Documentation And Your Demand Letter

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As a personal injury attorney, how well you can help a client in dealing with the insurance company is most dependent upon the documentation that treating doctors provide to you. Like any other chain, you are only as strong as the weakest link.

With the American Academy of Motor Vehicle Injuries, my purpose is to teach doctors how to diagnose, document and manage a personal injury case. I have no qualms about repeating to my classes the importance of proper documentation and how that can make or break a case.

Jaburg Wilk

Too often I hear chiropractors complain that a personal injury attorney is nothing more than a high priced billing agency. I am always quick to correct that misconception. There are of course plenty of attorneys who dabble in personal injury and as such, lack the knowledge, experience or expertise to succeed in this arena, as well as someone who specializes in personal injury. As for the doctors who put forth that billing agency complaint, they tend to be the ones with the weaker documentation.

Winning the insurance companies’ game is just like any other game. When you understand the rules you tend to play much better and in doing so increase your chances of winning. When both doctors and lawyers understand how each diagnosis can add value to a case, provided the testing is there to support the diagnosis and the treatment is consistent with the findings, then everything that has been documented will add value.

By the same token every detail that is overlooked and not documented in the doctor’s notes or included properly in the attorneys demand package diminishes the value of a case.

As someone who observes independent medical exams (IME) and defense medical exams (DME) for attorneys I can tell you that “examination” has minimal value compared to the lack of documentation in the file that has been presented to the insurance. Having reviewed IME reports more often than not, it comes down to: “There are no objective findings to support the diagnosis,” “There are no objective findings to justify treatment,” and all too often, “There are no objective findings to indicate the need for an MRI.”

Doctors in our program understand the importance of documenting everything. They understand the value of performing the right test at the right time during care. They also understand the importance of demonstrating measurable improvement to justify continued care or the lack thereof to justify referral to the appropriate practitioner.

If we don’t provide you with the best documentation possible, then you are going into a gun fight with a pocket knife.  Dr. Bill Gallagher, DC, CMVI

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