Doctors on the medical board that greenlighted fraudulent disability benefit applications have defended their actions, claiming there was no way they could have detected the fraud.

“We were as shocked as everyone else to learn of the racket because it was designed in a way that makes it impossible for the board members to know if an application was fraudulent,” one doctor said.

“We feel like we have been cheated as well.”

Six doctors and sources close to the government-appointed medical board spoke to Times of Malta on condition of anonymity, saying they must be cautious given that police investigations and court cases are still ongoing.

They said the fraudulent applicants seemed to have every single document in order and the medical certificates appeared to be signed and rubberstamped under the hospital’s official letterhead by their colleagues who they know, trust and had worked with for a long time.

In reality, those signatures were forged, allowing millions of euros in taxpayer’s money to be diverted to people claiming serious illness they did not have.

“The doctors who appeared to have signed the documents are our colleagues, mentors and friends. Some of them taught us at the university, they work diligently and are professionals of great principle and integrity and we trust them blindly,” one source said.

“We knew they would never certify someone as having a condition they did not really have. So, when we saw their signatures and rubberstamps on medical certificates, we never doubted it for a second.”

'We had no reason to doubt'

Asked why they did not conduct sporadic checks on the authenticity of the certificates, the sources said the board was never instructed to work in that manner.

“In hindsight, now that everybody knows there was a racket, it’s easy to say we should have checked whether there were forged documents. But, back then, we had absolutely no reason to doubt the documents’ authenticity,” another source said.

“In our decades-long careers we have never seen anything like this... we’ve never seen anything of this magnitude,” another said.

They said they only realised there was a racket when the police called them to inform them of the discovery of forged documents and when their colleagues – who had their signatures forged – told them about it.

The government-appointed medical board came under the spotlight after Times of Malta revealed earlier this month that former Labour MP Silvio Grixti was implicated in a racket that saw scores of people – possibly hundreds – access disability benefits they were not entitled to. He has, so far, not been charged with his suspected key role in the racket.

Police investigations indicated Grixti, who at the time was a backbench MP, would allegedly give people an envelope containing forged medical documents certified by several Maltese consultants, all saying that they examined the benefit claimant and found them to be suffering from a severe disability.

The revelations have since raised questions over why the board, which is tasked with validating the applications, did not notice the fraudulent applications.

But doctors and sources close to the medical board told Times of Malta it is not fair for people to turn the guns on them because the way the board works makes it impossible to detect a dishonest application.

“Imagine this: an applicant comes before you saying they suffer from epilepsy. There is no way you can assess the symptoms of a condition like that during an interview and you are asked to decide on the application there and then, so you must rely on medical certificates.

"The applicant hands you medical certificates signed by doctors you trust blindly, confirming they really have the condition and, according to the benefit criteria, they are truly eligible for the benefit. What do you do? You have no option but to green-light that application,” one source explained.

“That is why many board interviews lasted all of five minutes. It’s not that we were carelessly shunning our responsibilities but when you open the envelope and see a trusted doctor’s signature confirming a disability which qualifies for the benefit, that’s all you need to know – it’s case closed in a few minutes. You must approve it.”

All the sources denied they were complicit in the racket or suspected their colleagues and said they never received calls from people in higher authority to let dishonest applications slide.

The board is comprised of around 20 physicians and every application is assessed by a rotating panel of three people – two doctors and a board secretary.

‘Sheer incompetence’

Speaking to Times of Malta on Monday, a neurologist who had his signature forged on the documents of at least 30 fraudulent applications, said the documents were “literal photocopies” and were almost all identical.

Senior neurologist Anthony Galea Debono said the writing was illegible, had a rubberstamp he had not used in around six years, the text was riddled with grammatical errors and did not make medical sense.

He said this led him to question how the doctors on the medical board had not smelt a rat when they came across a series of “such nonsense”.

“How is it possible that none of them noticed they were presented with 30 identical photocopies of certificates,” he asked.

“It was sheer incompetence. One wonders whether they were really medically qualified.”

But the medical board sources insisted that, since the doctors rotated, it was very unlikely for the same doctor to come across two photocopied certificates and, even if they did, they would have seen the second one weeks – or even months – after the first one, making it virtually impossible for any doctor to remember or compare the similarities.

Times of Malta has seen several forged medical documents, some of which were written in virtually illegible handwriting. Some consultants said they could not even read the handwriting that was on documents that had their signature.

‘Stricter due diligence imposed’

“Since the racket was uncovered, we changed practices and are dealing with applications differently,” one medical board source said.

Grixti was himself appointed to the government medical board in 2013 and served as one of the doctors who validated social benefits applications around the beginning of the Labour administration.

According to sources, however, the forging of documents appears to have started after he had stopped serving on the board.

Times of Malta also sent questions to the director general of the social security department – Grazio Barbara – on why so many fraudulent applications went unnoticed by the board.

He said the independent board that was appointed last week to evaluate the process of how benefits are awarded will also look into “the medical verification of applications”.

Barbara said the board has also been tasked with making recommendations and their report will serve as a basis for any further actions.

Asked whether the Social Security Department has taken any action against any of the medical board members, he said that the authorities will follow the instructions of the police and cooperate fully “should the police instruct any action following its investigations”.

“However, it must also be stated that,  in the first months of 2022, stricter due diligence was imposed on the medical review procedures,” he said. “This intensified after a number of suspect cases were detected by the income support and compliance division in September 2022.”

Editorial note: The Medical Board is made up of 19 doctors whose names are publicly available. However, not all members of the board took part in assessments for severe disability benefits concerning epilepsy.