14 hours ago ABC Auto Insurance PO Box 111 Suisun City, CA 11111-0111 Patient: LAST, FIRST Claim Number: 00-12345-6 D.O.B.: 01/01/1940 Date of Injury: 03/28/2006 CHIROPRACTIC MEDICAL-LEGAL REPORT Dear Mr. Adjustor, This report is submitted as the final report regarding injuries sustained by First >> Go To The Portal
Our Research Section includes clinical research trials discussing the impact of chiropractic on a wide variety of visceral and musculoskeletal conditions. There are also articles discussing the difficulties of designing an inert placebo for manual care trials.
The therapeutic goal is to maintain function and prevent or minimize sequelae. There is limited research on spinal adjustment for inflammatory diseases and even scarcer wherein symptoms are related to rare diseases like DM. Further research to better clarify the role of chiropractic is necessary.
The Amelioration of Symptoms in Cervical Spinal Stenosis with Spinal Cord Deformation Through Specific Chiropractic Manipulation: A Case Report with Long-term Follow-up J Manipulative Physiol Ther 2004 (Jun); 27 (5): e7 ~ FULL TEXT.
Chiropractic Management of the Kinetic Chain for the Treatment of Hip Osteoarthritis: An Australian Case Series J Manipulative Physiol Ther. 2010 (Jul); 33 (6): 474–479 ~ FULL TEXT Four patients diagnosed with hip osteoarthritis had decreases in WOMAC scores and increases in hip range of motion after chiropractic management.
If you do any PI work in your chiropractic practice, it’s likely your patients have (or will) receive a letter from personal injury payers that can have several potentially disastrous effects on your patient’s care, your claims and, ultimately, the reimbursements you receive for your hard work.
Chiropractors need to educate their patients on how to navigate their PI claim: In a perfect world, your patient would be free from any financial conflicts of interest and allowed to focus on getting well. Obviously, in today’s marketplace, this is not the case.
personal injury patient should be asked to list previous traumatic accidents with a short description of any injuries, and the resolution of those injuries (if any). Injuries include more than automobile accidents, such as traumatic sports injuries, workers' compensation injuries, and others. Automobile insurance companies communicate with each other, and are well aware of other injuries. Asking and clearly stating previous injuries shows that both the doctor and patient are honest and truthful, important qualities of any witness at trial.
This seminar specifically focuses on the personal injury narrative report, by teaching and demonstrating the degree of competence necessary to prove a personal injury case to both claims adjusters and in court, avoid negligence, and being able to prove that no insurance fraud has occurred. This material is the game plan for correctly and competently handling personal injury cases. This material is the nuts and bolts of personal injury, presented clearly and concisely. It is a roadmap for showing the doctor the information needed to be obtained from the patient pertaining to the history, physical exam, radiology, management, and treatment of a personal injury case. This seminar is unlike most other personal injury courses and does not focus on the scientific research or justification for doing what is done in these situations. Instead, it is based on courtroom and other experience as a full time practicing personal injury attorney at law in rare combination of practice as a doctor of chiropractic. This seminar explains what needs to be done when handling personal injury cases and excludes what is not necessary.
Way back in chiropractic college, what was usually taught in regards to taking a patient history was to ask for a chief complaint and additionally other complaints. Although that is appropriate for most situations, it is inadequate for a personal injury patient.
The patient was the driver of a 2011 Honda Accord wearing her seat belt and shoulder harness, stopped due to traffic conditions. Just prior to impact, she was looking up at her central rear view mirror with extension, right rotation, and also possible right lateral flexion of her neck. Both hands were on the steering wheel and her right foot was on the brake pedal, when she was suddenly rear-ended with a moderate speed impact. She was aware of the impending impact, as she stated she felt horrified and in fear when viewing the fast approaching vehicle that struck her car in her rear view mirror.
In general, this is because it is assumed that something (a given fact) didn't happen when it is not expressly stated. Even when two given diagnoses are partially redundant, it is much better to state both as compared to just one of those diagnoses. Providing less information than the whole picture conveys the idea that a patient is not injured as badly as they actually are.
It is extremely important to obtain chart notes from other health care providers that a patient has seen for a personal injury accident. The doctor needs to be aware of any potential problems in additional to other possible issues. These chart notes from other providers may shed light on other aspects of care and the narrative report, such as diagnoses. This is also further proof of a doctor performing their duties in a competent manner.
Complying with the State of California Chiropractic Act and its associated Rules and Regulations generally speaking is not hard to do . More often than not, compliance involves thinking before doing, and having enough common sense to know when to read the Act, Rules, and Regulations when being suspicious that a given course of action might be at issue. Fortunately, most chiropractors are blessed with a high degree of common sense.
Immediately following the accident, the patient's main complaints included neck pain and stiffness, pain in the low back, fatigue, and pain in the upper back. Following the accident Mr. Sample drove himself home.
Sample indicated that he had not experienced prior symptoms similar to his current complaints, and was symptom free at the time of the aforementioned accident/onset of May 1, 2007.
Mr. Sample has no current complaints. His Oswestry Neck Disability Index, his General Pain Disability Index, and his Visual Analog Pain Scale scores have all been reduced dramatically.
Though he is not in pain currently it is possible that Mr. Sample may have some minimal residual effects from this incident that may require some occasional additional care, especially in the cervicothoraco junction (C6-T1), and the lower lumbars (L4-L5). These areas will likely be prone to reinjury and onset of traumatic osteoarthritic type conditions. Overall , Mr. Sample appears to have done remarkably well in healing his injuries. He was conscientious at keeping his appointments and following instructions for his care. I could not have asked for a more compliant patient. I believe we have achieved most of the goals of the treatment plan. Currently, he is doing well and is released from my care at this time.
The test is positive when the action causes radicular pain on the side of the flexion and rotation.
The examiner, actively flexes each thigh slowly while holding the other hand on the knee to prevent its flexion. The leg is lifted 90 degrees or until pain prevents further motion. The final angle of flexion at which pain occurs, as well as the location and intensity of the pain are noted by the examiner.
Kemp's Test , which usually confirms fracture, facet syndrome, or disc involvement, was positive on the left side. This test can be done with the patient standing or sitting. While stabilizing the pelvis, the patient's shoulder is firmly forced obliquely backward, downward and medialward.
The patient is told to walk on the heels several steps forward, then back the same way. If the patient has low back complaints and is unable to perform this action because of either pain or weakness, the test is considered positive. The Toe Walk Test was positive.
If this produces pain over the sacroiliac area, the test is positive. Lewin-Gaenslen's Test, which usually indicates a Sacroiliac joint lesion, was positive bilaterally. In this test, the patient lies on one side and pulls the knee of that same side up to the chest, while extending the other thigh.