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The adjuster is merely asking you to clarify your information regarding this patient. We do not know what information about your assessment was originally submitted or any other factors. You should use your best judgment to accurately relate your clinical findings to the history of the incident.

If it is your opinion, based on the complaints and examination findings, that the injury is from the initial rear impact, state that in your conclusions.

If you are unsure, it is appropriate to say that you cannot make that determination. It may be reasonable to request a second opinion from another doctor who may be more comfortable in discussing such conclusions. This is not to relinquish continued care and treatment, but to respond to the inquiry.

It does not appear to be an adversarial request, but one for clarification.

Tom Freedland

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Hi ,

Your patient was exposed to at least two impacts; a rear impact initially and then a frontal impact. The frontal impact would not have occurred had the rear impact not initiated the movement of your patient's vehicle, thus the rear impact is the cause of all of the injuries. With the exeption of some fractures, there is no way to determine whether it was the frontal impact or rear impact that caused most of the injuries, but it is reasonable to conclude that the injuries are more severe than they would have been had the vehicle only been struck in the rear with no subsequent crash. You are being asked to guess at questions that no one has the answers to.

D Freeman Mailing address: 1165 Union Street NE, Suite 300Salem, Oregon 97301ph 503 586-0127 fax 503 763-3581cell 503 871-0715 drmfreeman@...

-----Original Message-----From: B & J Kuhn [mailto:highdesertchiro@...]Sent: Friday, February 13, 2004 10:26 AM Subject: PI questionListmates,I just recieved a letter from an insurance adjuster that is asking me "In my professional opinion, which impact caused the extent of injury that Mrs. Patient is seeking treatment?". In the collision my patient was the thrid of four cars in the impact. they supplied me with photos of the collision but do not have any of the fourth car which rear-ended my patient and then took off. Is this normal? This company has been giving me alot of hassle and I do not feel comfortable answering this. Any suggestions.High Desert Chiropractic Clinic Kuhn, DC, CCSP & Kuhn, DC541.389.9373361 NE lin, Bldg CBend, OR 97701_________________________________________________________________Check out the great features of the new MSN 9 Dial-up, with the MSN Dial-up Accelerator. http://click.atdmt.com/AVE/go/onm00200361ave/direct/01/OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

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Sure Tom.

Insurance adjusters are primarily concerned with finding the truth.

They would NEVER ask a seemingly innocuous question with the hidden purpose being to avoid paying a claim.

Anyone who thinks so is just a cynical, money grubbing, FIELD DOCTOR.

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

Please note " New address " 315 Second Street

Lake Oswego, OR 97034

503-635-6246

drscott@...

or

info@...

From: TFreedland@...

Date: Fri, 13 Feb 2004 16:02:10 EST

Subject: Re: PI question

-

The adjuster is merely asking you to clarify your information regarding this patient. We do not know what information about your assessment was originally submitted or any other factors. You should use your best judgment to accurately relate your clinical findings to the history of the incident.

If it is your opinion, based on the complaints and examination findings, that the injury is from the initial rear impact, state that in your conclusions.

If you are unsure, it is appropriate to say that you cannot make that determination. It may be reasonable to request a second opinion from another doctor who may be more comfortable in discussing such conclusions. This is not to relinquish continued care and treatment, but to respond to the inquiry.

It does not appear to be an adversarial request, but one for clarification.

Tom Freedland

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

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,

Tom has a much more sanguine attitude than I about the openly adversarial stance of auto insurers toward providers who dare to treat patients with what they call "soft tissue injuries." I have served and continue to serve as an expert in bad faith lawsuits against insurers in various parts of the country and I have examined thousands of documents relating to claims adjustor training methods. Claims adjustors are taught to be skeptical and questioning when a patient is being treated for an "unobjectifiable" injury, so-called despite objective evidence of injury. Insurers aren't as much anti-chiropractic as they are anti-claimant; they just see chiropractors as weak links in the treatment chain so they harrass them more.

While Tom is certainly entitled to his perspective, it is my opinion that the purpose of the question from the claims adjustor is simply to hassle you. There is no possible benefit to the insurer in determining which of the impacts caused the injury, and clinicians are not trained to break down traumatic exposures in such a manner anyway. If you want, though, you can tell the claims adjustor that you don't know the answer but you will be pleased to send the patient to a forensic scientist who makes such determinations on a regular basis. Then you can refer the patient to me and I can tell the insurer what I just told you.

D Freeman Mailing address: 1165 Union Street NE, Suite 300Salem, Oregon 97301ph 503 586-0127 fax 503 763-3581cell 503 871-0715 drmfreeman@...

-----Original Message-----From: TFreedland@... [mailto:TFreedland@...]Sent: Friday, February 13, 2004 1:02 PM Subject: Re: PI question -The adjuster is merely asking you to clarify your information regarding this patient. We do not know what information about your assessment was originally submitted or any other factors. You should use your best judgment to accurately relate your clinical findings to the history of the incident. If it is your opinion, based on the complaints and examination findings, that the injury is from the initial rear impact, state that in your conclusions.If you are unsure, it is appropriate to say that you cannot make that determination. It may be reasonable to request a second opinion from another doctor who may be more comfortable in discussing such conclusions. This is not to relinquish continued care and treatment, but to respond to the inquiry.It does not appear to be an adversarial request, but one for clarification.Tom Freedland OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

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Great advice. . . Thanks!

RE: PI question

,

Tom has a much more sanguine attitude than I about the openly adversarial stance of auto insurers toward providers who dare to treat patients with what they call "soft tissue injuries." I have served and continue to serve as an expert in bad faith lawsuits against insurers in various parts of the country and I have examined thousands of documents relating to claims adjustor training methods. Claims adjustors are taught to be skeptical and questioning when a patient is being treated for an "unobjectifiable" injury, so-called despite objective evidence of injury. Insurers aren't as much anti-chiropractic as they are anti-claimant; they just see chiropractors as weak links in the treatment chain so they harrass them more.

While Tom is certainly entitled to his perspective, it is my opinion that the purpose of the question from the claims adjustor is simply to hassle you. There is no possible benefit to the insurer in determining which of the impacts caused the injury, and clinicians are not trained to break down traumatic exposures in such a manner anyway. If you want, though, you can tell the claims adjustor that you don't know the answer but you will be pleased to send the patient to a forensic scientist who makes such determinations on a regular basis. Then you can refer the patient to me and I can tell the insurer what I just told you.

D Freeman Mailing address: 1165 Union Street NE, Suite 300Salem, Oregon 97301ph 503 586-0127 fax 503 763-3581cell 503 871-0715 drmfreeman@...

-----Original Message-----From: TFreedland@... [mailto:TFreedland@...]Sent: Friday, February 13, 2004 1:02 PM Subject: Re: PI question -The adjuster is merely asking you to clarify your information regarding this patient. We do not know what information about your assessment was originally submitted or any other factors. You should use your best judgment to accurately relate your clinical findings to the history of the incident. If it is your opinion, based on the complaints and examination findings, that the injury is from the initial rear impact, state that in your conclusions.If you are unsure, it is appropriate to say that you cannot make that determination. It may be reasonable to request a second opinion from another doctor who may be more comfortable in discussing such conclusions. This is not to relinquish continued care and treatment, but to respond to the inquiry.It does not appear to be an adversarial request, but one for clarification.Tom Freedland OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

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