Board urges judge to reject effort by Valley Stream surgeon Dr. Joseph Weinstein, accused of performing unnecessary surgeries, to continue treating accident victims

An orthopedic spinal surgeon from Valley Stream, accused of performing unnecessary procedures without medical justification, repeatedly placed "injured workers in danger" and should not regain his ability to file claims with the New York State Workers' Compensation Board, the agency and its attorneys contend in new court records.

The filings, which ask an upstate New York judge to reject an application by Dr. Joseph Weinstein that would allow him to continue seeking reimbursement for the treatment of injured workers, indicate for the first time that a criminal investigation has been launched in Brooklyn into allegations — outlined in several federal racketeering lawsuits — that lawyers, doctors and other individuals conspired to collect millions in insurance payouts for bogus accident claims.

Weinstein, who did not respond to requests for comment, is among a number of surgeons, including several with practices on Long Island, who've been named in those RICO suits.

'Professional misconduct'

On April 2, the board rejected an application by Weinstein, who also has offices in Rego Park, Manhattan and New Jersey associated with Comprehensive Orthopedic & Spine Care, that would have allowed him to continue treating patients with workers' compensation claims.

The board said it conducted investigations of four patients with workers’ compensation claims treated by Weinstein and found they lacked credible documentation or medical justification, exhibited billing irregularities or appeared to show a predetermined outcome on the need for highly risky surgeries without considering less invasive and more conservative treatments.

Altogether, the behavior, officials wrote, amounted to "professional misconduct."

Weinstein appealed the board’s decision, arguing it was "riddled with inaccuracies and false conclusions and ignore or overlook pertinent patient records and treatment history." 

When the board rejected Weinstein's appeal and ordered him to cease treating workers’ compensation claimants, the surgeon filed a petition in state court in Schenectady County seeking to annul the state's denial.

Last week, the state Attorney General's Office, which is representing the board in the Weinstein case, asked for the petition to be dismissed.

The board's "denial was based on a detailed and thorough review of petitioner's care and treatment of injured workers," Assistant Attorney General David White wrote.

Weinstein has alleged "collusion" between the board and the insurance companies who filed the RICO cases in New York's Eastern District and contends the state agency was looking for reasons to deny his renewal.

The board concedes that the four cases cited in its determination letter were brought to them 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.

But in court filings last week, Michael Papa, the board's general counsel, said Weinstein's claims were "entirely baseless" and that their own investigation found the surgeon performed "unnecessary, invasive, dangerous and potentially life altering treatment."

DA launches investigation

Papa's letter said the board met with the Brooklyn District Attorney's Office as part of an unspecified criminal investigation "relative to the RICO complaint." In mid-April, Papa wrote, the board signed a memorandum of understanding with the DA's office providing prosecutors access to their files.

A spokesman for the Brooklyn DA's office declined to comment.

In its denial letter, the board said its medical directors’ office approved only 27% of the prior authorization requests submitted by Weinstein last year, intended to cover medical costs associated with certain treatments. Industrywide, the approval rate is about 54%, records state.

"Petitioner's proposed course of treatment was determined to be clinically appropriate and medically necessary only half as often as that of the average medical provider within the workers' compensation system," wrote James A. Tacci, the board’s medical director, in a Sept. 12 letter to the court.

On Sept. 8, five Democratic assemblymembers representing parts of Brooklyn, Far Rockaway and Harlem wrote to Gov. Kathy Hochul to call for an "immediate and thorough investigation into credible and increasingly concerning evidence" that private insurers involved in the RICO cases "have exerted improper evidence over Board proceedings."

The letter cites the board's denial determinations against Weinstein and Dr. Vadim Lerman, the associate director of spine surgery at Total Orthopedics & Sports Medicine, which has four offices in Nassau County. 

"Dozens of physicians with long and unblemished records have either had their licenses revoked or have simply chosen not to reapply, recognizing the open secret that the WCB has been compromised," the lawmakers wrote, adding that Hochul should suspend or fire Steven Scotti, the board's executive director. "The chilling effect of this compromise, in conjunction with WCB’s improper program of tacit bullying of licensed physicians, has created a provider shortage that leaves injured workers waiting longer for treatment, with fewer specialists willing to risk retaliation by insurers, their allies and likely the Board itself."

In response to the letter, Craig Smith, spokesman for the board, said: "The integrity and functionality of the Board and our employees are rock solid. We are committed to ensuring a fair system for each and every stakeholder. We deny these allegations and are confident that any investigation would only prove them to be entirely without merit."

By Robert Brodsky

robert.brodsky@newsday.com@BrodskyRobert

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.