Doctor in Arroyo case is linked to 2d claim

Fire chief had first been denied

Dr. John F. Mahoney signed off on the chief's disability claim.

The Boston fire chief who withdrew his disability pension application last week after two witnesses to his workplace injury recanted was declared disabled by the same Dorchester doctor who deemed firefighter Albert Arroyo permanently disabled, a case that made national headlines after Arroyo participated in a bodybuilding competition two weeks later.

As he sought a disability pension in 2006, District Chief James J. Famolare first went to his regular spine doctor, who refused to certify that he was permanently disabled, according to two senior officials who saw his medical records. Famolare then went to the fire department's medical office, where the nurse referred him to Dr. John F. Mahoney, a Dorchester neurologist.

Mahoney subsequently declared that Famolare was "totally disabled" based on his review of a back injury, which Famolare said he received while moving a box of personnel files at Fire Department headquarters in June 2006, said the officials, who spoke on condition of anonymity. The two firefighters who signed a form saying they witnessed Famolare receive that injury have now withdrawn their statements, the Globe reported last week.

Mahoney's involvement in a second questionable disability pension application adds fuel to questions raised by city officials that he and other physicians may have been sought out by firefighters "doctor shopping" for favorable disability evaluations.

Since 2001, Mahoney has evaluated 25 firefighters whose injuries he determined to be so severe that the city should award them accidental disability pensions, according to city records made available to the Globe under a public records request. Of the 25 firefighters, 21 have had their disability pensions approved; three more are awaiting final approval; the last was Famolare's.

Mahoney's lawyer, Paul Cirel, declined to comment specifically on Famolare's case, citing privacy laws. But in general, Cirel said, Mahoney makes the best determinations he can based on information he is provided.

"Doctors don't have an obligation to independently corroborate injury," Cirel said, citing Massachusetts court decisions regarding information provided by patients. "Doctors don't always agree on a prognosis; there is a fair amount of objectivity and there is a certain amount of subjectivity."

Famolare did not return messages left yesterday and last week at a residence listed as his in Billerica, and no one answered the phone at another home listed as his in Canterbury, N.H.

The department nurse who referred Famolare to Mahoney, Margaret M. Horgan, resigned last week, citing a stressful work environment, the officials said. It is unclear whether her decision was related to Famolare's case. It also was unknown if she was aware that Mahoney had evaluated and treated other Boston firefighters with disability claims. Horgan, who had been the department nurse since October 2004, could not be reached for comment yesterday. A number listed for her connected only to a fax machine.

Famolare had been on injured leave for more than two years while awaiting approval of his disability claim. He collected more than $300,000 in tax-free injured-leave pay before withdrawing his application last week and instead applying for a regular pension, which pays less than a disability pension. The firefighters who signed statements saying they witnessed his injury told officials they did not see anything but signed the forms because Famolare asked them to.

Famolare's is one of dozens of questionable injury claims by Boston firefighters under investigation by the US attorney's office, the officials said. The federal inquiry was prompted by a Globe report in January that found that 74 percent of Boston firefighter retirements between 2005 and 2007 were due to accidental disability, more than twice the rate of similarly sized cities.

Famolare's records were among medical files that recently disappeared from Fire Department headquarters, triggering a second investigation by US authorities of potential obstruction of justice.

Famolare was the district chief of administration when he began his injured leave in 2006. He reported numerous injuries during his 39-year career with the department, according to a letter sent by the fire commissioner to the Boston Retirement Board this month.

After a back injury in December 2005, the department referred him to the Spine Center at New England Baptist Hospital, where he was treated by Dr. James Rainville, according to a copy of the letter obtained by the Globe.

Rainville saw him two more times over the next six months, during which Famolare told him he was "doing well at work and undergoing physical therapy," the letter says.

But on June 19, 2006, when Famolare was filling in for the deputy chief of personnel, Famolare alleged that he hurt his lower back while moving the box of files and went on injured leave at the deputy chief's pay rate.

Six weeks later he went to see Rainville but apparently did not tell him about the new injury, the letter says. The doctor did not note the injury in Famolare's medical file and concluded at the appointment that Famolare was "capable of many physical activities and work," the letter says.

"As a result of this recommendation, it appears that Dr. Rainville would not sign paperwork to support a total and permanent disability claim," Fire Commissioner Roderick Fraser wrote in the letter. "It appears, at this point, that DC [District Chief] Famolare begins to 'doctor shop.' "

Rainville, an assistant clinical professor at Harvard Medical School, declined to comment on Famolare's case.

A note in Famolare's medical file - copies of which had been turned over to the FBI before the original was reported missing - shows that Horgan referred Famolare to Mahoney, who saw him on Sept. 7, 2006.

"Following that appointment, Dr. Mahoney then signs off on DC Famolare's paperwork, declaring him totally disabled," the commissioner wrote.

It's unclear whether Mahoney knew about Rainville's evaluation when he signed off on Famolare's disability.

In the letter, the commissioner said the Fire Department was opposed to Famolare receiving a disability retirement. The letter is dated Aug. 8, three days before Famolare withdrew his application.

Donovan Slack can be reached at dslack@globe.com.