Give Me All You’ve Got (I’m Not Your Expert): A Legal Nurse Consultant Speaks Out!
Published On: November 3, 2009
Thanks to Guest Blogger Alice Adams, a Legal Nurse Consultant (LNC) who speaks out as to the role of the LNC in a Personal Injury Case. Pulling no punches, she tells it like it is.
This article clearly and succinctly spells out for both lawyers and lay people some very salient medical issues that arise in Personal Injury cases. I know you’ll enjoy her perspective.
Give Me All You’ve Got (I’m not your expert)
by Alice Adams, BA, RN, LNC
A common misconception is that legal nurse consultants double as expert witnesses. They do not, and you do not want them to.
As an attorney, you provide medical records to experts for their review and opinion, a process that involves your selective inclusion and omission of data. Your expert witness is limited to a field of expertise, a narrow window that allows them to render an informed opinion. An expert witness can make or break a case, but the number needed grows with the complexity of the case and so do the expenses involved.
By contrast, you only need one tenacious legal nurse to work a personal injury file.
For that reason, you need to send your LNC every scrap of data in your possession. We are bloodhounds. If you omit information, we will know it and we will track you down.
I always ask for the entire file. I will actually use very little of it by the time I have scanned once for the initial sort, scanned again to remove duplicates which I now recognize, scrutinized the remaining and highlighted what catches my eye, perusing them one more time while looking for missing data.
I will sort by provider to get a sense of the continuity of care and further narrow my focus. When I actually CaseMap the events, the picture truly comes together, revealing gaps or overlaps in care, prescribing irregularities, inconsistencies in complaints to various providers, etc.
The most relevant data will be the hardest to find. That chicken scratch that passes for cursive writing may be at odds with the typed dictation. The casual comment to the ER nurse or EMS may not be testimonial, but is no less relevant to the case.
By now, I know the records well enough that I cannot stop thinking about them, even in my dreams. Still, the pleading and interrogatory is critical to revealing the mindset of the claimant and the temerity of the attorney. I simply must have it.
As the defense, it is in your best interests for a complaint to include every medical mishap that has occurred in the life of the claimant. This opens the door to investigating all past medical care. Discrediting even one specious charge will cast doubt on those that may actually be related. It is quite difficult to arrive at adulthood in perfect health until that unwitnessed slip and fall in the drugstore.
As a plaintiff’s lawyer, be suspicious of the client who casts a wide net of complaints. You are equally prey to a nondisclosive claimant selectively providing you data (in much the same way that attorneys provide data to the aforementioned experts).
Everyone tells everyone else what they think they need to know – deciding on their own to share this thing but not that thing. This form of picking and choosing data will come back to haunt both plaintiff and defense attorneys…particularly if the opposition has a nosy LNC on the team.
Alice M. Adams, BA, RN, LNC
5555 Peachtree Dunwoody Rd, NE #251
Atlanta, Georgia 30342