User talk:Rivers david24

I am very concerned about the abuse of our medicare ,medicaid systems. As it stands, the Government access system abuse strictly to the population boom, welfare fraud , immigration , production cost and other abuses ; However there is one abuse that is allowed to go unchecked and i have yet to see a government crackdown on this mega million abuse by long fingered inc. ins. fraud!

If the government can go after ENRON that this should be the next big fish on the government's hit list! ("Speaking about medical expense reform.")

The word here is: Cooperate insurance abuse! In short the insurance companies such as State Ins. Fund inc. They are not worried about the quality of life of their claimants ( injured workers Etc.)All they care about is cutting their own medical cost expenses.

It is companies like this that are allowed to refuse quality medical care and force patients to out of desperation turn to Hip VIP and medicaid other HMOs to to cover the cost for the medical care and Meds.; "That by right should be covered by the carrier!""

Example: I am on SSI; injured 5/10/1985. The carrier opened up their argument that claimant's Dr. did not send a medical to them; therefore the carrier only paid the claimant $115.00 and $50. weekly partial rate.

Mind you, that this went on frivolous appeals until 1988 - third party closing. The claimant lost all monies been held in abeyance's carrier cut off medicals ETC..

If one were to read the medicals dated step.8th,1988.It is clear to see that there was a current medical posted - June ,2,1985.

That the entire episode of carrier appeal and non classification as-well as for the continuing underpayments were unwarranted; And in fact the WCB had on legal grounds to warrant payments not to continue!

This the type of Carrier deviousness and fraud that is allowed by the NYS Workers Compensation Board to go on! These acts are called by all parties of concern " Working the claim!

1)Devious Insurance carriers

2)WCB insider brokers working claims in favor of the carriers, even if it means selling out claims of injured workers that will never be able to return to the work force due to on the job injuries.

3)Crumb snatching Ambulance chasing Attorneys (certified )working for the workers compensation Board representing injured claimants and brokering less than acceptable insurance settlements for the claimants (in favor of the ins. companies!)

This is how these Attorneys make their money! A single claim may linger without resolve for yrs. ""But each time these crumb snatcher appear they get a Dime - these attorneys collect a paycheck!

These are little lackeys who work claims in favor of the carriers in order to collect meager fees and to stay in the Good grace of all concerned parties! In Short they feed on the injured claimant's misfortunes. This practice is should be outlawed by the government!

In short if we want to begin to fix the medical system, we need to start with the WCB and the insurance carriers!

This is an open piracy of the medical care market and It needs to be stopped by the government! The incorporate medical scam run by these Insurance companies as fraudulent medical care providers do more damage to the medical care system in one year than 1000 cases of client medical fraud could do in ten years!

All one has to do is look at the medicare & medicaid claims cost output percapitor in comparison to the so called insurance medical coverage claims percapitor and review just how many of these medical bills are being paid out by the medicare & medicaid of the for injured claimants that should be covered by the Insurance carriers!

Note if a claimant receives monies from third party ins. claims the Government will cut the income of the claimant!

well if this the case, at least stand up to these ins. companies and force the to provide good quality medical care to the injured workers the they have been collecting monies from! - And that the INS. companies be regulated by government to afford good care with consistent and accounts of all medical care provided to medicare and the department of social service and and medaire with all monies paid to a claim, be Receipts of payments being through the IRS. as nontaxable just as in social security payments, tax fraud will become virtually impossible!

Therefor ""these agencies would has to do the right thing ""or find other avenues of deceit - Against the People and the Government of the UNITED STATES OF AMERICA. Insurance carrier medical fraud will become a federal offence! I'm sure that none wants to play that game!

a)THE GOVENMENT WILL ABLE TO SAFELY SAY, THAT THE BUCK STOPS HERE!

b)THE PRESSURES ON THE MEDICAIDE AND MEDICARE SYSTEM - WILL BE RELEIVED!

c)THE FINNICAL PRESSURES ON THE RETIREMENT SYSTEM AND ON THE ELDERLY AND LESS FOUTUNIATE WILL BE EASED.

d)THE G.O.P CAN SAY THAT THEY HAVE AGREED AND ACCOMPLISHED SOMETHING POSITIVE FOR THE PEOPLE FOR ONCE DURING THE 2006 REIGN!

Comment - We the people might start even singing the Star spangled Banner!

Common sense - If we can catch illegal aliens even put walls up around the country" - And close down sweatshops around the world; Than ""we can afford to fix the medical fraud being done by incorprate insurance companies and their paid cronies!""

Try closing some of these loop holes and stop just beating your gums and maybe just maybe this all Republican congress can succeed in working for the People!

This government is supposedly be Run by We the People for the People By the People! Not run by any incorporated brokers!

1991, the WCB declared the claimant Permanently Partially disabled and afforded only symptomatic care.

The claimant was declared totally disabled by Social security Dr's. 1987 to date - affording total care to a now disabled worker!

The insult to injury: the carrier claims all monies paid in full to the claimant - this is a letter from the NYS Workers compensation Board! the carrier claims to have paid the claimant from 5/10/1985 until closing at the legal rates.

This is not true because the claimant was never classified at a total rate since the opening of the claim and that this died in appeals and the claim was assessed against the claimant for ten years - post third party settlement.

Please explain just who gets credit for the write off of all that stolen money owed to the claimant? ( the carrier and whoever they paid off to get that judgement.) Claimant went into spinal surgery 2001 and reopened the claim.

Listen to this medical malpractice issue: a)The carrier, NY State ins. fund inc. Would not increase the medical care warranted to the client!

b)carrier used 1990 award partially disability with systematic care against the claimant, post spinal surgery 2001 only affording the claimant symptomatic care And in the end result suspended all physical therapy claiming that it was too excessive!

c)The claimant now suffers from chronic back lower pains with weakness, Atrophy of the left leg with left foot drop!

continuing pain management: Epidurals, med. but the carrier refuses to pay for outstanding medical bill ,afford continuing physical therapy!

d)The claimant the claimant's attorney Susan Klein and associates Filed a 45 week late claim for underpayment post 2001. the claimant claimant had to say goodbye to this attorney he is caught with his fingers in the cookie jar and milking the claim! Now the claimant is fighting for himself!

Note: requested a full board review and the WCB claims my case is not warranted!(WHY) a)Because they are just as immersed in their mess as the carrier so if they grant this full board review they will be exposed for just what wrongful acts they committed!

b)the claimant am requesting an appeal in the Supreme court 3rd. dept Appellate Division to have the courts to decide the claim!

A major major issue here aside the outstanding issues being submitted me in court is : That the ins. carriers get away with HMO insurance fraud.. Large amounts of money can buy People and in this system there are just too many doors left opened at both ends to intrigue inside traders - to do - the insurance company's dirty work for them!

That Social security and the medicaid system are being strained to their limits by incorporate ins. fraud and if the government dared to put their foot down on insurance incorporate fraud, their Government would recover trillions of valuable medical expense dollars.

1) These acts are not some grand Ma and grand Pa operations. First we my get a better handle on the Workers compensation Board! they have a free hand to operate without challenge. they can adlib the laws and terms in favor of the insurance carriers! they are supposely be neutral, ( What have they to lose in investigate this claim in its entirety!

2)The government needs to revamp and set government requirements and Workers compensation Board and incorprate insurance policies for settling Workers compensation claims. These All claimant payment settlements should only be resolved at the State supreme court level just as done via third party claims! this take a huge bite out of Workers compensation adventurism's for potential wrong doings and manipulation of WCB claims in favor of the inc. insurace carriers, who has great potential of manipulation of workers compensation claims and settlements Via willful persons accepting under the table monies from these carriers for their services!

3) to alleviate unnecessary Workers compensation Board errors that only wides up as a burden against that tax payers monies for unnecessary WCB and these Incorperate insurance carriers litigation's being brought before the State Supreme courts to resolve alleged litigation's and Board room errors! It is for sure that once these everyone knows that they have to go before the State Supreme court to settle all WCB claims, that that everyone will want to . their T and cross their I.. relieving the burden of service to all parties of interest!

"Why?"" Because the workers compensation board at this point and time dose not have to explain their actions and nothing is final as seen in my case except their own rulings even if they find that they have error-ed!They can not be trusted in investigate themselves in times of misjudgements and human error and it is wasting tax and payer Dollars! These some cost expenses that we the people can afford get rid of!

I find it simpler to resolve ant claims matter in the supreme court just as would be done third party settlements claims! ""There is no Law higher than the Law of the land ""-A supreme court decision all judgements are final with out bias to any party!

This act will cut down on medical medical malpractice medical fraud or theft of services by carriers and will put a lid on alleged claim of payments to the claimants which cannot be substantiated.

This also will cut down court costs and many other litigation's.

Example: The carrier will not the leeway to be able to use an antiquated workers compensation board decision; such as the one been used against this claim and the WCB could not get away saying that the carrier has done nothing wrong  because ti will be out of their hands!

In closing These steps taken by the US Government will Help re- store the medicaid and medicare systems and preserving our retirement plans, welfare and social security programs medical costs. It would be for this cournry to get a hold of our medical cost problems. Thurs is just no excuse for not having a national health care plan in place! this is supposedly be one of the richest countries in the world!

I would like to thank you for your time and i welcome any comments please contact me at rivers_david24@yahoo.com.

Mr. David Rivers