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.