Information for attorneys

FOR ATTORNEYS

What makes a cervical injury opinion survive cross-examination is not how firmly it is worded. It is whether the diagnosis was tested or assumed.

The diagnostic problem in a neck case

Cervical facet joints are the most commonly identified source of chronic post-traumatic neck pain, and they are invisible on imaging. That leaves two ways to reach an opinion. One is to note the mechanism, note the persistent pain, note the unremarkable MRI, and assert the connection. The other is to anesthetize the medial branches supplying a specific joint and record what happens to the pain.

Only the second produces a document that holds up. Single diagnostic blocks carry a well-documented false-positive rate, which is precisely why the finding is confirmed rather than accepted on one result. An opposing expert who knows that literature will ask, and an opinion built on assertion does not survive the question.

What you receive

• Records, complete and legible, with the diagnostic reasoning visible rather than implied.
• A narrative report setting out mechanism, findings, what was tested, what the testing showed, and what was excluded.
• A causation opinion where the findings support one, scoped to the structure actually identified.
• Impairment and work-capacity comment where it is asked for and the record supports it.

What you will not receive

An opinion the testing does not support. If the blocks are negative, the report says the blocks were negative. That costs a case something in the short run and it is the reason the reports that do support causation are worth having.

We also do not route a patient onward to a surgeon as a first move. The diagnosis gets refined first — the exception being a genuine emergency, where care is urgent and immediate. The findings that qualify.

Liens and letters of protection

Both accepted. The statutory right and the letter do different jobs and this practice uses them together — see medical liens and letters of protection. Missouri work injuries are carved out of the lien statute and run differently; that is set out here.

The bill is for services rendered and your client remains responsible for it regardless of outcome. We tell them that at the first appointment, in those words, so it is never a surprise at disbursement.

Records requests

Send the signed authorization with the request. A letter warning that a subpoena will follow is not a substitute for a release, and it does not accelerate anything — the release is the thing that lets us respond at all. With one attached, requests are handled promptly and without a chase.

What is useful to send with a referral

• The mechanism, in a sentence or two, including vehicle positions or the lifting task.
• Prior imaging, on a disc or with portal access rather than the report alone.
• Any prior cervical treatment and what each intervention did, including partial responses.
• Which state the injury occurred in.

Clinicians referring a patient will find the same reasoning set out for them on information for referring physicians.