Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Posts Tagged ‘Dr Griffith’

Racketeering and Comp: When the Denial of an Injury is an Injury

Posted by defensebaseactcomp on December 14, 2009

Food for thought all of you injured contractors who have been denied by AIG and CNA.  We’ve been saying all along that these denials are criminal.

How many of you continue to be sent to Houston (from out of state to boot!) to see AIG’s hired guns for DME’s,  that they misleadingly call IME”s, over and over again?  Why would you travel out of state to do this when common sense and the law do not require you to leave your geographic area (50 miles).  Why do your lawyers suggest that you do?

Only the DoL can arrange an IME, an Independent Medical Examination.  If the insurance company, their claims adjuster, or their lawyer arranges it it is called a Defense Medical Examination.  Nothing Independent about it.

How have so many contractors lost their claims due to testimony by Dr. Griffith?

Another one from Worker’s Comp Insider

Racketeering and Comp:  When the Denial of an Injury is an Injury

Imagine you work as a commercial driver for a long-established trucking firm that self-insures for workers comp. You are injured on the job. You seek benefits under the comp statute. The TPA handling the claim refers you to a company doctor. The doctor determines that the injury is not work related. The adjuster for the TPA denies the claim. End of story?

Not quite. What if you shared your story with five other employees, all of whom filed comp claims, all of whom saw the same doctor (a family practitioner), with the same result: claim denied by the same adjuster at the TPA? A coincidence or a conspiracy?

Five employees of Cassens Transport in Michigan concluded that there was a conspiracy to deny their claims. They filed suit in federal court, alleging a violation of the Racketeer Influenced and Corrupt Organizations Act (“RICO”). A district court dismissed their claims, finding that their individual claims did not constitute a “pattern” of activity and that invocation of the RICO statute would violate the McCarren-Ferguson Act by interfering with state regulation of insurance.

The U.S. Court of Appeals for the 6th Circuit reviewed the case and overturned the district court’s ruling. Now the U.S. Supreme Court, by declining to get involved, has upheld the Appeals Court. The Appeals ruling is a fascinating document which explores the nature and definition of racketeering, the relationship of workers comp benefits to insurance and the roles of state and federal governments. It’s required reading for attorneys and highly recommended for all others.

Criminal Acts?
The district court has been ordered to reconsider the allegations. The five Cassens drivers allege that Cassens, their self-insured employer, Tina Litwiller, a claims adjuster for the TPA Crawford and Co., and Dr. Saul Margules conspired to deny their comp claims. (While you might expect Dr. Margules to be board certified in occupational medicine, he appears to be a family practitioner.) The Appeals Court does not address the substance of the allegations: it simply rules that denial of the workers comp claims might involve a violation of the RICO statute and thus is appropriate fodder for the federal courts.

Some folks are alarmed that the feds are getting involved in what is usually a state issue. That might be a problem, but let’s not lose sight of the delicious prospect before us. During the course of the new hearings, plaintiff attorneys will seek access to some fascinating communication records: between Cassen and Crawford, detailing the status of individual claims; Ms. Litwiller’s claim notes; and communications between Crawford and Dr. Margules, who had so much difficulty finding a connection between a given injury and work. As much as I enjoyed the Appeals Court’s discussion, I am really looking forward to the nitty-gritty details of the proceedings in the district court. (You don’t suppose that some of the written and electronic communications have disappeared, do you?)

At heart, this is a very serious matter. The five employees allege that they have been unlawfully denied the protection of Michigan’s workers comp law through a conspiracy of company, TPA and doctor. If the allegations are proven, if the accused violated the RICO statute, they will face the consequences of a criminal conspiracy. In the Insider’s burgeoning annals of fraud – employee, employer, attorney, doctor, agent, insurer – this case will surely offer one of the more compelling narratives

Posted in AIG and CNA, Department of Labor, Racketeering | Tagged: , , , , , , , , , , , | 7 Comments »

The DBA X Files: Unravelling the mysteries of the abducted PTSD cases

Posted by defensebaseactcomp on May 19, 2009

Thanks to American Contractors In Iraq for hosting the DBA X Files series

The first episode

Unravelling the mysteries of the abducted PTSD cases

has just gone online

The ALJ’s and DME’s come up with the  MOST BIZZARRE ideas and rulings !!

The Department of Labor should be humiliated for allowing this science fiction to ruin peoples lives.

Check out the site for the FACT CHECKS.


Killer Robes

The administrative law trials of civilian war contractors with psychiatric injuries are reminiscent of the Salem witch trials 400 years ago.

Over half of the PTSD or mental injury cases arising from the Iraq and  Afghanistan wars have been denied or inadequately awarded by the Labor Departments  Administrative Law Judges in the 38 decisions issued since 2006.

No less that ten of the 17 denied cases involved insurance psychiatrist Dr John Dorland Griffith, who doubts if PTSD is a valid condition.

Two judges are responsible for almost 60% of all denied claims.

Even more astonishing is the impossibly low number of PTSD claims filed.

At last count, there were 303 PTSD claims filed by civilian contractors who outnumber troops in the war zones, and have outnumbered them for the last five years.

There have been roughly 300,000 cases of PTSD reported among the soldiers.

The chilling effect of these vicious and often ludicrous court proceedings on claimants and their lawyers is undeniable.

The end result:

Thousands of people suffering from a potentially fatal mental disorder receive no treatment or compensation for PTSD.

The DBA X Files

Posted in Uncategorized | Tagged: , , , , , , , , , , , | Leave a Comment »

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