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Medical Legal Services
MKC Medical Management’s legal nurse consultants have been helping attorneys and claims representatives with complex, medically-related cases for nearly 20 years.
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Under Kari's leadership, MKC Medical Management has grown from one nurse to a seamless, nationwide network
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A trained and experienced Legal Nurse Consultant will spot things in the medical record that claims adjuster will probably miss.
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From The Blog
Here are studies, reports and stories that caught our eye in the last month. Auto technology and insurance claims: Technology and consumer expectations are among the issues driving the evolution of auto insurance as we know it, according to an article in Property Casualty 360. The article explores “seven key areas that are ripe for further discussion, research and analysis.” Storefront crashes: “Storefront crashes,” which involve a vehicle running into a commercial, public or retail building, cost insurers millions of dollars a year, according to an article in Claims magazine. In fact, in 2015 and 2016, the Storefront Safety Council is aware of more than $100 million in claims paid. “The trend is increasing as more cases go to trial and plaintiffs find it easier to show that a location was poorly protected against a foreseeable and preventable risk,” says the article, which also details new safety standards and trends to watch. Top liability loses: Allianz Global Corporate & Specialty’s Global Claims Review 2017 recently ranked the top modern corporate liability exposures. The report finds that defective product or work; collisions and crashes; and human error were the leading causes of liability losses. Drowsy driving: At least 21 percent of fatal crashes involve exhausted drivers, according to an article in Claims Journal. But activities to keep drivers alert, including radio adjustments and opening a window, come with their own risks. The article explores the issues, signs of drowsy drivers and ways to ensure drivers get enough sleep before they hit the road. More data needed: According to a report from the National Safety Council, 2016 may have been the deadliest year on the nation’s roads since 2007. Last year, 40,000 people may have died because of a motor vehicle crash. Another 4.6 million were seriously injured. But, the council’s...
Why what’s missing is sometimes the most important detail There is no safe blood lead level in children, according to the Centers for Disease Control and Prevention. But, more than 500,000 U.S. children have elevated levels, which can cause lifelong developmental delays. One of our clients, an insurance company, pulled in MKC Medical Management to review the alleged lead poisoning case of a toddler. The child was healthy as an infant, but he developed significant speech and other developmental delays. Doctors eventually diagnosed the child with pervasive developmental disorder (PDD), which is on the autism spectrum. What we found, according to the medical records, was that the child had lived in a building with toxic levels of lead. Tests also revealed that he had elevated blood lead levels. But, those findings don’t necessarily mean that lead poisoning was behind the child’s diagnosis and delays. In any case under review, correlation doesn’t always mean causation. Here are the facts of the case: Overview: The claimant is a three-year-old child who, the plaintiff attorney alleges, has developmental and behavioral issues because of lead exposure in the home. MKC’s legal nurse consultants worked on the defense team for the insurance carrier. What the records say about the child’s lead levels At one year of age, the child’s blood level was 5 mcg/dL, which is considered elevated. Five months later, it was up to 5.3 mcg/dL. Six months later, it was up to 6.9 mcg/dL. The blood lead level was later reported to have spiked to 16 mcg/dL before dropping to 11 mcg/dL, but no lab reports for these final two tests were submitted for review. What the records say about the child’s home When the child was age two, city officials sent a letter to the property owners of the building...
Lead poisoning, especially in children, has made headlines in recent years, for good reason. The condition, found in more than 500,000 U.S. children, can lead to lifelong delays, including damage to the brain and nervous system; slowed growth and development; learning and behavior problems; and hearing and speech issues. The most recent blast of headlines began with the crisis in Flint, Mich. There, after the city started drawing drinking water from the Flint River in 2014, the number of children under six years with high levels of lead in their blood almost doubled. Those rates returned to normal levels after Flint went back to its original drinking water source – Detroit’s water system. Several officials face charges in the case. But, those headlines have only continued as further research has uncovered high levels of lead poisoning among children across the country. One examination by Reuters, the news agency, discovered nearly 3,000 U.S. communities with high rates of lead poisoning among their youngest residents. More claims, cases This renewed concern means some of our clients are seeing more claims related to lead poisoning, a condition the Centers for Disease Control and Prevention calls the “most preventable environmental disease among young children.” But, to truly understand the medical records and history in those case files and get to the bottom of the cause, you’ll need to explore more than just the patient’s health information. Everything from whether the child ever lived outside the country to what products their family uses to the child’s own genetic history are critical for a fully informed review of a lead poisoning case or claim. Aware for decades The public and officials have been aware of the dangers of lead for decades. In the 1950s, the first cities started passing laws about lead-based paint. The federal...