1. Actual Conversation @ Concussion Case
Claims adjuster: “but she didn’t hit her head.”
Eggleston: “Her head hit the head restraint.”
Adjuster: “It doesn’t say that anywhere in the medical records.”
Eggleston: “it is so obvious that doctors don’t waste their time writing it down.”
Adjuster: “but it’s not in the records.”
Eggleston: “If you fall out of a boat on a lake, would you hit water?”
Adjuster: “Of course.”
Eggleston: “It is just as obvious that your head will hit the head restraint in a rear-ender. That’s the name of the device, to restrain the head during a rear-end impact.”
Adjuster: “But it doesn’t say she hit her head so we don’t believe she could have a concussion.”

2. Write it Down “Head hit the head restraint”
The doctor’s records are “Just The Facts, Maam” of the case.
Doctor’s records are essentially ALL the facts used by both sides to negotiate.
If you don’t write it down, it doesn’t exist in the legal negotiations when settling a case.

3. “Be Accurate, Honest, & Thorough”
CCA-OC February 18, 2009
“The Doctor’s Job”
Symptoms
Get them ALL
Write them ALL
Make it understandable
Physical Exam
Test all reported symptoms
Write down all test results
Diagnosis
Diagnose EVERY Symptom
Write EVERY Diagnosis
Make it understandable (use ICD-9 codes)
Treatment Plan
Make Treatment PLAN for EVERY Diagnosis
Write EVERY proposed treatment (aka “plan”)
Make it understandable (use CPT codes)
“Be Accurate, Honest, & Thorough”

4. Narrative MUST Include
CCA-OC February 18, 2009
Narrative MUST Include
Injuries Diagnosed & Treated
ICD-9 (“9+”)
CPT (“Active”)
Prognosis for EVERY ICD-9
Complaints (“Symptoms”)
Treatments (“Treatment Plan”)
Intensity (“Intensive” = >3x/wk sometime during Tx Plan)
Duration (“Prolonged” = >30 days meds, >90 days active Tx)
Testing (“Positive”)
Prior/Subsequent Injuries
Majority/Minority
Medical Supplies Prescribed
Medical Supply
Medication
Ambulance
Dental & Orthodontic Treatment
Disfigurement
Impairments
AMA Guides WPI
DUD
LOE
Disability
Depression/Anxiety
TMJ
Future Medical
Probable (50-75% = 1x multiplier)
Definite/Certain (75-100% = 2x multiplier)
Failure to Address
Each & Every
One of These Items
Is BELOW
Minimum Competency
To treat PI Patients

5. How to Write a Narrative Report
Get all the SYMPTOMS
Update Monthly to show Duration (“Prolonged”)
Make all the DIAGNOSES
Show the positive EXAM TESTS
Show all your TREATMEMTS
Update Monthly to show Duration (“Prolonged Active Tx”)
Update Monthly to show Intensity (“Intensive”)

6. Throw OUT… Your OLD Intake Forms This is all you need
Stop doing “Accident Reconstruction”
You are a DOCTOR. Be a GOOD one.
Symptoms – Diagnosis – Exam – Treatment are a four-leg chair. Remove any one of these essential “legs” of your records and the chair is unstable.

7. The Symptoms Form should be filled out like this
Blacken in all the boxes
Do not make check marks
Do not make X’s
On re-exam days, explain to patient to check any symptoms they are experiencing “intermittently”, even if he/she is not experiencing them at that moment in the office. Otherwise, your paperwork is not accurate.
This is easy to read from a 4th or 5th generation photocopy, which is what the claims adjuster looks at when deciding how much to give the patient in the PI settlement.

8. The Diagnosis Form Must by Filled In Like This Note the ICD-9 Codes are on it

9. The Doctor must
give a diagnosis
for every injured
body part. There
are 5 “body parts”
in each body area.
Bones
Tendons
Ligaments
Muscles
Nerves

10. The Doctor must make ALL
Diagnoses the patient has…
Not just chiropractic ones
Not just those he treats
ALL of them
Be Accurate, Be Truthful

11. Use this form to document the treatment to be delivered to the patient
Use this form to document the treatment to be delivered to the patient. This form tells Colossus both your in-office treatment and your patient’s home treatments.

12. CPT Codes This form contains CPT codes for 2 reasons
CPT Codes This form contains CPT codes for 2 reasons. It helps the office biller work more quickly AND helps the Colossus data entry person work more quickly to settle the claim. Keeping good medical records makes the claim adjuster and all attorneys’ jobs easier because they have all the “facts” to know what is wrong.

13. Symptoms, Exam, Diagnosis, Tx Plan…
Doctor, this is your job.
Do it well.
Be accurate in your RECORDS because that is what adjusters and lawyers look at (not what is in your head.)

14. Here is an example of BAD use of my forms Symptoms = Low Back Pain Diagnoses for Low Back = NONE Treatment for Low Back = a lot Does this make sense?????

15. Here is another example of BAD use of my forms Patient reports Symptoms of Anxiety No Anxiety Diagnosis Treatment Prescribed for Condition with No Diagnosis

16. Please… Be GOOD Doctors
Be Accurate
Be Honest
Be Thorough

17. www.HBTinstitute.com Steven C Eggleston, D.C., Esq. Attorney at Law
1301 Dove St, Suite 120
Newport Beach, CA 92660
(800)