Blog November 5, 2021

Chiropractic and Personal Injury in 2022

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Hi, I’m Dr. Mark Studin, and I’d like to first thank ChiroSecure as always for giving me the opportunity to present information to you and to just share some of the knowledge that I’ve acquired through the years. So let’s get right to it. We’re going to talk today about personal injury next year in 2022, what are the changing needs of the lawyers, the courts? What are the changing needs of empties to work with you? What the referral sources need to refer to you without asking and what documentation is required. And it’s interesting this morning, I actually wrote, um, a paper, a white paper, actually. Um, and it said 20, 20 twos, personal injury solutions are found in 2021. And we’ll get to that as we move on. But before we do that, I want to just get this off the table. Colossus has been the rage in our profession for close to maybe a decade, maybe a little bit less every few years.

It seems there is a rage that’s supposed to be the next greatest coming. They get rich quick program. Well, Colossus is first Colossus for those of you who don’t know Colossus was created in the 1980s by the government of Australia to value the, um, amount given to workers that got injured on the job. And they did a great job. And Allstate realized in the 1980s that in fact, um, there were too many, um, hands-on, uh, um, um, valuations of what’s settlement offer should be, and they wanted to automate it. So they went to Australia and they purchased it from the government. They came back and they called the Colossus. Today. There is 80, 90 something, some number up there. It changes all the time versions, each carrier calls. It’s something different, stay phone calls, the teacher, et cetera. It’s real, it’s important, but it is a teeny tiny piece of the puzzle, teeny tiny.

And if you think that’s going to be the core of your referrals, you’re mistaken because I’ve lectured to, I would like to say tens of thousands of attorneys, but that’s not accurate. It’s closer to hundreds of thousands of attorneys. And I can tell you that most of them still don’t believe it’s real. They’re not wired to refer to you because you’re a Colossus provider. They’re referring you for myriad of other issues. So I get tons of people call me, I bought this expensive program. I did this. The programs are great. They’re wonderful. They do what they intended to do, but I’ll not get what you want to get, not get you to where you want to be. And let’s talk about how you’re going to do that. So in order to be the best of the stay right there, in order to be, uh, the best of the best in order to get referrals to run after you, you must be the best of the best.

You’ve got to have a business strategy. You have to have a plan. You have to be able to build an infrastructure. You have to get credentialed and manage cases. All of these things have to be coordinated because if they’re not coordinated, it’s not going to work. You need a system to manage these cases. You need an infrastructure. You need knowledge base because the key folks is to get referrals to run after you. Now that’s something that we get our doctors to do, and it’s working really well. Then someone told me never to say this number, but I don’t really care. I kind of danced to my own drummer, but as of 2012, which is nine years as of this morning, we’ve gotten 1 million, 300 and reading it off this statute, 1 million, 382,730,000 referrals in, in 49 states, additional referrals to our doctors, which equates to somewhere between 15 and 25 new PI cases per month per doctor on average.

Now, why, well, why, why did that happen? And how did I come across figuring that out? Well, unfortunately back, um, over a decade ago, my wife had cancer, not once or twice, but three times. And we had to find the right doctor for her. And I searched that I’m in New York. So we searched from Boston to New York, to Philly, to Washington to find the right doctor for it. And we actually did. And I call for an appointment. He said, well, it’s going to be three weeks. I’m sorry, six months to get an appointment, six months, say six months. You crazy. We’ll lose her by that. So I called everyone. I knew, I call friends, family, politicians, people within the hospital. And I finally found the right person. It took me about three weeks to get there. And we got her and we got an appointment.

She was taking care of. It was a five-year journey. And today she’s doing great. But the point is, is going through that. I said to myself, why don’t people run after chiropractors? The way I ran after that cancer surgeon? Why? Well, you’d say, well, it’s not life and death, but you know what? Think about some of your patients that are coming in their whole life is upside down. They can’t function. They’ve lost their life and you’re giving it back to them. So in actuality, there’s not much difference. And the answer I came up with is we’re just nothing special. What makes me special for someone to run after me or you? I mean, you’re, you’re involved in politics. Uh, you took a CE course. I mean, there’s what is there. And usually it’s personality driven and we have to take that out of the equation and off the table.

Here’s the formula. And I’m going to give you the secret. Here’s the formula. You start with building an infrastructure, your paper flow, your documentation, how you communicate, how you triage, all of that is infrastructure. And then you get your compliance data and appropriate documentation. Then you get tools which are your academic credentials. And then you create individual relationships. And those individual relationships are going to start referring cases to you. And you’re going to become the solution for the case. Now you’re at the top of the pyramid, and they’re going to see that you are good at managing the case. And then over time, they’re going to give you more referrals. And then you’re going to be seen as the solution, not just to the case, but for the practice of the MD’s and the lawyer. Yes, you’re going to help their patients, their clients, but you’re going to become their solution.

And then what’s going to happen is they’re going to start sending you second opinions, and you’re going to be, you’re going to create those types of relationships, where you going to do a, me as a plaintiff, Ima just like an IME, but on the plaintiff’s side. And then you’re going to do peer relationships and second opinions for collaborative physicians. Then you’re going to start teaching, teaching them and sharing literature with them. Then you’re going to get them their exclusive referrals. Then they are going to advocate for you to be included in there. And the bar association and the trial lawyers association. They are a little, they’re their little circle of masterminds. And then with their medical doctors and the medical organizations you’re going to become, and they’re going to be your, their advocate. They’re going to get you in hospitals and emergency rooms. That’s how this occurs.

And it works like a charm every single time, every time. So if you want to get referral sources to run after you, and when you need to be special, this Dr. Steve countable down in Florida is trauma qualified. He’s taken a certain number of courses, this fictitious person, and we just created this, um, has become a fellow in primary spine care. When was the last time a chiropractor can be coz certified a fellow through a medical school, continuing education departments by, uh, completing a certain number of courses, never. But now what we do is we have these doctors completing a certain level of academics and being recognized as a fellow and chiropractic academia also recognizes that this is what makes you different. This is the credential that they, that they look for to in fact, refer to you. What makes you different? And in order to see and understand that you have to understand how you’re going to document, what are you going to document?

What makes you different other than your credentials? It’s the knowledge base behind that? You’ve got to make an here’s the word. And here’s the key word is demonstrable. You have to make what you’re doing. Understandable. Listen, I have 30 to 40 minutes today and I want to share with you that I am not going to teach you this stuff. I’m going to expose you to this stuff. And I’m going to give you a lot. And learning from me is like taking a sip of water out of a fire hydrant on full blast. It takes a lot of repetition and a lot of stuff. I’m going to gloss over this, but I’m going to give you opportunities at the end, learn this. You have to be able to demonstrably, which we touched. You have to show it. You have to see where the spinal cord is there.

Religion. These are pain generators, the theoretical SAC. I need to be able to see that the disc itself has nerve fibers in it. Number four, myeloma elation is, is softening or, um, democratization of the spinal cord. Then you have nerve root compression. Then you have connective tissue pathology, which is strain sprain, but it’s a lot worse than most people think. And when you see, then you can identify it on the images. Then you need to create a graph and you need to document that so people can see where the pain is coming from. Nobody does this. These are the little things in documentation that was part of the pyramid going up that makes you invaluable to the attorney. That makes you an expert according to the medical physician so that they can collaborate with you. You’re going to start teaching them this stuff. So when we look at spinal cord, these are all the six things we talked about.

This is advanced documentation, along with your credentials, you’re going to start getting referrals. And that’s really, really important. So we look at documentation. I mean, look at MRI, you’ve got to understand them or I in this world, you just have to, if you’re talking about personal injury, you see this image. This is advanced documentation that a doctor actually in Texas learn, he went into an orthopedic surgeon’s office. The ortho gave him three minutes. He was busy to kiss his ring, basically because the ortho wanted referrals from him. He spent, um, I believe he told me he been 45 minutes in total. You know what? They talked about this right here, this the MRI slice acquisition sequences, identifying lesions. I mean, demonstrably. He walked out that day with eight referrals. And the first year after that, 125 referrals, you have to be to send them the neurosurgeon he went to right after that had a similar scenario.

Okay. He walked in, he talked about this type of image and this type of documentation and slice sequences. And this is an [inaudible] central herniation with fecal SAC compression, mild right canal stenosis, right quadrant, uh, quadratus, a motor loss. He walked out with 140 referrals that first year, just because he understood this stuff and the surgeon wanted to work with him. You really need to understand this. It affects your diagnosis, prognosis and treatment plan. And it’s scary because general radiologists at best have a 43.6 43.6% published error rate. And in fact, the neuroradiologist say it’s closer to 95%. So you’re delivering a high velocity, thrust into something with close to a minimum 43.6% error. But this is the core of your referrals is understanding. This lawyers don’t want fancy reports. Lawyers don’t want gift baskets and being taken out to dinner. They want an accurate diagnosis, prognosis treatment plan and incredibly well documented.

That’s what they want. This level of documentation. This was given to an attorney, simple herniated disc effecting the Eagle, sacrificing the spinal cord demonstratively documented. This took his case from $75,000 to 1.4 million settlement. And, and this was me actually nine referrals in the first two months after that, that’s just the tip of the iceberg. I got all his active cases right now, but I’m going to keep getting more. It’ll never stop because he wants this. Okay. I want an accurate diagnosis, prognosis and treatment plan. All these little things matter. You have to understand mile lock with it. That’s a biggie. Most people think it’s a muscle problem. It’s this myelopathy is cord compression with ensuing neurological deficit, distal to the level of level of lesion. You’ve got to understand that that’s a huge issue in healthcare collaboratively. It’s a huge issue when you’re dealing with attorneys and then you’ll look at myeloma Malaysia, conversely, and you have to understand what that is.

It’s considered softening the spinal cord. However, it represents cell death. And it’s highlighted here. I’m going to get fancy with high signal or bright area in here. And it can be caused from a herniated disc over time. It may cause from a myriad of things. So you see all of these little things matter tremendously because what’s occurring is, is you have to be able to demonstrably show what’s on here. Now this is a piece of technology Colts, and Virta that’s, x-ray digitizing. We’ve put little dots on the bones that are like GPS coordinates. And then what we do is we measure how the bone slide forward and back, and there is two lines here. The green means there’s pathology. Anything to the right of the line. That’s pathology, that’s that’s strength. That’s a muscle. Let me rephrase that. That’s a ligamentous sprain. I never say strain sprain, right?

I got to say, it’s not, that’s a ligament this spring. So we know this pathology here, but there’s red line as an administrative award of a whole person impairment of 25%. And you can pro-rata that. So when you’re dealing with collaborative physicians and they say, oh, it’s non-specific back pain, which is total nonsense. This is very, there’s no fracture, tumor infection or herniation. That’s what they treat. That’s anatomical lesions. This is a biomechanical lesion. Here’s your primary lesion. You’re telling me, you can see this as you know, varies. It’s very specific tells you where the problem is. So now you know how to fix your patient. There’s no more guessing. And that’s the cake, same thing. We go in the cervical spine. This is the lumbar spine again. And it’s all right from the AMA guides. And we’re looking at impairment versus pathology. Again, glossing over quickly.

Why Deere means it’s a, it’s a legal term credentials. Can you testify as an expert hearing? So when we look at this, so we look at this report, this is on Dr. Kappa ferry and Georgia. And the judge originally ruled in state court that a chiropractor is not qualified to apply an MRI. They denied his testimony in four cases. This is the third of fourth cases where the judge handed over, uh, were overturned. It judges overturned them three out of four. And the fourth word is in the judge Andrews to overturn again. And he says, Dr. CA captain ferry does qualify because he’s trauma qualified. He’s got advanced training and MRI interpretation. He has credentials both through chiropractic and medical academia. Those things matter tremendously. And the judges recognize this. This originally occurred back in 2013 in New Jersey called Lam L M B versus Allstate, where the judge to the chiropractor out.

And we, and we couldn’t get that Cairo back yet. But we created our first course back in 2013. And then the judges in New Jersey started allowing chiropractors to testify. If you can’t testify in court on this stuff, the lawyer will never work with you. That’s the end of personal injury. Cause they, they don’t start with you unless they could finish with you on the witness stand, which is an incredibly unfair because they know and you know, and I know you’re hardly ever going to get there, but that’s how they judged you. Dr. Kappa ferry spent tens of thousands of dollars for a lawyer to help him get these arguments. Overturn the case was probably only worth about five or $6,000, which he didn’t see anything of it, but he needed to do that because his career would have been over. And he understands that as most do.

So when you get your CV and you need to create it, and if you go to the U S chiropractic directory, you could create an admissible CV. It’s the only place in the world. You could do that. And it’s part of a program. Uh, it’s a directory. You get listed in a directory and you use it and the lawyers can work with you because it’s posted publicly. They can send their clients center for a lot of doctors are getting a lot of referrals, but more importantly, you’re building your CV, which you need to have an admissible CV. Most doctors have a resume and that’s good, but you need tools to put on that CV. And part of those tools are qualifying programs, get trauma, qualified, primary spine care, qualified, get MRI, qualified hospital, qualified expert, witness, qualified evaluation, a management call. But these are all academic recognitions through.

And these are all through Cleveland university in Kansas city chiropractic and health sciences. So it’s all recognized by Cleveland university, all of that matters. And if you want to go to the next step, become a fellow in primary spine care, get an F P S C after your DC. That course is recognized and joint sponsorship with the state university of New York at Buffalo Jacobs school of medicine and biomedical sciences through the office of continuing medical education in joint sponsorship with Cleveland university, Kansas city chiropractic and health sciences. That’s the pinnacle, that’s it. Once you become that fellow, it’s going to be game over for a whole lot of things, not just in personal injury, but especially in personal injury, because you’re getting a certain level of academics through a medical school, which is recognizing you without, by having you earn your fellowship. I mean, it just really, really works.

It all gels and comes together. But the other thing you need to be concerned about, and gosh, I’m going awfully fast. But another thing you need to be concerned of is documentations ups and downs, the ups and documentations you making money. The downs in documentation is holy crap. I got to do all this stuff. And if you don’t pay attention, you’re going to be served. And I mean that sincerely too many doctors are getting a knock on the door. Don’t change the page. Now change the page. Okay? Which says you’ve been served. Why? Because codes have changed and too many peoples have not stayed current. Too many people haven’t stayed current. I like working with H share Ross coding and Kira touch because they do a great job of informing you of when those codes are changing. That’s very, very important. I also like to know that if I’m going to change the code, I’m going to get paid because the carriers are denying claims on the big issue, using an outdated code.

You’ve got to use a valid code in order to get paid. And when you start cutting corners, coding is one of them. Um, you, you hurt you. You can terribly terribly, terribly injured. Your reputation and reputation equals referrals, not just with primary care MDs, medical specialists and lawyers, all of them. It helps you get paid to prevent losses. It prevents ordinance. This is the easy button for new patients is ensuring you a thorough documentation. Because if you have thorough documentation meeting all the requirements, your reputation is intact. I mean, let’s look at a little Subaru. I forgot to take that down. Let’s look at a little simple thing. Little tiny bit. You’re ready. I have no idea how to turn this phone off. So we’re just going to keep ringing.

Sorry about that. Okay. So let’s look at a documentation. Photoshop. Mary reported that she was a driver and a pink BusOp reason. Mary Jones history. Mary was a driver to pick the side that was hit from behind while stopped. Mary immediately felt pain in the neck and low back. The police arrived at the scene and Mary was taken from the hospital. Now, if you’re on the witness stand, first thing I would say is doctor, do you have a relationship with Mary? Do you have like, do you go like bat your eyes with her and do crazy things and smoke a cigarette when you’re done? And of course it sounds ridiculous. But the point is by using the patient’s familiar first name, it renders an air of prejudice. Mrs. Jones, Ms. Jones, Ms. Mary Jones, I’ve, I’m in the gamble almost 41 years. I’ve never used the patient’s familiar first name in a formal report because it’s often the little things that will destroy your reputation.

And you know what? It’s not even on the witness stand. It’s the lawyer who can refer to you is reading your report and knowing that this is what’s going to happen and they won’t want to work with you. And it’s an issue. The other thing you have to be concerned about is the sword and the shield. The sword against you with the carriers is a lawsuit. Your shield is your documentation. So when we look at it, do you take lazy shortcuts, travel cards? If you’re working with travel cards, that is the shortest way to a lawsuit, burn them, get full reports, burn, travel cards. They don’t belong in our industry. They’re very 1960s. Miss elements. You have to have certain amount of elements or time or in your report. Do you want flight time or do you have incident to support staff treating your patients when they’re not allowed to under your state scope? And do you have cookie cutter reports? They’re all the same. You know, if your initial evaluation, your ENM evaluation and management is a half a page long or a page long, you’ve cut so many corners. That’s incredible. If you’re spending less than 20 minutes with your patient on the first encounter, I’d like to say 30 minutes. You’re cutting corners. It’s just a matter of time. Oh, nobody gets in trouble. If you, no one gets in trouble. Guess what?

This is how you’ve destroyed. Not only your reputation, but your finances in your life. See, this is a part of the reading club. I read federal cases all day long. If you were served, who would you tell the answer is nobody folks. You’re not going to tell anybody it’s going to be a secret. You’re not going to sleep for five years. Okay? Your friends and buddies, aren’t telling you if they’ve got issues and a lot more people, and I don’t want you to think the sky is falling, but if you’re taking the shortcuts, those are the things that happen with shortcuts. The things that the carriers are saying, you have predetermined treatment plans that they want to go after you jointly and severally, meaning you personally as well. So what they’re doing is the carriers are aggregating statistics. 93% of the patients get the same diagnosis.

96% get the same treatment. 98% get the same. X-rays. Now we don’t have that many variations. And I like to call them treatment protocols. But it all depends on how your documentation is supporting that. And I say, oh, I’m going to downcode I’m going to build a 9, 9 2 0 1, which you cannot do the 9, 9 2 0 1 does not exist for us. We started a 9, 9 2 0 2. But even if you downcode well, this doctor down coded and they want a million dollars back and that’s plus treble damages cause it’s in federal court. So they’re asking for $3 million back because the doctor didn’t meet a certain amount of elements. And this is before the January 1st change, or it could be the time code or the time element. They want to see if in fact there’s a pattern. So you have to understand it. Look at these intake forms. I don’t know if you could read them.

I can’t. They’re crappy. Every time you share one of these copies with an attorney, with an insurance company, your reputation is destroyed and you’re going to create a compliance issue where they might bring you in. And you’re going to have to hire a lawyer or they’re going to Sue you not just investigate you, but actually go after you in court, a civil light, um, because you can’t read the elements. All of these little things matter tremendously. You see documentation is a process and it becomes begins with a patient’s first phone call where it’s a team effort where your staff starts to do intake and take information on the telephone. And then what occurs is, if you think your report writing starts, when you’re actually writing, no, it’s what your staff is acquiring information. It’s what the patient is writing down. It’s how you review all of those things.

And when we look at that stuff, now think about it. Your CA answers the phone. It’s vital for them to get information you need to decide. Are you going to accept the patient? Can I make the patient’s office experience better? Can I save time for myself and the patient? So you want to have a system now where the, the phone is going to give you a lot of that information. What if there’s no insurance and they come in and you spend an hour with them only to find after they leave, there was no insurance. So you can’t treat them and you can’t get any money from them. You just wasted an area of thought. Here’s a big issue for me. I don’t care if you waste my money, I can always waste more money, but do not waste my time. I can never make more.

Remember that. So you need a system that supports your time, because you say in personal injury from the moment that patient calls you and your staff are preparing for court. That’s what this is about. It’s personal injury. You’re preparing for court. And often, often, often we’ll get to this slide in a moment you’re kind of like a CSI crime scene investigator. You’ve got to have all this information, forensically done, times online, good, everything in order. And that’s how it works. By the way. I’ve given you a very, very, very cryptic, um, answer for personal injury. I’d like to invite you all on December 3rd, fourth, and fifth, uh, to our, uh, 12th, uh, primary spine care symposium. You don’t need the first 11. And that’s when I introduce everything we’re going to do next year. Everything it is by far the best marketing event of 2022 I’ve lectured in the past few months to, I don’t remember anymore.

Where was I? I was in Florida. I was in Georgia. I was in Colorado. I was in Texas. I was in California, actually Thursday night. I’m back in California. I was in New Jersey. Um, I don’t, I don’t, I’m like where’s Waldo speaking to attorneys and speaking to medical doctors and working with hospitals. Um, I was on the phone this morning with a hospital system. I gotta be on the phone with another one that just a little bit, but you see, you need to learn the new and there’s new magic language. How to speak to attorneys, what to give them, what documentation, when you sit with them and not with the breakfast, lunch, and dinner to bribe them, but to educate them, you need language that they understand that they speak. There are new hospital guidelines for DCA inclusions. They need Kairos in there. Okay. There are new court rulings that make PIEZ and we want to ensure that your documentation is made easy.

We want to ensure, and I also want to show you how to redirect MDs to refer to DCS first. And there’s a lot of literature out there. There’s a lot of research in the literature. I’m going to give you evidence of why chiropractic is so much more effective than physical therapy. I’m going to share with you the latest research on how and why the mechanism of chiropractic works. And to show you that there is bone on nerve, just not the nerve root. We’ve been saying it wrong all these years. There’s so much going on, by the way, you’re going to get 20 CE hours and 10 CV citations. If you got to teach, take a pen and paper out. If you’re going to teach Kairos, as, as you see on the click on the course dates on top, and you can get onto the course and share with us and have fun.

Listen, we don’t run. Get rich quick programs. We don’t, but understand something from a business perspective, Pennsylvania gets upwards of 200. And by the way, I did the research for this. So I know it’s accurate. Pennsylvania gets up to the 2 35, a visit Texas gets up to 500, a visit Michigan up to three 50 California to 10 Delaware, 400 Washington state three 15, Virginia, 300 Utah, 2 27, Tennessee, upwards of three and on and on and on it goes. So it’s an incredibly good business decision to deal with personal injury. But if you’re in a get rich quick program, oh, use this documentation, it’s going to work like magic. Use this written narrative. This it’s going to be incredible. This research report is all you need. You know, you’re going to take the lawyers out and all this other stuff. So it’s just, it’s just, um, you get rich quick, doesn’t work.

It just doesn’t work. It just doesn’t work. So the other thing I want you to share, I’d like to share with you if you’d like, um, I got that, um, is, uh, we have a consulting program and what we’ve just released actually today is a free consulting trial. If you’d like to do a consulting course with us, there’s no charge. You don’t have to put a credit card in, just email me at I’ll send you the link. It’s just easy. I’ll put my email address up in a moment. I’ll send you the link. It’s a piece of cake. I it’s just so much fun. And I really love sharing this with you. I really do a moment ago. I said you could join us in this primary spike here at 12. If in fact you watching this after December 3rd, fourth or fifth, we’ve recorded it.

It’s up there. It’s online. If you go to teach, you could find it, or you could email me. I’ll share you the link. It’s just easy. It’s just easy. So folks, I cannot believe this. I actually finished on time. I don’t know how or why I did that. Um, but if you have any questions, please call me, feel free to call me. It’s my pleasure to share any of this information with you to answer your questions. I’m a mode. Be most happy to do that. If you would like to be part of our primary spine care symposium on December 3rd, fourth, and fifth. Just email me again with Um, or if you’d like to have a free trial on our consulting better, there’ll be my pleasure. So again, I’d like to thank so much ChiroSecure and just let you know next week, Dr. Janice Hughes is presenting. Um, she’s just wonderful. And I look forward to catching you shortly. Thank you so much. Have a great day.