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.

 
 
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

Present Your Client’s True Functional Limitations and Get Your Case Settled in Mediation

Present Your Client’s True Functional Limitations and Get Your Case Settled in Mediation

When developing a personal injury case, the hardest thing to prove to an insurance company or jury is how the client’s accident affects their life. It’s one thing to document and prove an injury via diagnostic tests that show a disc herniation, ligament tear; etc. but it doesn’t relay how those injuries affect their ability to perform work duties, ADL’s, or leisure activities.

These “loss of quality of life” variables are only documented through a Functional Capacity Evaluation. The skilled Functional Capacity Evaluator will spend 3-4 hours with the client assessing all aspects of their ability to perform functional tasks using their upper / lower extremities and core.

Typically, when a Functional Capacity Evaluation is included on a personal injury case, it presents to the insurance company with the client’s true functional limitations which drastically helps to get the case settled in mediation. Should the case go to trial, the jury can easily relate to functional losses documented in the Functional Capacity Evaluation much more than complicated diagnostic test outcomes and pathological conditions.

brad@injuryreportingconsultants.com

 

 

Why Aren’t Your Cases Settling in Mediation?

Why Aren’t Your Cases Settling in Mediation?

One of the biggest reasons a case might fail to settle in mediation is due to improperly prepared claims. Since the mediator has little control over the preparation of each party’s case, it’s easy for either the plaintiff’s attorney or the defendants’ attorney to drop the ball. To help streamline this process and ensure that the case is moving toward a resolution, I have prepared a list of questions the mediator can ask counsel when the claim is first scheduled for mediation.

A. Have you determined all disputed issues?

B. If Applicable, Have you started working on “Medicare Set Aside” and “CMS” Approval?

C. Has “All Discovery” Been Answered?

D. Has all relevant information been updated prior to mediation?

  1. Rating(s)
  2. Restrictions, including all Functional Capacity Evaluations
  3. Causation/future treatment opinions from all physicians
  4. Medical Bills, both paid and unpaid
  5. All medical records, including any prior relevant medical records

E. Has a “Demand” been sent prior to mediation?

F. Are there any Life Care Plans or Medical Cost Projections determining future medical care and costs?

The case that includes the components above allows both the plaintiff and defense to clearly understand what is being asked for and validates the value of the case. This provides for a swift and fair settlement.

Let Injury Reporting Consultants help guide you on your next case to help make the process easy to understand and provide the value you need to help settle your case in mediation. brad@injuryreportingconsultants.com