Monthly Archives: January 2011

Insurance Company Complaint Gets Pain Management Doctor Suspended

Most lawyers handling cases involving permanent injuries and ongoing complaints of pain are familiar with the medical sub-specialty known as “pain management.” These doctors (often with experience in anesthesiology) concentrate in the management of long-term chronic pain. This is done by medication management and other methods. This is a legitimate medical specialty with its own certifying boards.
This kind of treatment is often viewed with some skepticism by insurers and juries. Anecdotally, I think this is because this treatment cannot result in a “cure” for whatever is wrong. Instead, it concentrates on making the patient as comfortable as possible by ameliorating the effects of painful permanent conditions. This leads to concerns that pain management treatment is not medically neccessary, or that it encourages drug-seeking behavior in patients.

Legitimate pain management doctors go to great lengths to establish medical neccessity, and to control concerns about drug-seeking by patients. They obtain records of past medical history, keep meticulate prescribing records, make patients sign treatment contracts, and often use urinalysis to monitor compliance. On the other hand, illegitimate pill-mill doctors have been known to omit these precautions, and will write endless streams of prescriptions for powerful narcotics, often based on nothign more than the patient’s say-so that it hurts. Most experienced personal injury lawyers have run into both kinds of pain management doctors. At least, I have.

Here is an order from the Maryland Board of Physicians summarily suspending a (not board-certified) pain management doctor. This doctor is alleged to have engaged in some of the unprofessional practices noted above.

What’s interesting is the source of the complaint- an investigator from Travelers Insurance Company.
Apparently, two injured workers in Travelers’ cases were being trated by this doctor. Travelers discovered that the doctor was not actually seeing the patients, the prescriptions were written based on the patients’ responses on a mailed form, and the payments for the services were mailed to the doctor’s home address. This was enough to get the Board to investigate, ultimately finding enough evidence about the treatment of 12 patients to justify a summary suspension.

I have never seen something like this before. Now that I think about it, I am surpised I haven’t. If you think about the volume of claims for pain management that workers compensation insurers see, you would think that it would be enough for patterns to emerge for some doctors. And it would be in the insurer’s interest to a) not pay for these claims, and b) ensure that injured workers are seen by competent doctors. Of course, it will be a cold day in hell before Travelers makes a complaint about one of the doctors it hires to evaluate injured workers giving an unsupported opinion.

Helping Clients With Multiple Disabilities

I am representing a client who has been deaf from birth. Unfortunately, he also suffers from a brain injury. The combination of the two makes communicating with him challenging under the best of circumstances.

Most of us are familiar with the process of using an American Sign Language (ASL) interpreter to communicate with deaf clients. However, I just became aware of another sort of interpreter that is invaluable for communicating with deaf clients who also have diminished or different communication skills. This is a Certified Deaf Interpreter, or CDI.

ASL interpeters are hearing individuals who translate the spoken word into sign language. However, they are not able to communicate with deaf people as effectively as another deaf person can. This is because every person signs differently, and because sign is often augmented by gestures and expressions. A CDI is another deaf person who is certified as an interpreter. They assist the deaf client in understanding and responding to the translation of the ASL interpeter. This is particularly helpful for people who have communication difficulties beyond deafness, like a diminished mental capacity.

Here’s how it works. A question is spoken. The ASL interpeter translates the question into sign. The CDI signs the question again to the deaf client, and then takes the client’s signed answer and communicates it in sign to the ASL interpreter. The ASL interpereter then translates the answer into speech for the hearing participants.

It sounds cumbersome, and it is. It certainly adds to the time required for a deposition, for example. But having done depositions like this both with and without a CDI, I can say that for the right client, it makes a huge difference in the ability to communicate effectively.

Attorneys should also know that these kinds of reasonable accomodations are required by the ADA. Not only that, but the cost of these services cannot be passed along to the client as a case expense. My experience is that the deaf are generally aware of their rights, so you should not be surpised when you receive these sorts of requests. Afterwards, you will be glad you complied. It really makes a material difference in the quality of the representation.

A Frivolous Lawsuit Story Overlawyered May Have Missed

One of the biggest names in the “legal blog” field is, primarily written and edited by Walter Olson. The site’s self-description states:
“ explores an American legal system that too often turns litigation into a weapon against guilty and innocent alike, erodes individual responsibility, rewards sharp practice, enriches its participants at the public’s expense, and resists even modest efforts at reform and accountability.”

I love the site, and read it nearly every day even though as a trial lawyer I am clearly on the other side of the debate. I often disagree with Mr. Olson, but over the years I have grown to respect the work he does. Like I said, I’m on the other team, but I think Overlawyered is usually intellectually honest. One of the main things we see on Overlawyered is sharp critiques of lawsuits seen as frivolous or unfair.

In fact, there is a piece up right now talking about SLAPP lawsuits, which are suits filed by corporate interests to silence public opposition. What’s funny, is I just saw a piece about a lawsuit like this that would seem ideal for Overlawyered. Except it hasn’t shown up there.

I am referring to this story. Koch Industries is described as a “petroleum/paper cup/carpet conglomerate.” It looks like some activists set up their own website parodying Koch Industries’ official website. The parody stated that Koch would cease funding conservative think tanks because of the positions they take on global warming. What did Koch do? It sued two Utah web hosting companies to find the names of the folks who put up the parody site, presumably so they can be sued as well. Koch describes the parody site as “a willful act of identity theft, theft of intellectual property and impersonation that extends beyond the boundaries of free speech.”

How could Overlawyered miss a juicy story like this? Well, it could be that the story is just new enough (the suit was filed Monday) that it hasn’t yet come to the site’s attention, or that it was seen and not really considered noteworthy. Or it could be that David H. Koch, one of Koch Industries’ co-founders, is a member of the Board of Directors of a conservative think tank called the Cato Institute. Overlawyered’s Walter Olson is a Senior Fellow at the Cato Institute. Some might argue that the story’s absence from Overlawyered is evidence that Mr. Olson has no interest in biting the hand that feeds him. I won’t go that far, because I really don’t know. But I do think it raises some interesting questions.

Useful Links for Personal Injury Cases

Yesterday I spent some time doing a little year-end trimming of my internet favorites list.

Like most people, I keep a fairly extensive favorites list of websites that I use (or think I will). Some sites turn out to be extremely valuable, and I use them all the time. others seem promising, but end up only being sporadically useful. I make cuts at the end of the year, taking sites that are rarely used off the list.

Here are some sites that made it onto my keeper list:
Maryland Board of Physicians: This is an excellent resource for checking the license history of treating physicians and potential experts on both sides. If a doctor you are relying on has a history of licensure issues, you need to know.

Maryland Judiciary: One of the best things about this site is that new appellate opinions are posted the day they are issued. Invaluable for staying abreast of developing areas of the law.

Maryland Judiciary Case Search: Free searching of electronic court records covering all of Maryland’s district and circuit courts. I use this as a quick and dirty background check. I run literally every person who will potentially take the stand in every one of my cases. If a witness has convictions that may be admissible for impeachment under Md. Rule 5-609, it is almost malpractice to not know ahead of time. You’d be amazed at how often I find good stuff on here.

Mapquest: I use the directions feature to compute approximate travel times. This can be very useful in trucking cases, where it may matter how far a driver traveled, in what amount of time, and whether driving time and break regulations were followed.

Vinelink and the Federal Bureau of Prisons: Both of these sites can be useful for attempting service of process. You can use them to determine if an individual is an inmate in a state or federal correctional facility.

Service Members Civil Relief Act: This site allows you to determine whether an individual is serving on active duty in the armed forces. Very useful for service of process, or for execution of a “non-military affidavit” in cases involving a request for default.
Maryland SDAT and DC Registered Organization Search: Great for finding the Resident Agent of Corporate entities.

Federal Motor Carrier Safety Adminsitration Rules & Regulations: This is great for trucking accident cases. This site features an indexed, searchable database of all of the safety regulations that commercial drivers and motor carriers are required to follow (and often don’t). An outstanding source of cross-examination material for drivers and corporate representatives.