Independent [Insurance Co] medical reviews [IME’s] in PI cases
Chiropractic Hero Dr. Gary Lewkovich is taking on the
“denials” for care from phony chiropractic
reviewers.
Many IME’s are simply bogus. They cut off your right
to med pay payments. They hurt your PI credibility.
Fraudulent IME’s need to be challenged and
discredited. Here are some tools you can use.
1. What “authority” is insurance doc using to limit
care? If the Official Disability Guidelines [ODG]
2. If using the ODG, is there also a denial of rehab
visits?
3. Does the IME doc use “Rehabilitation of the
Spine”?
4. Is the IME doc licensed in California?
5. Does the IME doc reference ACOEM, if so, ACOEM
does not specify whiplash associated disorders.
E-mail
johntawlian@shawnsteel.com
for a detailed copy of this report.
SHAWN’S SPEAKING SCHEDULE
CCA-Districts
San Gabriel Valley 02/02/2011
San Bernardino County 02/08/2011
Riverside County 02/15/2011
Long Beach 02/16/2011
Alameda County 03/03/2011
North Bay 03/16/2011
Tong & Associates
San Luis Obispo 02/05/2011
Riverside 03/05/2011
CCCLA 04/21/2011
Burbank 05/14/2011
For questions call John at 310-697-9000 or
e-mail:
johntawlian@shawnsteel.com
San Francisco’s Bagherian DC – Another big winner
Patient Santangelo, 39 - contractor, was driving his
truck southbound 880, was rear-ended and pushed forward
into the car in front of him. He sustained injuries to
his back, neck, left shoulder and left biceps.
Santangelo received acupuncture, chiropractic and
medical care. The crucial injury was a ‘torn bicep
tendon’ to his left arm. He could not perform overhead
activities and lifting is difficult. One MD opined that
Santangelo would “need arthroscopy” for his shoulder
and bicep.
Defendant offered $38,250 before trial. Santagelo
demanded $50,000. After trial the jury awarded
$148,813. The breakdown is important: $18,313 past
medical costs + $22,500 future medical costs + $7200
past loss of earnings + $10,800 future loss of earnings
+ $90,000 for past and future pain and suffering.
Chiropractors Alireza Bagherian and Tyler Tollstrup of
Belmont both testified for the victim. Two orthopedists
also testified for Santangelo. Opposing plaintiff was
Bruckman MD, San Francisco & Stroud PhD, a famous
bio-mechanical, Thousand Oaks.
Plaintiff petitioned court for an additional $40,232 in
costs for exceeding its pre trial offer to settle.
Santangelo vs. Galicia, Alameda County Jude Wynne
Carvill: HG 08381973
PRACTICE TIP: Juries will be more generous if they
believe the patient still suffers -- even after MMI.