As some New York contractors and insurers push back against what they describe as a surge of fraudulent injury claims orchestrated by attorneys and medical professionals, Ramon's case was one of several where defendants inquired indirectly about the plaintiff's immigration status. Undocumented immigrants, who are more likely to be injured during construction projects, are entitled under New York law to workers' compensation and the right to sue for negligence. 

They also play the leading role in many fake injury schemes, according to two insurers, some attorneys and recent local media reports.

To lawyers representing Ramon, who say in a court filing he underwent needed spinal surgery at a major New York City hospital last year, the demand for proof of immigration status is meant to intimidate him.

The issue came out into the open during preparation for a trial when lawyers for defendant PNA Contracting Corp., a facade and masonry restoration and roofing contractor, and the building owner, demanded to know Ramon's social security number. The contractor also asked for his passport records, an apparent attempt to discover if he was either an undocumented immigrant or lacked permission to legally work in the U.S.

Although its role in the work isn't clearly stated, a subcontractor to PNA Contracting, Melville, N.Y.-based APA Construction Services Corp., is also named as a defendant. Like PNA Contracting, APA denies the negligence claim against it. If Ramon sustained injuries, APA stated, it was due to his own carelessness and recklessness.

APA's attorney is the one who put the photograph of Ramon and the EMT into the court record.

Ramon's lawyer refused to provide the social security number or passport records, saying that the state court of appeals has ruled that undocumented workers are eligible for workers' compensation payments. The lawyers added that Congress has never passed a law preventing an undocumented immigrant from recovering the cost of medical care and lost wages due to negligence.

"We refuse to subject our client to be intimidated or harassed by defendants based on his immigration status while the defendants reaped the benefits of our client's work," wrote James W. Coscia, a lawyer with Subin Associates, in a letter to the defendant's lawyer last year that is now part of the lawsuit record.

Faked injuries and the resulting legal claims, settlements and damage awards they generate put money in immigrant pockets but mainly enrich law firms and medical clinics and doctors, the two insurers say. 

In recently filed racketeering lawsuits, the insurers accuse lawyers of employing "runners" who recruit the immigrants and initiate the staged injuries, medical care, lawsuits and workers' compensation claims that's led to settlements or court awards. 

The lawsuits use similar language in accusing law firms of orchestrating construction-related injury lawsuits. One insurer, Roosevelt Road Re Inc., charged Ramon's attorneys, Subin Associates, a New York-based personal injury law firm, along with medical service providers, with racketeering in operating a scheme to generate fraudulent claims.

"Many of the claimants are undocumented immigrants who do not speak English and were assisted by defendants in obtaining false work authorization credentials," the insurers allege.

A photograph in the case docket of Edison Fernando Pesantez Ramon's negligence lawsuit apparently showing the aftermath of the fall in which he injured his spine.
Photo: New York State Courts

The workers, the insurers claim, "were instructed to fake or misrepresent their accidents and injuries and to receive a myriad of healthcare services that were unnecessary, excessive, unwarranted and costly."

The lawsuits need to be considered in light of New York's unique workplace injury insurance environment. State scaffold laws 240 and 241, which date to 1878, hold project owners and contractors 100% liable when a worker sustains a fall-related injury. In addition to adding hundreds of millions of dollars each year to the cost of construction in New York State, the laws have helped drive several insurers out of the market.

On the day of his accident, an ambulance took Ramon, a Queens resident, to a hospital. There is no evidence that his medical treatment at the time or his spine surgery last year was unneeded. 

But there is also very little specific information about how his accident actually occurred. In Subin Associates' amended complaint against the contractors, all that is stated is that Ramon fell and that some construction material was involved. In a pleading made in 2022, the building owner demanded specifics about where, on what step and stairway, and in what manner Ramon's trip and fall occurred.

An official of Subin Associates, which represented Ramon in 2022 and 2023, could not immediately be reached for comment, but the law firm had issued a statement to ABC-7, a local television station. “Subin Associates LLP," it stated, "has an eight-decade record in matters involving serious personal injury. The firm takes its ethical responsibility obligations seriously.”

A partial view of the ambulance and pre-hospital care report entered into the record in Ramon's lawsuit over his trip and fall injury.
Image: New York State courts.

The issue of faked injuries was originally reported last year in investigations by ABC-7, which showed videotape of workers arraying themselves on the sidewalk outside a small building undergoing renovation, apparently to simulate the aftermath of falls. Another report showed workers in seemingly faked slow-motion falls.

Another investigation, by the New York Post, in June also described attorneys and medical service providers employing immigrants in fraud schemes. That story claimed that Subin Associates was dropping cases and handing them off to other firms after deciding that those cases posed ethical issues. Partly as a result of the ABC-7 and Post investigations, a new bill was introduced into the New York State Senate in January that, if adopted, would make a staged construction accident a felony.

New Attorney Represents Ramon

Subin Associates recently resigned as Ramon's attorney, court records show, handing the case to another law firm as the critical evidence discovery phase was about to begin in state court in Queens County.

That and other cases Subin Associates sought permission to bow out of raises questions for Alex R. Malino, an attorney who represents contractors. He told ABC-7 that there was "reason to question" why the Subin legal practice would transfer to others what Malino said were 300-plus cases. The number of cases transferred out of Subin Associates could not be confirmed by ENR, however.

To Malino, the matter is serious because the cases involve "a lot of money, millions and millions and millions of dollars,” he told ABC-7.

The lawyer now representing Ramon, Joseph Guardino of Hach & Rose, said his firm is continuing to press Ramon's claims.

Hach & Rose, he said, has "not received anything that says the claim isn’t legitimate."