Personal Injury litigation has a great need for Certified Legal Nurse Consultants. Today’s Webinar was hosted by Vickie Milazzo and Barbara Goldstein, and we were Live on Zoom Webinar. This group mentoring activity is useful learning for providing attorney-clients with good service, and ideas for marketing to the Personal Injury Specialty.
Brief Synopsis of Events
Goldstein explains that the initial Personal Injury case review for a CLNC is typically 3-5 hours, and roughly 3-5 pages are prepared. The nurse hired for this role summarizes the pertinent elements of a case to provide quick reference materials for busy attorneys. A synopsis is used during prelitigation to get an overview, then expanded upon in the event it goes to trial. There are a range of damages covered, along with post-injury complaints. Often there is a lack of objective evidence, and a professional nurse is able to provide this with more certainty. Causation of the injury related to the event are concerns Goldstein addresses in her report, along with any missing records, any gaps of treatment and an evaluation of the medical bills. CLNC contractors would then offer an opinion and request any additional information needed in order to form a reliable recommendation.
One case review Goldstein referred to was a gentleman who rode his scooter into the elevator door and eventually died. The scooter had been recalled, and the patient had a history of trigger finger which caused the injury. This information uncovered relieved the elevator company of liability, and was a small example of how vast the needs are for CLNC in the Personal Injury Arena.
Chronologies for Trial
If the case is not settled in pre-litigation, the CLNC works to provide attorney-clients with a more in depth review. This accounts for the story of the patient’s injuries in a more meticulous way. One of the tools Goldstein used is called a chronology. This detailed review requires a more in depth study of the records, and plots on a graph to get a picture of all the remote history of the patient. This is where a CLNC service may be priceless for a case, although there are many attorneys who tend to wing it on their own. A nurse will be able to give light to potential disasters in litigation to protect their client. In one instance, Goldstein provided the information needed to exclude erroneous charges being added to the case for psychotropics the patient was already taking prior to claiming the personal injury resulted in the emotional trauma.
Some of these areas are so subjective that a nurse who understands care planning, medication reconciliation and the nursing cycle in multiple areas of health care. Attorneys could waste a lot of time trying to figure out insignificant pieces of information while the smoking gun for the case is missed due to not having knowledge of specific clinical practice or overall intuition that comes with being a nurse.
Goldstein said she likes marketing to lawyers exhibiting in person. That is because it is more beneficial to gain trust face to face. It gives an eye to eye ability to explain with personal examples how her nursing expertise comes in handy. In some cases, it is blatantly apparent to see how the use of the CLNC branch of nursing is an essential element for lawyers to be successful protecting their clients best interest. In the long run, the relevance is an issue discovered with the help of Goldstein’s practice, and legal issues are worked out to prevent wasting unnecessary expenditure when the case does not have an actual basis of causation or the damages to not match the mechanism of injury.
With the questions Vickie Milazzo presented, Golstein did not hesitate to explain the criteria she looks for when considering whether to utilize a specific CLNC as a resource and hire them as a subcontractor. The CLNC for subcontracts need to be:
- Able to perform a sample case review that provides an acceptable reference of work product.
- Able to take criticism wisely and implement, ensuring good service of attorney-client.
The Zoom webinar live stream has some glitches, with audio timing out. That can be minimized with a solid internet connection. A CLNC may try logging in ahead of time to other presentations to preview the platform and learn the layout. The drawback of trying to do so before the start of the webinar, is that it doesn’t allow for navigation until the host is logged in. It may be a good idea to try it out or look for a YouTube of using the Zoom prior to the event. This can alleviate some problems, but connectivity issues may still get in the way of watching the presentation. It is a good idea to plan on a backup, if possible, in case of any internet coverage breeches.
The content of the webinar was helpful to see the timeline of each case is unique, therefore the individual case has to be considered without using blanket rules. For example, an insurance company may argue a gap in treatment shows the additional damage is unrelated to the personal injury claim. That attempt to refute partial liability can be argued if the gap has explanation and is not a long time in between treatment, as well as the therapy being directly related to the ongoing care and mechanism of injury.
For a poetic summary, take a peak at my Nurse Becca Blog on Wealthy Affiliate.
The poem has 7 tips for chronologies that member of our online business community can learn to make a road map encouraging their referrals, and an analogy reviewed in ACLS training of 2nd degree heart block. It is meant to be amusing, not confusing. For attorneys who would like CLNC service, and if you think of any questions, please email firstname.lastname@example.org.
-R. Nixon, RN, CLNC
PS Comments are welcome and appreciated!
6 thoughts on “Live Zoom With Vickie Milazzo and Barbara Goldstein, Certified Legal Nurse Consultant Learning: Personal Injury Litigation Strategy”
Hello Nurse Becca!
I didn’t know about the role of a Certified Legal Nurse Consultant until I read your post. Very interesting. I would imagine your medical expertise is invaluable to attorneys these days. I can think of so many cases of disability fraud that could have been avoided had a CLNC been onboard from the beginning. Your examples of psychotropics really illustrated the importance for the legal community to consider CLNC assistance.
Do you have a favorite case you can share without violating HIPAA?
The HIPAA law does not truly apply to cases, because it is public information. Confidentiality is the key. We can give examples without releasing the identity of the client. Many attorneys do not mind being promoted as a colleague, and some welcome the opportunity to help build trust with social proof. There is a fine line of releasing information for monetary gain. When it is an educational exercise, many times details need to be discussed for learning. I hope this makes sense. I was a Skin Expert on a case in which the injection was improperly administered. Under Respondeat Superior, the employment organization is responsible for maintaining continuing education and verifying skills of nurses. The injection melted away a divot in the fat layer of the skin. The manufacturer of the medication also has a percentage of adverse drug events. In this case, the training for the patient would be required to document the patient understood the risk of taking the drug, what symptoms to report, and when to seek advice of professional health care providers. The way the summary is worded, the defense was quick to settle.
On another case I loved working, there were over 200 pages of state survey to review and research. Each statute cited, I looked up and consolidated into a training for caregivers to prevent the same errors from occurring and improve the quality of care. This case was my first in a new interstate compact, when New Jersey added in the okay for nursing reciprocity. It was a joy to me to comb through the records, learning and gleaning knowledge to share. Nurses can include mentoring for others without releasing any information about the individual.
Where HIPAA law comes into play, there are no games messing around. The fines are hefty, and the training is often insufficient. Liability insurance can cover some of the fines for independent contracting, if documents are discovered that have protected information. This can be at absolutely no fault of medical providers in certain instances. I think the law can be a bit misunderstood, as the information needed to provide care should be the absolute minimum necessary for that patient. Many times, a thorough history is needed, and people are not always accurate historians. Needless to say, HIPAA can compromise quality care in some regards because when it comes to care at the bedside, the background necessary is not always accessible in time to make life saving changes to a care plan.
The fragmented care in the USA can be attributed to the HIPAA threats when people are more worried about secrecy to save face and money than respect for privacy and offering the best of care. But, this is the law. When the HIPAA law first released ICD 9 codes, they related to AIDS and HIV diagnoses. It makes sense to protect people from being shunned from society due to an illness that can be prevented with the proper knowledge and practice. When ICD9 started, they had no idea they would ever run out of numbers in the system for these codes, then ICD10 was released, along with a new learning curve. The transition was not altogether smooth, since billing under the wrong code is a way of fraud, waste and abuse of insurance dollars. A small difference in the number can be an entirely different disease state, or a false billing. While this is often done unintentionally, there are always people with bad motives tinkering just to make a buck. The transition to the new coding system also made it vital for employers to show evidence of the training to ensure their workers are properly trained. But the certificate of completion is a lot different than actual practice. HIPAA officers are well aware and at times hypervigilant in over punishing small organizations who make an honest mistake. I once worked for a pharmacy and someone pput a whole bag of HIPAA protected documents into the garbage. It was a catastrophe, and ended up with a 2 million dollar fine! The small mom and pop shop pharmacy quickly closed down afterward.
I know you probably didn’t want an entire dissertation, but these are my non thesis thoughts on the issue. I truly appreciate your input, and would agree entirely that CLNC work is vital for attorneys who want to make a good impact on their client outcomes, and increase revenue for their firms.
Thank You & Kind Regards,
-R. Nixon, RN, CLNC
The role of a CLNC is really very important and the way you put it made me aware of that! I’ve never thought about it and I believe that’s because my country doesn’t really have as many cases as yours. Nevertheless, liability plays a huge role in society and everybody should be alert.
Your post is really thorough and enlightening on the topic and I’ll be giving it a thought for sure.
Thanks a lot and keep safe, nurse!
thank you for your kindness in commenting
My good friend is a RN nurse. I have not heard of her having to provide information in a injury litigation case. I would assume in today’s society that it would be an easy thing to pursue. This would be something they would be compensated for? Or would they just be providing facts of the injury itself.
Nurses can earn a significant earning when we help out in litigation. A few good relationships with attorneys will manifest a sustainable future for many of thier families, and provide a venue for nurses who are no longer able to help out at the bedside.
With Lawyer SEO research, a nurse may also be a great benefit to law firms. The competition is steep, and attorneys invest a significant portion of their revenue on endless marketing. It is not a popular attorney task to do their own targeted promotions. Furthermore, many nurses are not well-versed on what it means to create marketing material which targets long tail end keyword phrases as well as a myriad of details to attend to in order to get content in front of the right people who convert to ongoing clients for their firms. It has been one of my areas of focus to discover litigation trends and emerging market segments because this will create a wealth of opportunity.
Nursing can be strenuous both mentally and physically, and it helps to plan for the future, as well as unforeseen obstacles to financial security. After my injuries in a car accident, the at-fault driver’s insurance has made it more difficult to recover with the cover of CoVid to conceal complacency, almost to the end of passive aggressive. If they had to experience the pain in my neck, they would surely take care of the issues, such as timely rental car payment. No one plans for someone to total their vehicle, but it ruins lives. Thankfully, I have the knowledge required to work from home. It makes the spasms worse, but does not require standing for 12 hours back to back.
There are other jobs which nurses can do from home, such as health and wellness coaching, Health Care Consulting, or a number of niches related to the bedside position. With staffing shortages, all who are able are needed to put their hearts in hands on care. I miss that immensely. Last year was a hard time for many, especially health care providers. They are often scoffed for policies we as nurses did not make, and I have experienced abuse and some lateral as well as administrative violence. This has been an ongoing problem for many. It seems the cultural awareness has also built an assumption that if a nurse is not of a minority race, they are assumed to be part of the problem, and it is demonstrated in the sense that if I were obviously another nationality, this may not have occurred. They would have resisted bullying due to the risk a law suit could be for Civil Rights issues, tarnishing their brand and reputation. There is not animosity toward a single organization in my employment history, just an observation which is odd because two tribes are in my blood. As pale as you get for working long shifts, people would never know. One day burned in the sun, the next a dark tan like a California beach bunny!
Thank you for the question, yes there are pro bono tasks and questions which nurses may answer, but they put all of the years in education, service and expertise and should not work as a consultant without a healthy compensation.
I hope this helps!
-R. Nixon, RN, CLNC