An expert is recommending approval of $4.1 million in claims, including $2 million in funeral costs, filed by victims of a Detroit-area doctor who committed fraud by putting hundreds of patients through needless cancer treatments.

Randi Roth gave an update Tuesday to a judge who is overseeing the case of Dr. Farid Fata. She said 81 percent of 741 claims are fully or partly eligible for restitution.

Fata is serving a 45-year prison sentence for fraud, money laundering and conspiracy. He admitted putting patients through grueling chemotherapy — even when they didn't have cancer.

Fata's victims can seek reimbursement for funeral costs, remedial health care and mental health treatment. Out-of-pocket costs paid to the doctor and his clinics are also eligible for repayment.

Pain and suffering and lost wages, however, aren't covered.

"The suffering is staggering," said Roth, an attorney in St. Paul, Minnesota, who specializes in deciding claims in large-scale litigation. "All of us want to help as much as possible but the law is strict."

Final approval in the months ahead rests with U.S. District Judge Paul Borman. The restitution process includes a way for patients or their family to appeal if Roth determined a claim wasn't eligible.

"This is a huge situation with tragic consequences. I'm going to be on top of it," Borman said.

The judge said patients and families are first in line for restitution, followed by insurance companies and the federal government's Medicare program.

Outside court, Teddy Howard, 57, of suburban Detroit said he's frustrated. He said his claim has been rejected because his doctors won't certify that some of his subsequent health care was related to the harm caused by repeated doses of chemotherapy ordered by Fata.

Howard said he had a liver transplant and has also lost eight teeth.

"I didn't think I'd be crawling around, begging. This is crazy," he said.