Tag personal injury attorney

In this blog, I’ll be reviewing U.S. annual statistics specific to injuries requiring medical care, as well as the types of insurance claims Barber Medical Legal Nurse Consulting, LLC has the expertise to support specific to case development.  I’ll provide some common examples of insurance liability defense cases, as well as some common defenses.  I’ll close with examples of the scope of work our Senior CLNC performs specific to insurance liability cases. 

2020 Statistics:

24.8 million injuries in the U.S. require medical care

200,955 unintentional injury deaths in the U.S. annually

6 million motor vehicle accidents in the U.S. annually

40,698 motor vehicle accident deaths in the U.S. annually

87,404 unintentional poisoning deaths in the U.S. annually

Annual number of injuries on construction job sites:

1. 266,530 cases involving sprains, strains, tears
2. 128,220 cases involving injuries to the back
3. 211,640 cases involving falls, slips, trips

Types of Insurance Claims Barber Medical Legal Nurse Consulting, LLC Supports (Case Development)

• Commercial liability (business insurance)
• Personal liability (automobile, homeowners, property)
• Workers’ compensation
• Medical Personal Injury Protection (no-fault insurance)

Insurance Liability Defense Case Examples (Commercial and Personal Injury Allegations):

• slips, trips, and falls resulting in orthopedic injury such as rotator cuff injury
• automobile accidents resulting in spine injury such as “whiplash”
• injury from dental procedures such as broken teeth
• food poisoning
• nail salon injury
• injury from urogynecological interventions such as surgical mesh implants resulting in mesh exposure and erosion causing vaginal scarring, fistula formation, painful intercourse, pelvic, back and leg pains

Common Defenses for Insurance Liability Cases:

• plaintiff’s injuries were present before the incident
• mechanism of injury does not correlate with alleged injury
• condition is degenerative, not acute or traumatic
• plaintiff delayed seeking treatment after incident

Barber Medical Legal Nurse Consulting, LLC Supports Insurance Liability Case Development (Scope of Services):

• Interacts with members of each case (E.g., claims representative, defense attorney, insurance company, education division, special investigations unit for fraud or criminal investigation)
• Investigates claim
• Reviews medical documents, medical records, school, and employment records, medical bills
• Reviews police and accident reports
• Reviews photographs
• Organizes records
• Performs medical research
• Performs case analysis and report writing including development of a chronology
• Educates staff to support a successful outcome
• Submits requests for production, interrogatories, preparation of deposition questions for claims department, and defense attorney
• Attends independent medical examination (IME)
• Interviews witnesses
• Obtains a life care plan
• Identifies and locates testifying experts, and medical reviewers
• Reviews and analyzes testifying expert reports and depositions

References:

Association for Safe International Road Travel. https://www.asirt.org/safe-travel/road-safety-facts/

National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/accidental-injury.htm

United States Bureau of Labor Statistics. https://www.bls.gov/iif/

P.S.  Comment and share about your role in insurance liability case development.

In 2000, the Institute of Medicine (IOM) published a book titled, To Err Is Human: Building a Safer Health System.  Alarming statistics were revealed within this text, referencing that an estimated 98,000 people die annually in the U.S. from medical errors occurring in hospitals.  Medical errors were referenced as the third leading cause of death in the U.S.  Within the text, the IOM outlined a national agenda for reducing medical errors and improving patient safety through the design of a safer health system.  The IOM made broad range recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and the development of effective systems at the level of direct patient care. The text reinforced that the problem is not bad people in health care, rather good people working in bad systems that need to be made safer.

In 2016, Johns Hopkins patient safety experts calculated that more than 250,000 deaths annually were due to medical error in the U.S.

The U.S. DOH and Human Services, along with the Agency for Health Care Research and Quality (AHRQ) published a November, 2021 U.S. DOH report referencing strategies to reduce medical errors.

In response to the increase in medical errors, the U.S. DOH and Human Services, along with AHRQ, have proposed the following defense strategies:

• Monitor risk by using analytical approaches to patient safety research, measurement, and practice improvement.
• Monitor patient safety problems by increasing the use of research methodologies
• Implement evidence-based practice in real-world settings supported by useful tools and infrastructure.
• Utilization of patient safety strategies outlined in the National Action Plan by the National Steering Committee for Patient Safety.

Key Highlights:

• The report referenced the importance of developing learning health systems as such healthcare systems are better able to support the integration of the most current evidence to improve care.
• The report referenced the importance of analyzing healthcare data, specific to procedures and patient outcomes to evaluate safe practices and opportunities for improvement.
• The development of a learning healthcare system requires a culture of safety and a shared mental model to drive improvement in clinical practice that is outcomes based. 

To view full report, see the AHRQ.gov link below:

AHRQ.gov: https://psnet.ahrq.gov/issue/strategies-improve-patient-safety-final-report-congress-required-patient-safety-and-quality

HealthcareITnews.com: https://www.healthcareitnews.com/news/feds-point-learning-health-system-key-patient-safety

Institute of Medicine. 2000. To Err Is Human: Building a Safer Health System. Washington, DC: The National Academies Press.https://doi.org/10.17226/9728.

John Hopkins Medicine: https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

In this blog, I’ll be sharing another case type Barber Medical Legal Nurse Consulting, LLC has the expertise to review.  Workers’ compensation cases involve job related injuries that arise out of, or in the course of employment.  In workers’ compensation cases, compensation can be obtained secondary to the damages and hardship acquired. 

The claimant (employee) must be able to show that he, or she suffered impairment or incapacity resulting in an inability to earn wages he or she was being paid when the injury was sustained in the same or other employment.

Examples of workers’ compensation cases include: auto accidents, back injuries, injuries involving objects striking workers, cumulative trauma disorders, as well as equipment and machinery related injuries.

In these types of cases, Barber Medical Legal Nurse Consulting, LLC assesses the alleged damages or injuries.  The extent of injuries, damages, and hardship is assessed, as well as the presence of underlying medical conditions that could influence causation.  Factors that caused or contributed to the alleged damages or injuries are identified. 

The 21 years of experience specific to medical record review, allows Barber Medical Legal Nurse Consulting, LLC to efficiently, and thoroughly organize, tab, and paginate medical records.  We identify and review relevant medical records.  Following an objective review of the medical records, Barber Medical Legal Nurse Consulting, LLC summarizes, translates and interprets the medical records.   Strategic literature searches are performed and the literature is integrated into the case analysis.  Upon client request, Barber Medical Legal Nurse Consulting, LLC can be involved in interviewing claimants, consulting with healthcare providers, as well as coordinating and attending independent medical examinations (IME’s).

P.S. Comment and share what has been the most challenging aspect of representing worker’s compensation cases, medically, and/or legally.