Advice for Chiropractors Who Take Personal Injury Patients: Getting Paid

If getting paid is a problem, three attorneys have some advice based on both life and work experience.

A doctor sits with a patient to give him advice.
(Image credit: Getty Images)

Today’s story will be of special interest to students in chiropractic college or young chiropractors who have just opened their office, would like to develop a practice that concentrates on treating auto accident patients and want to be paid for their professional services.

If that statement seems a bit odd – wanting to be paid – just ask Southern California attorneys Shawn Steel and Alexander C. Eisner about the reality facing chiropractors across the country when it comes to having their bills paid by lawyers who ignore signed liens obligating them to protect the doctors’ bills.

My History with Chiropractors

Going back years, when I opened my law practice, we handled personal injury cases. One day, my paralegal, Patti, made an interesting observation: “Our clients who are seeing chiropractors report feeling much better, sooner, than those treating with MDs and taking pain medication.”

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That was what I repeatedly noticed as well. To this day, I am a strong believer in the value of chiropractic care and have been a patient myself.

Upon settling each case, the first check we wrote was to pay the chiropractor and other health care providers, in full. “That put you in a class by itself,” observes Steel, “as, based on our experience, a very high percentage of lawyers – especially the ones you see all over television – try to wiggle out of paying health care providers and, in particular, take advantage of chiropractors.”

A Gift for Chiropractors Just Starting Out

It is one of the reasons they wrote The Intelligent Chiropractor’s Guide to Survival: Your Manual for Navigating Personal Injury in an Ethical and Profitable Way, which, in my opinion, is a gift to young chiropractors just starting out who want to develop a strong personal injury practice and get paid.

“Our objective,” Steel notes, “was to condense the knowledge that takes new chiropractors years to acquire – to literally save them an enormous amount of misery. We show them some of the major pitfalls that most chiropractors experience and put it into a clear format that helps prevent them from getting burned by insurance adjusters and attorneys.”

Eisner points out, “So many excellent chiropractors quit handling personal injury cases because of the way they were dealt with.”

While their book is literally a handbook for how to run a successful personal injury chiropractic practice, they devote a substantial amount of time to the realities of getting paid.

I asked them how to minimize the shenanigans pulled by members of the legal profession that defeat a chiropractor’s legitimate right to be paid for their skill and time spent treating patients.

1. Don’t Work With an Attorney You Haven’t Vetted

Consider these questions:

  • Will the lawyer sign your lien? There are lawyers – typically those whose ads you see on the sides of city buses and all over television – who are only too happy to send you cases. But will they sign your lien? If not, refuse their referrals, as you can’t compel them to pay your bill.
  • Can you get the attorney on the phone so that you can discuss the case? Will they return your phone calls?
  • Will the attorney give you photos, the police accident report, insurance information and medical records?
  • Who is the attorney’s chiropractor? The odds of you not being paid by the attorney go up exponentially if the lawyer does not believe in chiropractic.

The consequences of not considering these things means that you risk working with an attorney who will not treat you ethically and fairly at the end of the case. They will try to cut your bill for no justifiable reason, send your patient to a different health care professional – in short, cheat you. Asking these questions is a way to weed out the bad attorneys early on.

2. Know How to Respond When an Attorney Asks You to Reduce Your Bill

One of the greatest problems doctors who handle personal injury cases have are attorneys who consistently ask that the bill be cut without justification while refusing to reduce their own attorney fees. It is an epidemic that, in our experience, is standard operating procedure for 50% of lawyers who handle personal injury cases.

Some attorneys believe that chiropractors’ bills should always be reduced and have a predatory attitude, thinking that a chiropractor is easy prey.

So, when the lawyer informs you of an intention to cut your bill, send your own letter, enclose a copy of the signed lien, your bill (which they already have) and allow 72 hours in which to pay the lien in full. If not, state that you are prepared to take this to court and suggest that the lawyer read their state bar’s rules. If you do not receive your money, file a complaint with your state bar.

Lawyers hate getting a letter from their state’s bar. Therefore, this approach typically gets payment or a reasonable proposal.

3. Be Willing to Reduce Your Bill if the Request Is Legit

Sometimes there simply isn’t enough settlement money to pay everyone in full. So, when asked to reduce your bill, reply by saying, “Send me a breakdown of all expenses. Are all the other providers reducing their fees? Are you reducing your attorney fee?” This must be justified in writing, not over the phone.

If the attorney is reasonable and has given you proof of why your bill should be reduced, then always seek fairness.

4. Communicating With the Personal Injury Attorney Is Critically Important

You have far more contact with the patient than the lawyer will ever have. So, keep the attorney informed on how the patient is doing – are they reporting signs of depression or fear of driving or have a possible new diagnosis? This is crucial in building the case, getting the patient the care they need, and increases the probability that your bill will be paid in full.

There is a wealth of practical, relevant, down-to-earth guidance in The Intelligent Chiropractor’s Guide to Survival: Your Manual for Navigating Personal Injury in an Ethical and Profitable Way, which is also a great read for other health care practitioners. It would make the perfect graduation present for that son or daughter about to graduate from chiropractic college.

Dennis Beaver Practices law in Bakersfield and welcomes comments and questions from readers, which may be faxed to (661) 323-7993, or e-mailed to And be sure to visit


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H. Dennis Beaver, Esq.
Attorney at Law, Author of "You and the Law"

After attending Loyola University School of Law, H. Dennis Beaver joined California's Kern County District Attorney's Office, where he established a Consumer Fraud section. He is in the general practice of law and writes a syndicated newspaper column, "You and the Law." Through his column he offers readers in need of down-to-earth advice his help free of charge. "I know it sounds corny, but I just love to be able to use my education and experience to help, simply to help. When a reader contacts me, it is a gift."