Q:

Hello.  I need some of your professional assistance again, if you don't
mind.  You have a good way with words, and although I have strong
feelings about this, I cannot phrase myself in a brief manner.

A patient of mine was involved in a car accident.  He was not seriously
injured, but he did have a some whiplash neck and lower lumber pains.
He is a college student, and in good health.  We adjusted him for about
a month and a half, and he improved both in symptomotology and on X-ray
findings.

Problem is that now the opposing insurance company (he was hit from
behind) says that he didn't really hurt himself, that Chiropractic was
not justified, and that his pains would have gone away on their own, and
that they will only give him $300 for his pain and suffering.

The student's mother feels this is BS, and has hired an atty.  The atty
wants a concise statement from me explaining all that I did (no problem)
and why Chiropractic is justified here.  I have plenty of ideas floating
in my head, but I can't make it sound pretty.

Help!

A:

Thanks for the e-mail .. don't try to make a mountain from a mole hill. The nature of the PI 
business today is simple ..unless your head goes through the windshield or you die on the 
spot .. there is nothing wrong with you and they don't want to pay. 

I keep SOAP notes on my PI patients .. something I created to make it simple .. I send 
these notes with all PI claims and to the attorney. I also send a supplemental report .. sweet 
and simple .. no need to get technical. 

The attorney needs something from you explaining the patient's condition at the time she 
first saw you and how she was at the end. We deal with structure .. after an accident there 
is instability .. irritating to the paraspinal supportive soft tissue components (muscles and 
ligaments) and unstable cervical spine (via hypolordosis) various areas of vertebral 
misalignment creating further structural instability resulting in the need to first stabilize her 
acute condition .. then rehabilitate the injured area. The mode of care you offered was 
conservative chiropractic. 

Patient was initially seen due to a collision. Her condition warranted a schedule of specific 
care to stabilize her. This resulted in a prescribed visit by visit series of adjustments over a 
period of two months which assisted her towards stability and rehabilitation of the injured 
areas. During her care with you she was offered advice concerning specific lifestyle 
changes and exercises. She was monitored visit by visit.

If you wish to get technical .. state it like this:

Patient was seen on February 16, 1999 as the result of an auto collision dated February 9, 
1999. An examination was performed on her first visit which provided me the protocol 
necessary to stabilize her condition utilizing conservative chiropractic care. Her evaluation 
revealed specific areas of paraspinal supportive soft tissue component instability that were 
hypereactive to this trauma .. such as muscle splinting within the upper thoracic spine, 
hypomobility within the cervical spine with pain and acute lumbar pain. Her subjective 
complaints were headaches, which were along the areas of the Greater Occipital Nerve, 
parathesia into the right upper extremity, unilateral costal irritation along the T5-6 region, 
pain within the right pelvic region radiating into the right buttock.

I provided a number of lifestyle changes to assist in her healing as well as stretch exercises. 
I also cautioned her to refrain from sport activity for at least two weeks. She was also 
asked to refrain from work for seven days.

A schedule of care was provided to stabilize her condition which resulted in 15 visits over a 
period of 7 weeks. During this time a visit by visit evaluation checked her progress and it is 
my opinion that each visit was of the therapeutic nature. She was released from active care 
on April 10, 1999.

If there are any further questions please do not hesitate to call me.

How's that .. 

Have a Great Day

Dr. M