The Presque Isle Rehabilitation Service Medical Legal Division

Our cache of highly trained, multi-decade medical legal professionals have the knowledge and experience necessary to succinctly educate attorneys on complex, and often subtle, medical matters; research, compile and report their data and findings in a comprehensive yet accessible manner; and most of all: facilitate effective outcomes.

Led by PIRS President and Owner Michelle Repman-Pifer and Life Care Planner/Medical Case Manager Dana Bissontz, the PIRS Medical Legal Division comprises a robust and dedicated team capable of servicing the Mid-Atlantic region and well beyond.

Whatever your needs, Presque Isle Rehabilitation Service is your Medical Legal Expert Resource.

 

 

Our Medical-Legal services include:

Life Care Planning

The Life Care Plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with the associated cost for individuals who have experienced catastrophic injury or have chronic healthcare needs. It is a consistent process for analyzing the immediate and lifelong needs of patients necessitated by the onset of a disability.

The process of creating and maintaining a life care plan has been standardized and regulated with a consistent methodology. Lifecare planners themselves come from many professional walks of life, including rehabilitation specialists, physiatrists, nurses and physicians, and social workers.

Thorough training for board certification in life care planning (CLCP) is available via the Commission on Health Care Certification, and it provides life care planners with a comprehensive, standardized knowledge base from which to operate.

We have six Certified Life Care Planners to meet your needs — from completing a Life Care plan, to providing expert consultation on Life Care Plans prepared by other companies.

Medical Cost Projections

Medical Cost Projections are often referred to as “mini life care plans.” They follow a consistent process for analyzing the immediate needs of patients that may not result in a life-long disability. They are prepared for less complex cases where the future medical care is more straightforward and/or where there are no extensive, life-long rehabilitative needs.

For a downloadable/printable list of the required documents when requesting a Medical Cost Projection, please click here.

Limited Cost Estimates

A limited cost estimate is a report utilized to quickly estimate future medical costs for non-catastrophic cases. It includes current medications, durable medical equipment, physician visits, diagnostics, surgical procedures, injections, and physical therapy. This is a consulting report only, advisable for mediations and demand packages. It is not suited for deposition or trial testimony. If you are requesting a testifying report, you will need to consider a Medical Cost Projection or Life Care Plan.

Medical Record Reviews & Summary Timelines

A medical record review is a formal examination of patient data and personal medical records for the purpose of validating a diagnosis, settling billing disputes or facilitating paying a health insurance claim.  We can customize medical bill review to your specific needs to help identify actionable ways to improve cost savings.

Medical Chronologies and Timelines

A medical chronology is valuable to those involved in a case to understand the nature of the injury or illness and the client’s past medical history and how it may impact the case. We will provide a clear, concise chronology of the events of the case making it easy to find the information quickly. Chronologies also help to ensure complete discovery and allow everyone on the trial team to share case knowledge.  Timelines are another valuable tool to assist the attorney’s understanding of the medical records in a more concise manner from before or on the date of injury or illness going forward.

Trial Preparation and Consultancy

Consider us a part of your trial team. Our litigation support services include assisting attorneys in developing or adjusting questions for deposition, trial testimony, and cross-examination for cases involving Life Care Plans, Medical Cost Projections, Medical Malpractice, Mass Tort Injuries or Illnesses, Loss of Earning Reports, and Rehabilitation Reports. We are available virtually or in-person during the entire trial process as you may require, assuring that every medical aspect of your client’s case has been expertly identified and addressed. Not sure which expert physician would be appropriate in your client’s case…ask us!

IME Coordination and Attendance

PIRS will schedule the IME, recommend the best physician for the type of injury, notify the injured worker of appointment via certified mail, arrange transportation, attend the appointment, and we will draft a detailed observation report following the exam. The typical turnaround for the report is 48 hours or less.

Medicare Set Asides

Workers’ Compensation Medicare Set Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury, illness, or disease. These funds must be depleted before Medicare will pay for treatment related to the workers’ compensation injury, illness, or disease.

 

Legal Nurse Consulting

PIRS will work with attorneys in complex legal claims assisting in obtaining records, summarizing the conditions, and answering questions. Our certified legal nurse consultants will analyze and evaluate the facts and testimony relative to your case, authoring researched and supported opinions regarding the nursing and healthcare provider services and outcomes, and the nature and cause of injury. We uphold the standards for certification in the legal nurse consulting industry, proving our knowledge, skill, and competency for quality practice in the profession.

Medical Case Management/Disability Management

The Medical Case Manager Coordinates medical care and provides ongoing communication between the injured worker, employer, medical provider, and insurance carrier. A Medical Case Manager is assigned to manage the care of an individual to promote a safe and timely return-to-work. This may include the identification of a temporary modified duty position or the development of a permanent modified duty position when medically appropriate This coordinated effort helps control costs and provides effective medical care.

Catastrophic Case Management

In the event of a catastrophic injury, our Registered Nurses are available on a priority basis. The Catastrophic Nurse Case Managers are trained to assess complicated medical issues related to a Catastrophic Injury and to report those issues back in layperson’s terms. The Nurse Case Manager can also assist the injured worker’s family with questions and help them coordinate the transition from the hospital to home by creating a comprehensive care plan to include home health care, in-home preparation, medical equipment needs, transportation of the party, and so on. The Case Manager may also utilize components of our Life Care Planning System to identify vendors and short-term costs for in-home care and durable goods.

 

Plus:

Rehabilitation Reports

Earning Capacity & Loss of Capacity Reports