Forensic Chiropractors

Being involved in legal cases as a forensic chiropractor can be intellectually stimulating and financially rewarding

Each year thousands of attorneys, insurers, and self-insurers are involved in the litigation of Workers’ Compensation, personal injury, social security disability, long-term disability and short term disability cases. In many of these cases, chiropractors can and do play a significant role. Being involved in legal cases can be intellectually stimulating and rewarding in other ways as well.

At the present time, our legal system, jurors, attorneys, and judges appear to be significantly biased against the chiropractic profession. However, chiropractors can overcome these biases if they are well-trained and:

1. Always tell the truth.
2. Never compromise their integrity.
3. Understand medical/legal issues and the civil litigation process. 4. Only testify regarding issues with their area of chiropractic expertise.
4. Are sure to support their opinions with as many objective findings as possible.
5. Draft high quality IME and narrative reports.
6. Learn to be effective in direct and cross-examination.

What is Forensic Chiropractic?

Forensic chiropractic is a science that deals with the relation and application of chiropractic facts to legal problems. The term forensic chiropractor refers to the chiropractic professional who performs an orderly analysis, investigation, inquiry, test, inspection, and examination in an attempt to obtain the truth and from which to make an expert opinion.

A forensic chiropractic examination would refer to that part of the chiropractic professional’s practice that is carried out to provide an expert chiropractic opinion.

Forensic chiropractors do not “win” or “lose” cases. Forensic chiropractors conducting examination seek only the truth and conduct evaluations, examinations and inquiries, and report the true results of their findings in an unbiased and objective manner.

Eight Forensic Chiropractic Skill Sets

The forensic chiropractor examiner should:

1. Possess all the necessary chiropractic skills and training in physical, behavioral, psychological, and occupational assessment.
2. Draw upon in-depth experience to perform credible evaluation.
3. Provide thorough, objective, written analysis regarding diagnosis, causation, prognosis, maximum medical improvement, impairment, work capacity, appropriateness of care, and care management.
4. Testify as an expert witness.
5. Recognize the value of impartiality and thoroughness in case evaluation.
6. Strive to conduct timely, cost-effective evaluations.
7. Abide by a guideline of conduct and ethical practice.
8. Exhibit commitment to professional excellence and integrity.

The Preferred Chiropractic Consultant

In 1996, a detailed three page, chiropractic skill set survey was completed by 1,000 insurance companies, managed care groups, adjusters, medical, and plaintiff and defense claims lawyers. The results indicated that their choice of chiropractic consultant would be the chiropractor who had formal forensic skill set training in the following areas:

• Effective in direct and cross examination.
• Understand the civil litigation process and medical/legal terms.
• Prepare for depositions and trials.
• Write an excellent IME and narrative report.
• Utilize effective and dignified marketing approaches to increase referrals.
• Able to assess and avoid common errors in impairment evaluation.
• Qualify as an expert chiropractic witness.
• Able to assess and explain the complexities of chronic pain.
• Able to appropriately deal with trick questions and trial tactics.

Additionally, the respondents indicated they would be more likely to use the trained forensic chiropractor examiner who:

1. Teaches at legal seminars, chiropractic seminars, and/or insurance meetings.
2. Writes for legal, chiropractic, and/or insurance publications.
3. Advertises in legal trade shows, on-line forums, and web pages.

They are least likely to obtain the services of a chiropractor who:
Only advertises in the Yellow Pages, local business ads or display ads.

The most sought-after chiropractor from the survey results were those DC’s who received formal instruction from an American Trial Lawyer Association member, Certified Independent Medical Examiner trainer, and a nationally recognized Independent Certified Forensic Chiropractor Medical ExaminerTM with extensive courtroom experience.

The medical/legal/insurer field is seeking chiropractors to perform the following forensic services:

• Independent Medical Evaluations.
• Functional Capacity Evaluations.
• Review medical records for plaintiff and defense.
• Case management assessment.
• Provide affidavit for medical malpractice cases.
• Appropriateness of care.
• Assist with question preparation for depositions and interviews.
• Standards of care assessment depositions and interviews.
• Treatment decision-making.
• Provide expert forensic chiropractic witness testimony.
• Impairment and disability decision-making.
• Review expert witness testimony assessment.

The Mission of the NBOFC

The National Board of Forensic Chiropractors, Inc.TM was created to promote competency in the chiropractic professional’s ability to perform detailed independent forensic chiropractic examinations and to succeed and be recognized as an expert chiropractic witness.

The NBOFC anticipates that through a disciplined, unbiased approach to forensic determination of impairment/disability/investigative/expert witness consultation, requesting agencies such as the federal government, Social Security, workers’ compensation boards, insurance companies, investigative agencies, attorneys, medical directors, the legal profession and individual patients will week out the Certified Independent Forensic Chiropractic Examiners.

We support the concept that through this approach, a new, recognized specialty of the chiropractic profession will emerge and become an integral part of our medical/legal system.

Statement of Purpose

The purpose of our training protocol is to provide the forensic chiropractic profession with proactive strategies to adapt in order to survive and prosper in the new and rapidly changing health care environment of today and tomorrow.

Our aim is to present a practical agenda, which, if followed, will:

1. Enable forensic chiropractors to penetrate the competitive medical/legal marketplace and become recognized as an expert witness for complex medical/ legal cases­­ providing a spectrum of forensic services capable of dealing with a variety of medical/legal issues.
2. We will identify forensic consultation opportunities and provide strategies and programs for turning these opportunities into immediate and long term revenue.

Strategic Forensic Marketing

This refers to the edge you hold over your marketplace with others that provide a similar service. This edge may be in the quality or work, timeliness, technology, particular expertise, availability, and general reputation, experience, or some combination of all. It is the service that you provide that sets you apart from all other chiropractors.

Peter Druker, considered as a renowned management expert, said it appropriately in his book The Practice of Management,” Any business enterprise has two, and only two, basic functions, marketing and innovation. Marketing is the distinguishing, the unique function of the business. A business is set apart from all other human organizations by the fact that it markets a product or a service. Neither church, nor army, nor school, nor state does that. Any organization that fulfills itself through marketing a product or a service is a business. Any organization in which marketing is either absent or incidental is not a business and should never be run as if it were one.”

The NBOFC Training Certification

Training seminars are being developed and refined to increase the skill sets of those chiropractic professionals who are willing to put their reputations and credibility at risk each time they undergo cross-examination. Training seminars by the NBOFC will instruct you in:

Your roles as the independent forensic chiropractic examiner in the claims process and legal arena, which includes discussion of the legal, ethical, and practical day-to-day challenges faced by independent forensic chiropractic examiners.

How to make your report your best marketing tool. What insurers, self-insurers, fact finders, and attorneys are really looking for in workers’ compensation, personal injury, and disability IME reports.

The attributes of a detailed IME report, the secrets of perfecting the IME, and techniques to enhance your ability to prepare a high quality report in a minimum of time without the “canned” look. What is required in an excellent IME report, and how the report should be structured.

Key aspects of preparing a quality report that will withstand legal scrutiny. Demonstration will show how an excellent report can ease the taking of expert testimony and how your report can be used by an attorney to impeach your credibility during cross-examination.

How to assess pain with an efficient multiaxial approach to assessing the complexities or chronic pain. Symptom magnification and malingering is discussed. This includes the use of medical records, history, assessment of the non-physiological and other behavioral findings, pain drawings, and others.

How to minimize chiropractic risks involved with the independent forensic chiropractic examination. Practical, specific suggestions are provided on how to minimize these risks, including use of specific office policies, release forms, wording your reports, and appropriate management of the threatened actions.

Legal requirements for qualifying as an expert witness including the special knowledge requirement, factors impacting qualifications and preparation.

The key “magic words” chiropractors must be familiar with. These include the terms of possibility, probability, causation, aggravation, exacerbation, recurrence, new injury, impairment, disability, standard of care, “to a reasonable degree of certainty.”

What every chiropractor should know about the civil litigation process including depositions, subpeonas, interrogatories, discovery, protective orders and judgments.

Why depositions are taken and how deposition testimony differs from testimony taken at trial.

How to maintain your honesty, integrity and credibility while participating in an adversarial judicial system.

The most effective responses to questions by counsel concerning appropriate use, new appropropriate treatment, the extent and duration of treatment, continuing a supportive maintenance, preventive care, and chiropractic necessity vs. convenience.

Trick and difficult questions chiropractors face and techniques for answering them without compromising your integrity.

How to deal with repetitive, abusive and invasive questioning, disregard for personal comfort, unreasonable time constraints and how to deal with “tough questions.”

We encourage you to join and support the NBOFC in it’s nationwide marketing of the forensic chiropractic specialty. We are recruiting leading chiropractic professionals to train and refer to the various medical/legal entities that have responded to our survey.