Academy of Chiropractic
Lawyers PI Program

Narratives #76

Testifying #10

From the Desk of: 

“Demonstrative Evidence”

A Matter of Business

In the past, we have discussed using labeled imaging to demonstratively show the bodily injuries in an accident case. This is a topic I have been discussing with legal educators on courtroom protocols and realized that we are missing many opportunities in other aspects of your BUSINESS. Does this change how you practice… NO… but it does change how your patients understand their report and assure a higher level of compliance as well as carriers paying your claims at a higher rate and often, for as long as is needed (provided you don’t OVER-TREAT).


In the past, I strongly recommended that you include graphics with explanations in your narrative reports and still do. There must be 2 levels of sharing demonstrative evidence; for your narratives as explained above, and the second for your E&M reports.


The image below is a perfect example of a “narrative ready” image:



This is an image with cryptic explanations, has arrows, colors and leads you to what you want to explain while on the witness stand. Whether you get there or not, it will give the lawyer a lot of ammunition to further settle the case. If you do go to trial, these are you “cheat sheets” on the stand where everything is visualized in front of you.


When doing an E&M report, the game is different. In these reports, whether an evaluation of re-evaluation you need your full opinion, not a cryptic explanation. As an example:



First, you must always document that you personally reviewed the images (see language above) and the include your opinion. DO NOT COPY THIS word for word from the radiologist as this is your opinion. Also, don’t be afraid to disagree with the radiologist and you do not need to include their opinion, just the rationale for yours.


This type of reporting, as a matter of business, will make your trial experience more fruitful, but short of that, it will help the claim’s examiners understand the severity of the case better and be more likely, then not to approve an appropriate amount of care. I also share this reporting with my patients as it is part of the report of finding experience and the explanations go a long way to ensure compliance. I find it extremely beneficial to give the patient a copy of their report. It helps to have an extra set of eyes reviewing my history to ensure accuracy and is highly educational. There is no down-side.


Next, the report goes to the patient's primary care medical provider and all other specialists. This report gets a “lot of mileage” in building my reputation.” That is also why I ensure that it is perfect in format, grammar and, content.