Academy of Chiropractic’s Lawyers PI Program

Narratives 51

From the Desk of :

“Documenting Usual and Customary Fees”

It is now LAW
(Narrative language at the end)

Validation comes in many forms, and last week I received a note from a NJ doctor who shared with me specifics of a law in New Jersey that should never impact a single doctor in this program because everyone does what I suggested! 

First…I want to remind you that if you are not in New Jersey do not say, whew…that is not me...IT IS!!!! New Jersey is currently one the 3 bell weather states nationally with New York and Texas. What we see today in those 3 states usually sets the trend for the other 47 and although they might not become law, the carriers, courts and licensure boards often follow suit in what is the accepted norm. 

 I previously reported a Florida doctor who had a New York lawyer (interstate case) threaten to sue him and report him for ethics charges for excessive fees.  

I have now been informed that it is a law in New Jersey that both the doctor’s CV and fee schedule MUST be attached to any narrative report for a personal injury case. Although the law is very clear, currently the defense lawyers (according to the trial lawyers) are not mandating a copy of your fee schedule, however it is their legal right and is an area that you have significant exposure should your fees not be usual and customary. 

Serendipitously, I wrote on this very subject last week and to learn about securing usual and customary fees, I refer you to the full consultation located at Infrastructure #139. Please note that you cannot derive your fees because your friends in the community have them, that is the shortest avenue to losing either a licensure complaint or defending a lawsuit about excessive fees. You are dealing with lawyers who have no issue using the full power of the courts and licensure boards to discredit you in order to win their cases. They do not care about turning your life upside-down…and it’s not their fault if you are ignorant, lazy or the best healer since Asclepius (for those of you who are illiterate…like me…look it up…I had to because I had no frigging clue who this was… click for lookup link because no one is going to know this…expect for the biggest nerd in the group and please identify yourself so I can post your name and new status).

The reason these things become laws in some states and not others is “tactics” by the carriers to leave as many avenues to prevail should they need leverage. The defense tactics is to use what works in other states and create arguments in your state. What judge would not allow a lawyer to ask a doctor to provide their fee schedule with the argument it is so important it is law in some states?  Judges have full authority over allowing anything into testimony and even if it is not allowed, the jury still heard it. 

You need to be prepared and although there will be issues you are not prepared for, you do not want to be the cause for things you have been prepared for, but just didn’t prepare. 

When writing narratives, the following language should be added as I have been informed by trail attorney’s that this statement will suffice without attaching your full fee schedule (for now).

“The bill are usual, reasonable, customary and related to the accident dated XXXX”

WARNING: This statement does not protect you if challenged where your fee schedule derived from unless you have a published resource that is legally defensible.