1. Personal Injury for Chiropractors
How to correctly document PI cases
Get PI cases referred to you by Attorneys
How to prepare for depositions & court
What to charge for your expert time

3. How to Correctly DOCUMENT
Lawyers do NOT understand any medical words in your report or records.
Lawyers can NOT read your scribbling, medical terminology, or abbreviations.
Lawyers SKIP everything in your report and go straight to the Conclusions Section.

4. How to Correctly DOCUMENT
The BEST records for PI cases can be found at:
Lawyers can read and understand these forms. You merely need to check off the boxes. It’s a win-win.

5. How to Correctly DOCUMENT
4 Forms That Help Lawyers WIN Cases
Patient Information
Symptoms
Diagnosis
Treatment Plan

6. Go to Doctor Forms

7. Attendees of this Lecture
Have access to the
HBTinstitute’s Doctor Forms
User Name = pay
Password = doctors
Please do not let insurance company
Employees or Lawyers use your
User Name or Password. They will
Use this information to NOT “Pay
Doctors”

8. This form follows the first 4
Data input screens in Colossus.
This is all the basic information
You need to get. This is all the
Insurance companies pay any
Attention to in your records.
Get the patient’s personal MD
AND get the records.
Get ALL medical records of all
other providers of medical
services since the accident.

9. These are the IMPORTANT Symptoms the insurance
companies look for in your
records.
NOTE: The entire left side &
1/3 of the right side are BRAIN
CONCUSSION symptoms.
A Brain Concussion with Mild
Traumatic Brain Injury is worth
an extra $20,000 - $40,000 in
your patient’s PI settlement.
(You diagnose and document
the brain injury and you will
get MANY referrals from PI
Attorneys.)

10. Use This Diagnosis Form
You should have 15 – 30 boxes
filled in (like a scantron, blacken
in the boxes completely so they
can be seen on the 5th generation
photocopy that the claims
adjuster sees.)
Always use the Sprain code AND
the Subluxation code or insurance
Adjusters will offer the attorney
a very LOW offer.
Always make any Brain
Diagnoses (multiple) that apply.
If the patient checked something
on the Symptoms Form, YOU make
the Diagnosis on THIS form.

11. This form shows the claims
adjuster that you have a
well-thought-out PLAN to
treat this patient.
About 1/3 of PI patients have
a Brain Injury.
- See it on the Symptoms form
- Mark it on the Diagnosis form
- Have a plan to treat it OR
refer to MD.
The more boxes you check on
this form, the higher your patient’s
PI settlement will be.
(Don’t make up stuff…
Just be a good, thorough doctor
and stop missing injuries that are
staring you in the face…)

13. Download these free forms at
NOTE: There are many advanced forms
on this web site. HBTI teaches 12 hour
Seminars in Advanced PI about how to
use the advanced forms. All these forms
were designed by a chiropractor with
20 years experience who is now
a Personal Injury Attorney in California.

14. Start Documenting Well & Start Getting PI Cases Referred to You.
These forms represent the
MINIMUM documentation
you can do on a PI case
if you want to be taken
seriously as a PI doctor.
If your documentation is
less thorough than this,
you should not be treating
car accident patients.

15. HOURS Claims adjusters & lawyers spend between 30 and 100
scrutinizing your records
on the average PI case.

16. They are looking for ways to: Not pay you Criticize your work
Prove you are incompetent

17. Problems in Your PI Records
Very little is written down
Can’t read your scribbles
Don’t understand your
cryptic shorthand
4. Can’t find the info they need
Records show no logical
thought pattern

18. Differences Between PI Record Keeping & Regular Patient Record Keeping
For regular patients, you are required by law to merely document enough so you
YOU can keep track of your patient’s condition.
Since only you will read them,
it hardly matters what you write or how you write it.

19. Differences Between PI Record Keeping & Regular Patient Record Keeping
Your PI records will be gone through with a fine tooth comb by:
Your patient’s Attorney
Ins. Co. Claim Adjuster
The computer program Colossus (or one like it)
DC or Orthopedist paid by Ins. Co. to make you look bad
Lawyers for Ins. Co.
12 people chosen for jury duty

20. WHAT WILL THESE PEOPLE THINK OF YOUR RECORD KEEPING?
Your patient’s Attorney
Ins. Co. Claim Adjuster
The computer program Colossus (or one like it)
DC or Orthopedist paid by Ins. Co. to make you look bad
Lawyers for Ins. Co.
12 people chosen for jury duty
WHAT WILL THESE PEOPLE THINK OF YOUR RECORD KEEPING?

21. Bad Record Keeping = Low PI Settlements

22. Bad Record Keeping = Low PI Attorney Income

23. Bad Record Keeping = NO Referrals from Attorneys

24. Good Record Keeping = HIGH PI Settlements

25. Good Record Keeping = HIGH Income for PI Attorney

26. Good Record Keeping = PI Referrals for YOU

27. Ironically… I will show you today that good documentation
is also the first step to doubling or tripling
the doctor’s income when treating PI patients.
Let’s take a close look at good documentation with these forms.

28. Med-Pay Coverage? Ask it right on the intake form.
If the patient doesn’t know, ask
him/her to bring in a copy of
the Declarations Page of their policy.

29. Why ask for the patient’s Uninsured/Underinsured?
You have to make a business
Decision about whether to take a lien on a PI case. If the patient has UM coverage, it is less risky to take a lien.
If the patient doesn’t know, ask
him/her to bring in a copy of
the Declarations Page of their policy.

30. Date of Accident v. Date First Dr. Colossus considers a PI case much
weaker with GAPS IN CARE.
“Patient can’t be that injured if he didn’t go to a doctor for 4 weeks.”
While not true, it helps you make a business decision about a lien.

31. Cost of ALL medical treatment?
You need this info for your final report to the attorney.
This section down here helps you get the amount of other Dr. bills & to get the records.

32. Why ask about Loss of Income?
It needs to be in your report.
YOU are the one putting the patient on disability.
Patient gets reimbursed 100% for all lost income in PI cases.
PI attorney makes more money.
You get more referrals.

33. Why ask Property Damage (PD)?
Under $2000 PD is sent to the “fraud” investigation dept.
Over $2000 PD is not questioned much by insurance
It’s a business lien

34. You MUST, MUST, MUST get the patient’s medical records.
Why ask Personal MD?
You MUST, MUST, MUST get the patient’s medical records.
They are full of info important in a PI case.
Ins. Co will have these records and use them against you. Know what is in them before you write your report.

35. Ambulance, Hospitals, Doctors?
These are facilities that have
treated the patient AFTER the
accident. There is great info in
them. A good PI doctor will include
in the report both the cost and
what is in the records of each and
every provider.

36. Colossus doesn’t look much at those things.
WHERE IS ALL THE REST?
Seat belts
Angle of impact
Head turned
Mechanism of Injury
Hat flew off
Etc.
Colossus doesn’t look much at those things.
Colossus “values” the case based on the information on these 4 forms.

37. Be sure to fill in the boxes (like a Scantron) Don’t make check marks
Don’t make X’s
The patient fills this out.
You go over it with the patient
during the consultation.

38. Traumatic Brain Injury
Every symptom on the left
and all those on the right
down to “Feeling Isolated”
are symptoms of:
Brain Concussion
&
Traumatic Brain Injury

39. Several things are so important they are asked multiple times on
this form:
Sleepiness
Very Tired
Dozing During Day
Fatigue
Sleeping Problems
A brain concussion that causes
“Hypersomnolence” is not only
common, it is a ratable
PERMANENT IMPAIRMENT
that the PI attorney can use
to get the patient an extra
$10,000 - $40,000
in the settlement.
Do you want referrals?
Hmmm…

40. Permanent Impairment-Cognition The other ratable brain impairment
is for abnormal Cognition.
The symptoms include:
Difficulty Concentrating
Mindless Staring
Blurry Vision
Headache
Attention Problems
Groggy
Can’t Remember Numbers
Reading Problems
Difficulty Adding/Subtracting
Poor Attention
Difficulty Learning New Things
Difficulty Understanding
Difficulty Remembering
Re-reading things
Difficulty Planning/Organizing

41. Permanent Impairment-Cognition
The PI attorney can get your
patient an extra $20,000 - $40,000
for a rated brain cognition
impairment.
About 1/3 of your PI patients
have a ratable brain impairment.
Most of you have noticed that
the patient has this problem… then:
1. failed to diagnose it
2. failed to document it
3. failed to test for it (and bill $250)
4. failed to do followup testing (and
bill another $250 every re-exam)
5. failed to treat it (and bill $45
each visit for cognitive exercises)
Sloppy doctoring = Low doctor pay

42. Brain Concussion Good doctoring = High doctor pay
Find it on this form.
Diagnose it (on next form)
Treat it
90801 = Neuropsych consultation
90801 = $95 each time
90801 = 6 to 10 times in avg. case
96118 = $150 each time
96118 = 6 to 10 times in avg. case
97532 = $45 each 15 minutes
97532 = times in avg. case
Good doctoring = High doctor pay

43. Brain Concussion $2,400 to $3,000 Good doctoring = High doctor pay
Average billing for diagnosis and treatment
of a brain concussion patient with MTBI and
cognition impairment…
$2,400 to $3,000
Good doctoring = High doctor pay

44. Brain Concussion $2,400 to $3,000 (in addition to your other fees for
diagnosing and treating the
Musculoskeletal Injuries)
Good doctoring = High doctor pay

45. Brain Concussion $2,400 to $3,000 $3,000 to $5,000
plus
$3,000 to $5,000
PI bill = $5,400 to $8,000
Good doctoring = High doctor pay

46. Lawyer settles the case Lawyer gets % of settlement
Brain Concussion
PI Doctor’s Bill $8,000
Lawyer settles the case
For $20,000 to $30,000
Lawyer gets % of settlement
You get more Referrals
Simply be a GOOD doctor…
that’s all the PI lawyer asks of you.

47. Scope of Practice
This presentation is based on the California Scope of Practice
Check your state’s Scope of Practice laws to see if you can diagnose and treat brain concussion and MTBI

48. The Right Side of the Form
“Clunk” Sound in Neck
About 25% of your PI patients
will check this box.
What does it mean?
About $20,000 - $40,000 extra
in the patient’s settlement.
PI attorneys will refer you a LOT
of cases if you do a GOOD job.

49. The Right Side of the Form “Clunk” Sound in Neck
This is the pathognomonic sign
of Ligament Laxity
Look for it on the Davis Series
3.5mm of Translation on the
Flexion & Extension films
is a ratable permanent impairment
of 25-28% Whole Person.
Want referrals? Try just being a
good, thorough doctor who
doesn’t miss these injuries.

50. Blanket Apology I know you are all good doctors
who are trying your best…
Colossus & the Insurance Companies
changed the rules of the PI game.
To be a GOOD doctor in the area of PI,
you must play by the new rules.
I’m here to teach you the new rules today.

51. The Right Side of the Form The musculoskeletal injuries
are on the right side below
“clunk” sound in the neck.
These are only 1/3 of the
symptoms listed on the form.
They are worth less than 1/10
of the money that PI attorneys
can get your patient.
Pay attention to them
Treat them
But don’t ignore the high-value
Symptoms and diagnoses on
the rest of the form… if you want
referrals from PI attorneys.

52. 854.0 Traumatic Brain Injury
The Diagnosis Form
What are the high value
diagnoses on this form?
728.4 Ligament Laxity
850.0/850.1 Concussion
854.0 Traumatic Brain Injury
780.8 Sleep Disturbance
Somnolence
300.0 Anxiety
300.4 Depression
Disability

53. NOT JUST SPRAINS !!! The Diagnosis Form This example is a basic,
run-of-the-mill
Chiropractic patient that was in a
car accident. No high-value
diagnosis. Basic stuff.
NOT JUST SPRAINS !!!
Use all the appropriate
ICD-9 Diagnosis Codes
for each body part injured.
Don’t forget Disability…

54. The Diagnosis Form About 1 out of 3 patients who walk into your office
after a car accident will
have most of these
Diagnosis Codes.
Be thorough
Document well
Make ALL appropriate Dx
(if you want PI referrals)

55. The Diagnosis Form
728.4 ????
What’s that?

56. The Diagnosis Form
728.4 ????
What’s that?

57. 728.4 ???? What’s that? Have a DACBR read ALL your
The Diagnosis Form
728.4 ????
What’s that?
Have a DACBR read ALL your
films in PI cases. You can
download a DACBR consultation
request in the Doctor Forms
section at

58. 728.4 ???? It is the reason patients still have pain a year after
The Diagnosis Form
728.4 ????
It is the reason
patients still have
pain a year after
the accident.

59. 728.4 ???? It is the cause of the “clunk” sound when the patient turns
The Diagnosis Form
728.4 ????
It is the cause
of the “clunk”
sound when the
patient turns
or moves neck.

60. 728.4 ???? It is an injury that chiropractic treatments can
The Diagnosis Form
728.4 ????
It is an injury
that chiropractic
treatments can
only make feel
better with
Lifetime Care.

61. 728.4 ???? It is an injury that a decent PI attorney can get
The Diagnosis Form
728.4 ????
It is an injury
that a decent PI
attorney can get
$20,000-$40,000
from the
insurance
company.

62. 728.4 ???? It is an injury you can see on a Davis Series.
The Diagnosis Form
728.4 ????
It is an injury
you can see
on a
Davis Series.

63. 728.4 ???? It is the #1 most overlooked injury by DCs who treat
The Diagnosis Form
728.4 ????
It is the #1
most overlooked
injury by DCs
who treat
accident patients.

64. (If you want PI referrals)
The Diagnosis Form
728.4 ????
Please stop
Overlooking it.
(If you want PI referrals)

65. The Diagnosis Form
850.0 v
What is the
Difference?

66. 850.0 v. 850.1 The Diagnosis Form Brief Loss of Consciousness (LOC)
is any loss from mere seconds
up to 24 hours.
Were you unconscious?
is a stupid question. It is like asking
Are you asleep?
If the patient doesn’t remember
their head going back, then forward,
then knees hitting dash, then the car
moving forward 8 feet, then…
(you get the point)

67. 850.0 v. 850.1 The Diagnosis Form Brief Loss of Consciousness (LOC)
is any loss from mere seconds
up to 24 hours.
Ask “Do you remember…”
If not, there was a momentary LOC
which is an 850.1
If they remember everything,
then it is an 850.0

68. 854.00 MTBI The 2nd most overlooked injury in PI Cases.
The Diagnosis Form
854.00
MTBI
The 2nd most
overlooked
injury in PI Cases.

69. The Treatment Plan Form
There are 2 purposes for this form.
It forces you to think about
what you are doing to the
patient.
2. It is an easy-to-read form
with the CPT codes already
on it that claims adjusters
can use to input your
treatments into Colossus.

70. The Treatment Plan Form Some people still say…
Don’t bill over $100 per visit.
If you show a thoughtful
Treatment Plan
with multiple therapies
to multiple body parts,
including MTBI treatment,
there is no reason you
should not bill $175-$250
per visit.
(please… straight chiropractors
who only adjust the patient and
do no therapies should bill no
more than $75 per visit)

71. Diagnosis Codes Straight Chiropractors who treat
PI patients have an inherent
conflict of interest.
If you are philosophically opposed
to diagnosing the patient’s
injuries, you may be helping
the patient with your adjustments,
but undermining their legal case.
The PI attorney will have nothing
to fight the Ins. Co.
The new rules of the PI game
are driven by:
Diagnosis Codes

72. The Treatment Plan Form 97110 Therapeutic Exercises $45 for 15 minutes
97532 Cognitive Rehab Exercises
$45 each 15 min. unit (1-4 units
once a week if you are doing it
correctly.)
Be sure to always check off (and
give to patients) lots of home
therapies and exercises.
Note: and 96118
Med-pay carriers pay you $245
each time you do both of these.
You typically do them 6-10 times
during the treatment of an MTBI.
($1,470 - $2,450 in fees for being
a good doctor. What a concept.)

73. The Treatment Plan Form HBTI’s 12 hour seminar
teaches you how to do all
tests & how to bill for them.
Note “Order Impairment Rating”
You MUST get an impairment
rating on ALL your patient’s
injuries at the end of the case.
Learn how at the HBTI seminar.

74. Do this form once.
Do these 3 forms
at first exam and
every re-exam.

75. Click 2008 Seminars

76. Personal Injury for Chiropractors
How to correctly document PI cases
Get PI cases referred to you by Attorneys
How to prepare for depositions & court
What to charge for your expert time

77. Preparing for Depositions
Have good records
Review your records before the deposition
The other side (insurance company’s attorney) wants to talk to you
The other side pays you for your time ($250-$300/hour is normal)
Get the check in advance (from insurance company’s lawyer) or
on the day of the deposition before the deposition begins
It is reasonable to ask for a 2 hour minimum
The insurance company’s lawyer asks all the questions at a deposition
Your patient’s lawyer will be there but won’t say much
The best answers are “yes”, “no”, and “I don’t recall”
If you are not sure, look at your records before answering
Don’t volunteer information
Don’t speak just because nobody else is… there is a lot of silence in a deposition

78. Preparing for Court or Arbitrations
Have good records
Review your records before you testify at court or an arbitration
The patient’s attorney pays you to show up and testify ($ /hr is normal)
Get the check 1 week in advance (from your patient’s lawyer)
It is reasonable to ask for a ½ day ($1000 to $1200)
Your patient’s lawyer will ask you a lot of questions (and be nice to you)
Answer your patient’s lawyer’s questions fully, but briefly
The insurance company’s lawyer will then “cross examine” you (and be mean)
The best answers are “yes”, “no”, and “I don’t recall” on cross examination
If you are not sure, look at your records before answering
Don’t volunteer information
Don’t speak just because nobody else is… there is a lot of silence in a court
After you hear the question, pause, think, turn to the jury, and answer
Make eye contact with the jury
Relax. You are there to help non-doctors understand doctor stuff
Act like you are doing a report of findings and explain it to the jury

79. Personal Injury for Chiropractors
How to correctly document PI cases
Get PI cases referred to you by Attorneys
How to prepare for depositions & court
What to charge for your expert time

81. Any Questions? Steven C Eggleston, D.C., Esq.
Practicing Personal Injury Law in California
Director, Human Biomechanics of Trauma Institute