What Forensic Chiropractors Do
The forensic chiropractor must have a solid understanding of clinical skills to perform a thorough orthopedic and neurological examination, using medically accepted references and algorithms.4-11 Use of the AMA's Guides to the Evaluation of Permanent Impairment, 5th edition12 is a must! If something is not documented (in writing), it (de facto, or "in reality") never happened. Therefore, it is imperative that the forensic chiropractor documents everything.
The legal requirements for qualifying as an expert forensic examiner witness include knowing and understanding the Federal Rules of Evidence, rule 702:
"If scientific, technical, or other specialized knowledge will assist the trier of fact (judge/gatekeeper) to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, expertise, training, or education, may testify thereto in the form of an opinion or otherwise. The forensic chiropractor (witness/expert) must be qualified by knowledge, skill, expertise, or education and assist the trier of fact to understand the evidence and determine the fact in an issue."
This is why we need to know our stuff.13 The issues of an expert's qualifications must be determined on a case-by-case basis.
What are the reasons that each judge and court will examine your qualifications in each case?
The basic common-sense rule to follow as a forensic chiropractic examiner is: If you don't feel comfortable "in your gut," refuse the case and refuse to testify.14,15,16 It is important that an expert chiropractic/medical witness understands issues raised in the Daubert case (Daubert v. Merrell Dow Pharmaceuticals, Inc., 113 S. Ct. 2786, 1993). The Supreme Court held that the trial court as the so-called "gatekeeper" under Rule 702, "must ensure that any and all scientific testimony or evidence is not only relevant, but reliable," and that there must be a "grounding in the methods and procedures." The knowledge "must be derived by the scientific method" to establish reliability, and the knowledge may be "relevant" to the facts of the case. The further you stray from your area of expertise and accepted traditional cases and opinions, the more likely you are to be found unqualified to testify. Under Daubert, a physician will no longer be able to testify to causation in these cases based solely on his or her medical degree. The forensic chiropractic examiner's methodology in arriving at the opinion will be examined by the judge as a threshold matter.
Investigative Professional Opportunities
Certified independent forensic chiropractic medical examiners (CIFCME) are currently employed as consultants and examiners in a variety of capacities for government agencies; lawyers; public and other health care providers; criminal investigative organizations; and the insurance industry. Additional forensic chiropractic evaluation opportunities are available for the investigation of suspicious chiropractic medical claims.
There is an unidentified group of health care providers who are interfering with the public's trust and right to receive competent examinations, diagnostic studies and treatment. This group represents a waste of public health care dollars being spent today.
Every person pays for the price of unnecessary health care treatment, examinations and other schemes and scams. These include abusive, overutilized and fraudulent billing procedures.
Fraud in health care may potentially be reaching epidemic proportions. This can occur in the areas of diagnostic testing, upcoding and "unbundling," overutilized or abused diagnostic procedure codes. Not only have these suspicious medical claims become an arena for entrepreneurs without any chiropractic background, they become a source of income for treating chiropractors through various "kickback schemes."
CIFCMEs offer training and health care fraud investigation for patients, attorneys, criminal investigators, government agencies, special investigative units and insurers in the following areas:
The CIFCME performs consulting services to clarify complex issues, such as impairment; work restrictions; maximum medical improvement; apportionment; causation; multifactorial causation; stability of condition; prognosis; risk factor identification; sensitivity; specificity; predictive value positive; stability over time; test acceptability; variability; regression to the mean; problems of interpretation; and predicting risk procedures for the following medical, legal, state or government actions:
References (1-3 refer to Part I)
(Editor's note: This is the second of two parts. Part I can be found at www.chiroweb.com/archives/20/13/03.html
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
