Where Criminal Meets Civil Law

Eric Turkewitz at New York Personal Injury Law Blog lays out in a post he calls “To Tell the Truth: Which Doctor’s Signature is the Real One?” some evidence that whatever is happening on the defense side of personal injury medical examinations, it smells just as bad as any fraud being perpetrated by a scammer under indictment.

Over the transom this week sails medical reports allegedly signed under oath by one Joseph Tuvia, M.D., who’s been doing medical-legal reviews of radiology films since about 1996. He was reviewing, back then, a thousand films a year, and was doing 95% of it for the defense.

As you might guess from the title of this post, the questions today revolve again around potential perjury, not from the witness stand but by signing medical-legal reports under penalty of perjury. Or, perhaps, by having others sign his name.

This goes to one of the bedrock assumptions that underlie law, that a signature made “under penalty of perjury” actually means something. Judges buy into it. Lawyers buy into it. The law buys into it. Once a signed document shows up in court, we all fawn over it as if it’s real. If it’s not, then the fabric of litigation begins to unravel. More to the point, then it can constitute the crime of perjury. You know crimes, those things that are against the law, worthy of prosecution and in many instances, prison?

Is there an exemption from crime by doctors? Is there a special dispensation for doctors when they’re being paid by insurance companies to opine that the guy hit by a Mack truck with two severed legs barely suffered a sprain?

Eric puts together four reports from Dr. Tuvia.  Does anything look awry here?

Tuvia1

Tuvia2

Tuvia3

TuviaJoseph-jane 2

As Eric puts it:

But who, in this case, is actually signing under penalty of perjury? Do any of those signatures belong to Dr. Tuvia? Do they belong to someone on the support staff? Do they belong to a broker funneling business to the medical practice on behalf of the insurance company?

Is anyone changing the report after it’s dictated? Would Dr. Tuvia even know?

Is anyone laughing about this?

If these were mortgages and some bank lost twelve bucks, chances are particularly good that some prosecutor somewhere would be preparing his press release to announce an indictment. So are they investigating the fact that these reports, executed under penalty of perjury, are being used by courts to determine whether people who claim damages have been injured or are fakers? Somebody is a faker here, but it’s not the injured party.

People in the personal injury defense biz would likely slough this off, saying that physicians are very busy, very important people, whose time is far too valuable to sign their own name to reports whose validity is accepted because they are made under penalty of perjury.  Seriously? The half-second it takes to sign is more than these very important docs can handle?

But far, far more importantly, if they can’t be bothered to sign their own reports, do they read them? Do they even write them? They don’t get paid extra for making sure the report they dictated (or pulled out of their library of possible reports concluding that the party is healthy as a horse) is right on the money. After all, they can only give five minutes, tops, to the actual examination. What do you expect of these poor guys?

To see four reports with four obviously different signatures, all in the name of one physician, is to put the lie to physical examination, and by extension, to the merit of the defense denying people who were injured just compensation.  And if that’s the case, then it’s every bit the scam as if it was some hustler on the street.

As Eric properly notes, if there is pervasive fraud on the med exam side of personal injury defense, then it fundamentally undermines the integrity of the legal system and demands some very serious investigations and some very serious remedies.  That this involves docs having others sign their names to reports of unknown accuracy or origin “under penalty of perjury” is ripe for prosecution.

Will the District Attorneys ever investigate? Will the Attorney General? Will the U.S. Attorney?  How about the Insurance Frauds Bureau at the Department of Financial Services where Benjamin M. Lawsky is the Superintendent?? Or is it only individuals that get investigated while insurance companies get a free pass?

Yeah, I keep dreaming about this stuff, hoping someone in the media will wake up when they realize the scope of the issue, that someone will realize how many tens of millions or hundreds of millions are at stake, hoping that one day we will see a little more integrity in the system.  Hoping that someone, somewhere, will pick up this drum and start banging on it.

Hello? Is this thing on? Is anyone out there listening? Does anyone give a damn?

This is our legal system, for better or worse, and if what these signatures suggest is happening is indeed happening, we better all give a damn because if it’s not cleaned up now, it will still be dirty when it’s your turn to need it.

4 comments on “Where Criminal Meets Civil Law

  1. C. N. Nevets

    This is a messy situation. Based on what I’ve seen, there’s not a necessary link between false signatures and false examinations. I’ve seen this in two situations, and in those situations it boiled down to people who think themselves both more busy and more important than other people who work for them making the determination that the signature is the least important part of the work.

    (1) Several years ago now, my wife worked in a clerical capacity for the office of a chancellor of a major land grant university. The chancellor would routinely have his clerical staff sign his name to letters. Many of them were legally insignificant, e.g. attempts to raise funds or to pass along good wishes to faculty receiving tenure. Some of them were more important, e.g. official reports on university business to the state legislature. One day there was a form, which gave a legal disclaimer, re: perjury, at the bottom. My wife refused to sign. It was the the beginning of the end of her employment there. The chancellor had filled out the form himself, so the information was actually his and presumably correct, but he had come to a mindset where signing his own name was beneath him.

    (2) As an EMT, I’ve seen a lot of skating by signature rules in hospitals. Everyone knows they’re not supposed to do it. Almost everyone finds ways of justifying it. Doctors rattle off orders to nurses and tell them to sign their names. They perform an exaggeration and hand their notes over to nurses and have the nurses fill out the official document. The view expressed is that patient care is what’s most important, and the other stuff is a formality. I’m not saying it happens all the time, but it happens often enough, and usually when I’ve seen it, the doctor has done his or her medical duty up to the point of actually signing.

    All of that is to say that there is a chance that the examinations were still valid, despite the invalidity of the signatures.

    The legal question is, I suppose, does this invalidate the power of the signature or does it mean that the false signature is sufficient to invalidate the examinations, regardless of the literal activity of the examinations per se?

    1. SHG Post author

      No, phony signatures do not, by definition, mean phony reports. But the rationalization process by which people come to believe themselves above signing their name when doing so under penalty of perjury is bullshit. And if they are prepared to lie (no matter what excuse they embrace) in one place, then the line ceases to exist between truth and falsity.

      Docs aren’t special. No one is so special that they get to lie when their signature is endorsed under penalty of perjury.

    2. Turk

      If the doctors don’t sign the reports, how do they know they accurately reflect the findings?

      From a 2009 expose on Workers Comp fraud by the insurance industry in the NYT:

      Reports were sometimes altered by brokers and exams often were done at airports, hotels or in the garages of doctors’ homes.

      Sorry for putting a link in the comments, but the NYT article is here:
      A WORLD OF HURT: Exams of Injured Workers Fuel Mutual Mistrust

  2. Pingback: Doctor Testifies That Six Different Signatures Are All His – New York Personal Injury Law Blog

Comments are closed.