Your client has serious injuries from an automobile accident that was the fault of another driver. Your responsibility is to successfully represent your client and obtain for them the highest reward possible. The navigable waters that lie between the starting line of the initial consultation and the finish line of a successful settlement is Case Management.
Obvious vs Not-So-Obvious.
A winning smile is not one that is missing a tooth. As soon as that person smiles, it’s obvious that something’s missing. But they can still smile, talk, sing, eat, kiss, and all the other things one does with their mouth. It doesn’t affect them much.
But a missing football player is not always instantly obvious. How many times are we made aware of this after the play with “not enough men on the field” or even “too many men on the field”? Eleven men is what the rules call for and eleven men is what is needed to properly execute a winning play.
Your cases deserve and demand the same attention to comprehensiveness. A missing piece of the puzzle is unacceptable. Don’t allow one “one missing tooth” or “too few men on the field” to be the reason your case didn’t settle for what it should have.
Case management, or to be more specific medicolegal case management, is the ability to manage a medical case, from initial visit through discharge, while cognizant that the patient has an attorney and there exists the potential for a legal settlement.
Fully documenting the patient’s injuries.
Good case management involves the diagnostic work-up of every complaint, every injury, and every aspect of that injury. It involves impeccable documentation and note taking of the treatment that occurs in one’s office. It also involves the ordering and referring for all medically necessary tests, consultations, and procedures at their appropriate times. We must connect the dots between the subjective complaints, the clinical exam findings, and the objective diagnostic testing.
For example.
A patient might present for initial evaluation, two or three days after the date of accident. Typically, they’re in a significant amount of neck and back pain. If they struck the inside of the door, they might also have shoulder and upper arm pain, or hip and thigh pain. They might have wrist pain if their hands were on the wheel. They might have knee pain if they struck the underside of the dash. They might have ankle pain if their foot was depressing the break at the time of impact. These significant injuries and the associated pain require immediate attention.
The patient might also be suffering a moderate headache that is overshadowed by the other areas of pain. Upon questioning, it is discovered that the patient hit their head on something. They might have even suffered a temporary loss of consciousness. They might be feeling a little dizzy, might be somewhat confused, unable to sleep, experiencing nightmares about the accident, and might even find it emotionally upsetting to get back into a car. Some might overlook this, choosing instead to focus on the high-level areas of pain. But this presentation warrants a referral to a neurologist.
Closed head trauma with concussion can result in long standing, even permanent sequela. These injuries require MRI of the brain, EEG and QEEG. Treatment may consist of specific medication, vestibular training, biofeedback, meditation, and/or psychological intervention and treatment. To overlook these injuries with the thought that they’re self-limiting, seriously misses the boat when it comes to fully documenting all aspects of the patient’s injuries.
A network of healthcare professionals.
Good case management also involves the building and maintaining of a network of healthcare providers to whom we can refer. This takes years of relationship building. A doctor who has built an extensive network of healthcare providers to treat every possible type of auto-related injury can be invaluable to the attorney.
The doctors and facilities to whom we refer most, and those that have taken years to develop are:
Pain Management Orthopedic Surgeon
Physiatrist Neurologist
Neurosurgeon Imaging Center with Neuroradiologist
We also have relationships with, and on occasion refer to:
General Surgeon Podiatrist
Wound Care Specialist Physical Therapist
Dentist Occupational Therapist
Maxillofacial Surgeon Durable Medical Equipment
Psychologist Pharmacy
This network of healthcare providers is not merely a list of a few doctors from each specialty. Far from it. Everyone in this network fully understands how to treat auto-related injuries and more specifically, how to properly handle the medicolegal aspects of a motor vehicle accident. Even more importantly, their office staff understands the specifics and challenges of auto insurance. This network is a team and as a team, we work best when we all work together. This means working together for the benefit of the injured patient and of the attorney who is representing them.
Upon Discharge.
Good case management involves much more than discharging the patient at the appropriate time. Good case management, as it relates to discharging the patient, involves:
- The ability to state what injuries failed to appreciate recovery to a pre-injury status and are now permanent.
- The ability to state that the injuries were causally related to the accident for which the patient presented.
- The ability to address any prior trauma that may or may not have resulted in permanent residual injuries and how they may or may not have impacted the outcome.
- The ability to address any pre-existing conditions and whether there was any exacerbation, aggravation, or worsening of those conditions.
- The ability to partition any prior injuries from those from the current accident.
- The ability to state with a reasonable degree of medical probability whether there was a permanent loss of function.
- The ability to address and state the impact of any permanent injury on the patient’s activities of daily living and their quality of life.
Final
And finally, good case management involves the preparation of a final narrative report along with copies of all office notes, diagnostic reports, consultation reports, and any additional medical procedures.
If you need a guide to help your client through the journey from start to finish, then let us be your guide. With proven medicolegal case management skills, we can navigate your case and guide your client through the murky waters of auto insurance and deliver them to your safe harbor.
