Chiro Nation: What is a "Good PI Case"

I have many attorneys and doctors call me up and tell me that they “may have a good PI case” to refer to me.   I can assure you that I am very appreciative of every call.  If I could have the opportunity to sit down for 8 hours a day and take those calls, that would be a blessing. Let me help you understand what a plaintiff attorney is looking for when evaluating those referrals. These items are not exhaustive, but they are listed in order of importance.    Here you go:

 

1. An Honest Patient.    This goes without saying… but credibility is the key.   You can give me a great case that on paper looks like it is worth quite a bit, but a lack of credibility does not make it worth the hassle.  The person needs to not only be honest, but be warm and empathetic.   She needs to have friends that she has sewn the seeds of friendship with that are willing to help tell her story of hardship and how her life has changed since the traumatic car/truck wreck that changed her life.    Of course, you may have just started treating with this person, so you may not have a total handle on this character trait, but many times you have a gut feeling. 

Consistency in complaints is helpful. 

 

2. No recent history of identical injury without recovering before the wreck at issue:  I recently had a case where the gentleman I was representing was involved in a medium impact car wreck case.  I discovered during the course of obtaining his medical bills and records and a mere 5 days before the wreck, he had gone to the doctor complaining of the identical neck pain in the same area of the neck, existing for the prior 6 months.  How do you tell the 2 neck pains apart?   Which part of his pain is related to the car wreck, and which was related to the pain he experienced 5 days before the wreck that he said was “chronic?”  Even if you can show me exactly how it did get worse, then that would be what I call “courtroom proof” or, enough evidence to allow it inside the courtroom, but likely not enough of what you really need, “jury proof”, which is that level of proof to allow the jury to believe it and vote for your patient.   Now, you can certainly have exacerbations which are recoverable.   But it would certainly help the case if the exacerbations are accompanied by some type of documented anatomical change.  Without that, these types of injuries make my job very tough.  These cases are certainly winnable, and I have won big on some of them, but the client’s credibility (see #1 above) is paramount. 


3. Visible Property Damage:  It is simple.  No visible property damage cases are winnable, but they are very tough.  And the more damage, the better.  However, that is not the case with may soft tissue injuries.   A good rule of thumb is that if there is $2000 or more in property damages, that helps make it an easier case to win.  I have recently won a case with a good verdict in a very conservative venue with absolutely zero visible property damage.   It can be done, but I will tell you the defense lawyer had a picture of this pristine car enlarged to 4 feet by 4 feet.   They harped on it the whole trial.   Ask your patient to provide pictures of the property damage to you, if you can.  At the very least, they need to take pictures of their car, and preferably the car that hit them.  In rear end cases for example, the car that gets hit often does not display as much damage has the car that rammed them from behind.  A convenient trick for the insurance companies is to claim that they do not have, or did not take, or lost pictures of their insured’s car that did the hitting.  Get your patients to take those pictures if you can to help document their case.  Of course, if the patient comes to me for representation, I will take care of that immediately.

4. No LONG Gaps In Treatment:   Many people try to “tough it out” after receiving soft tissue injuries.  I write in my book that people that try to be “heroes, get zero’s.”    I always ask my clients every time I speak with them. “How are you feeling?”  If they tell me anything other than, “I feel 100% where I was before the wreck” then I ask them when is their next doctor’s appointment.   One thing that you must know about insurance companies is that “if it is not in a doctor’s note, then it never happened.”  This is especially true in soft tissue injuries.  You have to remember that if a case like this ultimately goes to trial, the plaintiff looks normal, the x-rays are usually normal, with the exception of degenerative disc disease that pre-dated the auto wreck anyway.  But gaps in treatment, or waiting too long before the first visit is very detrimental to the case.  Even after they start treating, missing appointments or not treating for a month or longer when otherwise directed or reasonable is damning to the case.  Insurance adjusters and their defense lawyers are scouring your records looking for gaps to ram down your client’s throat. 

Going to the Emergency Room by ambulance is the best scenario, just because it avoids lots of absurd questions by the insurance companylawyers.  Going the same day to the ER by private vehicle is next best.   Waiting 2 weeks to go to any medical provider is very negative in the eyes of the insurance companyand their adjusters/defense lawyers.

The “no gaps in treatment” rule can take a twist.  If a person has a very painful injury that leaves her bedridden and in great pain, it may “mask” over another injury that is significant.  For example, I have a client who had a very painful sternum fracture that left her bed ridden for approximately 2 weeks.  After that time, she began to walk for longer distances that just going to the bathroom and refrigerator.  It was about two weeks after the wreck that she noted that her knee was also hurting and somewhat swollen from the wreck.  Her first appointment with the doctor was three weeks after the wreck in which she disclosed this to her doctor for the very first time.  This was not her fault, and the doctor fully explained this type of behavior was totally reasonable.  Still, the defense lawyer tried to infer that the client was faking her injury to her knee to increase the value of her claim. 

It did not work. 

Make sure early on in treatment to ask your patients to list every single injury from their head to their toes.   Make them be through in their responses to you. 

5. No Intervening Causes:    Insurance adjusters are looking for ANYTHING they can find to cut off causation.  Let me give you a few recent examples that insurance defense lawyers and adjusters have brought up as a defense to paying claims:  - A lady slipped on her front porch which increased her back pain – A lady was lifting a 50 lb bag of dog food and her back “twisted” – A man put on his overcoat to go to church and felt a “twinge” in his neck – and the list goes on and on.   Stuff like this gets put in your patient’s notes and then the insurance company orders them and voila!   Your patient’s case is stranded on the tracks.  And how does stuff like this get in your notes?  YOU PUT IT IN THERE YOURSELF! 

I can here you say…. “But John, we have an obligation to document our files.”   Of course you do.  But your client could have told you that her hair color changed from brown to red and her shoulder started to hurt worse.   That is a bad example, but you need to address this with your client with knowledge of how it will be used against her.  If you believe that the incident she shares with you has made the pain worse, then certainly, without question, you would want to document that.  But if you think the pain is more coincidental, then you must use your own independent judgment in documenting your patient’s notes. 

There are several other important factors.  Time is your enemy in cases like this.  

If I can be of service to any of your patients having issues with the insurance company or their adjusters and lawyers who refuse to make it right, call me.  I can help.

John Griffith
Nashville Personal Injury Attorney
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