It's a story with such sinister implications you might find yourself hoping it isn't true.

Because if it is, it will confirm your most cynical suspicions about the symbiotic relationship between some lawyers, doctors and judges.

The FBI continues to investigate whether a cabal of lawyers and medical professionals plotted to pad costs and fix civil injury cases worth many millions. Federal agents are also weighing whether those same attorneys and doctors curried favor with willing judges in an effort to oil the wheels of justice. Gathering facts in the investigation is difficult because it's in no one's best interest except the public's to have the story told prior to an expected indictment.

It is suspected that doctors and lawyers have been running up millions in medical costs literally on the backs of unsuspecting patients. There's serious talk of excessive treatments in personal injury cases, including unnecessary back surgeries in which the victims were repeatedly cut on in an effort to drive up the eventual settlement costs.

One element that must intrigue investigators is the possibility that personal injury lawyers kicked back millions to their confidential physician partners.

But how would they do that without creating an obvious paper trail?

Were funds sent to phony corporations, or the physicians' family members? Were big bucks paid out in consulting fees?

Is there an e-mail trail linking lawyers, consultants and doctors in possible criminal shenanigans?

Last week, KLAS TV-8's George Knapp reported that several target letters went out to persons of specific criminal interest to the FBI and U.S. attorney's office. In brief, a target letter means a person is being officially considered for prosecution. It's also a sign that an aspect of an investigation has reached a conclusion.

But in a case this deep, there's obviously no need to rush to the courthouse. In fact, informed sources confirm the federal investigation is far from finished. It's little secret that defense attorneys still are complying with federal requests for document production. That's a clear sign the investigation is ongoing.

And that eventually could mean more trouble for more players in a widening web of conspiracy.

That web is said to include veteran judges, at least one of whom gained notoriety in the L.A. Times' lengthy series on Las Vegas-style justice. If the juice flowed from certain lawyers to the District Court bench in exchange for big political contributions, spa vacations and more, then the real legal bill might yet come due.

It's hard to imagine any case this complex and politically sensitive being made without cooperating inside witnesses, people who participated in the suspected criminal acts or at least found themselves with front-row seats. It turns out there are at least three. The informants include two doctors and one attorney.

I've also been able to confirm independently that a target letter was sent to legal/medical consultant Howard Awand, the man in the middle of this case. As a consultant, Awand presumably would have intimate knowledge of the cases, clients, attorneys and physicians. He also would have access to physicians who would be potential witnesses in personal injury cases.

Awand is a professional associate of attorneys Robert Eglet and Robert Vannah, but I've learned that neither lawyer has received a target letter. Both are no doubt feeling the sting of the rampant rumors circulating about the FBI's investigation.

In May, Eglet filed a defamation suit against a local attorney for mentioning the federal investigation during an unrelated civil arbitration. The Mainor Eglet Cottle law firm, which touts its multimillion-dollar awards in the Yellow Pages, has been mentioned in connection with the investigation.

Vannah is also a successful personal injury attorney with a track record of courtroom victories.

It's no sin to be successful as long as the game's not rigged.

Driving up medical costs with needless treatments is bad enough. But conning unsuspecting patients into signing off on unnecessary back surgeries is an act so despicable it boggles the mind.

Anyone who has suffered from a back injury or knows someone who has understands the excruciating pain involved.

You want to believe no one would stoop so low to make a buck, but as the facts slowly emerge from the federal investigation you're left to wonder -- and shudder at the dark possibilities.

John L. Smith's column appears Sunday, Tuesday, Wednesday and Friday. E-mail him at Smith@reviewjournal.com or call 383-0295.