High Trauma

From his Lakewood offices along the Sixth Avenue freeway frontage road, attorney David Mintz can see the towering 1-800-4INJURY sign in his parking lot and the blur of commuter traffic beyond. It's a handy juxtaposition. Road warriors who get rear-ended on the freeway can whip out their cell phones, call the toll-free number — and let the Mintz Law Firm handle the lawsuit to come.

Over the past two decades, Mintz has built one of the busiest personal-injury practices in Colorado. His clientele includes many immigrants whose ability to negotiate the American legal system is quite limited; the firm's website promises "legal professionals who speak both English and Spanish to assist you" and happen to be "closely associated with doctors that speak Korean, Chinese, Vietnamese and Russian." Like most PI lawyers, Mintz works on a contingency basis: He helps clients get treatment for their injuries, files claims against at-fault drivers, and typically takes a third of any settlement for his trouble.

It's a tough, competitive business, and it's only gotten tougher since 2003, when the state legislature scrapped Colorado's no-fault auto insurance system. The move reduced auto insurance rates, but it also eliminated the personal-injury protection (PIP) coverage that allowed motorists to have their medical bills paid by their carrier, regardless of who caused the accident. Without PIP, attorneys like Mintz have become increasingly involved in getting their clients' injuries diagnosed, documented and treated; arranging to have the doctors paid — and trying to make sure there's something left over for the client when the settlement rolls in.

"I would guess that more than half of my clients don't have health insurance," Mintz says. "They can't even get evaluated beyond the emergency room without some kind of agreement as to how the doctor is going to get paid."

Four years ago, as PIP was disappearing, Mintz thought he'd found a suitable workaround to the problem. He referred dozens of his clients to Spine and Injury Centers, a group of medical providers who not only seemed to know how to document treatment for the insurance companies, but were willing to wait for payment. The arrangement between the Mintz Law Firm and Spine and Injury Centers soon led to other business relationships, including intertwining marketing efforts and a joint investment in Mintz's office building.

But before long the deal began to go inexorably, disastrously wrong. Disputes over money erupted into complaints over ethics, a civil suit that's already devoured more than $400,000 in legal costs, and even allegations of criminal activity leveled against some of the medical providers. Mintz, who never had any disciplinary action taken against him in more than a quarter-century of legal work, suddenly found himself besieged with grievance investigations. While denying any wrongdoing, Mintz notes ruefully that he can't even publicly defend himself against assorted allegations because of confidentiality issues.

"I'm hamstrung in responding to some of these attacks by attorney-client privilege," he says. "It makes me very unhappy that I've been put in that position."

The principals of Spine and Injury Centers, chiropractor Robert Walford and physician Joseph Ramos, haven't escaped unscathed, either. Mintz has accused Spine and Injury Centers and related companies of deceiving and overbilling his clients, prescribing unnecessary treatments, and other questionable behavior; the business that Ramos and Walford started, Mintz's attorneys contend, is "a fraudulent sham intended to enrich certain doctors."

Ramos and Walford dissolved their partnership three years ago. Walford left Colorado for a time, while Ramos has gone on to launch another series of injury-treatment clinics, Mile High Medical Group, with orthopedic surgeon Steven Nadler, who also worked at Spine and Injury Centers. Attorneys for Ramos, Walford and Nadler insist their clients did nothing wrong. But the repercussions of the once-cozy relationship between the Mintz Law Firm and Spine and Injury Centers have been far-ranging and quite costly — personally, professionally and financially — for almost everyone involved.

In late 2005, Mintz filed what's known as an interpleader lawsuit in Jefferson County District Court, asking a judge to decide how to distribute approximately $135,000 held in his trust account. The money is the residue of settlements his firm negotiated with insurance companies on behalf of 37 clients. Walford, Ramos, Nadler and their related enterprises claim that the money is owed to them for treatments provided to the clients, but Mintz has refused to release the funds, contending that the billing information provided is inadequate and possibly fraudulent. While Mintz himself has no claim on the money — he's already collected his fees out of the settlement proceeds — he says that he has an obligation to challenge the medical providers' claims, as the funds may rightfully belong to his clients.

The doctors' attorneys have fired back with incendiary assertions of their own. They insist that Mintz is simply retaliating against them because they stopped paying the "kickbacks" that he had supposedly demanded for sending them patients. He's withheld their money for no good reason, the attorneys claim; Mintz got paid, the clients got their share, but the doctors didn't.

Mintz calls the kickback charge a red herring. "Like a lot of other things they've said, it's demonstrably not true," he says. "If you're interested in blowing smoke and making allegations to attack people rather than responding to the issues in a case, you can do that. Eventually, the evidence comes out."

And sometimes smoke leads to fire. The lawsuit has become a crackling conflagration of cross-claims and brutal accusations, touching off related suits. One attorney involved called it "a battle of epic and monumental proportions and venom." A dispute over the leasing of the building that Mintz and the docs had purchased together led to the medical group's being locked out of the office for weeks and eventually evicted from the premises. Court filings allege that Spine and Injury Centers engaged in tax fraud and money laundering, and that Ramos broke into the office of a business associate and removed documents sought in an insurance investigation — all emphatically denied by Ramos and company. There are insinuations that the person who handled billing for the doctors defected to the other side and refused to give back their records (disputed), and claims that a disbarred attorney and convicted felon, who once worked for a company owned by Mintz's wife, went over to the Mile High Medical Group (admitted) and took confidential documents with him (denied).

Caught in the middle of this dust-up between professionals are several dozen former clients of the Mintz Law Firm. At least two have sided with Ramos, Nadler and Walford, professing bafflement that their attorney hasn't paid the bills for what they considered to be appropriate care. Others have questioned the quality of care they received or portrayed the medical providers as avaricious. Some have been dropped as parties in the lawsuit, but the rest are seeking to recover some portion of settlement funds that have been tied up for years, even if it ends up being a pittance of a pittance.

"These are people, for the most part, of modest means, for whom the money would make a difference," says Richard Levine, the attorney representing 27 former Mintz clients in the case. "None of them wanted to be in the epic battle that we have. But they were named as defendants and have to protect their interests."

The $135,000 at issue is now on deposit with the court. Collectively, the warring parties have already spent far more than that amount battling over who gets the money, Levine notes. Even if the case goes to trial this fall and his clients win, the prospect that they'll emerge with more than they started with is remote. "No reasonable person...could afford or would want to engage in this sorry example of scorched-earth litigation," Levine wrote in a motion filed in the case last week.

The case of the feuding personal-injury specialists may be unusual in the depth of its bitterness, but it's hardly unprecedented. The litigation reflects the jarring impact that people are feeling in the hazardous new world of tort reform and soaring health-care costs, a place where lawyers and doctors spin their wheels and forge deals — and underinsured accident victims take the brunt of the collision.

The way Joseph Ramos tells it, he first found out about the deal within the Deal in the spring of 2003. He was at work, waiting impatiently for the office manager to finish whatever she was doing at her computer so that she could help him. Time dragged on, and finally he demanded to know what was taking so long.

"She said, 'Joe, I'm separating out these charges for David Mintz,'" Ramos recalls. "'Giving back that 20 percent — do you know how much work that is?'"

Twenty percent? David Mintz? Ramos had worked with an attorney named David Mintz, but giving back 20 percent was not part of the Deal.

On its surface, the Deal seemed straightforward enough. Ramos, a doctor of emergency medicine, had built a successful business treating people who'd suffered on-the-job-injuries (otherwise known as workers' comp cases); by 2001, he owned three clinics in the Denver area and was looking to expand into the treatment of auto-accident victims. He formed a partnership with Robert Walford, a chiropractor and physical therapist, in order to offer a range of treatment services under one roof. The new company, Spine and Injury Centers, opened its first clinic in 2002 and, through a network of related companies, provided acupuncture, massage and other therapies as well.

To get patients for the new enterprise, Ramos and Walford had to invest heavily in marketing — and in building relationships with attorneys. Like PI lawyers, doctors who specialize in accident cases have had to adapt to the loss of PIP coverage. Walford and Ramos agreed to provide treatment without requiring payment up front in return for a lien against any possible settlement in the case. To make it work, they'd have to rely on personal-injury lawyers to refer their banged-up clients to the "lien doctors" in the first place.

"When the tort system changed," Ramos explains, "people couldn't get care unless a doctor agreed to get payment at the end. That, or trade chickens with them or something. That means your alliances are with attorneys, whether you like it or not. They can be very good to you or very bad to you. They control the checkbook."

Part of the Deal, Ramos says, was that Spine and Injury Centers shelled out thousands of dollars a month for marketing, directly and indirectly, including $10,000 a month to something called the Lawyer Connection. Owned by Julia Mintz, David's wife, the Lawyer Connection ran print and TV ads promoting the Mintz Law Firm; accident victims who called the ad's toll-free number in search of legal advice would be referred to the firm for a consultation. If those callers also needed medical care, they were urged to see one of several providers. Those providers had either paid for their own ads through the Lawyer Connection or were contributing to the operation's overhead, including paying for the phone dispatchers who screened the calls. According to Ramos, Walford and a few other chiropractors around town were subsidizing Mintz's marketing efforts in return for having Mintz clients referred to them for treatment.

It's hard to say if the average caller realized that the Lawyer Connection was more of an advertising vehicle than a referral service, or that the doctors being recommended to callers may have paid for the call to begin with. But Ramos knew about the arrangement. What puzzled him was the 20 percent. What 20 percent?

And that, Ramos says, was when the office manager told him about the deal within the Deal. In addition to the ten grand a month for marketing costs, Spine and Injury Centers was paying the Lawyer Connection up to 20 percent of the fees it collected from patients who'd been referred to them by Mintz's firm — a continuation of an arrangement that Walford had with the Lawyer Connection before Ramos entered the picture. Medical associations have varying opinions on the ethics of referral fees, but Ramos says he was alarmed to discover that his company was paying a fee based on income generated by the patient. "This was a very eye-opening afternoon for me," he remembers.

Ramos insists that his problems with David Mintz started soon after he found out about the referral fees and refused to pay them any more. "Up to that point, we were great doctors," he says. "The minute we cut off his kickback and he started fighting with my partner about what he was owed, he started settling cases and keeping the money. This went on and on."

Mintz's side has been careful to characterize the wrangle as one over advertising debts owed to the Lawyer Connection, not referral fees payable to Mintz or his law firm. The distinction is crucial. The Colorado Rules of Professional Conduct prohibit attorneys from paying or accepting referral fees; there are only a few exceptions, such as paying fees to a not-for-profit lawyer referral service. The notion of a lawyer collecting a fee for referring a client to a particular doctor "is fraught with conflict-of-interest issues," says John Gleason, who heads the Colorado Supreme Court's Office of Attorney Regulation Counsel. "Lawyers have routinely been disciplined around the country for engaging in that kind of practice."

Referral fees collected by a company in which an attorney has a financial interest could also be problematic, particularly if the underlying financial relationships aren't disclosed to the client. "I'm not sure you can do through the back door what you can't do through the front door," Gleason says.

But there was nothing improper about the Lawyer Connection's fees from doctors, Mintz says; he and his law firm received no payments from the deal. "The Lawyer Connection has never been about making money," he insists. "It's been about covering the costs of running the advertising. I have no financial interest in it. My wife's income has been minimal, if anything."

He acknowledges that the Lawyer Connection charged the doctors for advertising it did on their behalf and for overhead, as well as referral fees. "To the extent that they [paid for] overhead for the Lawyer Connection so it was available to answer calls for the Mintz Law Firm, that might have been sort of a side benefit," he says. "But we never took any of their money [to pay for] our ads."

And whatever outrage Ramos might have expressed about the fees, it didn't stop him from continuing to do business with Mintz and the Lawyer Connection. In the fall of 2003, Mintz, Ramos, Walford and two other doctors formed a partnership and purchased, for just under $1.5 million, the Lakewood office building that now houses Mintz's law firm. A few months later, as his partnership with Walford was dissolving, Ramos agreed to let the Lawyer Connection keep certain funds that Spine and Injury Centers had been demanding from the client settlement funds. "These payments will be retained as additional payments...for advertising and for amounts owed on patients referred to Spine and Injury and its affiliates by The Lawyer Connection," Ramos wrote in a letter to Mintz. "I acknowledge that these are valid debts."

Yet the arrangement did have nuances beyond the typical ad-agency deal. One proposed settlement agreement, signed by the Mintzes but not Ramos and Walford, indicates that Spine and Injury Centers owed money not just for patients referred through the Lawyer Connection, but also those referred to the doctors by "David J. Mintz and associates." Stranger still, the agreement proposes that in the future, the law firm and Spine and Injury Centers should alternate in choosing lawyers for those who call 1-800-4-INJURY when the case involves something other than personal injury; for example, Mintz would pick one workers' comp lawyer to refer a caller to, and the doctors would get to pick the next one.

Mintz says that the "kickback" claims are designed to distract from the real nature of his dispute with Spine and Injury Centers, which had to do with the company's treatment and billing procedures. Like many attorneys, Mintz routinely negotiates discounts on medical bills for his clients — "I know just because they put a number on the page doesn't mean that's the fair value," he says — but the billing issues with Ramos and Walford were on an entirely different plane.

Correspondence between the two sides dating back to 2004 shows Mintz complaining of inadequate documentation and being accused of other motives for withholding the money. At the same time, Mintz was receiving letters from insurance adjusters questioning the validity of Spine and Injury Centers billings and whether its related companies were owned by licensed medical professionals as required under Colorado law. (One court case on that issue, in which Allstate was challenging the company's operation and structure, led to partial summary judgment in favor of the medical providers.)

In 2004, Ramos and Walford went their separate ways, and Ramos launched Mile High Medical Group with Nadler. By some accounts, this wasn't an entirely smooth transition. A bookkeeper named Cheryl Clark would later claim that records went missing for months; attorneys trying to settle cases and pay bills couldn't locate the providers who'd treated their clients or the charts that established what treatment was done. Clark claims to have been saddled with piles of boxes containing poorly sorted patient records heaped in the former Spine and Injury Centers office in Mintz's building.

Ramos says that he and his former partner sent letters notifying patients and attorneys of the changeover to make sure that patients didn't have their care interrupted. "Of all the attorneys we work with, we only had problems with two of them," he says.

One of them was David Mintz. "The records that you have supplied to me are in a total state of disarray," Mintz wrote in a letter to Ramos's billing service in the fall of 2004.

At that point, Mintz says now, he had little choice about his course of action. "I made the decision that I was going to resolve these cases and hold the money in trust, pending them working out whatever they had to work out," he recalls. "The clients couldn't wait for their money."

An auto accident in 2003 left Janice Martinez and her mother, Mary DePriest, in need of a lawyer and a few doctors. They sought legal representation from the Mintz Law Firm and rehabilitative treatment from Spine and Injury Centers.

The two women were decidedly underwhelmed by their subsequent medical care. "We had a lot of questions about it," Martinez says. "A lot of the procedures didn't seem up to par."

At the first Spine and Injury clinic they visited, some of the medical equipment seemed shabby or outdated and the staff was "rude and ugly," she adds. "They talked to us like we were retarded. We didn't see the same doctor much of the time."

Martinez considered the physical-therapy routines too difficult for her level of pain and inappropriate for her octogenarian mother. She also thought that a few of the treatment providers seemed more interested in bolstering the size of their settlement than addressing their pain. When Martinez complained, she was sent to Dr. Ramos — who, she says, chided her for not coming to him sooner.

"To me, what he was telling me was that he could have diagnosed this earlier so I could get a real good settlement," she explains. "But I just wanted my body to work right."

Martinez kept asking if she could talk to somebody about the mental trauma she'd experienced since the accident, including recurrent anxiety and fear of driving. She was sent to a female therapist for ten sessions that greatly relieved her anguish. "That was the greatest thing that clinic did for me," she says. "And that doctor wound up quitting."

DePriest and Martinez are now among the former Mintz clients named in the interpleader case.

Prior to the lawsuit, Ramos says, he hadn't received a single complaint from a patient about inappropriate care. "I'll bet I've worked with seventy different law firms in this town," adds Ramos, who's also a member of the clinical faculty at the University of Colorado Health Sciences Center. "Thousands of patients. Never a complaint."

According to Ramos, the goal of Spine and Injury Centers was to provide more efficient and flexible care than the typical trauma clinic — and to do it for people who otherwise couldn't afford quality care at all. For example, having so many providers in the same place allowed for more individualized treatment rather than a set number of chiropractic visits or a mandatory physical-therapy regimen. At the outset, patients signed a series of lien agreements with an array of companies — Elite Chiropractic Care Inc., Physical Therapy Inc., A Shi Acupuncture Inc., and so on — but were only supposed to be billed for care received. Most patients never even saw their bills, which were sent to the attorneys and paid out of settlement proceeds.

Mintz's attorneys have described the arrangement as a scheme to defraud. Many patients didn't realize that the forms they were signing weren't multiple copies of the same lien, but rather liens from various entities, they contend. Some of the patients didn't speak English and couldn't even read what they were signing. Because Ramos and Walford had ownership interests in the subsidiary companies overseen by Spine and Injury Centers, the lawsuit claims that sending patients down the hall for additional treatment amounted to "unethical and illegal self-referrals."

In support of their claims, the attorneys filed an affidavit from Jay Schuetzle, an accountant who'd helped Ramos and Walford set up their business but later became allied with Mintz in the dispute. "Walford's business philosophy was summed up in a statement I often heard him make...'Bill 'em around the world,'" Schuetzle wrote. "This meant that they expected doctors to refer patients to the [clinics] for every diagnostic test and modality possible.... To my knowledge neither the medical doctors nor the chiropractors, nor the other providers — physical therapists, massage therapists, and acupuncturists contracted by the underlying entities — notified the patients [that] the doctors had a financial interest in those entities."

Schuetzle declined to discuss his association with Spine and Injury Centers with Westword. (Last year Spine and Injury Centers filed a breach-of-contract suit against Schuetzle that was settled out of court.) But court documents indicate that Schuetzle has his own simmering disputes with Walford and Ramos. He's accused the pair of coercing him to sign away his ownership interest in companies related to Spine and Injury Centers after he'd suffered an auto accident himself and was under the influence of powerful painkillers. He claims that Ramos burgled records out of his office and induced him "while drugged" to sign documents that he "could neither understand nor remember."

Ramos says that Schuetzle's claims are unfounded. He likens the multiple companies they managed to the way hospitals have contracted out various services, with a radiology group billing for X-rays, a group of emergency physicians running the ER, and so on. And, he adds, he's had no complaints from patients about the lien forms.

"Patients did sign lien agreements," says Ron Wilcox, one of the attorneys representing the medical providers in the lawsuit. "We've denied that there's anything unethical about that. Everyone understood that their care was going to be paid by their settlement."

Filings in the case accuse Ramos and company of everything from overbilling to violating the Colorado Organized Crime Control Act. A recurrent theme of the docs' responses is that Mintz considered them perfectly acceptable medical providers right up until the time Ramos began to question the payments his group was shelling out to the Lawyer Connection. By 2005 the dispute had come to encompass the accuracy of the doctors' bills and Mintz's refusal to disburse funds from his trust account; money owed to the Lawyer Connection by the doctors; and the deal over the office building. As the whole matter lurched toward court, the correspondence between opposing lawyers grew ever more ominous.

"My clients have records which will belie any claim of indebtedness to your client, unless your client believes he is entitled to some form of kickback," Ramos attorney Richard Cummins advised Mintz attorney Richard Levine (now representing Mintz's former clients) in one scathing missive. "Both of these parties are going to be in for what I am afraid is going to be a long and very painful encounter."

"I have very strong indications that certain of your clients and certain of their associates continue to spread their venom among the community of doctors, lawyers and clients against my client," Levine wrote in a similar vein. "Mr. Mintz's clients will decide for themselves whether to file grievances against your clients once they learn the full extent of self-referrals and billing practices through the time-consuming and expensive process of interpleader."

The rising acrimony didn't escape the notice of Mintz clients who were being treated by Ramos, Walford and Nadler. One of them, a registered nurse named Zahra Harrison, filed an affidavit alleging that Mintz had asked her to complain about Ramos to the state medical board and told her "that if I wanted to I could secretly record conversations between myself and Dr. Ramos."

Ethical guidelines for Colorado attorneys prohibit them from "surreptitious recording" of conversations or directing others to record. Mintz says he can't discuss a privileged conversation but denies ever directing a client to secretly tape someone. Harrison couldn't be reached for comment.

The medical group's bookkeeper also found herself caught in the maelstrom. Cheryl Clark, who ran a billing service and at one point was a salaried employee of Spine and Injury Centers, would later describe a series of cash-flow problems and declining revenues that seemed to stem from the elimination of PIP coverage in mid-2003. When Walford and Ramos ended their partnership a few months later, Clark was the one who ended up with boxes of patient files and requests from attorneys for records needed to settle clients' cases.

In addition to the battle with Mintz, "several insurance companies had begun investigating" Spine and Injury Centers, Clark noted in an affidavit. Ramos persuaded Clark to help him with the billing for his new venture, Mile High Medical Group — then instructed her to increase all billings by 25 percent, "so he could recoup any discount" the insurance companies or attorneys might demand from him. Clark eventually left Mile High, taking her billing records with her. She claims that Ramos and subsequent billing agents sought to obtain payments from some clients whose insurance companies had already paid their bills.

Ramos says it's not unusual for insurance companies to seek to slash doctor bills by claiming overcharges or unnecessary care. His falling-out with Clark left him unable to re-create all the bills his company had submitted to Mintz, he says, but now he's getting the information he needs through the litigation discovery process.

"It's been extremely tough on my business," he adds. "After a hundred thousand dollars in attorney fees, we've finally gotten to discovery. The other side has offered to settle twice, but this isn't about settlement to me. This is about principle and ethics."

Mintz says the dispute could have been resolved two years ago if the medical providers had only provided the documentation that he requested to support their bills — or, in the alternative, accepted the discounts he was prepared to offer on behalf of his clients.

"These same providers have accepted from my office substantially less than the amount billed on other clients," he says. "They basically refused to accept it from these clients. I really can't understand how you would spend more money fighting over the account than is in the account."

Few people in Colorado have ever heard of David Moskal. In Minnesota legal circles, though, Moskal is known for several remarkable achievements, including the fastest disbarment in the state's history.

Things happen around Moskal. The ex-attorney has only been a resident of Colorado a short time, but he's already played a supporting role in the Spine and Injury Centers litigation, having worked for people on both sides of the dispute.

In the mid-1990s, Moskal was a rising poobah among personal-injury lawyers, celebrated in the pages of Minnesota Law & Politics as one of a select group of "Tort Kings." A hardworking member of a large Minneapolis firm, he ingratiated himself with chiropractors and doctors, mowed clients' lawns and touted his staunch Christianity to build his caseload into a multimillion-dollar bonanza. He made partner by the time he was 33, and soon had all the usual perks: a house with a pool, a condo in Steamboat Springs, a lakefront cabin in a resort area, hefty alimony payments and a jewelry-bedecked second wife.

His criminal career was even more impressive. Over a period of five years, Moskal stole $2.4 million from his clients' settlements, other attorneys and his own law firm. The victims, one court later noted, included a mentally retarded accident victim, another who'd had a stroke, "at least eight minors, eight deceased persons, twelve people over the age of sixty, two clients who were either HIV-positive or dying of AIDS, and one homeless person."

When the thefts came to light, Moskal was fired, disbarred and indicted. He blamed clinical depression for his behavior and pleaded guilty in federal court to three counts of fraud. Ordered to pay restitution, in the weeks leading up to his sentencing he instead went on an $85,000 spending spree; the judge slapped an extra year on what was already a five-year sentence.

In 2003, halfway into his sentence, Moskal was placed on supervised release. He moved to Colorado and worked at the Lawyer Connection for a few months. But several clients and at least one attorney who had contact with him were under the impression that he worked for the Mintz Law Firm. Some even had the impression that he was an attorney. One filing in the lawsuit claims that Moskal "developed insidious relationships with certain staff members and contract employees at the Mintz law firm" at a time when the Lawyer Connection was housed in the same building.

Janice Martinez says that she and her mother dealt more with Moskal than with David Mintz, and that it was Moskal who promised to get them a certain amount in the settlement negotiations. "We never actually touched base with David Mintz," she says. "I didn't get a good picture of him until we met with him and Richard Levine to discuss the lawsuit."

It wasn't until that day that she learned Moskal wasn't a lawyer at all. "I felt we were violated," she says. "I think Mr. Mintz needs to be a little more responsible about the actions that went on in his law firm."

Mintz says payroll records show that Moskal only worked for the Lawyer Connection for a short period of time in 2003, rather than the eighteen months Moskal claims in a sworn affidavit. He then worked for an advertising firm started by Jay Schuetzle that did business with both Mintz and Spine and Injury Centers. Moskal was supposed to screen calls and "act as a liaison with the client," Mintz says; when he discovered that some clients were confused about Moskal's role and whom he worked for, he stopped using Schuetzle's company.

In the spring of 2005, Moskal started working directly for Ramos and Nadler as the marketing director of the Mile High Medical Group. A few months later, documents surfaced in the possession of Ramos's attorneys that reflected confidential settlement amounts Mintz had negotiated on behalf of three clients who were also Spine and Injury Center patients. Attorneys for Mintz and the clients were livid, and Moskal was promptly accused of being the likely source of the documents. Moskal has denied stealing documents from Mintz's office and maintains that the materials "were sent anonymously by mail to Dr. Joseph Ramos."

Moskal has continued to have an impact on the dispute in other ways. In late 2005, Raymond Callicoat, a Mintz client who'd been treaded by Nadler, tried to negotiate his own peace with the doctors in order to free up the funds still in Mintz's trust account. Unemployed and homeless, Callicoat was desperate for money, but Mintz had advised him that he was still awaiting billing documents from Nadler before he could disburse the rest of the settlement.

According to Callicoat's affidavit, he got confusing information from the medical providers about what he still owed. He told Ramos he could get a check from Mintz for the balance of the settlement if they could work out a figure. A few minutes later, Callicoat got a call from David Moskal, identifying himself as Ramos's attorney. "He said they would accept payment of my bills for 75% of the check from Mr. Mintz and give me 25%, " Callicoat said, "but only if I would sign an affidavit accusing Mr. Mintz of all sorts of things."

Various negotiations with Moskal and Ramos followed, leading to a meeting at a bank where Ramos was supposed to cash the $4,700 check and give Callicoat a quarter of the money back. "When I showed him the check, he got angry and started ranting about Mr. Mintz," Callicoat said. "Ramos said he would not accept anything less than the entire amount of money held by Mintz in the trust account, which he said was more than $4,700."

Ramos won't comment on Callicoat's story, saying that the matter is still in litigation.

In 2005, an Arvada man contacted the police about Moskal, saying he'd believed that Moskal was a lawyer when he hired him to represent his son, who'd been badly injured in an auto accident. The man admitted that Moskal had never specifically said he was an attorney, but recorded phone calls and e-mails produced in the investigation certainly didn't contradict that impression. According to police records, Moskal talked about preparing subpoenas and releases, boasted that "this is my favorite case so far," and told the man that the settlement check would be made payable to the victim, Moskal, and a Nevada attorney Moskal was working with. "I am turning up the pressure on American Family just like I did with Farmers Insurance," Moskal wrote in one e-mail.

Last fall, following a federal hearing in Minnesota, Moskal was ordered back to jail for thirty days and had his supervision extended another three years. Prosecutors argued that Moskal had violated conditions of his release by allegedly representing himself as an attorney and gaining access to patient medical records while working for Ramos. "It all kind of smells like what you were doing before," U.S. District Judge John Tunheim told the ex-attorney. "If you weren't practicing law, you came very close to it."

Moskal still works for Mile High Medical Group. Ramos, who testified on his behalf at the hearing, defends him as "one of the nicest guys I've ever met. He's kind and gentle to everyone, and he's a terrific marketer. He's also dating my mom."

Ramos says Moskal has helped his company by doing in-house evaluations of cases in which lawyers say they can't pay the medical bills because of a poor settlement; if there's extra money to be found, Moskal can find it. "I knew his history," Ramos says. "He's pretty up front about what he's done."

Recently, the litigants agreed to drop Moskal as a defendant in the case.

Moskal declined to be interviewed. He did, however, release a brief statement through his attorney, noting that the events that led to his disbarment and prison time occurred "more than ten years ago." (Actually, the last embezzlement from his former clients reportedly took place nine years ago.) "I have served my time and paid restitution," he wrote. "I have worked hard to put my past behind me and regret that it is being used against others who bear no responsibility for my past actions.... I am grateful for the opportunity given to me by Mile High Medical Group."

Moskal isn't the only disbarred attorney and convicted felon to have ties to Mile High Medical Group. In 1997, Denver personal-injury attorney Brian Hugen was suspended from practicing law after numerous instances of stealing from his clients' settlement funds. He consented to disbarment, pleaded guilty to theft and was sentenced to six years in prison. Following the departure of Cheryl Clark, Ramos and Nadler have relied on Hugen to help with their records and billing issues.

In an article in the June issue of Mile High Medical Group's Monthly Review newsletter, Hugen explains how an accident victim can get more extensive care, heftier medical bills and ultimately a higher net settlement — three times as much, in one hypothetical case — by seeking treatment from Mile High instead of the health-care providers specified by their insurance.

Like Ramos, Hugen has had some caustic correspondence with Mintz about billing matters. In 2005 he sent a letter to patients informing them about the dispute with Mintz and urging them to assist him in obtaining payment from the lawyer; in exchange, he said, "the providers will not turn their bills over to collection." Hugen also suggested that patients peeved about the impasse might want to contact the Supreme Court's Office of Regulation Counsel to have Mintz investigated.

In court records, Mintz has disclosed that the medical providers have been involved in at least six grievances filed against him with that office; none of them have been found to have any merit. The providers claim that Mintz has filed multiple grievances against them with the medical regulators, too — also to no effect.

Two years ago, Mintz entered into what he describes as a "plea bargain agreement" in one disciplinary proceeding, admitting that he charged an unreasonable fee in one case, failed to inform a second client of a delay in paying a provider, improperly transferred money from one account to another in a third case, and made an improper loan in a fourth. He received a year of probation.

Mintz says he can't discuss the grievance action beyond what is already on the record. In the current lawsuit, though, he has alleged that David Moskal was involved in "coercing" that grievance, as well as others that were dismissed.

Richard Levine is representing former Mintz clients in the interpleader lawsuit on a contingency basis. He's invested considerable time and expense in the case on the bare expectation that he might claim 40 percent of any funds recovered somewhere down the road — not a sure thing, by any means.

"I didn't yearn for the case," he admits. "But I think representing people of modest means is an important thing to do."

Attorneys for the medical providers have argued that Levine has a conflict of interest in the matter, since he previously represented Mintz in the negotiations over the money and has other business dealings with him. But Levine notes that he disclosed those ties. "My participation on behalf of the clients is a logical extension of my effort to settle the case," he says. "There's no other lawyer that would have that efficiency and knowledge about the case."

Recently the Spine and Injury Centers lawyers filed a request to seek punitive damages against Mintz, claiming that the attorney hasn't been able to name a single client he contacted before filing the lawsuit, ostensibly on their behalf. The lawsuit "was concocted by Mr. Mintz in concert with Mr. Levine and others as a pretext for ulterior purposes," the attorneys contend. But in court documents, Mintz has maintained that filing the lawsuit was the ethical thing to do, given the underlying disputes about the money. In fact, it was what members of the attorney regulation counsel advised him to do.

The disappearance of PIP coverage has put attorneys in the middle of a far-ranging squabble, not simply between clients and insurance companies, but also between doctors and their patients — and if they go to court to interplead the settlement funds, they can get sued themselves. But the real story, Mintz suggests, is the peril faced by people who no longer have any protection in an accident and may not be able to find adequate treatment or recover anything close to the losses suffered.

Mintz realizes that many of his clients aren't pleased to be caught up in another lawsuit, even though the law requires that he name them as parties in the case. At the same time, he adds, "the ones I've talked to have been incredibly supportive. They understand there's a problem here. In our medical system, the amount of a bill depends on who it's billed to — and that's really the problem with the system."

Joseph Ramos says the case has spurred his own interest in the law. He's been writing a series of articles in his newsletter on lawyers and health issues, including one titled "Testosterone and the Lawyer"; he's also going to law school in his spare time.

"If you can't beat 'em, join 'em," he says. "I see how the law is used. There are huge changes in medicine on the horizon. Attorneys drive a lot of these government decisions."

Although Ramos intends to keep practicing medicine, he says he wants to have an impact on the "political-medical arena" some day. "I also have an interest in medical malpractice," he adds. "I want to do medical and legal ethics cases."

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Alan Prendergast has been writing for Westword for over thirty years. He teaches journalism at Colorado College; his stories about the justice system, historic crimes, high-security prisons and death by misadventure have won numerous awards and appeared in a wide range of magazines and anthologies.
Contact: Alan Prendergast

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