You're about to see evidence that proves many thousands of lives are destroyed every year because wealthy insurance companies are intentionally ignoring medical symptoms and removing important medical records from the files of :
(1) Disabled Workers
(2) Injured Workers in the U.S.
(3) Contractors Injured in War Zones
(3) HMO Patients
U.S. Magistrate Judge Bryant in Nashville wrote that I have "more than sufficiently alleged fraud" that is being committed by Metlife Insurance, but the government investigative agencies and politicians I've contacted have all failed or refused to stop these proven crimes !!!!!
Index of Content
(1) The U.S. Judges quotes you'll see include :
* U.S. District Judge Timothy J. Savage's written conclusion that Metlife and their Dr. Greenhood clearly ignored MRI reports that evidenced Multiple Sclerosis and lesions and plaque on the brain of patient Jacquelyn Addis.
* In the case of Joanne Vick, who developed diabetic kytoacedosis following childbirth, U.S. District Judge Robert Cleland wrote that Metlife and their Dr. Greenhood said Ms. Vick had never fallen, but Judge Cleland wrote that metlife and Greenhood were very obviously ignoring the medical records that prove Ms. Vick actually fell and broke her foot in 5 places.
* In the case of Brenda Zanny U.S. District Judge Richard Enslen wrote :
“MetLife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization.”
Full case quotes are seen in section 4 below.
(I have had cancer burned from one eye and it has taken many years for me to compile this evidence so please forgive any lack of writing proficiency. I pray the evidence will not be ignored if I present it incorrectly)
When U.S. Magistrate Judge Bryant wrote that I have more than sufficiently alleged fraud against Metlife he also wrote that the court does not have authority to prosecute and he instructed me to contact government investigative agencies.
I contacted Department of Labor EBSA Investigative Agent Gloria Polk. She told me that they would have to learn about the crimes first, and when I said I had just told her about them she said that did not count.
I made two trips to the F.B.I.'s office in Nashville and I was told their focus is terrorism. They refused to take any action. I was also told the F.B.I. did not look at this as a crime, and I responded that a U.S. Magistrate Judge trained in law wrote that I had "more than sufficiently alleged fraud."
During the exact time I was having cancer surgeries and 200 biopsies I went to the Tennessee State Capitol and talked face to face with so many powerful state and national politicians from both political parties. I could find no one who would do anything to stop the proven insurance companies crimes.
I was so desperate I went to the Capitol during times I had had cancer biopsies and I was bleeding through the bandages onto my suit, and itching terribly because of an allergic reaction to the Lidocaine.
***** I am adding this brief update because I have just seen evidence that indicates insurance companies including AIG are violating numerous laws in their administration of life and medical insurance policies for private contractors who are killed or injured in war zones including Iraq and Afghanistan. The insurance companies destruction of the lives of the contractors and their families is very heinous !!
You can visit the following websites to see the evidence:
www.americancontractorsiniraq.com
www.defensebaseactcomp.wordpress.com
(2) Insurance companies are also committing similar crimes against a large number of injured workers in the United States. At the end of this paragraph is a link to WFAA TV stations award winning series that mentioned injured workers in Texas even killed their selves because they were in such pain and could not get treatment.
This is organized crime because multiple insurance companies have implemented identical crimes in numerous cases in two different types of insurance (ERISA disability and Workers Comp). WFAA reported that insurance companies are intentionally removing very important medical records from injured workers files.
WFAA also wrote that many injured workers killed their selves because they were in such pain and could not afford treatment after their benefits were denied. If you click on the WFAA link now please remember there are also very compelling quotes from U.S. Judges that are seen in Section 4 below :
http://www.wfaa.com/sharedcontent/dws/wfaa/bshipp/stories/wfaa040518_gp_stateofdenial.1d42799e7.html
THIS EXACT QUOTE WAS WRITTEN BY WFAA IN THEIR INTRODUCTION TO THE 19 PART SERIES THAT WON A PEABODY AND DUPONT COLUMBIA AWARD :
“Several stories detail possible fraud or questionable actions practiced by at least several major insurance carriers, but ignored and unpunished by regulators. The WFAA-TV series has revealed how some insurance companies send peer review doctors medical files "stripped" of records important to the possible approval of workers' comp claims. Those peer review doctors who routinely deny care receive lucrative contracts, while those who approve care fail to be rehired.”
WFAA also writes the following regarding criminal prosecutions of insurance companies in Texas:
“the number of insurance companies referred since 2000? Zero.”
I have also presented evidence to State and Federal authorities and elected officials that proves an identical failure to prosecute insurance companies is happening in Tennessee. You can see this evidence by clicking on the following link :
www.insurancecompanyfraud.blogspot.com
The complete failure to prosecute insurance companies in Tennessee and Texas proves a pattern of failure to prosecute insurance company crimes. Add this to that fact that multiple Federal Government agencies failed or refused to investigate or prosecute the widespread fraud that U.S. Magistrate Judge Bryant wrote I had proved.
(3) You can see evidence that this is also occurring in HMO cases by going to the following website :
http://www.makingakilling.org/chapter1.html
(Full Judges quotes are 4 paragraphs below)
No one in the Bush administration would take any action regarding my numerous requests.
I have also made multiple requests to the Obama administration and new Attorney General Eric Holder, but they have not acknowledged the evidence and no action has been taken.
I have continued to damage my health in what seems like a completely futile effort to get anyone to take action. No one will even ask the insurance company fiduciaries to stop their blatant and deadly violations of law !!
I, Barry Schmittou, assert under oath with penalty of perjury, that the Judges quotes you're about to see are an exact copy of quotes that are included in my motion that was read by the Justices of the U.S. Supreme Court and the Solicitor General of the U.S. Department of Justice. The fiduciaries at Metlife Disability did not deny any of my allegations of fraud, and the fiduciaries at Blue Cross Blue Shield ( who filed in support of Metlife ) did not respond to my proven evidence.
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(4) The following quotes are from the Opinion written by Honorable U.S. District Judge Richard Alan Enslen in ZANNY v. KELLOGG COMPANY and METROPOLITAN LIFE INSURANCE CO.)
“Metropolitan Life Insurance Company has arrived at a formula for operating a profitable insurance business. It simply does not allow piddling things like facts to intrude upon its employee benefit claims decisions. Witness Zanny v. Kellogg Company and Metropolitan Life Insurance Co.”
“What is most shocking about the Report is the underlying context. In this instance, Mr. Kooi made the object of videotaped surveillance and spying at her home, on the road, and at her therapist’s offices a woman suffering extreme depression, paranoid symptoms, anxiety toward strangers and a history of repeated suicide attempts.”
“MetLife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization to foster mental health. MetLife should investigate the conduct of Mr. Kooi to insure that its agents are not either wittingly or unwittingly subjecting mentally-ill claimants to untoward risks of suicide death or other preventible injury.”
“This record is an open indictment of MetLife’s practices and treatment of the mentally-ill and long-term disability benefits. In this case, MetLife regularly reviewed the client’s file with an open intention to deny benefits despite the profound and compelling evidence of serious and prolonged mental illness.”
“On May1, 2002, MetLife requested Ann Tacl (a rehabilitation counselor) to provide a written report concerning Plaintiff’s employability. The Tacl report, for the most part, completely ignored medical information supporting disability, psychiatric hospitalization records, or the reports of examining psychologists and previous rehabilitation counselors who concluded that Plaintiff was not employable at any occupation nor able to operate a for-profit business. (Id.)”
“Tacl’s report is dated May 14, 2002. In it, she concludes that there is “no objective evidence that she [Plaintiff] has cognitive deficits . . . .” This conclusion is wildly inaccurate and wholly ignored the opinions of every psychiatrist or psychologist who has physically examined Plaintiff, including the most recent such examinations.”
“And What About those “Independent” Medical Exams and Reviews? Overall, the Tacl report is explainable only as the product of a professional who has been directed to reach a conclusion, has focused on data only in support of such conclusion, and who has scrupulously ignored all contrary data.”
(Quotes from Case 4:05-cv-00074-RAE Document 55 Filed 06/30/2006
UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION, Case No. 4:05-CV-74 BRENDA ZANNY v. KELLOGG COMPANY and METROPOLITAN LIFE INSURANCE CO.)
The following quotes were written by Honorable U.S. District Judge Honorable Timothy J. Savage in the case of JACQUELINE ADDIS v. THE LIMITED LONG-TERM DISABILITY PROGRAM :
“MetLife relied almost exclusively upon the report of Dr. Gary Greenhood, an internist specializing in infectious diseases hired by MetLife, who did not examine Addis and did only a records review. Dr. Greenhood selectively viewed Addis’s medical records, and MetLife then selectively adopted parts of Dr. Greenhood’s report to support denial of the claim.”
“Although the denial letter listed reports of several physicians, it relied exclusively on Dr. Greenhood, the internist it had retained, and gave little consideration to Addis’s treating neurologist, Dr. Tatarian. There is no discussion of the reports or findings of any of the other physicians who are listed.”
“Dr. Greenhood selectively extracted portions of Dr. Tatarian’s treatment notes to support his conclusions, which are contrary to those of Dr. Tatarian. At the same time, he ignores parts that bolster Addis’s complaints and support her doctor’s diagnosis and prognosis.”
“In his report, Dr. Greenhood states that Addis’s physical examinations were “either unremarkable or demonstrated increased tone in the lower extremities.” Implying that these were normal findings, he ignored Dr. Tatarian’s observation that the increased tone in the lower extremities was a spinal cord abnormality.”
“Dr. Greenhood states that there were no objectively abnormal findings in the materials he reviewed, creating the impression that the absence of such findings rules out a disabling condition. He also ignores the MRI reports evidencing MS, November 2, 2000, and December 9, 2003. To the contrary, Dr. Tatarian documents a variety of spinal problems; and, MRIs consistently showed the presence of lesions and plaque on the brain. Dr. Greenhood ignores Dr. Tatarian’s report of a positive Babinski sign, which is indicative of nerve damage consistent with Addis’s complaints of stumbling and falling.”
“Both MetLife and Dr. Greenhood ignored the Multiple Sclerosis Medical Source Statement of Functional Abilities and Limitations completed by Dr. Ana Lavdas, one of Addis’s treating doctors. Dr. Lavdas reported that her patient’s prognosis was poor and she had significant functional limitations. Among the symptoms were pain in the lower extremities, fatigue, weakness and shaking in lower and upper extremities, poor coordination, bladder and bowel problems, blurred vision, and other physical problems. She noted that Addis had “significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movement or gait and station.” Dr. Lavdas concluded that her patient was “unable to work,” and could not sustain a job.”
“Significantly, there is no discussion of the records of Doctors Lavdas, McDonald, Gray, Files and McCarel, which he lists as having been submitted to him. Dr. Greenhood simply ignores them.”
“MetLife assigned reconsideration of Addis’s claim to Tammi Phillips, who was not a physician and whose qualifications are unknown.” “Her assessment ignores Dr. Tatarian’s unequivocal diagnosis that Addis was suffering from “relapsing, remitting MS with possible repeat exacerbation.”
“Disturbing, in light of the clear evidence to the contrary, is Phillips’s conclusion that Dr. Tatarian did not provide “any specific restrictions and limitations” that would prevent Addis from performing her own job. On the contrary, Dr. Tatarian specifically recommended that due to her unpredictable weakness, fatigue, sphincter incontinence, visual difficulties, and cognitive problems, Addis could no longer work.”
Civil Action No. 05-357 in The United States District Court For The Eastern District Of Pennsylvania on March 30, 2006
Here’s Dr. Greenhood again. In the case of Joanne Vick verses MetLife, Honorable U.S. District Judge Robert Cleland wrote that Ms. Vick developed diabetic kytoacedosis following childbirth.
Ms. Vick’s treating physician noted that she fell and broke her foot in 5 places. Metlife’s Dr. Greenhood never saw Ms. Vick, and he reviewed the medical evidence and wrote, "there is no indication of seizures or falls."
Here are two quotes Judge Cleland wrote in this case :
“Noticeably missing from Dr. Greenhood's report is any mention of Dr. Al-Kassab's November, 2001 office notes, Dr. Churchill's November 13, 2001 office notes, and Dr. Churchill's March 14, 2002 office notes. This is particularly significant in that Dr. Greenhood's August 2, 2004 report specifically noted that "[t]here is no indication of seizures or falls." Dr. Churchill's March 14, 2002 report, however, indicates that as a result of her right sided weakness, Plaintiff broke her left foot in January 2002--in five places, no less.”
“Moreover, both Dr. Greenhood’s and Dr. Gosline's reports contained numerous errors and inherent inconsistencies, which should have been noted by the plan administrator and resulted in less weight being given to them. (E.D. Michigan, Southern Division. No. 03-CV-73124-DT)
The next quotes concern Dr. Tracey Schmidt who is paid by Metlife. Dr. Schmidt is certified by the American Board of Internal Medicine that certified Dr. Greenhood who is mentioned in multiple cases in this Brief.
Here are quotes written by the Honorable Judges in the UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT :
“Dr. Schmidt's analysis was unsatisfactory in other aspects as well. Contrary to her assertion that the file lacked mention of "any restricted ROM of joints other than the right foot abnormality," a February 2002 exam revealed that Audino's "wrists [were] swollen bilaterally with pain on range of motion of the left wrist" and her "left ankle was swollen with pain [on] range of motion." Although she noted in summarizing the evidence that Audino's physician had observed severe arthritis around the trapezius in August 2002, Dr. Schmidt failed to evaluate that finding in her analysis of whether Audino's impairments constituted disability under the plan.”
“Regarding Audino's rheumatoid arthritis and optic neuritis, Schmidt concluded that Audino's file lacked "objective evidence of a physical functional capacity impairment to a full time sedentary job."
GLORIA AUDINO versus RAYTHEON COMPANY SHORT TERM AND LONG TERM DISABILITY PLAN; METROPOLITAN LIFE INSURANCE COMPANY; No. 04-10729
You’re about to see quotes written by Honorable Judge Malachy Mannion in the case of JAMES KNOBLAUCH v. METROPOLITAN LIFE.
Judge Mannion wrote the first quotes regarding the questionable relationship Metlife has with the company Metlife pays to perform FCE’s that evaluate the claimant’s ability to work. Judge Mannion also details how there are far more limitations on the patients than Metlife is reporting :
“The court has noted, however, that there are several documents in the file which appear to contradict the defendants’ assertion that there was no questionable relationship between Isernhagen and Metlife or Synchrony. For example, there is a document titled “Isernhagen Work Systems Functional Capacity Report” which is on Metlife letterhead.”
“There is another document titled “Isernhagen Quality Providers/
MetDisAbility (sic) Referral Form” which gives specific directions to the FCE provider as to how Metlife FCEs are to be handled procedurally. This form requires the reviewer to“[C]ontact MetDisability with a verbal report 1 day after the FCE is completed.”
“There is a Metlife/Synchrony log entry dated April 5, 2002, which states:
...telephone call on voice mail from Cindy from Isernhagen
at 2:52 pm. FCE done 4/3 and 4/4...ee (sic) did pretty well. He
was compliant, cooperative, no self limiting. Unstable BP first
day, said she had to call MD his pressure was so high. On the
second day his heart rate was unstable and he was having
abdominal pain, so limitations were more medical [than] strength
factors...” (Doc. No. 20, p. 42)(emphasis added).”
“This more contemporaneous statement of the FCE results is telling in that it suggests far more limitations on the part of the plaintiff than later statements made by Metlife/Syncrony to the plaintiff in support of its decision to terminate benefits.”
“Also disturbing is the fact that Ms. Oxendine testified that she had not been provided with a copy of the plaintiff’s job description prior to performing the FCE. Ms. Oxendine stated, “...I did not have available to me at the time of his FCE a job description...[It] was not available at the time I performed the FCE.”
“Ms. Oxendine’s testimony also undermines the post-termination, post- appeal records review performed on July 9, 2002, by Joseph M. Nesta, M.D. For example, Dr. Nesta assumed that the plaintiff’s job description was before Ms. Oxendine at the time the FCE was performed.”
“After the plaintiff appealed the determination, the
defendants had a physician consultant, Joseph M. Nesta, M.D., review the
record. No independent medical examination was performed.”
“When Dr. Nesta did his records review, he stated, “...[B]y July 20, 2001
this individual was cleared by his surgeon to return to work.” He either did not know, or failed to include, the fact that the plaintiff’s surgeon, Dr. Scagliotti, released the patient “to return to light physical activity...as tolerated,” and that the plaintiff was “instructed to progress as tolerated.”. No interpretation of Dr. Scagliotti’s records could suggest that he was released to return to unrestricted full time work.”
“Dr. Nesta further stated in his report, “This individual also has had a
chronic pancreatic insufficiency. This is treated with pancreatic replacement
therapy.” As can be seen from Dr. Brislin’s above referenced report, the plaintiff’s ongoing pancreatic insufficiency was stated to be very difficult to control despite high doses of pancreatic supplements, and enzyme supplements.”
“There was never any discussion concerning the plaintiff’s other medical
complications including the inability to control the pancreatic insufficiency with medications, or fatigue. Fatigue is documented profusely in the FCE, but never mentioned by the defendants. There is no acknowledgment that
neither of the plaintiff’s treating physicians ever released him to full time work. In fact, the only treating, or examining physician who released him without restrictions was the orthopedic physician, whose actual name was never mentioned, and who clearly was referring only to the plaintiff’s shoulder capsulitis problem.”
MIDDLE DISTRICT OF PENNSYLVANIA CIVIL ACTION NO. 3:02-1801
The following quotes were written by the Honorable Judges from the 6th Circuit in the case of Wanda Glenn verses Metlife, (Case Number 05-3918)
“This inappropriately selective consideration of Glenn’s medical record was compounded by the fact that the occupational skills analyst and the independent medical consultant were apparently not provided with full information from Dr. Patel on which to base their conclusions.”
Here are quotes written by the Honorable Judges in the 6th Circuit in the case of Janice Spangler, v. Lockheed Martin Energy Systems, Inc.; Metropolitan Life Insurance Co., No. 01-5770, File Name: 02a0424p.06.
“Why Met Life did not also send Dr. Rice's report or the rest of Spangler's file to Crawford for review by the vocational consultant is inexplicable. Indeed, we can only conclude that Met Life, as Spangler contends, "cherry-picked" her file in hopes of obtaining a favorable report from the vocational consultant as to Spangler's ability to work.”
“Met Life's action in sending only Dr. MacKay's September 14, 1999, report to Crawford was arbitrary and capricious. Met Life should have provided Crawford with all of the medical records relevant to Spangler's capacity to work. As a result, the report by Crawford's vocational consultant was an incomplete and inaccurate representation of Spangler's ability to work.”
Reimer and Associates website shows the court wrote this quote in the case of Winkler v. MetLife, 2006 U.S. App. LEXIS 5447 (2d Cir. 2006).
“An administrator may, in exercising its discretion, weigh competing evidence, but it may not, as MetLife did here, cherry-pick the evidence it prefers while ignoring significant evidence to the contrary.”
In the separate case of Palmiotti V. Metlife, 2006 U.S. Dist. Lexis 13598 (S.D.N.Y. 2006) Reimer and Associates quoted the court as writing the following :
“MetLife's decision on Palmiotti's appeal was unsupported by substantial evidence because it was not based on a full and fair review of the initial decision and because material information was either ignored or was not solicited, and the information upon which MetLife did rely was fraught with errors.”
(end of case quotes)
Unum Provident
Here is more information I wrote and/or compiled that is included in my motion that was read by the U.S. Supreme Court Justices :
Multiplying the damage to ERISA participants is the fact that Metlife is engaged in these conflicts not long after Unum Provident was involved in a highly publicized settlement with 48 states regarding their inappropriate claims handling practices. Here are excerpts from the website of the Attorney General of New York :
The investigations focused on assertions that UnumProvident had inappropriately denied claims for benefits under individual and group long-term disability insurance policies.”
“The settlement announced today requires UnumProvident and its subsidiaries: (1) to reassess approximately 200,000 claims that previously had been denied; (2) to completely restructure their claim handling procedures to ensure objectivity and fairness; and (3) to pay a $15 million fine.”
The quotes written by the U.S. Judges, and the settlement with Unum Provident prove that two separate multibillion dollar insurance companies are involved in similar violations. Unum had numerous affiliates that were also charged with the same violations.
In their Brief supporting Metlife, Blue Cross Blue Shield wrote the following on Page 25 :
“ERISA already includes necessary safeguards to prevent an administrator from acting on a conflict of interest. There is no need separately to address the purported conflict of interest on judicial review of discretionary benefits determinations, because ERISA includes multiple safeguards to ensure that plan administrators will not act upon any potential conflict.”
The American Council Of Life Insurer’s Brief In Support Of The Petitioner Metlife wrote the following :
“The functional organization and regulation of insurers preclude employees who determine claims from wearing two hats. In rendering benefit determinations claims personnel must comply with regulatory requirements under both ERISA and state insurance law”
In their Brief Supporting Metlife, AMERICA’S HEALTH INSURANCE PLANS, THE AMERICAN BENEFITS COUNCIL, AND THE CHAMBER OF COMMERCE OF THE UNITED STATES wrote the following :
“ERISA’S FRAMEWORK PERMITTING A SINGLE ENTITY TO PERFORM FIDUCIARY AND NON-FIDUCIARY FUNCTIONS HAS OPERATED EFFECTIVELY AND FAIRLY”
“Market Incentives And ERISA Regulations Ensure That Funding Entities Provide Proper Fiduciary Service”
All these statements are very incongruous with what is occurring in numerous claims as evidenced in the quotes from the Honorable U.S. Judges.
The case quotes in this Brief were found with a search of the internet after having cancer removed from my eye; think what else may be found if skilled persons with normal vision had access to the Court records of all the cases where Metlife and other insurance companies were found to be arbitrary and capricious.
The fact Metlife’s Dr. Greenhood is involved in multiple cases of ignoring symptoms makes his reports very suspect in cases where the Court’s have not determined that he ignored symptoms, because the Court’s may allow his opinions to have standing and overrule the recommendations of the treating physicians.
Brief Details Of F.B.I. refusal to take action and why I filed a motion with the U.S. Supreme Court :
After U.S. Magistrate Judge Bryant wrote that I had more than sufficiently alleged fraud against Metlife I learned that many insurance companies are practicing the same reckless endangerment of sick, injured and disabled Americans.
I visited the F.B.I office in Nashville twice and they refused to take the action that Magistrate Judge Bryant said is the sole prerogative of the Department of Justice.
The Department of Labor EBSA division’s website has a mission statement that says their main priority is to prevent this exact type of problem, but when I discussed the judges quotes with their agent Gloria Polk she said they would have to learn about it before they could take action. When I explained I had just told her she abruptly said that did not count, and told me there was no need for me to call them again.
When I learned that Metlife had a case before the U.S. Supreme Court where they were claiming they have no profit motivated conflict in their actions, I successfully learned the rules of the u.S. Supreme Court and filed a motion to intervene and had the evidence of Judges quotes placed on the docket of the U.S. Supreme Court in the case of Glenn v. Metlife.
It was very difficult and painful to successfully learn the strict rules for docketing and then file the motion. I have no legal training, and I have had cancer removed from one eye and orbital surgery on the other eye and this kind of work can greatly exacerbate my existing problems including a tendency to fall and almost fall. Since filing the motion my vision has worsened and not recovered. It has taken me years to compile the evidence in these webpages. These are very desperate times for millions of Americans seeking health care and treatment for work injuries so did what I believed I had to do. Before my eyes give up completely I pray someone in government will actually perform their duty and stop insurance companies from endangering so many lives.
Metlife's most prominent attorneys did not file any denial of my allegations that they are engaged in a nationwide pattern of fraud against citizens with very serious and life threatening diseases.
I felt certain that if my motion was even docketed it would be denied because of the overwhelming nature of the truth regarding Metlife, but I just wanted the Justices to read the evidence and have it in their thoughts and on their conscience when they made their decision in the case of Glenn v Metlife.
The Supreme Court Justices did read my motion to intervene during a closed door conference to and they denied it, which means they gave no mention or consideration to any of the proven evidence you have seen.
Sincerely,
Barry Schmittou
barryschmittou@yahoo.com
(I am limited in responding to emails because of my visual problems and the exacerbation that too much typing causes, but I will try to file any responses I receive that have further evidence regarding Metlife and other insurance companies ignoring symptoms)
Numerous U.S. Judges Quotes Prove Insurance Companies Ignore Life Threatening Medical Symptoms