Former Philadelphia Police Inspector Tom Nestel thinks plenty of cops milk the city for disability pay. But he also believes the city has a history of skimping on medical care and treating everyone as if they're trying to scam the system.

Nestel said he's heard plenty of stories from other cops to support that belief, but he also knows the system from his own experience with a knee injury. Some details of his story are disputed by the city.

The city had far more control over the treatment of police injuries in 1998 when Nestel, then a captain, got hurt chasing a car-theft suspect who was fleeing on foot.

"He cut across a corner, I tackled him, and when we rolled his body pinned my leg, and I felt my knee pop," Nestel said. "I couldn't stand up."

Nestel said his emergency-room doctor suspected a torn anterior cruciate ligament, or ACL, and told him he'd need an MRI. The emergency-room report noted a diagnosis of "knee injury with ligamentous instability."

But Nestel said that when he visited his assigned doctor in the city's medical system two days later, the doctor said it was a strain and wouldn't require an MRI.

The doctor sent him to a physical therapist in the building, Nestel said, where he was asked to sign a form releasing the therapist from liability for any harm it might cause.

Nestel said he asked if the therapy might do harm if his knee had a partial ACL tear, and when the therapist said it might, Nestel said he refused to sign and was sent back to the doctor.

"He was enraged," Nestel said. "I think the city-contracted doctor has dealt with fraud and abuse for so long, he thinks nobody comes in with a legitimate injury."

The doctor relented and ordered an MRI, which revealed an ACL tear that required surgery. Today, Nestel is police chief of Upper Moreland Township.

The file on Nestel's injury, which the city shared with the Daily News after Nestel provided written permission, showed no record of Nestel's exchange with the physical therapist or the physician's initial reluctance to order an MRI.

City risk manager Barry Scott noted that Nestel got the MRI and treatment promptly, and that he was approved for surgery by a doctor outside the city's treatment network.

"This is not an example of the system not working. It's an example of the system working," Scott said. He acknowledged that there may be disputes at times about treatment.

"We are looking at controlling the cost of the program, so we don't throw an MRI at everything," Scott said, "but our doctors have a lot of experience treating these kinds of injuries. Are they perfect 100 percent of the time? No. but they are good at what they do." *