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.

 
 
Who is the “worst nightmare” of every insurance company?

Who is the “worst nightmare” of every insurance company?

As personal injury cases continue to become more complicated, insurance companies will continue to have the leverage and “hold the cards” in terms of the nature of the settlement and its amount. Attorneys today don’t exude the same “fear factor” power to get the insurance companies’ attention that they once did. Cases are taking longer to settle and sometimes for subpar amounts.   

Who is the “worst nightmare” of every insurance company?

The main reason this is happening is that insurance companies today aren’t taking attorneys seriously simply because they don’t have to. The insurance companies have deep pockets and will do everything in their power to avoid paying on claims. Oftentimes they are able to take advantage of the standard demand package or trial documents presented that do not portray the client’s true impairments, disabilities, and how these two affect the client’s livelihood. 

So, who is the insurance companies’ worst nightmare? Someone like me, a doctor that has the personal injury know-how and certifications to back it up. I have decades of experience educating insurance companies about client impairments and disabilities and explaining demand letters and trial documents from a doctor’s perspective. 

At Injury Reporting Consultants, we specialize in providing expert reports such as functional capacity evaluations, vocational and earning capacity evaluations, medical cost projections, and life care plans that will support your legal documents in order to help obtain a swift and fair settlement.      

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 me directly at 720-982-2000 or email me at: dr.bradleypoppie@physicalrehabspecialists.com

Visit IRC on Youtube for educational videos on this process! 

Be Aware of Bogus Medical Cost Projections

Be Aware of Bogus 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.

  1. 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.
  2. 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.
  3. 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.
  4. 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!

What level of certainty is required of your medical malpractice expert?

What level of certainty is required of your medical malpractice expert?

What level of certainty is required of your medical malpractice expert?

Experts on the stand define the certainty of their opinion in two similar but vastly different terms. These terms are “Possibly related” and “Probably related”. In context, they’re voiced about the relation of the injuries to the treating practitioner and whether the injuries are the result of negligence or deviation from the standard of care.

When experts write out their opinions and opine on causation, that opinion must be expressed in terms of “probability”.  Words or phrases that convey the expert is “guessing” or is “not sure” of the correlation between the cause of injury to the negligence or deviation of standard of care will discredit the expert and make it difficult to persuade the jury to side with their opinion.  

Other terms an expert might use relating an injury to a cause include terms like “consistent with”, “possible to occur”, “reasonable to say”, “is highly suggestive of”, or that “there might be a connection with”. However, these terms lack the strength to convince a jury that “more probable than not” the negligence or deviation in the standard of care is linked to the injury. 

The job of the expert on the stand is to portray the causation of the injury to the jury in an easy-to-understand method and to speak this opinion with conviction. The jury will then decide the facts based on how certain they are in their ability to convey their opinion so it’s important to understand the impact of the words they choose. 

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 and medical malpractice 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!