Attorneys often struggle when analyzing a claimant whose issues span multiple medical and surgical specialties. For example, say that a 65-year-old woman fractured her hip, and then developed a stroke, renal failure, and pressure ulcers during her hospitalization. She is now in a nursing home requiring full assistance. Will the attorney require experts in Orthopedic Surgery, Nephrology, and Wound Management, or is there one specialty that can provide a global overview to the trier of fact? The answer may be as simple as securing an expert in Physical Medicine and Rehabilitation.
Physical Medicine and Rehabilitation, also known as “PM&R” or Physiatry, is a specialty of medicine dealing with the management and rehabilitation of chronically ill and injured patients. PM&R specialists treat patients once the acute problem (e.g. stroke, paralysis, respiratory failure) has stabilized. Such patients often require long-term management of special needs, and that is when PM&R specialists intervene.
PM&R patients are typically adults or children with short-term or chronic impairment of physical or cognitive function. Such conditions are typically associated with some degree of disability, and patients benefit from a PM&R approach that enhances physical performance and decreases pain. Since PM&R is a non-surgical specialty, Physiatrists specialize in diagnosis, testing, physical therapy, and the use of orthotics (devices like braces and splints that stabilize parts of the body). While some physiatrists specialize in particular areas such as stroke or cardiac rehabilitation, many work in long-term care hospitals (LTCH) and rehabilitation centers. In either setting, PM&R physicians treat patients with injuries and diseases affecting every bodily organ and system. As a result of their training and experience, PM&R experts can provide both global and granular assessments of claimants who suffer from multiple conditions.
Common conditions treated by Physical Medicine and Rehabilitation include:
- Neurologic disease: TBI, stroke, multiple sclerosis, Alzheimer’s disease, ALS
- Spinal cord injury: Paraplegia, quadriplegia
- Respiratory failure: Ventilator-dependent patients, COPD
- Trauma: Traumatic Brain Injury (TBI), fracture rehabilitation, multi-system injuries
- Chronic Pain, Fibromyalgia, and Phantom Pain
- Stroke rehabilitation
- Burn rehabilitation
Counsel for both plaintiff and defense may utilize a PM&R expert to educate the trier of fact on a variety of issues. For example, a PM&R expert can explain the medical interplay between several unrelated conditions in terms of the effects upon the claimant. The PM&R expert can also draw conclusions regarding causation, prognosis, and future medical expenses. For example, for the woman described above, did her hip fracture cause her stroke? Will her pressure wounds respond to conservative treatment instead of surgery? What medical needs will she require over her lifetime to manage her stroke? Although other experts may be required to address specialty-specific standards of care, the Physical Medicine and Rehabilitation expert can often speak to the complete picture. PM&R experts also work with Life Care Planners by providing disease-specific information to inform life care planning and valuation decisions. They can also provide “day in the life” insight into the challenges faced by people suffering from chronic illness or injury.
From a strategic perspective, an experienced PM&R expert is an invaluable asset in complex personal injury cases. To find the right expert for your case, contact us today.