Attorneys turn to legal nurse consultants to help them understand the medical issues in a case. Here are 5 things you can do to help an attorney with this responsibility and prove worth to the attorney.
1. LNCs Evaluate Medical Records
You have the ability to decipher medical records. An LNC is often responsible for initial review of medical records as a case begins. You are also expected to keep abreast of the plaintiff’s current medical status and periodically obtain additional medical records. In your review of records, you may see references to additional providers that the plaintiff forgot about or didn’t mention. You will make a recommendation of whether those records are important to get.
Typically firms on both sides obtain records from the plaintiff’s primary care physician, going back at least 10 to 15 years prior to the alleged malpractice, in order to get a sense for the client’s baseline health, especially pre-existing conditions.
It’s also important to know whether there is anything in the records which might impact the plaintiff’s credibility. The records may refer to a history of drug or alcohol abuse or troubles with the law. Prove worth to the attorney by pointing out these issues.
Failure to keep appointments may raise the defense that the plaintiff is partially responsible for his own injuries, such as failure to undergo a recommended course of treatment.
2. LNCs Obtain Medical Literature
Both defense and plaintiff LNCs may conduct an in-depth medical literature search as the issues in the case become more focused regarding the liability or damages issues. This would include obtaining peer-reviewed journal articles, excerpts from authoritative medical text books and clinical guidelines written by professional organizations. You have the ability to read what are often dense scientific papers and determine what is relevant to the case.
3. LNCs talk with Experts
You may search for and interact with experts retained to review the liability, causation and damages issues. Following completion of depositions in which a lot of additional information is obtained, both plaintiff and defense LNCs may coordinate further review and discussions with experts based on information that was revealed during the course of depositions. Typically this involves forwarding copies of the relevant transcripts to the experts and then following up with a phone conference or sometimes a meeting with the expert.
4. LNCs Evaluate the Expert’s Positions – a Great Way to Prove Worth to the Attorney
Both plaintiff and defense LNCs assist their attorneys to evaluate the deposition testimony and reports of experts. Medical experts in some states are not identified or deposed before trial.
In these states, LNCs for both sides’ attorneys review and analyze opposing sides’ “expert witness disclosure”, which is a document that’s exchanged just prior to trial which sets forth the general qualifications of the experts and the basis for their opinions but does not reveal their identity.
5. LNCs Write or Evaluate the Demand Letter
Plaintiff LNCs may be called upon to draft a demand letter for the attorney, which draws upon the legal nurse consultant’s ability to analyze and synthesize information, organize it and explain it in simple terms. This requires is a pretty high level skill summarizing the liability, causation and damages issues, before the attorney reviews it.
The defense LNC would then review the plaintiff’s demand letter and provide the defense attorney with an analysis of the strengths and weaknesses of the case along with their likely exposure (meaning the risks) if they proceed to trial.
Take Home Points
When you work with or market to attorneys, here are the key points to emphasize:
- You have the skills to read and analyze medical records, which saves the attorney time and offers a skill he or she may not have.
- You have the ability to locate relevant medical literature and to understand how it impacts the case, a skill which the attorney usually does not have.
- You can speak the expert’s language and act as an interface between the expert and attorney. This helps the expert stay focused on the relevant issues.
- You can evaluate and summarize the expert’s position.
- You can synthesize, organize and analyze the liability and damages issues.
Pat Iyer MSN RN LNCC is president of The Pat Iyer Group. As president of Med League, an independent legal nurse consulting firm, she performed these services from 1987-2015.
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