BLOGS
The Role of Occupational Therapy and Physical Therapy in Legal Cases
When being assigned a new legal matter as a Physical Therapy or Occupational Therapy expert witness there are a few things to consider as a medical expert.
Understanding the Clinical Setting where the matter occurred
- Medical malpractice matters and personal injury matters occur in a variety of settings. In my clinical physical therapy and occupational therapy practice, I have worked with inpatient and outpatient orthopedic and neurological populations including both adults and pediatrics. It is very important that the expert therapist understands the in’s and out’s of the setting the incident occurred in (e.g acute inpatient hospital, outpatient clinic, skilled nursing facility, and school.).
Analyze the Complaint
- The expert therapist is responsible to understand the accusations in the case. Whether the expert is working with the plaintiff or defense the therapist needs to understand the allegations and where to focus the review. Having a complaint when initiating a review is helpful and also assists in saving the therapist time during the review so they can focus on the issue at hand.
Reviewing Therapy Records and Understanding Medical Jargon
While reviewing documents for the legal matter, therapists are responsible to interpret for the attorney and understand the medical jargon that is documented. These are examples of common therapy terms that are often seen during medical chart reviews that are important and that are often discussed with the attorney:
- CGA during transfers-Contact Guard Assistance -therapist hands are very close and occasionally on the patient; < 25% assistance from the therapist.
- Min assist during transfers- Minimal assistance- therapist hands are on the patient and the therapist is offering between 25-50% of the assist during the transfer/movement.
- Dyspraxia- difficulty in performing coordinated movements, often associated with a neurodevelopmental condition in children (developmental coordination disorder).
- ORIF-Open Reduction Internal Fixation- occurs usually with a displaced bone fracture and a pin is placed in the fractured area to ascertain anatomical alignment.
- THA-Total Hip Arthroplasty -otherwise known as total hip replacement. It is important for the therapist to understand the surgical approach that the surgeon used whether it was an anterior approach or a posterior approach as the approach determines the continuance of care.
Review past Medical Records and History (Surgeon or MD)
It is imperative that the therapist understands the past medical history of either the plaintiff or defendant in the matter. Past medical history allows the therapist to better understand the plaintiff or defendant and enables the therapist to determine if their past medical history or surgical history influenced the current matter.
Keeping in mind the Practice Act of the State and APTA/AOTA Code of Ethics
It is the expert therapist’s responsibility to understand the practice act of the state where the matter took place. Different states hold different responsibilities for physical therapists/assistants, occupational therapists/assistants, and the expert needs to be guided by that state act. The code of ethics is a national set of ethics set for physical therapists and occupational therapists separately.