Academy of Chiropractic’s Lawyers PI Program
Lawyers and Medical Specialists Meetings & Communication #24
From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Bad News vs. Good News
The bad news: The bad news is that most lawyers really do not understand Colossus, the documentation requirements required for a fair and equitable settlement, your credentials and how they position you in the medical – legal process and how working with you is the financial solution to their practice. Over the last few months I have been in multiple states presenting to hundreds of attorneys and have certified the above statement is factual.
In spite of our efforts the carriers have held ground and have not made any significant changes recently to alter their settlement positions and still render “lowball” offers to attorneys on a regular basis in all 50 states. You would too if you are making as much money as the carriers. However, this creates an ongoing challenge to reposition the reality of the lawyer in front of you to get them to understand THEIR needs.
The following list are the current challenges we face in educating the legal community and your solutions to their problem. Please realize that many our current issues we have discussed in the past which the carriers are still profiting from rhetoric versus science and fact:
1. Strain/sprain: the carriers still argue that strain/sprain is a transient issue and submit summary judgments for dismissal to the courts on these patients.
Solution: 2013 research from the Open Rehabilitation Journal resolves this issue and will help the attorney prevail. This research article conclusively takes off the table that strain/sprains are transient.
2. Arthritis: any arthritic problem indicates that their client’s problems are all pre-existing and the carriers’ counsels submits summary judgments for dismissal to the courts for these patients.
Solution: in the bimonthly flyers there are numerous references certifying arthritis as a risk factor that renders greater bodily injury with less force. This must be taught to the attorneys
3. Asymptomatic Herniated Discs: the carriers are still contending that research shows much of the population having herniations and therefore your patient’s diagnosis of disc herniation is pre-existing being consistent with that literature.
Solution: in the bimonthly flyers there is a significant literature debunking this myth as the arbiter for a current problem and to age date herniations has been clearly outlined in the carriers asymptomatic herniated disc argument is severely flawed.
4. Impairment Rating: with the exception of Connecticut in Florida there are zero attorneys who either understand or welcome the use of a whole person impairment. The lawyers believe this number will “pigeonhole” them into a value they will not want to use and prevent them from arguing for a higher dollar amount.
Solution: it is here that you must start teaching those “Colossus algorithms” to get the attorney to understand that an impairment rating is worth 25% of their settlement offer. This also is the opening line of the “magic language” to get their attention.
5. IME and Peer Review Rebuttals: IME doctors still get the last word on almost all of you. The carriers are “upping” their level of aggression to destroy both your reputation and relationship with the attorney and the lawyer’s case based on the conclusions of these “so-called independent specialists.”
Solutions: you must write IME rebuttals so that the last word is not how bad a Dr. you are and how much you have inflamed your opinion as to the bodily injury of your patient. Lawyers are desperate for solutions to the “IME problem” and once they realize that you have a real solution you will get their full attention in a very short amount of time.
6. Testifying: lawyers do not want chiropractors to testify and do not want to pay for medical specialists for “soft tissue cases” because the money just isn’t there. As a result they are now turning those cases away and many of the injured feel there is no treatment for them because their lawyer told them their cases are insignificant.
Solution: if you got to treat every case that was rejected from the lawyers you can fill your practice and 10 more. My strongest suggestion of no testifying fee makes you an insurance policy for the lawyer provided you have the credentials to withstand an expert qualification hearing.
7. Falsely Reported No Bodily Injuries: too many general radiologists are misreading the MRI images and not appropriately reporting pathology. As a result, the lawyers are not accepting cases and many that do, are being argued and settled for much less complicated injuries.
Solution: get certified in MRI spine interpretation and then take the Mini Fellowship in Neuroradiology with Dr. Peyster. This level of education is critical to the success of your practice, the care of your patients at the highest level and the attorney having an opportunity to prevail at the highest level.
8. Record Confusion: too many lawyers now are getting too many versions of the patient’s history and complaints. This is problematic in both settlement and arguing cases in court as the opposing side gets to use the patient’s own words against them with their own doctors.
Solution: gather all the prior records and any inconsistencies should be handled by communicating with the offending office with an accurate accounting of the history that has been signed off by the patient requesting an amendment in their records.
The good news: most of this is been handled in previous consultations and although you might feel that you have resolved this issue with the legal community, you haven’t. Many of the “faithful” lawyers that we currently work with are still bombarded with these issues from the carriers on a daily basis and further enforces old stereotypes so the carriers can continue winning financially at the expense of your patients.
Follow the solutions and utilize the presentation I have created for you to show the attorneys to help them understand that you are the solution. In addition I strongly urge you when meeting with the lawyer to hand them the evidence-based book I created at www.lulu.com (type “studin” in the lookup bar) so that you have a formal authoritative document to give them beyond photocopies. This is also a more cost-effective manner of duplicating the bimonthly flyers.