Training Classes

For more complete information about courses and core curriculum go to: http://www.aamvi.org/

Curriculum and Coursework:

The ten 15-hour classes that make up the core curriculum and lead to a Certificate in Motor Vehicle Injuries include five courses on examination and diagnosis. These are divided into two courses on radiology with an emphasis on MRI’s and brain scans as well as flexion/extension studies to document the extent of ligamentous injury in the spine. The physical exam courses are broken down into spinal exam, extremity exam, and concussions and cranial nerve exam. Each of these puts a strong emphasis on understanding the mechanism of injury. This is based on the assumption that if you understand what structures can be damaged by the forces involved in a motor vehicle collision, you will have a better understanding of what injuries to look for.

Important Note, personal injury is not health care. It is injury care.

If you do not know how to diagnose the injuries you are not only doing damage to the case but you would be doing a disservice to the patient. You could very well find yourself facing a malpractice claim for failure to diagnose.

Core Curriculum

The core curriculum leading to a Certificate in Motor Vehicle Injuries consists of ten 15 hour seminars. Of the 150 hours half that time is devoted to exam and diagnosis. These classes include radiology with an emphasis on MRI and brain scans and spinal ligament injuries with an emphasis on plain film, flexion/extension studies of the spine. Physical examination and diagnosis is broken into three sections of spinal, extremity, and cranial nerves.
The other courses focus more on documentation and medical legal issues. These include outcomes assessment tools, case management, medical legal issues and whole person permanent impairment ratings.

With examination and diagnosis there is a strong emphasis on understanding the mechanism of injury on the assumption that when you know what can be injured, you also know what to look for. As such there is a far better chance of finding and treating those injuries.

We devote considerable time to a history and how to master that art form, including what questions and what types of questions contribute the greatest value leading to a strong diagnosis. The physical exam classes devote considerable time to hands on experience of how to properly perform the tests and make out a complete examination. This is information that cannot be learned from a book as well as it can be with the hands on experience.

The diagnosis portion of this class takes into account all of these factors and lead the doctor to a proper diagnosis. This will assist in providing better treatment and making the proper referral to specialists best qualified to assist with treatment.

Our examination classes go into considerable depth of as to what structures can be injured so that our doctors know to go well beyond a diagnosis of a simple sprain or a simple strain. The sprain diagnosis is often used by chiropractors. It is a more appropriate diagnosis than a strain injury often used by medical doctors. Strains involve muscles and we know that muscles do heal well and that they do heal relatively quickly. Sprains involve ligaments and we also know that these do not heal well and these that they do not heal quickly and . I these in fact these sprain injuries will have some permanence that will need to be addressed on a long term basis.

Our doctors are trained to qualify the injury by the level of involvement but also the extent of the ligamentous damage. Our doctors are also trained to quantify those injuries and are aware of which thresholds change the value of a diagnosis.

On the examination portion of these classes. We go into detail on how to perform orthopedic and neurological tests correctly. We place a strong emphasis on how to interview a patient and when to ask and not ask questions of the patient who has probably suffered a concussion. Most doctors who take the program are embarrassed to find out how poorly they had been performing examinations, if they had been performing them and at all. Most doctors who now know how to properly perform the individual tests are able to have a stronger diagnosis to direct them to a better course of treatment and to provide the attorney with the ammunition needed to get a better settlement for the patient.

Our cranial nerve examination class utilizes Lois Laynee’s Dynamic Functional Cranial Nerve Assessment Tool®. Unlike so many who rarely see a positive finding on cranial nerve testing our doctors learn how to properly perform these tests and find multiple positives on concussed patients.

The other five courses are focused primarily on management and documentation. Documentation is of the utmost important for several reasons. First, on a personal injury case, the likelihood of referring to a specialist or several specialists increases. With those referrals there should be enough information so that the specialist knows what they are looking at and what to look for.

Documentation is also important with the insurance industry which has a standard of care that requires the doctor to demonstrate improvement or care will be deemed not medically necessary. If we do not demonstrate improvement in a two week period, we are allowed a second two week period to try additional therapies and then demonstrate improvement. If we fail to demonstrate improvement over the course of the first month of treatment the insurance companies by their own standards, are perfectly justified in not paying for care that has not demonstrated valuet. In addition, when the attorney sets out to get a good settlement, they can only argue what is in the written record. They cannot extrapolate from the doctor’s notes and expand upon that. They can only go by what each treating doctor, each treating therapist has documented.

Our documentation classes include:

Outcomes Assessment Tools, how to utilize them in a personal injury practice and how these questionnaires can establish the effectiveness of the care and thereby the need to be paid.

Our Case Management course outlines the parameters for referring and what should be documented.

The Whole Person. Permanent impairment course is based on the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, the most current edition and the one that automobile insurance companies now favor. It includes an understanding of which injuries carry the greatest value and then and how much documentation is needed to support determining an impairment. The bottom line here is that without a permanent impairment rating that an attorney can present to the insurance company we have effectively told them that there is no permanence. Without permanence, the assumption is resolution of all injuries and the patient will be compensated only for their inconvenience. This class provides a better understanding of the value of each diagnosis along with each supporting test and complaint that match the diagnosis. It allows a doctor to provide the attorney with a report of what injuries have not resolved.

Core Curriculum

The other courses focus more on documentation and medical legal issues. These include outcomes assessment tools, case management, medical legal issues and whole person permanent impairment ratings.

Case management

This class lays out the process step by step of how to handle not just the injuries but the case. This class covers what forms to utilize for documentation and when and to whom referrals should be made. Our Case Management course also outlines the parameters for referring and what should be documented.

Documentation

This class covers what needs to be included in a file to communicate with other doctors and attorneys. It also covers what the insurance company expects from a file. Having this information not only makes a stronger case for the attorney but gives the doctor a better understanding of what they need to know in order to provide the best possible care. This class lays out exactly what the insurance companies are looking for and is taught by James Mathis, the one person most responsible for the algorithm uses to minimize the value of personal injury cases.

Whole Person Permanent Impairment Rating

This class is based on the AMA Guides to the Evaluation of Permanent Impairment Sixth Edition. This class provides a better understanding of the value of each diagnosis along with each supporting test and complaint that match the diagnosis. It allows a doctor to provide the attorney with a report of what injuries have not resolved.

Medical Legal Issues

This course strives to give doctors a better understanding of the legal process involved with personal injury. This includes ethics, documentation and also focuses on legal precedents. This class aims to provide doctors with an understanding of the legal issues surrounding their cases. One third of this class is devoted to the process of testimony in a deposition, arbitration or trial.