The board cited five cases of Lerman \u2014 who has\u00a0been named in four civil federal racketeering lawsuits, alleging he conspired with others to collect millions in insurance payouts for bogus accident claims \u2014 performing “highly invasive” surgeries without medical justification; questionable “billing irregularities” and\u00a0inadequate medical recordkeeping.<\/p>\n
‘Baseless complaint’<\/p>\n
In mid-August, Lerman\u00a0filed a petition in state court in Schenectady County seeking to annul the state’s denial, which his attorneys described as “arbitrary, capricious and unlawful.”<\/p>\n
WHAT NEWSDAY FOUNDA Long Island spinal surgeon is asking an upstate court to reverse a decision by the State Workers’ Compensation Board and reinstate his ability\u00a0to seek reimbursement for the treatment of injured workers.In April,\u00a0the board rejected an application by Dr. Vadim Lerman, associate director of spine surgery at Total Orthopedics & Sports Medicine, to\u00a0treat\u00a0patients with workers’ compensation claims.Lerman, whose company\u00a0operates the Orthopedics Department at NUMC, has been named in four civil federal racketeering lawsuits, alleging he conspired with others to collect millions in insurance payouts for bogus accident claims.<\/p>\n
Medical providers are required to reapply for authorization with the board every two or three years, in line with their State Education Department license renewal.<\/p>\n
“The WCB\u2019s determination is unsustainable: it is based on a baseless complaint from a self-interested insurance company, unsupported by credible evidence, constitutes an abuse of discretion, and is marred by multiple legal and procedural errors,” wrote Mickey Keane, one of Lerman’s Great Neck-based attorneys. … “The WCB\u2019s decision was not the product of a fair or objective regulatory process. Instead, it was driven by speculation, mischaracterizations of clinical care, and disregard for basic due process protections.”<\/p>\n
In a strategy similar to arguments made\u00a0in the same court last summer by Dr. Joseph Weinstein<\/a>, another Long Island doctor barred\u00a0from treating injured workers, Lerman alleged the board’s actions were “part of a broader campaign” initiated by the\u00a0insurance companies that filed the RICO cases in New York’s Eastern District.<\/p>\n In addition, Keane said an “expert”\u00a0spinal surgeon reviewed Lerman’s work and concluded that his treatment methods were proper.<\/p>\n But James\u00a0Tacci, the board\u2019s medical director, wrote in an Oct. 24 letter to the court that Lerman’s “expert” has no experience in New York’s workers’ compensation system and is not authorized to treat injured workers in the state.<\/p>\n ‘Dangerous and improper treatment’<\/p>\n The five patient cases cited by the board, Keane wrote,\u00a0were\u00a0brought forward by a “stakeholder” in one of the RICO lawsuits, identified in court documents as James Manning, director of the Special Investigations Unit at New York City Transit.\u00a0<\/p>\n In an Oct. 24 court filing, Michael Papa, the board’s general counsel, said Lerman’s claims were “baseless” and that the application\u00a0rejection came after a review of the doctor’s cases determined he “engaged in dangerous and improper treatment of injured workers.”\u00a0<\/p>\n “The Board’s reasonable investigation of the RICO complaint allegations is what the governmental entity charged with the fair administration of the [workers’ compensation law] should do when it receives allegations of this nature,” Papa wrote.\u00a0“And where the Board’s investigation reveals unnecessary, invasive, dangerous and potentially life altering treatment … the Board has an obligation to protect injured workers by denying the practitioners … authorization to provide care to injured workers.”<\/p>\n In the cases detailed by the board, Lerman was criticized for opting for “predetermined” surgical procedures after only an initial consult, without full patient evaluations or exploring more conservative treatment options \u2014 including on patients as young as 24 \u2014 and without sufficient documentation to support the treatment.<\/p>\n The board concluded Lerman\u2019s behavior “amounts to professional misconduct.”\u00a0<\/p>\n Directed from Total Orthophedics to NUMC<\/p>\n Lerman is a board-certified orthopedic spinal surgeon who continues to hold\u00a0staff appointments at Beth Israel Medical Center, Mount Sinai South Nassau, NUMC and at Northwell Health hospitals.<\/p>\n Total Orthopedics, which has four Nassau locations,\u00a0and Lerman personally were named as defendants in several federal lawsuits, including one<\/a>\u00a0alleging they conspired with several Freeport residents, a Manhattan law firm and a vast network of other medical providers to collect millions in insurance payouts for fraudulent accident claims.<\/p>\n No one has been criminally charged in connection with the cases, but the Brooklyn District Attorney’s Office, which declined to comment, has opened a\u00a0criminal investigation connected to the RICO complaints, records show.<\/p>\n Court records reviewed by Newsday contend that surgeons at Total Orthopedics see patients \u2014 typically litigants in lawsuits stemming from alleged accidents in Brooklyn \u2014 and then direct them to spinal surgery at NUMC in East Meadow, which they or their colleagues later perform.<\/p>\n