The Deep Dive will discuss two opposing viewpoints regarding proposed New York legislation (S7950/A8429) aimed at combating workers' compensation employer fraud. One source, a letter from the iFraud Foundation, expresses strong opposition to the bill, arguing it creates duplicative structures, implements uncapped assessments on employers, and introduces governance conflicts of interest within the proposed fraud assessment commission. Conversely, the legislative text of A8429-B outlines the bill's intent to establish a fraud assessment commission and a new assessment on employers to fund investigations and prosecutions, specifically targeting employer workers' compensation premium fraud. The bill details the composition of the commission and the creation of a "workers' compensation fraud investigation fund" to which these new assessments would be credited, emphasizing the need for additional resources to combat widespread fraud and wage theft in the construction industry.

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This Deep Dive takes a look at the Third Supplemental Request to Consider Supplemental Exhibits submitted by The Willis Law Group, PLLC to the Supreme Court of the State of New York. The request centers on the case of Toribio, et al. v. 1936 Bath v. Apazidis, seeking the court's consideration of new evidence. This evidence includes Affirmations from Crystal Hodgson and William Hodgson, along with Record Excerpts, detailing Ms. Hodgson's medical ordeal following a surgery performed by Dr. Alexios Apazidis. The affirmations recount how Dr. Apazidis allegedly instructed Ms. Hodgson to bypass workers' compensation authorization by presenting through an emergency room for a cervical surgery, which subsequently led to severe complications including arterial dissection, blood clots, an aneurysm, and multiple strokes. Both Ms. Hodgson and her husband affirm that Dr. Apazidis dismissed their concerns, attributing her symptoms to Percocet, and that the operative report for her surgery was a generic, "copy-pasted" document identical to many others.

A horrific detailing of potential medical malpractice and fraud.

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This is a Deep, Deep Dive so grab your notebook as we break down the First Amended Complaint details a civil action brought by Union Mutual Fire Insurance Company against numerous defendants, including legal service providers, runners/support entities, funding companies, and medical providers. The lawsuit alleges a widespread fraud scheme involving staged accidents, fabricated injuries, unnecessary medical treatments (including surgeries), and fraudulent billing practices. The plaintiff asserts violations of the Racketeer Influenced and Corrupt Organizations Act (RICO), claiming that the defendants conspired to defraud insurance companies through a sophisticated enterprise designed to generate illicit profits. The complaint seeks damages, including treble damages for certain claims, citing instances of mail fraud, wire fraud, bribery, and money laundering as predicate acts within the alleged racketeering activity.

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This Deep Dive breaks down an amended complaint filed by Uber Technologies, Inc. against multiple law firms and medical professionals, alleging a fraudulent scheme. The complaint asserts that these defendants conspired to exploit individuals involved in minor vehicle collisions, fabricating or exaggerating injuries, including medically unnecessary surgeries like spinal fusions, to induce inflated settlements from Uber and other entities. Uber claims to be a victim of this widespread racketeering activity, which allegedly involves wire fraud, mail fraud, and bribery, leading to substantial defense costs and harm to their business. The plaintiff seeks equitable relief, monetary damages, and a jury trial to address this purported misconduct.

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This Deep Dive looks at a denial from the Workers' Compensation Board (WCB)  to Joseph Weinstein, DO, denying the renewal of his authorization to treat injured workers. The WCB cites multiple instances where Dr. Weinstein's treatment deviated from established Medical Treatment Guidelines (MTGs), including performing unjustified invasive surgeries, providing inadequate and inconsistent medical documentation, and engaging in billing irregularities. The denial is highlighting issues such as unnecessary procedures, failure to exhaust conservative treatments, improper documentation of patient progress, and repeated submission of denied authorization requests without escalation or new justification. Ultimately, the WCB concludes that Dr. Weinstein's conduct constitutes professional misconduct, leading to the denial of his authorization renewal and requiring him to transition his current patients to other authorized providers.

Let's Dive In!

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This Deep Dive is a follow up to the foundations video about the legal complaint filed by the State of Alabama against South Alabama Medical & Rehab LLC (SAMR), two law firms, and several individuals, alleging violations of the Alabama Deceptive Trade Practices Act. We break down the claims that the defendants engaged in a scheme to deceive accident victims into receiving "free" and inadequate medical treatment at SAMR, which then pressured them to sign retainer agreements with the associated law firms. Discussing the allegations that these firms maximized settlement values through inflated medical liens rather than prioritizing patient well-being, often without the victims' full understanding or consent.

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This Deep Dive breaks down the legal correspondence from The Willis Law Group, PLLC to the Supreme Court of the State of New York regarding a request to consider a supplemental exhibit in the case of Toribio, et al. v. 1936 Bath v. Apazidis.  The letter highlights the discovery of a 25th operative report, which is substantially identical to 24 others already submitted, yet includes a "Neurolysis of Adhesions" billing, despite no difference in content.

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This episode of the Deep Dive discusses various aspects of fraud within the legal system, particularly focusing on insurance fraud and staged accidents. We highlight recent criminal charges against individuals involved in a large-scale fraud ring and discuss how insurance companies are actively pursuing legal action to uncover fraudulent activities. We also touch on evolving defense strategies against such fraud, and note the impact of legal reforms in Florida on reducing auto insurance costs. Lastly, we address a peculiar tactic used by plaintiff attorneys regarding undocumented plaintiffs in jury selection and trial.

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This Deep Dive discusses several federal statutes that attorneys may violate by filing lawsuits with the knowledge or suspicion of fraudulent client identities. It highlights offenses such as fraud and related activities concerning identification documents, including the possession or transfer of false IDs with intent to defraud the U.S. government. Additionally, it covers making false statements or entries to federal agencies, healthcare fraud, and major fraud against the United States, particularly concerning large-value federal assistance or contracts. Finally, we discuss laws against possessing false papers to defraud the U.S. and penalties related to misrepresenting Social Security numbers for illicit gains.

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This episode of the Deep Dive discusses the  lawsuit filed by Uber Technologies, Inc. against several defendants, including two law firms and a medical practice, alleging a widespread fraudulent scheme. The complaint, filed in the United States District Court for the Central District of California, accuses the defendants of orchestrating fake personal injury claims stemming from minor traffic incidents involving Uber vehicles. Specifically, the suit claims attorneys directed clients to specific medical providers for unnecessary treatments and inflated billing on a lien basis, concealing secret agreements to discount these bills.

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