Is Your Client Faking Their Injuries?

Is Your Client Faking Their Injuries?

Wondering if your client is faking their injuries is probably one of the most daunting and upsetting thoughts that an attorney can have after their client retains them.

After all, the attorney wants to trust their client and believe that the severity of their injuries are not exaggerated. Any misinterpretation of a clients’ injuries can put the case in jeopardy of losing in trial which can be catastrophic for both the client and attorney.

So, how do you know if your client is telling the truth and portraying a true representation of their actual complaints of pain and the impairments that go along with them? While it is difficult for a client to “fool” multiple practitioners or even their attorney, it can and does happen.

While we as practitioners have tools in our tool belt to help navigate our evaluations in order to determine whether someone is a symptom magnifier and or a malingerer, these are not fail-safe measures to ensure the validity of the patients’ pain complaints or corresponding impairments.

There is one extensive evaluation, however, that has high validity, objectivity, and reliability to help determine the accuracy of a patient’s injury. This evaluation is the Functional Capacity Evaluation (FCE). In essence, the FCE is designed to confirm the diagnosis and quantify the severity of their injuries or impairments.

The FCE is a trial-tested evaluation that has been around for decades. It is the industry standard for how we document an individual’s impairments and disabilities and the effects of the injury on the patient’s life; more specifically, their ability to perform work related tasks, activities of daily living, and leisure activities. This 4-hour test has built-in validity and reliability measures that detect if a client is trying to pull the wool over the eyes of the evaluator.

Any symptom magnification or malingering tactics tried by the client will be discovered and documented to determine the true nature of the clients’ injury and if they presented truthfully by giving a full effort during the testing. This evaluation is the ONLY testing measure that we as clinicians have to accurately determine if the client’s subjective complaints are consistent with objective measures.

If you have a client where you are unsure of the accuracy of their diagnosis or are skeptical of their subjective pain complaints, a Functional Capacity Evaluation is the only evaluation that will confirm the severity of their complaints and impairments.

Dr. Poppie has served the legal industry as a treating clinician, damages expert, and educator for over 20 years. He specializes in the evaluation and treatment of multi-trauma injuries related to motor vehicle collisions, standard of care and malpractice claims, and as a damages expert to help educate insurance companies and both plaintiff and defense counsel to provide a viable pathway for obtaining a fair settlement based on ethics, research, and evidence-based standards of care.

As a certified functional capacity evaluator, Dr. Poppie helps to document the true objective measurements of how the impairments and disabilities that the client is suffering from impact their ability to perform work related tasks, activities of daily living, and leisure activities in an easy to understand method for the insurance company or jury members.

Dr. Poppie founded Injury Reporting Consultants to help attorneys and insurance companies resolve personal injury cases through medical analysis and reporting. Injury Reporting Consultants is a collaborative team of dedicated medical professionals using their knowledge to ensure fair outcomes for all parties in personal injury cases.

Recognized specialties include Motor Vehicle Collision, Life Care Planning, Medical Cost Projection, Functional Capacity Evaluation, Onsite Job Analysis, Functional Impairment and Disability, Workplace Injuries, Orthopedic Physical Therapy, Standards of Care, Current Best Practices, Physical Therapy Malpractice, Negligence, File and Medical Record Review, Improper Documentation, Expert Rebuttal Reports, and Expert Testimony.

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

Sincerely,

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
Certified Strength and Conditioning Specialist

Should the MD or PT give return to work recommendations?

Should the MD or PT give return to work recommendations?

In a lot of injury cases there can be confusion about whether or not a medical physician or a doctor of physical therapy should be giving the green light for a patient to return to work full time, part time, or with / without restrictions.

Usually, a medical exam is a general health screen consisting of range of motion measurements, strength testing, neurologic assessments, and muscular palpation. The physician or physician assistant typically see the patient every couple months for checkups throughout their case and these follow up appointments typically last just a few minutes. While these evaluative measures are helpful in determining what impairments an individual may be suffering from due to their collision, they do not paint a definitive picture of those impairments and how they affect the persons’ ability to perform work related activities.

On the other hand, the physical therapist will typically be working with the patient in the trenches 2-3 times per week for 2-3 months on average. The visits last anywhere from 30 minutes to 1 hour. During this time, the therapist is able to see how the patient is responding to functional activities and can often find other unidentified impairments that may be prohibiting optimal recovery from an injury.

Understanding this, which of these two practitioners would you ask if it were you going back to work?

This topic is further discussed by the American Medical Association who have determined that “evaluation of “ability and disability” can and should involve non-medical practitioners in such determinations: In general, “it is not possible for a physician, using medical information alone, to make reliable predictions about the ability of an individual to perform tasks or to meet functional demands…when functional ability is assessed by a standardized non-medical procedure in a vocational rehabilitation setting, the physician may have confidence in the determination.” — Guidelines to the Evaluation of Permanent Impairment (2nd Edition)

The Association then goes on to emphasize that
“impairment is defined as “a loss, loss of use, or derangement of any body part, organ system, or organ function.” Disability (activity limitation) is defined as “an alteration of an individual’s capacity to meet personal, social, or occupational demands because of impairment.” Impairment means an alteration of an individual’s health status that is assessed by medical means; disability, which is assessed by non-medical means, means an alteration of an individual’s capacity to meet personal, social, or occupational demands.” — Guidelines to the Evaluation of Permanent Impairment (3rd and 5th Editions)

According to the Guidelines to the Evaluation of Permanent Impairment (6th Edition), “Most physicians are not trained in assessing the full array of human functional activities and participations that are required for comprehensive disability determinations.” “The relationship between impairment and disability remains both complex and difficult, if not impossible, to predict…the same level of injury is in no way predictive of an affected individual’s ability to participate in major life functions (including work).” 

“Physicians are concerned with the degree of medical impairment, not with the contractual determination regarding whether the individual is “disabled.” Similarly, physicians are not typically trained in making occupational determinations. It is better to state a reasonable restriction and leave the determination as to whether it prevents the performance of a main duty to the appropriate resource.” — AMA Guides to the Evaluation of Work ability and Return to Work (2nd Edition) 2011. 

When physical therapists who are also certified functional capacity evaluators evaluate the client, a proper return to work schedule can safely be determined.  According to the Orthopedic Section of the American Physical Therapy Association, “A Functional Capacity Evaluation (FCE) is a comprehensive battery of performance based tests that are used commonly to determine ability for work, activities of daily living, or leisure activities.”  

The medical physician and doctor of physical therapy can and should work in concert together. By having the medical physician determine the clients’ impairments they can give a proper diagnosis. By having the doctor of physical therapy actually confirm the diagnosis and quantify its severity through a skilled functional capacity evaluation, you can be confident that the client’s impairments and disabilities have been properly documented as well as how they impact someone’s livelihood.  

Dr. Poppie has served the legal industry as a treating clinician, damages expert, and educator for over 20 years. He specializes in the evaluation and treatment of multi-trauma injuries related to motor vehicle collisions, standard of care and malpractice claims, and as a damages expert to help educate insurance companies and both plaintiff and defense counsel to provide a viable pathway for obtaining a fair settlement based on ethics, research, and evidence-based standards of care. 

As a certified functional capacity evaluator, Dr. Poppie helps to document the true objective measurements of how the impairments and disabilities that the client is suffering from impact their ability to perform work related tasks, activities of daily living, and leisure activities in an easy to understand method for the insurance company or jury members. 

Dr. Poppie founded Injury Reporting Consultants to help attorneys and insurance companies resolve personal injury cases through medical analysis and reporting. Injury Reporting Consultants is a collaborative team of dedicated medical professionals using their knowledge to ensure fair outcomes for all parties in personal injury cases.

Recognized specialties include Motor Vehicle Collision, Life Care Planning, Medical Cost Projection, Functional Capacity Evaluation, Onsite Job Analysis, Functional Impairment and Disability, Workplace Injuries, Orthopedic Physical Therapy, Standards of Care, Current Best Practices, Physical Therapy Malpractice, Negligence, File and Medical Record Review, Improper Documentation, Expert Rebuttal Reports, and Expert Testimony.

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

Sincerely,

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
Certified Strength and Conditioning Specialist

Cases Are Won or Lost By the Expert’s Ability to Defend their Report

Cases Are Won or Lost By the Expert’s Ability to Defend their Report

When a patient seeking treatment from a provider experiences an unfortunate injury due to the negligence and malpractice of the treating provider, they must carefully determine their next steps.

They have the choice to file a complaint with the clinic and continue treatment, or if the injuries are severe enough, they may choose to file a malpractice lawsuit. If they decide to go the malpractice route, careful consideration and screening must be given to determine what legal counsel is the right fit to represent them with their claim.

The same careful screening process must be followed when the attorney selects an expert to opine on the extent of the malpractice. The attorney may use a listserv to find an appropriate expert, analyze google reviews, or ask a referring colleague for an expert they have used in the past.

Once an attorney has someone in mind, they’ll want to research whether the expert has ever been excluded as an expert or had their report thrown out.

The Frye Test and Daubert Decision, Rule 702, and Rule 26 are the defining standards for admissible scientific evidence in trial for an expert’s testimony and 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.

Over the course of my career, I have heard many attorneys speak poorly of some experts they have used in the past; not necessarily due to the report that they wrote, but rather that they did not testify well on the stand. 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 effective expert MUST educate the jury on the methodology they used, the conclusions they came to, and how those conclusions affect the livelihood of the client in an easy to understand manner. If this does not happen, the jury may discredit the expert and disregard their report or their testimony which could prove to be catastrophic to the case. 

No matter how seasoned the expert is at writing reports or how many years of practice they have under their belts, if they cannot translate the verbiage on the paper to the minds of the jury members, their expertise is ineffective.

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

Dr. Poppie has served the legal industry as a treating clinician, damages expert, and educator for over 20 years. He specializes in the evaluation and treatment of multi-trauma injuries related to motor vehicle collisions, standard of care and malpractice claims, and as a damages expert to help educate insurance companies and both plaintiff and defense counsel to provide a viable pathway for obtaining a fair settlement based on ethics, research, and evidence-based standards of care.

Dr. Poppie founded Injury Reporting Consultants to help attorneys and insurance companies resolve personal injury cases through medical analysis and reporting. Injury Reporting Consultants is a collaborative team of dedicated medical professionals using their knowledge to ensure fair outcomes for all parties in personal injury cases.

Recognized specialties include Motor Vehicle Collision, Life Care Planning, Medical Cost Projection, Functional Capacity Evaluation, Onsite Job Analysis, Functional Impairment and Disability, Workplace Injuries, Orthopedic Physical Therapy, Standards of Care, Current Best Practices, Physical Therapy Malpractice, Negligence, File and Medical Record Review, Improper Documentation, Expert Rebuttal Reports, and Expert Testimony.

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

Sincerely,

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
Certified Strength and Conditioning Specialist

Helping your client understand the need for a Functional Capacity Evaluation

Helping your client understand the need for a Functional Capacity Evaluation

As your client progresses through their personal injury case, it’s common for them to experience heightened anxiety, treatment burnout, and mental and physical fatigue.



Personal injury cases can be very complex so keeping your clients’ interest and enthusiasm can be a challenge after months or years of treatment has passed. Many times when we as practitioners make referrals to other specialists, we hear, “why do I have to go to someone else?” or “I just want to be done with all of this.”  This is certainly understandable because client treatment often feels more like a marathon than a sprint.  Many clients describe this process as being a part time job in excess of their actual full time employment.  Running to different appointments is exhausting to say the least.



Just when your client thinks their treatment is finally done, you tell them the daunting words that they do not want to hear. Those words are, “you’re now ready for a Functional Capacity Evaluation.”  Before the steam starts coming out of their ears, here are some tips for helping your client understand WHY they need this evaluation.

  1. Start by educating them on why the test is done.  Let them know that even though they went through tons of treatment from different providers, the Functional Capacity Evaluation is the evaluation that ties everything together.  This is the industry standard of documenting their impairments and disabilities affect their ability to perform work related tasks, activities of daily living, and leisure activities. The hardest thing to prove to the insurance company is how their injuries affect their lives and this is the evaluation to showcase that.
  2. Remind them that everything has a purpose. The purpose of their medical, chiropractic and physical therapy treatment is to help them heal, decrease their pain and improve strength/range of motion, but this treatment doesn’t showcase the impact the injury has on the client’s daily life and abilities. That’s where the FCE comes in. The insurance company needs to know how these impairments relate to their life and their ability to perform life’s tasks with real-world functional task simulation and evaluative measures to understand the full impact of your clients’ collision.
  3. The Functional Capacity Evaluation tees-up the impairment rating given by the physician which plays a significant role in educating the insurance company of their overall damages.

It is also important for the client to understand the intricacies of the evaluation itself. For instance, if the attorney has not educated the client as what to expect the day of the evaluation, the client may be surprised to learn:

  1. The evaluation takes approximately 4 hours to complete.
  2. They need to wear comfortable clothing due to the physical functional tasks that are required in the test.

I actually had an attorney refer a client for an FCE years ago and reassured me that they had prepped the client about the test.  When the client arrived, they were wearing 4” stiletto heels, a dress, and asked how long the evaluation would take as they had a meeting in 30 minutes. Needless to say, the evaluation had to be rescheduled.

If you’re uncertain about how to adequately prepare your client for the Functional Capacity Evaluation, please don’t hesitate to reach out to the evaluator so they can inform your client as to why the evaluation is being done and what to expect.

If you have a client that you think may need a Functional Capacity Evaluation in order to help educate the insurance company of how their impairments and disabilities affect their life, feel free to reach out to us at Injury Reporting Consultants.  We specialize in the preparation and documentation of easy-to-read and understandable reports to help with a swift and fair settlement process.

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

Sincerely,

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
Certified Strength and Conditioning Specialist

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.