Medical and Legal Symposiums
Tuesday, October 18
International Academy of Independent Medical Evaluators (IAIME) Module
Medical Causation in Litigation: Application of Evidence-Based Principles to Common Workplace and Motor Vehicle Crash Scenarios (3.25 credit hours)
Since 1986 and now celebrating their 40th year, the International Academy of Independent Medical Evaluators (IAIME) -formerly the American Academy of Disability Evaluating Physicians (AADEP) – has developed educational materials and courses for medical professionals, the insurance industry, the legal field, and governmental organizations. Their course work covers a wide variety of professional skills such as disability and functional capacity evaluation to determine the physical demands of the various Categories of work, based on the Dictionary of Occupational Titles (DOT); proper techniques to perform impairment ratings based upon the various editions of the AMA Guides to the Evaluation of Permanent Impairment, apportionment, relatedness, return to work process, and societal issues of the disabled worker.
In keeping with their mission to advance the science, prevention, evaluation, and management of disability, this IAIME course is designed to teach attendees how to apply the current evidence based medicine tools, techniques and procedures, to sort out some of the most common yet sometimes seemingly complicated injuries that accompany a MVA – the Low Back and Shoulder. Taught by top veteran disability evaluators and experienced faculty, this course is sure to enhance your skill set in handling such cases medically and legally.
Nudelman and Associates, LTD Module
Fraud & Abuse in Litigated Medical Claims - Where is the Line?
(3.0 credit hours)
Lien based medicine is the newest twist to the need for medical services, treatment and charges in WC, Liability and many other litigation settings where medical billing is involved. While in the past unnecessary medical care by providers was kept somewhat in check by the prospect of he charges not being paid. With Lien Based Medicine, that hurdle now often no longer exists. But who controls the quality of care or manage the costs under this new way of paying?
1:10 – 2:10 pm - Session I
Workers Compensation: A Comparison of GA & FL's Available WC Fraud Remedies
There are many aspects of WC cases that are distinct to that forum, as the overwhelming majority of WC cases are generally litigated to final resolution in the administrative legal forum. While everyone knows claimants caught working at a construction job while drawing catastrophic benefits gets busted if busted, but what about the more subtle cases? In Georgia, the Georgia State Board of Workers Compensation has an Enforcement Division, but stakeholders in the system say that it has no “teeth”. Since the criminal system is overwhelmed with other more pressing matters, referral to the Attorney General or other law enforcement is not likely to result in prosecution for fraud against a physician for lying at a WC depo, or a claimant found not to have had any head injury, even though that is the basis of their claim.
Why are things so different than in Florida? In the Sunshine State, the same fact pattern that gets nowhere in Georgia can result in the barring of the entire WC claim. How does the Major Contributing Cause language of the FL statute make a difference in the outcome? What happens when a psychologist give a diagnosis of probable malingering, and is that sufficient to establish WC fraud? Aside from the enforcement division, is there any other civil remedy available to an employer? Is there anything that you can do to prepare a case for referral to the Georgia WC Enforcement Division? What is necessary to prove the case? What are the red flags that one managing the claim can do early on, to look out for “straw clinics” or medical treatment “mills”? What about the DEA or state departments of drug enforcement when diversion of narcotics or other drugs valued on the street is established?
2:15 – 3:15 pm - Session II
MVAs and Other Personal Injury
From staged minor impact accidents, complete with multiple dubious injured parties treated at “Straw Clinics”, all the way to surgical and other invasive treatments for MRI findings and indications that simply do not exist, learn strategies for how to combat these claims. Absent fee schedules learn a new approach of settling based upon usual & customary payments of medical treatment, instead of charges. Is software enough to identify upcoding and unbundling, especially in surgical procedures when unscrupulous parties are involved? Is there such a thing as “Advocagenic Injury or Illness”? What role do pseudo-experts holding pseudo credentials, contribute to the problem and what can be done to expose them? Is lien based medicine a blessing in disguise – or not so much?
3:35 – 4:35 pm - Session III
Georgia State Board of Medicine - An Ethical Alternative Recourse for Fraud and Other Unprofessional Conduct
Hear directly from both Chairperson John S. Antalis, MD, DABFM and Executive Director Bob Jeffery, MBA of The Georgia State Composite Board of Medicine. Ask them your questions.
How many times have you asked yourself "How is this possible?" when you see the same doctors, doing things that your medical consultants tell you does not meet the minimal standard of care - over and over - and it seems like there is no way to stop them. Not so!
According to the Medical Practice Act, unprofessional conduct for which a licensee may be disciplined includes "any departure from or failure to conform to the minimal standards of acceptable and prevailing medical practice ..."
What constitutes Unprofessional Conduct (Rule 360-3.02 and 360-3-.04) and what does not.
How Rule 360-3-.02 Unprofessional Conduct Defined - (19) Providing a false, deceptive or misleading statement(s) as a medical expert can be reported to the Board of Medicine.
About inadequate record keeping, and practicing outside the scope of one's license as a basis for a BOM complaint.
How failure to comply with Board Rule 360-3-.06 for Pain Management can result in discipline, and possibly loss of license to practice.
ACLM: The Fundamentals & Ethics of Medical Experts & their Use in Evidence:
“This Is Not the Era of Your Father’s Expert Medical Witness Seminar”
(3.0 credit hours)
This Seminar is intended for Maximal Group Participation, so bring your experience, your stories, your opinions and your attitudes with you, and share them. We will address the following themes, not necessarily in this order:
A Brief Review of the Relevant Statutory Law, including Federal Law and the Law of the State of Georgia.
A Review an Discussion of Trial Techniques Governing the Testimony of Expert Witnesses
A Discussion of How, Why and Under What Trends andInfluences the Scope of Expert Medical Testimony is Changing, and How It Can Help or Hinder You
Presentation of Cases Demonstrating the Changing Scope of Expert Medical Testimony. And Why Medical Malpractice Trials are going the way of the Ink Pen, and why they are not.
Cases Demonstrating that “This is Not the Era of You Father’s Expert Medical Witness”
A Shocking Induction into a College Fraternity
A Threat Upon the Life of the President of the United States of America
Somebody Stole My Bones
Love and Marriage and Divorce and Alzheimer’s Disease
Wonder Where the Yellow Went?
The History, Ethics and Jurisprudence ofExpert Witnesses, Medical and Otherwise
Abundant Syllabus Material has been prepared for this course and will be distributed on CD to registrants. If you have a laptop with a CD Drive, bring it with you. The Organizers will serve as facilitators for what we hope to be a lively and memorable group learning experience.
Wednesday, October 19
American College of Legal Medicine (ACLM) Module
The Art of Choosing Medical Experts in Malpractice Litigation -
Advanced Level Tips (3.25 credit hours inc. 3.0 Trial and 1.0 Ethics)
Enjoy this unique interdisciplinary exchange of ideas and information, between those in the healing arts and legal professions, providing the attendee new insight into the selection process of medical experts. Over the course of the three sessions, learn how to appreciate the differences of what factors are most important and how they drive the process of which expert is chosen, and what Ethical Guidelines exist, that may be used to buttress or impeach and expert witness. Hear about what can go wrong if you let it, and how you may be able to prevent that from ruining your case. Listen to the outcomes of litigation over issues involving Expert Witnesses. http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/expert-witnesses.page We will flip a coin to see if the defense or plaintiff side goes first!
9:15 -10:15 am - Session I (60 min. inc. 10 of Q&A)
What economic constraints, limitations of the available pool of medical experts and other factors distinguish the needs of the plaintiff attorney? Local or out of town? Professor or Community based physician? What education, training and experience is the most important? What are the fatal credential flaws that rule out an expert? What should you expect to pay for a credible and reliable expert medical opinion? How can you reduce the cost – or can you? What is lien based medicine and what are the good, bad and perhaps ugly things a malpractice attorney should know? How can you turn the defense expert into one for the plaintiff – or is that just on TV?
10:20 – 11:20 am - Session II (60 min. inc. 10 of Q&A)
Why does it seem that the defense rarely has a problem in retaining highly credible and reliable medical experts? Is it just a way for the physicians to circle the wagons and protect each other? How do defense malpractice attorneys seek out their experts? Local or out of town? Professor or Community based physician? What education, training and experience is the most important? What are the fatal credential flaws that rule out an expert? What should you expect to pay for a credible and reliable expert medical opinion? How does the defense evaluate the reliability and credibility of the plaintiff expert?
11:40 am – 12:40 pm - Session III (60 min. inc. 10 of Q&A)
Ethical Conduct of the Expert Witness
According to the AMA code of Ethics, Opinion 9.07 - Medical Testimony, “…in various legal and administrative proceedings, medical evidence is critical. As citizens and as professionals with specialized knowledge and experience, physicians have an obligation to assist in the administration of justice.” What are the Ethical Rights and Responsibilities of the Expert Witness? Who else sets ethical standards for medical and psychological experts and what weight do they hold? Can they be enforced and if so how? Learn about some cases that involved the Ethical conduct of an expert.
http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/litigation-center/case-summaries-topic/expert-witnesses.page; http://aapl.org/AMA_expert_witness.htm; http://c.ymcdn.com/sites/aclm.site-ym.com/resource/resmgr/Docs/ACLM-Expert-Witness-Guidelin.pdf
Joint ACLM and IAIME Module
Early Recognition and Management of Traumatic Brain Injury Cases That Didn't Seem So Traumatic
1:10 – 2:10 pm - Session I
Head Trauma, Traumatic Brain Injury and Post-Concussive Syndrome
Understanding the Terms of Art that distinguish head trauma from Brain Injury is critical to the proper management of a head injury claim. What imaging is appropriate, at what point and how often? What impact do things like loss of consciousness (LOC), lump on the head or the Glasgow score have upon the prognosis? Why does the Post-Concussive Syndrome diagnosis seem so prevalent in cases of Minor Head Trauma? How long should it last?
2:15 – 3:15 pm - Session II
The Nuts, Bolts and Application of Neuropsychological Testing: What It Can and Cannot Accomplish for Your Case
While neuropsychological testing can be costly and take significant time to accomplish and interpret properly, it can be a treasure trove of objective measurement for cognitive impairment. Learn how the testing is validated, and why that is so important in identifying those who are not giving a good and be perform, and what can you do to help make them choose the ones most likely to yield the information you seek in the case? What records and other information help the neuropsychologist to do the best job? Be surprised to learn how much pre-existing chronic depression or anxiety disorder can result in cognitive impairment that is unrelated - and far greater in magnitude - than any resulting from a given brain injury. Find out how pre-injury IQ affects outcome and the degree of cognitive impairment that results. What to know about medications and neuropsychological testing?
3:35 – 4:35 pm - Session III
The Dual Benefit of an Early Assessment Program: Maximize Outcome of Brain Injured Patients and Defend Embellishment of Claims
So what kind of program can be implemented to assist in identifying those who are likely to have had a significant brain injury, and get them the early and best medical intervention? Perhaps, for example at a at a large school system where student athletes and coaches, kitchen and maintenance workers, security guards and police officers, all may have on the job or at school head injury ? How and why might this same best practice program assist later in ruling out claims that are embellished or outright fraud/malingering? What might such a program look like, what providers would be involved and how much might it cost?
IAIME: The Nuts & Bolts of Effective Medical Expert Report Writing
Topics, subject to change, include:
Analyzing the Needs of the Referring Party and Questions Posed
Contents of the Well Prepared Medical Record File
Plaintiff vs. Defense Clients: What Each Looks For in a Report
Personal Injury vs. Workers' Compensation: Differences in Report Structure
Contents of a Well Written Report
The Importance of Independent Viewing of Imaging Studies (if Applicable to the case)
Remuneration and How Referring Parties Determine Value