The Role of the Rehabilitation Doctor in a Personal Injury Case

The Role of the Rehabilitation Doctor in a Personal Injury Case

From a healthcare standpoint, personal injury cases can involve a wide array of professional disciplines including medical, chiropractic, physical therapy, speech therapy, and psychology to name just a few.

These different healthcare specialties not only treat the patient to help them return to their prior level of function, but each discipline can offer specific insight into the patient’s progress and future prognosis.

Many times, however, an expectation is put upon the treating medical doctor to give an opinion about the overall prognosis of a patient. While medical doctors can say whether they think a person has achieved maximum medical improvement, they typically have to consult with the patient’s rehabilitation doctors to determine the patient’s actual rehabilitative potential. The difference here is that medical doctors diagnose and treat pathology and rehabilitation doctors such as physical therapists, evaluate and treat dysfunction.

To further break this down consider this: If you asked a physical therapist to prescribe certain medications or read an MRI report, they wouldn’t be able to do so because it’s out of the scope of their practice and not licensed in this field. On the other hand, if you asked a medical doctor to perform a physical therapy rehabilitative treatment regimen they would not be able to successfully treat this patient because they simply aren’t trained in doing so. Each respective discipline, both medical and rehabilitative, have their own unique training and skill sets that give them credibility to opine on specific aspects of the patients’ overall prognosis.

Now knowing that your patient’s medical doctor can only opine on a portion of your client’s injury and recovery, you can see why a collaborative approach with various healthcare professionals is critical when determining a patient’s overall prognosis. When the question “what is the patients’ rehabilitative potential” or “has the patient achieved maximum medical improvement” is inevitably asked in trial, if the appropriate experts are not in line to give an expert opinion on this topic, it will be difficult to prove to a jury if maximum medical improvement or maximal rehabilitative potential has been achieved.

As a Doctor of Physical Therapy, I have testified in trial numerous times against medical doctors ranging from orthopedic surgeons, physiatrists, and interventional pain physicians. Most often, the opposing opinion of these experts is different from mine in regards to the improvement of the patient.

It’s not necessarily that their opinion is wrong, it typically comes down to their opinion being based off of the client’s pathological condition and if that diagnosable condition has been cured or if there is an impairment that still exists. From the rehabilitation doctor’s perspective, we are looking at the overall rehabilitation potential of the patient and whether their function will improve or regress over time; thus providing a rehabilitative prognosis.

From a medical standpoint, the person may have reached maximum medical improvement from a disease or pathology standpoint, but the doctor of physical therapies’ view is if the person has reached maximum rehabilitative potential. The physical therapist has the education, experience, and expertise to opine on this question with certainty and should be integrated into determining the overall prognosis of the patient.

Make sure you provide the insurance company and or jury members both the medical doctors’ AND rehabilitative doctors’ opinions in order for an accurate and well-rounded prognosis to be made.

Want to learn more about IRC and the services we provide? Visit our channel, Personal Injury Today for informative videos, or visit our website to set up a free case consultation.

Functional Capacity Evaluations confirm the diagnosis and quantify injury severity

Functional Capacity Evaluations confirm the diagnosis and quantify injury severity

In today’s ever-evolving personal injury world, insurance companies are also changing the way they relate diagnoses to an injury as well as how they equate those diagnoses to an impairment.

What does this look like? Well, when someone gets injured in a car accident, they typically endure soft tissue injuries such as damage to the muscles, ligaments, and tendons. Many times these types of injuries are not considered serious or life changing and can be a challenge to prove their severity to an insurance company. With soft tissue injuries it can be difficult to verify severity because of the subjective nature of the tissue which can’t be quantified in medical reports. For example, a doctor cannot document that your lower back is 50% more stiff after your car accident because that is purely a subjective complaint from the patient. There is no way to objectively measure or quantify the subjective severity of the increased stiffness.

Patients can also suffer from more severe injuries that cause a higher degree of pain and suffering. These injuries are more catastrophic in nature such as head injuries, broken bones, spinal cord injuries, amputations; etc. These types of injuries are more easily documented and are objectively quantifiable through diagnostic testing measures.

Whether your client has sustained a soft tissue injury or a catastrophic injury, you must always go a step beyond getting the diagnosis to win your case. The problem with solely relying on a diagnosis is that the diagnosis often describes the type of injury sustained but not the full extent of the damage. Without a full understanding of the extent of the injury(ies) how can you prove the impact of the injury and/or what care the client will need long term?

Confidence in the injuries sustained in the client’s accident must come from a correct diagnosis as well as how that diagnosis affects the injureds’ life.  The only trial-proven test to confirm the diagnosis and prove the impact is the FUNCTIONAL CAPACITY EVALUATION (FCE).  During this 4-hour evaluation, the client’s impairments and disabilities are discovered which confirms not only the diagnosis itself but it also quantifies the severity of the diagnosis.

As a certified functional capacity evaluator, I have encountered numerous cases where a client has come in with a diagnosis and discovered through the FCE that this particular diagnosis has caused numerous other impairments and disabilities that would never have been discovered had the diagnosis been the only form of artillery that the attorney presented to the insurance company in their demand letter.

Arm your case with double barrels ablazing. One barrel is the diagnosis and the other barrel is the functional capacity evaluation.  Both fired together produce a tremendous force that launches a substantial impact.

Want to learn more about IRC and the services we provide? Visit our channel, Personal Injury Today for informative videos, or visit our website to set up a free case consultation.

Expert Reports are only as VALID as the expert writing them

Expert Reports are only as VALID as the expert writing them

When someone sustains an injury from a car accident and is seeking an attorney for representation, they will typically go through some degree of a screening process to determine what law firm or attorney is right for them and their case.

This process may include asking friends or family for a referral or by googling or calling around to various firms in their area to determine the right one for the job. The injured person may even choose based on whoever’s advertisements have imprinted the most on their brain.

The same screening process should hold true for attorneys looking to hire an expert witness to help support their case. Let’s say an attorney is looking to hire a life care planner to determine the future medical / rehabilitative care and associated costs for their clients’ case.

The attorney may call colleagues to ask who they use or may just go online and do a search. They may even hire the company who puts up the most advertising dollars to make an impact and determine that they are the best.

I’ve been a personal injury doctor for over 20 years and have heard from both clients and attorneys the horror stories, headaches, mishaps, and nightmares these individuals have experienced from hiring expert witnesses that were unqualified, insufficient or unprofessional.

From an attorney / expert relationship point of view, the most common complaint I have heard is, “the experts they hire don’t perform well on the stand”…and as we know, an expert’s report is only as good as their ability to defend it to the opposing counsel and win the hearts of the jury.

The Frye Test and Daubert Decision, Rule 702, and Rule 26 are the defining standards for admissible scientific evidence in trial from an expert’s testimony and their reports. If the criteria and rules of evidence set forth by these rulings are not met, the court may not allow acceptance of your expert to testify on behalf of your client. Make sure you choose your experts wisely to avoid this issue at trial.

I think a more common issue, however, is if the expert is unable to fully educate the jury on the methodology behind their report, the conclusions that they came to, and how those conclusions affect the livelihood of the client. If this happens, the jury will often discredit the expert and disregard their report or their testimony which could prove to be catastrophic to your case.

Over the last two decades, I have testified for numerous cases both as a treating doctor and an expert. Understanding what evidence is admissible in trial and how to portray that evidence to the jury is imperative, and has become a personal commitment to deliver highly qualified and understandable reports to help effectively educate the jury.

 

 

The biggest mistake a life care planner can make that is death to their report

The biggest mistake a life care planner can make that is death to their report

Throughout my career, I have reviewed many life care plans, medical cost projections, and future needs assessments. The conclusion that I have come to is that the majority of them do not have up-to-date future medical recommendations which lowers the validity of the overall report.

According to Life Care Planning methodology, medical records that are over 6 months are considered archaic and therefore not a true representation as to how the client is presenting at present day.  When those older medical records are utilized in a report, not only does this equate to inaccurate future medical costs but also decreases the credibility of the life care planner who wrote the report.

It is imperative that the report contain the most updated information that is available.  This is why attorneys need to get the life care planner involved in the case well before disclosures are due.

A properly trained life care planner can help you guide your case along to make sure you understand where the client is in their treatment and what treating physicians/rehabilitation professionals are working with the client in order for those providers to give updated and accurate information that is essential for a valid report.

Here is an example.  Many times, clients slip through the cracks and don’t necessarily communicate with attorneys what treatment they are receiving and who is providing it. Maybe the attorney thought that they had completed a series of facet joint injections but in all reality, the client never went to get them in the first place.

Let’s say that your client is scheduled for their first cervical medial branch block in two weeks and disclosures are due in one month.  There is no way the treating physician administering the blocks will be able to opine on future injections including facet injections and/or radiofrequency ablation procedures due to inadequate time to see how the client will respond to the first round of injections.  This is where a skilled life care planner can help communicate these issues with the attorney.

By getting the life care planner involved early on, they can help make sure the records are up to date and inform the attorney where the client is in treatment. After all, the validity of their life care plan is based on the treating practitioners’ future care recommendations and if the life care planner is not on the ball in regards to getting those recommendations, the report is not valid.

Set your case up for success and reach out to a skilled, qualified, doctor life care planner that can ensure that the proper updated recommendations are utilized in order to create a valid report that both plaintiff and defense attorneys can use as a method to a swift and fair settlement.

Dr. Brad Poppie has over 20 years of personal injury experience providing care as a treating doctor, coordinating rehabilitative case management, and expert trial testimony services.  If you have a client that you would like to discuss their need for an expert report, please contact me directly at 720-982-2000 or email me at: brad@injuryreportingconsultants.com

The “RIGHT” life care planner can make or break your personal injury case

The “RIGHT” life care planner can make or break your personal injury case

Have you ever faced the unfortunate situation where your “trusted” life care planner constructs a future needs report for your client only for you to realize that their report was not tailored toward the nuances of a personal injury case?

This can be devastating to your case as you’ve just invested thousands of dollars, for its value to be diminished or even dismissed as irrelevant.

We see this happen all too often in personal injury cases due to the simple misconception that all life care planners are created equal. While all life care planners are indeed certified, many are not familiar or trained in personal injury specific life care plans and instead work primarily in elder care cases, where they develop a strategy that helps define a senior’s wishes and assists caregivers / family in handling the physical, personal, and financial affairs of their aging process. This type of life care plan is MUCH different than a custom life care plan tailored towards your client who has impairments and disabilities that they sustained in an automobile accident.

If you think about it, you wouldn’t hire a general surgeon to perform an ACL reconstruction surgery on your knee, it’s much wiser to hire a “knee-specific” orthopedic surgeon that works on knees on a daily basis.

The same holds true with life care plans. Personal injury tailored life care planners have a very good understanding of how to cost out injury / trauma specific treatments – whether those be physical therapy, medial branch blocks, radiofrequency ablation procedures, orthopedic surgery; etc. Costing out such therapies / procedures is a sub-specialty in and of itself that takes an expert to not only accurately predict future impairments and disabilities but also to put the correct price tag on those recommendations. I’ve seen many life care planners struggle with understanding how to do this job accurately. Inaccurate life care plans are not taken seriously and set that life care planner up to be dismissed as an expert in your case.

Don’t settle for a “general” life care planner for your cases. Hire an expert personal injury specific life care planner that will help educate plaintiff / defense counsel, and the insurance company. At Injury Reporting Consultants, we specialize in expert reports specifically for personal injury cases such as functional capacity evaluations, vocational and earning capacity evaluations, medical cost projections, and life care plans that effectively communicate to all parties’ the client’s future needs in an accurate and well thought out manner. We believe that a well-crafted life care plan utilizes effective communication and effective communication is key to solving problems.

Dr. Brad Poppie has over 20 years of personal injury experience not only as a treating doctor, but as an expert witness in trial.  If you have a client that you would like to discuss their need for an expert report, please contact directly at 720-982-2000 or email: brad@injuryreportingconsultants.com​