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

The Role of the Rehabilitation Doctor in a Personal Injury Case

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.

The reason why this collaborative opinion with the rehabilitation doctor is so important is because of their unique training. For example, if you ask a physical therapist to prescribe certain medications or read an MRI report, they are not able to do this because it is out of the scope of their practice and they are not trained to do so; not to mention they are 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 set of skills and training which gives them credibility to opine on different aspects of the patients’ overall prognosis.  

Oftentimes in trial, the question “what is the patients’ rehabilitative potential” comes up and whether or not they have reached their “Maximum Rehabilitative Potential” and/or achieved “Maximum Medical Improvement”. 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” have 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. Quite often the opposing experts have differing opinions than mine regarding the improvement of the patient. It’s not necessarily that their opinion is wrong, but more often that it comes down to their opinion being based off of the patient’s pathological condition and whether or not 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.

Medically, the patient may have reached “Maximum Medical Improvement” from a disease or pathology standpoint, but the doctor of physical therapies’ standpoint considers whether the patient 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.  

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 answer to this question is simple. You get the only life care planner you can trust.  

When someone suffers an impairment they may be facing both a physical and functional abnormality, loss, or disfigurement, as well as the potential for psychological damage from their injury or incident. It must be determined whether these impairments will be permanent of resolve over time. 

If an impairment is likely to be permanent, one of the challenges of getting an adjustor to compensate a client’s future medical care is adaquately answering the adjustors’ question of “possibilty vs. probability of lifetime impairment”. 

How do you achieve this?  You must first prove to the insurance company that your client has suffered permanent impairment and that ongoing care will be needed to manage those impairments. While it’s relatively easy to prove the presence of physical impairments such as, decreased range of motion, weakness, muscle spasms; etc., the real difficulty lies in proving how these impairments will affect the patient throughout the rest of their life. It takes a very seasoned clinician with experience treating these types of impairments over the course of many years to have the ability to know and opine on how these impairments may affect the patient in the future. 

Typically, maximum medical improvement (MMI) or maximum rehabilitative potential (MRP) determinations will be made by medical and rehabilitative specialists during the patient’s treatment. After the patient has reached MMI or MRP, the remaining impairments are labeled as permanent. 

It’s common for opinions on “permanency of impairment” to vary among doctors and therefore conflicting opinions can arise in regards to what impairments are permanent and what future treatment, if any, those impairments will require throughout the rest of the patient’s life.  

So how do we know which doctors’ opinions are correct (or most plausible) for the continued or future care of the impairments? It really comes down to the doctor and their experience treating these impairments over the course of many years.  A doctor that has been in the trenches with these types of patients throughout their treatment, is the one that has the credibility to make these determinations. They can also back up their opinion with decades of clinical decision making processes, which in essence, provide the best insight into clinical outcomes. 

Who better to opine on the future care requirements of your client than a doctor life care planner who not only understands your client’s injuries, but also their response to treatment, diagnostic pathophysiology, and their impairment progression over time. 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 doctor Life Care Planner, Dr. Poppie helps to guide attorneys through all phases of their case and documents impairments with accurate associated costs that are reliable in educating opposing sides as to the true extent of injury. Evidence-based practice guidelines are utilized in all reports in order to ensure the needed criteria is met to withstand scrutiny within all legal jurisdictions. 

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

Typically, a medical diagnosis will determine the nature or cause of a disease or impairment. 

Diagnosis may be clinical in origin based on signs, symptoms, imaging, or laboratory findings. These findings can also be found by physical examination, patient interview, medical history; etc.  It is so important to remember that a medical diagnosis is only as good as the functional assessment that backs it up! 

While the informational pieces listed above can certainly help an insurance adjuster or jury member understand what pathological condition the patient is suffering from, it by no means helps them understand the INTENSITY or MAGNITUDE of their suffering. A medical diagnosis alone does not clearly depict how a patient’s facet sprain, partial rotator cuff tear, or bulging lumbar disc impedes upon their ability to perform work related tasks, activities of daily living, or leisure activities. 

Here is where solely relying on a medical diagnosis alone provides insufficient information towards the true injuries your client is experiencing. Over the course of 20 years as a treating doctor, I have received numerous physician referrals with the diagnosis “lumbago” or “cervicalgia” written at the top.  These diagnoses are also known as “low back pain” and “neck pain”, respectively. While the patient may indeed be suffering from such pain and there may be a real and underlying pathological condition as to why they are suffering from them, a medical diagnosis alone does not provide enough impact to alarm the reader of the true functional effect the diagnosis has on the person.

Millions of people are walking around today with neck and lower back pain that have never been in a car accident, work-related incident, sports trauma incident; etc.  

Insurance adjusters are aware that while a diagnosis helps to decipher what is wrong with the patient medically, it doesn’t give any information from a functional standpoint as to how that diagnosis affects their ability to carry on a normal life. In terms of functional loss, I am referring to disability. 

In fact, according to the Guidelines to the Evaluation of Permanent Impairment 5th edition, the American Medical Association defines, “ability and disability can and should involve non-medical practitioners in such determinations.” It was also stated that, “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.”

According to the Orthopedic Section of the American Physical Therapy Association, a Functional Capacity Evaluation (FCE) is noted as a comprehensive battery of performance-based tests that are used commonly to determine one’s ability for work related tasks, activities of daily living, and leisure activities.  

As you can see, while it is important to have a medical diagnosis, the diagnosis itself is only as powerful and objectively reliable as the functional assessment that backs it up. In personal injury, the hardest aspect to prove to an insurance adjuster or jury member is how the person’s accident and subsequent diagnosis affect their daily life.  

This is why it is imperative to obtain a Functional Capacity Evaluation in concert with a medical diagnosis in order to not only confirm the medical diagnosis but to quantify its severity as well. A Functional Capacity Evaluation allows the insurance adjuster to understand why the patient is hurt and what they are or are not able to do because of their injuries and thus a viable pathway for settlement is created.

If you have a case that you feel as though you may need more objective data in order to properly educate an insurance adjuster or potential jury, please reach out to discuss your clients’ needs.  

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 guide attorneys through all phases of their case and documents functional objective data that is reliable in educating opposing sides as to the true extent of injury. Evidence-based practice guidelines are utilized in all reports in order to ensure the needed criteria is met to withstand scrutiny within all legal jurisdictions. 

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. 

Learn more at Dr. Poppie’s educational videos!

​