DPT vs MD: Who Should Provide “Back to Work” Recommendations in Personal Injury Cases?

by IRC | Apr 22, 2025 | IRC Services, Demand Letters

DPT vs MD: Who Should Provide “Back to Work” Recommendations in Personal Injury Cases?

When it comes to personal injury cases, accurate “back to work” recommendations are critical for determining a plaintiff’s future earning capacity, vocational ability, and overall recovery. These recommendations are often provided by healthcare professionals, but the question arises: who is more qualified to make these recommendations, a Doctor of Physical Therapy (DPT) or a Medical Doctor (MD)? Understanding the distinct roles of these professionals can help attorneys make better decisions in advocating for their clients.

Understanding the Roles: DPT vs. MD

Doctor of Physical Therapy (DPT)

A DPT is a healthcare professional specializing in the evaluation, diagnosis, and treatment of movement dysfunctions. They are experts in physical rehabilitation and are highly trained in restoring function following injuries, surgeries, or illnesses.

Specialization in Functionality: DPTs focus on how injuries or conditions affect a person’s ability to perform daily tasks, including their job-related physical requirements.
Movement & Rehabilitation: DPTs evaluate an individual’s strength, range of motion, endurance, and functional abilities, which are critical in assessing whether a person can return to work, and if so, in what capacity.
Work-Specific Evaluations: DPTs can perform Functional Capacity Evaluations (FCEs), which assess whether the patient can meet the physical demands of their job, and they can provide specific guidelines for activity restrictions or modifications.

Medical Doctor (MD)

An MD is a physician trained to diagnose and treat illnesses and injuries. Their education includes a broader understanding of various medical conditions, pharmacology, and surgical procedures. MDs often focus on the medical and systemic aspects of recovery.

Diagnosis & Treatment of Conditions: MDs provide a comprehensive diagnosis of the injury or illness, treating underlying medical issues that may contribute to delayed recovery.
Holistic Health Considerations: MDs often manage complex conditions that go beyond physical injury, such as chronic pain syndromes, cardiovascular issues, or neurological impairments, all of which may affect return-to-work decisions.
Authority in Legal Contexts: MDs often carry significant weight in court settings due to their broad scope of medical knowledge and status in the healthcare field.

DPT vs. MD: Comparing “Back to Work” Recommendations

While both DPTs and MDs can provide “back to work” recommendations, they offer different perspectives based on their training and expertise. Attorneys need to understand these differences to select the most appropriate expert for each case.

1. Focus on Functional Recovery (DPT) vs. Medical Stability (MD)

DPTs primarily focus on functional recovery. They assess a client’s physical capabilities and determine whether they can perform job-specific tasks. For example, they might assess whether a construction worker can lift heavy materials again or if an office worker can sit for long periods without aggravating their injury.
MDs, on the other hand, focus on the medical stability of the patient. They may clear a patient for work based on the resolution of medical symptoms or successful treatment, without necessarily diving into the physical requirements of the job. While an MD might declare a patient medically stable, they may not have the expertise to determine if the patient is physically capable of performing job-specific tasks.

2. Functional Capacity Evaluations (DPT) vs. Medical Clearances (MD)

A DPT is uniquely qualified to perform a Functional Capacity Evaluation (FCE), which provides a detailed analysis of a client’s physical capabilities compared to the demands of their job. These evaluations are essential for determining specific work restrictions and accommodations, ensuring that the client can return to work without risking further injury.
MDs typically provide medical clearances for return-to-work, often based on diagnostic tests and the resolution of symptoms. However, they may not evaluate the specific functional limitations the individual faces, particularly if the job requires physical exertion.

3. Depth of Workplace Understanding (DPT) vs. Broader Medical Perspective (MD)

DPTs often have a deeper understanding of workplace ergonomics and physical demands, especially when dealing with physically intensive jobs. They can offer recommendations on workplace accommodations, modifications, or alternative job duties to facilitate a safe return to work.
MDs, conversely, may provide valuable insights into the overall health of the patient, including co-morbidities or medical complications that a DPT may not address. This broader perspective is essential in cases where the injury interacts with other medical conditions.

When Should You Choose a DPT or MD for “Back to Work” Recommendations?

Understanding the distinction between DPTs and MDs allows personal injury attorneys to choose the right expert for their client’s situation.

DPTs should be considered when the primary issue involves physical functionality, such as determining whether a client can perform the specific physical tasks required by their job. They are particularly useful in cases where the injury affects movement, strength, or endurance.
MDs are essential when a case involves complex medical issues or multiple injuries that require a holistic view of the patient’s health. MDs are also often required in legal contexts where the court needs a comprehensive understanding of a client’s overall medical condition and recovery.

Conclusion: The Value of Both Perspectives

Both DPTs and MDs provide essential insights in personal injury cases, but their recommendations serve different purposes. DPTs excel at evaluating functional capacity and physical limitations, while MDs offer a broader medical perspective. In many cases, the best approach may be a collaborative effort, where both professionals provide input to ensure a complete and accurate “back to work” recommendation.

Attorneys should assess the nature of the injury, the complexity of the medical condition, and the physical demands of the client’s occupation to decide whether a DPT or MD is the appropriate expert to consult.

By leveraging the specialized skills of both DPTs and MDs, Injury Reporting Consultants can provide comprehensive assessments that help achieve just resolutions in personal injury cases.

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.

Put the Kibosh on Lowball Settlement Offer Nonsense!

by IRC | Oct 8, 2024 | Expert Reports, IRC Services

Put the Kibosh on Lowball Settlement Offer 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.

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Beating Lowball Settlement Offers: How Functional Capacity Evaluations Can Strengthen Your Personal Injury Case

by IRC | Jun 11, 2024 | IRC Services

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.

Be Aware of Bogus Medical Cost Projections

by IRC | Mar 3, 2024 | IRC Services, Medical cost projections

Medical cost projections come in all shapes and sizes, some portraying valid content while others showcase invalid projections that do not stand up well to an insurance company or a jury.

Why is there such a big discrepancy in the validity of medical cost projections?

The short answer is that each life care planner has their own methodology for how they construct the report. This leads us to the next question, “how do you know what differentiates a valid medical cost projection from an invalid one?”

Here are some tips to help you decipher possible red flags that may come up in the medical cost projections that come across your desk.

Utilizing non-credible costing databases: If the costing database sources used are not nationally recognized databases, they are biased and do not provide accurate billing / coding information. Some companies use “their own” costing databases that only they are privy to using. This creates a bias when constructing the report.
Utilizing “treatment trends” when costing: Many costing specialists will rely on what the treatment trend has been over the last few years for a particular service in order to justify what is needed for a patient’s future care. Here is an example: Let’s say that the patient underwent follow-up appointments with their pain management physician four times per year for the last three years but they haven’t seen the physician in over a year. Some cost specialists will extrapolate out physician visits four times per year through life expectancy as a “treatment trend” even though the patient hasn’t actually seen that physician in quite some time. A phone call to the physician is critical to see if there is a continued need for those follow up visits.
Overreaching to pad the costs of the cost projection: Often times you will see extraneous items that have been recommended and costed out by the life care planner that may not be a necessity for future care. You might also see additional treatments that the client does not want solely to add to the amount of future costs. Here is a common example: Adding in a gym membership through life expectancy to a client that needs this care but has told you that they will never use this. Maybe pool therapy or a stationary bicycle in their home would be more suitable especially if a client voices that they would use it over a gym membership. Future costs must be justified, and if they aren’t, it leaves the life care plan open to speculation.
Opining on items that are outside the life care planner’s scope of practice: Oftentimes future items and costs are thrown into a medical cost projection that the life care planner cannot opine on due to their scope of practice. For example, a nurse life care planner is not able to opine on the future frequency and duration of physical therapy because that is out of the scope of their practice. Life care planners can get into hot water if they are adding in future treatment and costs that are out of the scope of their practice and therefore are unable to opine on these items themselves. Again, a call to the treating physical therapist is warranted to make sure the items that go into the cost projection are accurate.

Medical cost projections are designed to follow the same methodology of a life care plan. The main difference is that medical cost projections are typically drafted for non-catastrophic injuries and life care plans service catastrophic injuries. Both reports should provide the reader with a clear and identifiable pathway to understand what their client’s future care needs are and the costs associated with them.

Remember, the more ambiguous the report, the more susceptible the report is to failing Daubert and Frye standards. Make sure you hire a credible and expert life care planner for your life care plans and medical costs projection needs. The expert must also understand impairments / disabilities and personal injury cases in order to fully understand the needs of the client.

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

Learn more at Dr. Poppie’s educational videos!

Does Your Case Truly Support Your Demand Letter Settlement Request?

by IRC | Nov 14, 2023 | Demand Letters, Expert Reports, IRC Services, Life Care Plan, Medical cost projections, Resources for Mediation

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.

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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

by IRC | Oct 10, 2023 | Expert Reports, IRC Services, Life Care Plan

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 about 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.

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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.