A New York orthopedic spinal surgeon has been denied reauthorization to treat workers’ compensation patients in the state. A Supreme Court judge in Schenectady County has upheld a bar against Dr. Joseph Weinstein that was ordered by the New York State Workers’ Compensation Board (NSWCB) in April 2025.
The state workers’ compensation board based its refusal to authorize Weinstein as eligible to treat workers on multiple allegations of professional misconduct. They included allegations of unsubstantiated injury claims. unnecessary and dangerous invasive surgeries, violations of medical treatment guidelines, inadequate documentation, improper pre-authorizations and incorrect billing. The board determined that Weinstein’s treatment was improper at a rate twice that of the average medical provider.
Weinstein asked the court to lift the ban as unfair, claiming that the board was biased against him because he had been named in a RICO (Racketeering Influenced and Corrupt Organizations) lawsuit accusing him and 18 other medical and legal services providers of filing inflated and fraudulent worker injury claims. He argued that the board’s denial of authorization was “arbitrary” and “capricious” and maintained that the board did not conduct its own inquiry into the allegations. He argued that he was the victim of a “conspiracy” in which the board simply adopted the viewpoint of the RICO plaintiffs.
The NYSWCB defended its action by explaining that the RICO complaints were the “beginning of its reasonable investigation” into Weinstein, “not the end.” The board showed that its denial was based upon a “detailed and thorough review” of his care and treatment of injured workers and “was not arbitrary and capricious but rationally based on the information.”
On March 5, the Schenectady County Supreme Court judge found the “sinister implications” of a conspiracy in Weinstein’s accusations were not supported by the record. The court upheld the NYSWCB action, finding that it had in fact conducted an independent inquiry using medical experts, presented evidence of actual patient cases, and came to its own conclusions about his record.
As a result of the court ruling, Weinstein is not permitted to treat or receive reimbursement for patients in the state’s workers’ compensation system. Weinstein has several offices including in Valley Stream and Woodmere on Long Island, Rego Park in Queens, and New York City.
The RICO Suit
The RICO lawsuit that named Weinstein and others was filed by reinsurer Roosevelt Road Re and managing general agency Tradesman Program Managers. The suit accused 19 defendants— law firms and medical providers including Weinstein— of conspiring to collect millions in insurance payouts for fraudulent, exaggerated, or “bogus” workplace accident claims and lawsuits against their insureds. They argued they suffered damages in term of the costs of managing the claims and lawsuits.
On March 11, just six days after the state court upheld the denial of his reinstatement, a federal judge for the U.S. District Court for Eastern New York ruled that Roosevelt and Tradesman had not provided sufficient evidence of association or cooperation among the 19 law firms and medical providers to support a claim of conspiracy under federal RICO law. The court said the complaint did not allege facts suggesting that there was an agreement between the defendants. Indeed, some of the medical providers were competitors, and there is nothing to suggest that they knew any of the others except those who referred business to them or those to whom they referred business.
The court also found that the factual allegations did not make out a direct relationship between the medical and legal services providers’ actions and the insurance firms’ alleged monetary damages to satisfy the RICO statute.
Accordingly, the judge concluded, the complaint did not state a claim for RICO conspiracy.
The court has permitted the insurance firms to amend their complaint and present their claims under state laws.
Topics
Legislation
Workers’ Compensation
New York
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