act Defense Medical Examinations: Rewriting the Report

Posted by defensebaseactcomp on November 23, 2011

As a Defense Base Act Claimant you are required to submit to an examination by a physician the insurance company chooses for a second opinion.  These examinations are often improperly (fraudulently ?) referred to as Independent Medical Examinations which are something very different under the LHWCA/DBA.

Doctors who will do this work for insurance companies are generally known to write reports favorable to the insurance company.  Otherwise they would not continue to reap the large fees they receive for a single visit and much larger fees for being deposed under oath or testifying live at an ALJ hearing.

On occasion a DME Doc will actually acknowledge the claimants true diagnoses or simply not deny it vehemently enough to suit the insurance company that hired them.  So the insurance company asks them to rewrite the report, sometimes even telling them exactly how they want the report worded.

When the DME Doctor does not comply some insurance companies will go so far as to have another physician who has never even seen the patient, rewrite the report in their favor, and without your permission to use your private medical records.  This may be referred to as a Peer Review.

We know they do, we have some of the emails and the reports.

Add to your DME preparation list a signed HIPAA form directing the DME Doctor to provide your treating physician with any and all medical reports regarding you.  Your treating physician will have these forms and prepare them for you.

You are entitled to any and all reports, lab results, test results, regarding your medical.  You will probably have to have your attorney subpoena these but never ever allow them to not provide them.

One Response to “Defense Base Act Defense Medical Examinations: Rewriting the Report”

  1. Obama’s Hell on Earth For The Holidays !!

    “Metlife and its henchmen” is an exact quote written by U.S. District Judge Richard Enslen in a disability case linked later.

    WFAA – TV in Dallas wrote this about Workers Comp :

    “a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care.

    Doctors’ paid by insurance companies are engaging in fraudulent and deadly organized crimes in five types of insurance as evidenced below including :

    Quotes from numerous Judges proves insurance company doctors ignore Brain Lesions, Multiple Sclerosis, cardiac conditions of many patients, and a foot a new mother broke in five places.

    Obama receives huge contributions from the insurers, and does nothing about the doctors ignoring medical records !!

    **** No one was prosecuted for huge bid rigging to increase sales of these exact policies.

    Two Obama contributors signed MetLife’s third Non Prosecution agreement for bid rigging as seen below !!

    This extremely evil destruction of thousands of lives is being willfully enabled and protected by DOL Secretary Solis, AG Eric Holder, and Presidents Obama and Bush !!

    TYPE 1 HELL ON EARTH –

    ProPublica.org wrote these quotes about insurance companies destroying injured war zone contractors :

    “Workers fought long battles for medical care, including such things as prosthetic devices and treatment for post-traumatic stress. The Labor Department seldom took action to enforce the law. One official called the system a “fiasco.”

    “Labor officials can recommend cases for prosecution to the Justice Department–but have only done so once in the past two decades, according to Labor officials.”

    Iraq War Zone Contractor Daniel Brink had his leg, fingers and toes blown off, and many other injuries from a car bomb blast. Here are exact quotes :

    “The Sheriff repossessed my wheelchair because CNA Global Insurance stopped payment on the check that they issued to the suppliers and my life really started spiraling out of control”

    “My medication that I need because of PTSD and the severe pain I experience, has not been paid for three months. My teeth are extensively damaged right down to the nerves due to grinding caused by the severe Post Traumatic Stress Disorder I am suffering from.”

    “I am sleeping on the floor on a mattress in the living room with my Night care Assistant sitting on a chair next to my mattress. I have to use a bucket and a bottle to urinate in the evenings.”

    TYPE 2 HELL ON EARTH –

    WFAA – TV in Dallas wrote this about Workers Comp :

    “a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care. Some insurance companies send peer review doctors medical files “stripped” of records important to the possible approval of workers’ comp claims.”

    During the time period of the suicides AIG rigged billions of dollars in bids to increase sales of Workers Comp policies; No one was prosecuted !!

    TYPE 3 HELL ON EARTH –

    Quotes from Numerous Federal Court Judges Prove Insurance Company Doctors’ ignore disabled patients life threatening medical conditions including Brain lesions and Multiple Sclerosis, cardiac conditions of many patients, and a foot that a new mother broke in 5 places.

    Here are two case examples :

    In the case of Wright verses Metlife U.S. Magistrate Judge Jennifer Guerm wrote these quotes :

    “MetLife relied on clearly erroneous findings of fact in making its benefit determination. MetLife’s review of Plaintiff’s appeal consistently omitted or misrepresented relevant information in several ways. On October 18, 2004, Dr. Barnett wrote a letter to MetLife stating:

    “I am gravely disturbed by your misrepresentation of the facts with regard to my discussion with your independent physician consultant and your lack of due diligence in collecting further medical information regarding Mr. Wright’s health condition. Indeed, Mr. Wright has ongoing cardiac disease including ischemia and loss of function due to previous myocardial infarctions.”

    U.S. District Judge Nancy Gertner won the Thurgood Marshall Award of the American Bar Association in 2008.

    Here’s three important quotes Judge Gertner wrote about Metlife:

    “It misquoted Whitehouse’s doctors and cherry-picked or took out of context statements made. The denials continued to press factual inaccuracies even after being informed of the errors.”

    “Perhaps most egregious of all, it misquotes Dr. Bhan as stating that Whitehouse “[was] able to function” AR 116 when, in fact, he said “she was not able to function.” AR 121 (emphasis added).

    Multiple Judges prove MetLife is also very fond of endangering Psychological claimants lives !!
    Obama’s DOL and DOJ Directors have seen this evidence but will do nothing to stop these crimes even though the patients may die before their case is heard by the Courts !!!!

    The quotes can be seen at the following website but please finish this index before viewing them :

    http://www.deadlyorganizedcrimes.blogspot.com

    You’ll see how Independent Consultant Dr. Gary Greenhood was paid by MetLife to write reports where he ignored MRI’s that showed brain lesions and Multiple Sclerosis of Ms. Jacquelyn Addis. The same Dr. Greenhood ignored a foot new mother Joanne Vick broke in five places, and he ignored every eye cancer symptom and sharp eye pains that are documented in my medical records. Dr. Greenhood did this at the exact time my medical insurance and savings ran out and I had no more money for surgery and follow up.

    Professor’s quotes prove multiple insurers are destroying the lives of very sick patients!!
    This quote was written by Joseph Belth, Professor Emeritus for Insurance at Indiana University :

    “They’ve turned Erisa on its head,” “It was supposed to protect employees, and it’s being used to protect insurers.”
    (end of quote)

    “The most important federal insurance regulation of the past generation is ERISA,” says Tom Baker, deputy dean of the University of Pennsylvania Law School in Philadelphia. “If ever a law backfired for the public, ERISA is the perfect example.”

    John Marshall Law School Professor Mark Debofsky wrote:

    “empirical evidence is now available that shows insurers operating under ERISA have systematically engaged in the wrongful denial of claims. Cases of abusive benefit denials involving other disability insurers abound. Unum turns out to have been a clumsy villain, but in the hands of subtler operators such misbehavior is much harder to detect.”

    (ERISA is the U.S. Title 29 Employee Retirement Income Security Act which regulates employee benefit health plans of all the 150 million Americans who work for private businesses and corporations in America)

    Here are quotes from Aaron Doyle, a professor of sociology and criminology at Carleton University in Ottawa :

    “What those numbers don’t measure is the trauma survivors like Jane Pierce face when wrongfully denied, says “Most survivors don’t have the stamina and knowledge to file a lawsuit, says Doyle, who has spent a decade interviewing life insurance customers, employees and regulators in the U.S. and Canada.

    State governments also protect the insurance companies. In addition to documenting many injured workers suicides WFAA TV also wrote the following regarding criminal prosecutions of insurance companies in Texas:

    “the number of insurance companies referred since 2000? Zero.”

    (end of quote)

    Tennessee also has zero insurance companies prosecuted !! Here is an exact quote written by the Tennessee Bureau of Investigations Special Workers Comp Fraud Units Karen Alexander :

    “The other question that you asked is why there are only press releases on employees who have been prosecuted. So far, only employees have been successfully prosecuted.”

    Overwhelming evidence proves these insurance company organized crimes are destroying the lives of many claimants in three different types of insurance while Obama and Bush’s DOL have protected them !!

    Please remember there have been multiple times MetLife’s violations caused me to be without money for medical treatment during times that MetLife completely ignored my Long term claims for eye cancer and disability for 6 years. I was referred to a Psychologist who wrote “Metlife’s actions seem irresponsible, inhumane, dangerous, and reckless”

    MetLife continued to ignore my claim even after they read the following quote I filed with the U.S. Court in Nashville :

    “the Plaintiff who has had cancer removed from his eye and leg and over 200 biopsies plus stitches in 100 places has no money for follow up treatment.”

    Soon I will again have insufficient funds for living and medical treatment because MetLife has just had two more doctor’s completely ignore medical evidence including my extensive records of falls and accidents that have occurred since I developed eye cancer.

    They did this even after reading my Psychologists 5/31/11 report where she wrote “Mr. Schmittou is in a desperate situation”

    Earlier she wrote how MetLife “significantly destabilized” me when three more doctors they paid ignored medical evidence !!

    My Psychologist also wrote the following quotes in an urgent letter to Assistant Secretary of Labor Ms. Borzi :
    “His thoughts and emotions are so troubled he describes feeling “like my brain is on fire”. I think he struggles to express the fullness of his distress.”

    “In light of the violations Metlife has committed against Mr. Schmittou and Metlife’s awareness of the additional harm caused him, Metlife’s actions seem irresponsible, inhumane, dangerous, and reckless.”

    (end of quotes)

    After seeing this the DOL sent me a letter saying there is nothing they can do !!

    The DOL website writes the Secretary “is responsible for protecting claimants rights”
    To see the full Psychologist’s reports please go to :

    http://www.mypsychologistsreport.blogspot.com

    I’m amazed that I have survived the stress from this while having so many surgeries. I still have tremendous problems sleeping and nightmares now because I feel a huge responsibility to get the government to stop the destruction of thousands more lives. The DOL and DOJ are very aware their inaction caused me to have nausea and nightmares during the exact time of biopsies and surgeries for deep tissue cancer. While I had this surgery MetLife also had two more doctors completely ignore my falls and accidents that are well documented in my medical records.

    After seeing all this evidence and much more, on 12/10/2010 DOL Regional Director RC Marshall wrote :

    “Please be assured that EBSA’s top priority is to protect the benefits of participants and to make sure that providers of those benefits obey the law.”

    On January 26, 2011 Department of Labor Director of Participant Response Ms. Sharon Watson sent a letter from Washington saying :

    “As we previously indicated, we take the allegations you have made that MetLife has engaged in a pattern of fraudulent activities regarding your claim and other participants’ claims very seriously and have taken the information under advisement.”

    Ms. Watson closed by saying :

    “At this time, there is nothing more EBSA can do for you regarding your claim.”

    It took me four years to get the DOL to even acknowledge and respond to the evidence I submitted. They are very aware that this is not just about my claim. I am asking them to stop these organized crimes from destroying lives in five types of insurance !!

    The DOL only responded when I placed a video on YouTube where the DOL agent repeatedly said “We can’t go against MetLife”.

    Here is the DOL EBSA Statement of Purpose seen on their website:

    “Under ERISA, the Secretary of Labor is responsible for protecting the rights and financial security of more that 150 million employee benefit plan participants and beneficiaries and for assuring the integrity and effective management of the private pension and welfare benefit system.”

    In spite of this responsibility the DOL and DOJ have done absolutely nothing after four years of my repeated requests to have them stop insurance companies and the doctor’s they pay from ignoring life threatening medical conditions of very sick patients !!

    As we continue please remember AIG rigged bids to increase sales of Workers Comp policies.

    Prudential Insurance, Unum Insurance, and MetLife also committed similar bid rigging violations regarding health care plans and have received multiple Non Prosecution agreements from multiple government agencies !!!!!

    The District Attorney press release about these three companies is seen at :

    http://www.sdcda.org/files/Insurance%20Settlement%204-28-08.pdf

    Obama Received Huge Contributions From MetLife and Two Men Who Actually Signed the Agreement Where No One Was Prosecuted !!

    Metlife Executive Vice President James Lipscomb gave President Obama $30,000 for his victory party.

    Please scroll down 1/3 page and look on the left side for the $30,000 contribution :

    http://www.campaignmoney.com/political/contributions/james-lipscomb.asp?cycle=08

    On Page five of MetLife’s third Non Prosecution agreement you will see the signature of Mr. James Lipscomb :

    http://www.gibsondunn.com/publications/Documents/metlife.pdf

    Attorney Bruce Yannett of Debevoise & Plimpton LLP/Attorney also signed metLife’s Third Non Prosecution agreement. His name and Debevoise & Plimpton LLP were listed as being counsel for MetLife.

    Here is a link to 19 pages that prove hundreds of thousands of dollars that Debevoise & Plimpton gave to Obama in 2008

    http://www.campaignmoney.com/advanced.asp?searchtype=contributors&cycle1=08&lname=&fname=&work=Debevoise+%26+Plimpton+LLP%2FAttorney&occup=&zipcodes=&fdate=&tdate=&state=&cycle2=10&cmtetype=&cmtename=&cmteorg=&igc=&cmteparty=&cycle3=08&cndoffice=&cndtype=&cndlname=obama&cndfname=&cndstate=&cndparty=&orderby=

    Here is a link to $2,500 Bruce Yannett gave Obama in 2008

    http://www.campaignmoney.com/advanced.asp?searchtype=contributors&cycle1=08&lname=yannett&fname=bruce&work=Debevoise+%26+Plimpton+LLP%2FAttorney&occup=&zipcodes=&fdate=&tdate=&state=&cycle2=10&cmtetype=&cmtename=&cmteorg=&igc=&cmteparty=&cycle3=10&cndoffice=&cndtype=&cndlname=&cndfname=&cndstate=&cndparty=&orderby=

    A group of MetLife executives and attorneys gave President Obama $78,980 for his 2008 Presidential campaign :

    http://www.opensecrets.org/pres08/search.php?cid=N00009638&name=(all)&employ=metlife&cycle=2008&state=&zip=&amt=a&sort=A&page=1

    Here’s a group of Metlife employees who gave $953 thousand dollars that went to almost every candidate for Congress and Senate :

    http://www.campaignmoney.com/political/committees/metlife-inc-employees-political-participation-fund-a.asp?cycle=10

    A Metlife group also gave Hillary Clinton $57,830 in 2008 :

    http://www.opensecrets.org/pres08/search.php?cid=N00000019&name=%28all%29&employ=metlife&state=%28all%29&zip=%28any+zip%29&submit=OK&amt=a&sort=A

    Plus MetLife spent $41 Million dollars lobbying over the last ten years !!

    Link To Lobbying totals :

    http://www.opensecrets.org/lobby/clientsum.php?lname=MetLife%20Inc

    President Obama received $198 MILLION dollars for the victory fund. He spent $196 MILLION.

    Here’s the list of the top 100 contributors including $33,100 from a Goldman Sach’s executive :

    http://www.campaignmoney.com/political/committees/obama-victory-fund.asp?cycle=08

    Metlife also has a Political Action Committee that makes contributions. Because of my vision and falls/accidents it will be awhile before I research that.

    This comment is being sent to the following Obama Directors who do read my communications, and I pray you will email them too !!

    solis.hilda@dol.gov; borzi.ebsa.assistantsecretary@dol.gov; watson.sharon@dol.gov; askdoj@usdoj.gov; usatnm.webmaster@usdoj.gov; young.patricia@dol.gov; clark.charlene@dol.gov; debra.hartman@usdoj.gov; san.diego@ic.fbi.gov; oigprograms@oig.dol.gov; ebreezes@hotmail.com; contact.sol@dol.gov

    As Obama and his Director’s prepare for a luxurious Thanksgiving and Christmas, and Obama leads prayers and quotes the Bible on TV, many very sick and injured Americans will continue their unimaginable extended Hells on earth because the Obama and Bush administrations protect insurance companies that ignore life threatening medical conditions in five different types of insurance.

    Since Obama will not prosecute them I pray someone on a Grand Jury will initiate an investigation soon so thousands more lives will not be destroyed. I have much more overwhelming evidence as seen at http://www.treasonevidence.blogspot.com

    I sincerely and humbly pray God please help us all.

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