For many DCs, personal injury (PI) is a loaded phrase they meet with a surge of apprehension.
Attorneys? Lien agreements and letters of protection? MedPay and PIP? Lowball offers and delayed payments? It’s easy to dismiss personal injury as more trouble than it is worth. But here’s the thing: DCs who crack the PI code don’t just survive; they thrive—financially, professionally and in ways that can be transformative.
What is it about PI that turns skeptics into its biggest advocates? The answer might surprise you: Personal injury offers DCs the opportunity to work with patients who stay on their treatment plan for improved health outcomes. These cases involve less paperwork than health insurance reimbursement. And, when approached correctly, PI offers the ability to be paid at or near full out-of-network rates while feeding all other practice segments.
This article explains why PI should be one of your specialty segments and provides tips for how you can increase success in this rewarding field.
Personal injury offers business advantages
Personal injury is not just another specialty. It can be the most lucrative and validating segment of your practice. Unlike traditional health insurance-based care, where treatment caps, denials and low reimbursements are the norm, PI often allows you to bill at full out-of-network rates and for treatment health insurance denies.
Skeptical about being paid in full? Don’t be. When you approach personal injury the right way—by positioning yourself as a value driver through proper intake, providing only medically necessary treatment, documenting the suffering and healing journey through SOAP notes, maintaining billing transparency and making timely and appropriate specialist referrals—you demonstrate your worth and earn every penny of your full fees. This doesn’t mean you’ll always get paid in full: Bad results, dropped patients or attorneys pushing for reductions can happen. Yet, getting all or most of your full-rate bill paid can become the norm in PI when you do it right. Your treatment, documentation and billing are the foundational support for your patient’s pain and suffering, which the attorney uses to get higher settlements. Good attorneys recognize and appreciate providers who handle PI the right way, rewarding them with full payments whenever possible.
That said, be aware that healthcare insurance reimbursements are shrinking. Fortunately, though, the financial resources available for PI cases are increasing. Many states have recently increased minimum auto insurance coverage requirements, with others planning to follow suit. That means more funds available in PI cases for patients, attorneys and medical bills.
Set yourself up for success
While you need a lot more to successfully navigate the PI space, here are three essential steps to setting yourself up for success:
Master documentation
Poor documentation by DCs is prevalent, an unfortunate truth that gives you a chance to stand out. Your treatment notes are more than medical records—they are the backbone of your payment claims and the foundation of any legal case. Attorneys rely on them to establish the existence and extent of a patient’s injuries and suffering to justify settlement demands. By ensuring your records are detailed, accurate and tell the story of your patient’s suffering and recovery, you increase your chances of securing full or near-full payment.
Mandate transparency
Too many attorneys hide too much from medical providers. The only remedy to this is mandated full transparency. If an attorney requests a bill reduction, require that they share the intended proceeds disbursement breakdown detailing how funds will be allocated. Confirm whether other recovery sources (e.g., MedPay, underinsured motorist coverage or other third-party defendants) exist. Understand your legal rights and those governing attorney ethics in your state. You might be surprised to learn that in most states, you have legal leverage over lawyers to get the information you need to make good business decisions about your bill.
Use the right lien or letter of protection
A proper lien is a contract for deferred payment. Contracts are the protection all commercial businesses use. It’s no different in personal injury. In PI, a well-crafted lien or letter of protection (LOP) is your contractual safeguard. Unfortunately, many providers rely on weak, outdated agreements. Make sure your lien and any LOP issued by an attorney include critical provisions, such as fiduciary duties to you, MedPay turnover, settlement transparency and patient payment responsibility. A solid and comprehensive lien or LOP can make all the difference when it comes time to be paid.
Personal injury allows you to lead
In many areas of healthcare, DCs are relegated to the sidelines, seen as supplementary rather than essential. Often, DCs face skepticism, dismissed as fringe or non-essential. PI changes that dynamic. Here, you’re not just part of the healthcare team—you are often the quarterback, diagnosing injuries, directing care and managing patient recovery from start to finish. Attorneys rely on your assessments to establish the medical damages determining the case’s value. Patients depend on you to restore their health and quality of life.
Indeed, PI is the only health segment where chiropractic is the leading medical specialty nationwide. So, lead that charge for your practice!
Document well
Your detailed treatment notes and professional insights are indispensable to attorneys. These documents form the backbone of their cases, establishing the extent of medical damages and enabling them to secure fair settlements. Your role isn’t supplementary, but pivotal. This leadership doesn’t just validate chiropractic—it positions you as a key medical professional whose expertise is essential in both the legal and medical communities.
For patients, the impact is equally validating. PI patients often arrive in acute pain, their lives disrupted by injuries. For many, this is their first experience with chiropractic care. Your treatment restores mobility, function and quality of life. Your medical magic is on full display for you and the chiropractic industry.
Own your new role
PI places DCs at the forefront of the healthcare recovery process. Here are three ways to own this leadership role:
Master the nuances of personal injury
PI has unique requirements for patient intake, documentation, legal processes and negotiation. Invest in education and skill development to navigate the complexities. You lead from the front.
Own your value
Don’t let outdated perceptions diminish your contributions. Highlight the critical role your documentation, treatment and billing play in determining case value and achieving settlements. Support your fees with data attorneys can use to counter adjusters and defense tactics. Doing this right will benefit the patient, their attorney and your practice. While you are a neutral medical professional when it comes to the PI case results, you are an advocate for the healthcare of your patient.
Take decisive action
Success in PI requires proactive effort. Develop skills, implement better processes and control negotiations with law firms. Leadership isn’t passive—step up, and success will follow.
Personal injury provides an opportunity to grow
PI offers three avenues for growing your practice: patients, peers and law firms.
Patients. When you deliver exceptional care, patients become loyal advocates who will refer others to your office. By educating them about your full range of services, you can grow all your practice segments.
Peers. PI fosters medical collaboration. Referring patients to specialists who accept liens or LOPs opens opportunities to educate those specialists, building stronger relationships and improving outcomes for shared patients.
Attorneys. Good attorneys value providers who deliver exceptional care, compelling documentation and defensible fees. By doing PI right, you become a go-to provider because your bills can withstand attacks by adjusters and insurance defense attorneys.
What other practice segment offers such diverse growth opportunities? With PI, you gain three distinct funnels to elevate your reputation and expand your practice.
Build relationships
PI gives you an opportunity to build a practice that’s not just bigger, but better—through relationships that truly matter. Here are three action steps for building these relationships:
Create and arm patients who are “raving fans.” When you deliver exceptional care, treat patients as individuals and “wow” them with your expertise, you create raving fans. Equip them with knowledge about all your practice segments through educational emails and testimonials they can share.
Work that peer network. PI naturally fosters medical collaboration, offering opportunities to expand your professional network. When you refer patients to specialists, their positive experiences with your care often speak volumes. Use these connections to educate peers about chiropractic’s value, strengthening relationships and opening doors for mutual referrals.
Be a value driver for attorneys. Stand out by demonstrating how you approach PI and how you avoid practices that can harm a PI case (e.g., diagramming accidents). Focus on value-driven processes like storytelling documentation, supportable bills and timely specialist referrals when appropriate. By remaining neutral and patient-health-focused, you boost settlement values, making you a go-to provider for referrals.
Final thoughts
Personal injury done right is a game-changer. Too many miss the mark without even realizing it, but when you master this segment, the benefits are undeniable—both for your practice and your patients.
Let this article be your starting point, not the finish line, to sharpen your skills, seize the opportunities in PI and transform your practice for your patients, your staff and yourself.
MICHAEL COATES, ESQ., is a California-licensed attorney. Over the last decade, Coates has established himself as a national authority on medical lien law, lien recovery and negotiations. He is a recognized innovator, advocate, coach, instructor and mentor. Having seen the good and bad in the PI business, he has helped hundreds of providers recover millions of dollars from law firms of all shapes and sizes. Coates is the US’s top lien and LOP negotiator. His company, Personal Injury Made Easy, gives providers, owners and staff a true business advantage in the PI space. Coates also has a company that serves as an outsourced lien negotiator for medical providers, personalinjurybillingpros.com. He wrote a book, Personal Injury Made Easy, to help guide providers; it is available on amazon.com. For more information, email mcoates@pimadeeasy.com.
