Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 330
"Persistent Functional Loss"
When concluding your narrative, many of you are following the plan of getting a statement from the patient and documenting what they can no longer do. One doctor, yesterday, shared with me the following:
Social Limitations: “Since the accident I cannot…
1. ride my bike without pain
2. jog or go to aerobics class
3. go to the movies or a night out without pain in my back or legs
4. make love to my wife the way I could before the accident
5. mow my lawn like I could before the accident without pain
6. build model aircraft without pain in my neck and back
7. read my Bible without pain in my neck and back
8. I can no longer concentrate on what I read due to pain”
Although this is a good framework, the question is not whether the person has pain and can do his/her tasks, the real question is whether the person can NO LONGER DO his/her tasks BECASUE of the pain. In the above example, the person can't read the Bible without pain in his neck and back, but he CAN read the Bible. He can still ride his bicycle and go to the movies. The only thing that has changed is that he now has pain, but his life hasn't changed. Although that has merit, the real purpose of this section is for what the person can no longer do that he/she could do prior to the accident and that is the focus of the documentation of functional loss.
The key phrase is "FUNCTIONAL LOSS." This is the most directly quoted section from judges when ruling on cases, verifying the merit of following the plan. As a note, this section was suggested by one of the smartest PI lawyers nationally. He was also one of the biggest pain in the asses I have ever worked with. This was also the biggest breakthrough when lecturing nationally in having the lawyers from coast to coast realize that I spoke their language. Therefore, PLEASE get it right. It is the foundation of your medical-legal knowledge. When guiding patients through the process, ask them to key in on what they can no longer do since the accident that they could do before the accident. THAT is the goal when such an occurance is present.