Put the Kibosh on Lowball Settlement Nonsense!

Put the Kibosh on Lowball Settlement Nonsense!

The initial settlement offer received from the insurance adjuster is typically so low that you will need to take a second and third look at it to make sure you read it correctly. The insurance company will use every trick in the book and ludicrous claims defending their lack of consideration towards justifying a fair settlement offer.  So why do insurance companies lowball? Because they can.

You may have the “perfect” personal injury case on paper proving no preexisting conditions, clear liability towards the offending party, received positive diagnostic imaging findings, and ensured your client diligently attended doctor-recommended treatment/therapies. And even after all of this, your client may still be experiencing ongoing pain and functional limitations. So, one must ask, “Why on earth would the insurance company still give a lowball settlement offer?” Again, because they can.

Inadvertently, what the insurance company is telling you is that even after you have dotted all of your “I’s” and crossed all of your “T’s”, you haven’t proven to them how all of your client’s injuries have affected their ability to provide for their family, care for themselves, or participate in the leisure activities they once did before their injuries. 

I know it sounds weird, but by simply dotting all of your “I’s” and crossing all of your “T’s”, you are still only bringing a knife to a gunfight in hopes of obtaining a fair settlement from the insurance company. The fact of the matter is that the injured person is simply a number to the insurance company and the injured client’s claim is punched into a computer program that equates their injury to a set value of the claim.

So how do we combat these lowball settlement offers? You have to arm your client’s case with heavy ammunition to not only get the insurance company’s attention, but also fully educate them on why your client deserves an appropriate settlement. You must come out of the gate with both double-barrels-ablaze.  

A proven way to do this is through a trial-tested functional abilities evaluation report that has over 4 decades of widespread usage in the personal injury and workers comp arena. This evaluation, better known as the Functional Capacity Evaluation (FCE), is the industry standard on how your client’s impairments and disabilities from their collision affect their livelihood; more specifically their ability to perform work-related activities, activities of daily living, and leisure activities. 

Don’t get caught up in the unnecessary back-and-forth negotiations with the insurance company unless you have the answer to the question, “How does your client’s impairments affect their life?” Get an FCE to help educate the insurance company and aid in a fair and swift settlement.

Does Your Case Truly Support Your Demand Letter Settlement Request?

Does Your Case Truly Support Your Demand Letter Settlement Request?

Drafting a demand letter is an essential step in the process of resolving legal disputes. It serves as a formal request for settlement and outlines your clients’ grievances, the desired outcome, and the consequences if their demands are not met. However, before sending out a demand letter, it’s crucial to evaluate whether your case genuinely substantiates your settlement request.

The cornerstone of any demand letter are the legal claims you are asserting. These claims form the foundation for your settlement request and must be substantiated by credible evidence. There are two primary reasons why insurance companies often don’t take your demand settlement package seriously:

1. Inadequate documentation of diagnosable impairments:  

Having reviewed hundreds of personal injury cases over the years, I’ve observed countless instances where ALL diagnosable impairments are not documented, inadequately documented, or completely disregarded and left unattended.

For instance, in many cases involving clients with multiple trauma injuries resulting from a motor vehicle collision, injuries are often prioritized based on their life-threatening or most severe pain-inducing nature which may cause overshadowing of less apparent impairments. Orthopedic impairments like broken bones, herniated discs, facet injuries, and ligament tears take precedence, while these less-obvious issues, such as short-term memory deficits, decreased attention span, dizziness, blurred vision, and tinnitus, often go undiagnosed and consequently remain undocumented. These signs are often symptoms of post-concussive and mild traumatic brain injuries and when left undocumented, can cause your client’s case to be severely undervalued.

2. Lack of Quantification of Diagnosed Impairments:

Orthopedic and cognitive impairments that are not quantified in terms of their severity and their impact on your clients’ lives are typically inputted into an insurance company’s system to generate a low-ball valuation based on the insurer’s subjective assessment of the impairments’ worth.

It is crucial to quantify how these impairments affect your clients’ daily lives, including their ability to provide for their family, perform activities of daily living, and engage in leisure activities. The most trial-tested, valid, and objectively reliable method to quantify your clients’ impairments is through a Functional Capacity Evaluation to assess physical abilities or a Cognitive Functional Capacity Evaluation to evaluate cognitive deficits and their effects on executive functioning skills, concentration, and attention span.

Before sending out a demand letter and making a settlement request, it is essential to evaluate whether your case comprehensively and quantitatively supports the impairments upon which you base your demands. By taking these two pivotal steps into account, you can significantly enhance the chances of achieving a successful resolution to your dispute.

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.

 
 
Your Case Is Too Important To Entrust With Amateurs

Your Case Is Too Important To Entrust With Amateurs

Suffering from a personal injury can be a life-altering event causing physical pain, emotional distress, and financial burden to your client. For such cases, seeking appropriate experts becomes crucial to ensuring you have the ammunition needed to properly represent your case.

Your experts not only educate the insurance company of the client’s diagnosis, functional impairments, and future care needs, but they also paint a picture of how these impairments affect the client’s life. Therefore, deciding which medical-legal expert to entrust your personal injury case with, is not to be taken lightly.

The Complexities of Personal Injury Cases:

While there are many expert medical professionals out there, not all possess the expertise and experience necessary to navigate the complexities of personal injury cases.

Personal injury cases encompass a wide range of incidents including car accidents, slip-and-fall, medical malpractice, and workplace injuries. Each case is unique, involving intricate legal and medical aspects that require careful analysis and attention. Amateur “experts”, or Life Care Planners who specialize in Senior Care rather than Personal Injury, lack the knowledge to fully understand the nuances of case management, establishing causation, quantification of impairments, and determining future care needs. Their inexperience risks critical errors that often jeopardize the chances of receiving fair compensation for your client.

Navigating What Expert to Hire:

Navigating the sea of possible medical-legal experts can be a daunting task. After all, you are entrusting this expert to make potential life-altering opinions regarding your client’s impairments and future care. Therefore, it is imperative to choose wisely.

An amateur expert might struggle to meet deadlines, miss important documents, or mishandle future care considerations for your client due to their lack of experience or understanding of the full extent of your client’s impairment.

In contrast, a seasoned and professional medical-legal expert with years of experience has a deep understanding of the legal landscape, ensuring that every step is executed efficiently and effectively.

Doctor life care planners work within their respective scope of practice allowing them to perform specialized examinations on the client as well as fully analyze the client’s medical records. This supports the doctor life care planner’s authority to opine not only their current care, future care, and future costs, but also how those three elements coexist with the client’s impairments and disabilities and affect the client’s life. A doctor life care planner can also help streamline the damages report process and improve the likelihood of a settlement being procured in mediation as opposed to trial.

Trial Experience:

While many personal injury cases are settled out of court, some do proceed to trial. In such instances, having an experienced medical-legal expert by your side, with a track record for winning on the stand can make a world of difference. Amateur experts struggle to present a compelling opinion and lack the courtroom presence and advocacy skills needed to properly educate and sway a judge or jury. On the contrary, skilled medical-legal experts are well-versed in courtroom dynamics, and their expertise can help tip the scales in your clients’ favor.

When choosing a doctor life care planner, consider one that has decades of experience treating the types of patients and impairments that your client is suffering from to support their credibility on the stand. After all, it’s not the question of if the authored Life Care Plan can hold up in court, but rather the question of if the one who authored the plan can hold up in court.

Conclusion:

When faced with a personal injury, the decision to seek the appropriate medical-legal expert should be backed by careful research and consideration. While amateurs might offer lower fees, the potential risks and consequences of entrusting your case to them far outweigh any initial savings. Personal injury cases demand a level of expertise, experience, and dedication that only seasoned professionals can provide. By partnering with an established medical-legal expert, you can rest assured that your case is in capable hands, increasing your chances of receiving the compensation your client rightfully deserves.

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.

 
 
Function Based Case Management Strategies

Function Based Case Management Strategies

A decade ago, the way the personal injury cases were analyzed and valued was typically via diagnoses, impairment ratings, and imaging studies. Multi-trauma diagnosis that were correlated with positive imaging findings of fractured bones, herniated discs, and ligamentous tears; etc. were substantial evidence that the injured’s  impairments were somehow catastrophic and warranted an appropriate settlement. 

Those days are long gone and providing the insurance company with that level of documentation and evidence of impairment is subpar. It no longer educates the insurance company on how the injuries that your client has sustained, equate to a loss of functional ability to return to their previous level of function and engage in their life the way they did prior to the collision; more specifically, their ability to perform work related activities, activities of daily living, and leisure activities. 

Today, case management MUST be centered around your client’s functional loss from the collision, slip-and-fall; ect. The question you must ask yourself when going through a case is, “how do the impairments that have been documented through treating practitioners and experts, equate to a functional deficit that leads to a disability?”

What if you had an extensive evaluation that you could present to the insurance company that would confirm the diagnosis, impairment rating, and / or imaging studies, and would actually quantify their severity? This evaluation exists and is the only trial-tested, objective, reliable, and valid way to determine how their injuries affect their livelihood. If you haven’t guessed it, the evaluation I’m referring to is the Functional Capacity Evaluation.  

The Functional Capacity Evaluation is designed to take the injured evaluee through a thorough series of functional tasks that allow the evaluator to determine functional impairments. These tasks measure fine / gross motor control and dexterity inadequacies, positional tolerances, lifting and carrying deficits; etc. and make valid conclusions reguarding the functional limitations found during testing and how they equate to functional impairments.  

Functional impairments are the new gold standard of documentation in personal injury cases. The functional impairments discovered through the functional capacity evaluation will help guide you through your demand letter settlement request and help pave the way for other experts involved in the case to make more holistic opinions on the permanency of your client’s impairment.  

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

Dr. Brad Poppie, DPT, CLCP, CFCE, CSCS  
Doctor of Physical Therapy
Certified Life Care Planner
Medical Cost Projection Specialist 
Certified Functional Capacity Evaluator
Certified Strength and Conditioning Specialist

Cognitive Functional Capacity Evaluations’ role in TBI

Cognitive Functional Capacity Evaluations’ role in TBI

Traumatic Brain Injury (TBI) or Post-Concussive Syndrome is unfortunately a very underdiagnosed cognitive pathological condition in personal injury. Oftentimes diagnostic imaging, neuropsychological testing, and/or cognitive therapy are relied upon heavily for diagnostic and treatment purposes. While these studies and experts can certainly help diagnose the injured persons’ condition, there is typically one very important clinical presentation that is not discovered with all of this testing. That is, how the brain injured individual is functioning in real environments, promoting the ecological validity of an evaluation.

The ecological validity differentiates how generalized experimental findings are relatable to the real world such as situations or settings that are typical of everyday life. Think of ecological validity as a subtype of external validity. This is where the Cognitive Functional Capacity Evaluation (CogFCE) comes into play.

The CogFCE evaluates an individual’s functional and cognitive capacity in relation to their ability to perform essential critical job demands with a focus on the intersection of physical, psychological, cognitive, and behavioral implications of an injury or medical condition.

The CogFCE includes the formal / standard functional testing such as range of motion, strength, mobility, limb coordination, postural tolerances; etc in addition to a standardized assessment of cognitive function. These assessments are both component and performance based tests, non-standardized assessment, with structured observations of physical, cognitive, behavioral, and psychosocial functioning.

The evaluator has the unique opportunity to evaluate executive functioning skills both practically and formally by using the clinical environment and environmental demands as an additional tool to measure the evaluee’s performance.

This form of environmental evaluation is a very useful and relevant quantifiable assessment for determining one’s functional capacity for employment and/or how the evaluee’s cognitive deficits affect their ability to perform activities of daily living or leisure activities. This approach highlights ecologically valid measures of work-specific tolerance, particularly in the areas of attention, activity tolerance / mental stamina, and executive functioning.

Make sure your cognitively injured client’s impairments are properly documented to effectively show how the injury affects their livelihood.

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