William Cockburn,D.C.
by William Cockburn, D.C.
1. Inconsistency in Doctor's Narrative Reports: a) Diagnosis does not support treatment rendered. b) Objective testing not performed to support or quantify clinical findings, c) No repeat of initial intake findings which were positive to determine factual status at MMI, d) No statements with reference to clarify positive finding affects on activities of daily living (work, home, recreational), e) Little if any correlation between forensics of trauma and injury, f) Very little summary correlation of findings - (many findings are simply stated with no expression of there application to the specific injury at question) g) Assumptive Prognosis with no basis or insupportable argument about tissue repair processes (Murphy Model) h) No MIC rating to support prognosis (Foreman and Croft Model) I) Findings which indicate Whole Person Impairment with no testing to determine impairment (AMA injury model) j) Inappropriate prior histories to link causation accurately
2. Inappropriate Utilization of Diagnostic Testing: a) Testing performed with no basis, b) Expensive procedures performed with high degree of false negatives {MRI, CT} - the non-weightbearing argument, c) Testing performed for the wrong outcome assessment purpose {i.e.: EMG for sensory nerve when CPT or SSEP's are more appropriate}, d) No testing performed when it is indicated,
3. Treatment Which is Not Consistent with History or Diagnosis: a) Strain diagnosis with myositis and treatment in excess of four weeks with manipulation and multiple modalities b) Strain diagnosis and prescription of cervical collars c) Strain\ Sprain diagnosis with treatment far beyond MMI d) Strain\Sprain Diagnosis with radicular findings and no second opinion or neurology consult.
4. General Considerations: a) Lack of referral when indicated to maintain control of patient b) Excessive charges for Initial and Final Narrative Reports c) Pre-mature optimistic prognosis' which create problems later when MMI can not be reached
5. Goals of Biomechanics Lab: a) Provide qualitative and correlative intake diagnostics and protocols at reasonable fees to identify case and advise direction. b) Assist the attorney to set case reserves appropriately within the first 21 days. c) Provide solid data that can be relied on to identify policy limits cases. d) Provide for qualified expert testimony for mediation, arbitration and trial. e) Provide graphs, charts or other court room tools and exhibits when necessary for clear understanding of actual damages to the client\patient f) Provide final second opinion evaluations and reports
Main Goals Definitions Legal FAQ Objective DX Library Related Sites