The Alleged Claim of Fraud

The next day, February 2nd, at 10:51am, attorney Davis returns Ed’s call and they have a 24-minute conversation. During the call, Ed tells his attorney about the ESI requested and he’s told to fax the report. Ed further said the doctor stated he could perform some form of sedentary work, while observing all restrictions placed by his primary care doctor. Ed further advised him of the redesign and what it paid.

Attorney Davis asked if Ed could work a minimum of 16 hours per week. Ed asked Andy who said no. The attorney then speaks to Andy himself. The attorney asks Andy if it’s possible to provide 16 hours of work per week. He stated, that would meet the part-time-status required for Ed’s attachment to the labor-market requirement. Andy said, “he could not provide that at that time, as he employs a woman who had been with him for years and he’s just trying to help out.”

Talking to Ed, the Attorney stated, that he: “needed to keep all records, including invoices and canceled checks for any work he did.” Further, “Ed would need to provide documentation of all work performed when ‘labor-market-attachment’ is raised by Sentry.”

On March 5th, Sentry hires Dr. Harris Krashen, a Georgia based family doctor through, Medical Review Management Company (MRM). Dr. Krashen is to perform a Record Review of Edward’s medical condition and provide a opinion to his condition. MRM sends Dr. Krashen, 114 documents including a cover letter. Sentry tells MRM what doctor to use and have the doctor focus on.

Although MRM is thought to be a independent, non-bias agency, Sentry told MRM to use Dr. Krashen. They told MRM what they wanted the doctor to focus on.  It’s found later that Dr. Krashen works directly for Sentry as a special consultant.

On April 5th, Dr. Kreshen provides his report to Sentry and they file it with the WCB. Dr. Krashen fabricated documents and misrepresented facts in the records he reviewed. He even failed to provide the correct date to Edward’s injury 5-times in his report. Dr. Krashen CV comes into review when its found to contain fraudulent credentials. This report will become relevant to the issue of fraud by Sentry during this blog.

On April 30th, Sentry files a claim with the WCB as a result of Dr. Krashen Report and denies Dr. Reynolds to perform further medical treatments on Edward.

At the Hearing of June 20, the question of “labor-market-attachment” was raised by Sentry.  Edward stated he had been providing contractural work since February 1st as a graphic designer and worked within his doctors restrictions. He stated, he notified his attorney, performed several additional small projects, worked three-hours per week and retained all documents.

Complying with his attorneys direction and advice, Ed kept track of all invoices and receipts.  Further, based on the definition of part time work, as provided, Ed never felt compelled to notify his attorney of these ongoing-one-day-a-week small projects.

After the WCB Decision was made, Ed called his attorney where he’s asked to forward all documents to him, in order to satisfy the “labor-market-attachment” issue raised.

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