John Cintineo, DC DAAMLP

Documentation and Coding, CPT Coding Guidelines for Initial and Established Patients with particular attention paid to Patient History, Review of Systems, Social and Family History, Physical Examination, and Medical Decision making. Specific differences in coding levels and required elements for a 99202-99203-99204-99205, and a 99212-99213-99214-99215. Academy of Chiropractic Post-Doctoral Division , PACE Approved for the Federation of Chiropractic Licensing Board, Cleveland University- Kansas City, Long Island, NY, 2021

Demonstrative Documentation and Ethical Relationships, Pathways to improve coordination of care, and interprofessional communication with collaborating physicians. Maintaining ethical relationships in the medical-legal community through documentation and communication of demonstrable diagnosis, prognosis, and treatment plans. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University-Kansas City, Long Island, NY, 2021

2021 Spine Management Conference - West - The Spine Management Physician, discussion of the Spine Management Physician concept utilizing supportive evidence was presented. Outline of trends in spinal pain management versus a curative model was discussed. Credentials, training, and triage methods were demonstrated for the Doctor of Chiropractic to increase proficiency in spine management. Scientific evidence supporting the need for a portal of entry physician dedicated to spine management oversight was outlined. Key differences between Spine Management Physician and Primary Spine Care was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City , Lehi, Utah, 2021

2021-Spine Management Conference -West- Chiropractic Evidence-Pain Management Care, Outline of neurological mechanisms of central nervous system modulation of pain in the human body was demonstrated. Specific peer-reviewed, medically indexed evidence was presented starting with 2021 Systemic Review outlining spinal manipulation's effectiveness in pain management. Current evidence as well as future trends were discussed and presented. Neurological downregulation was discussed including different afferent and efferent neurological pathways regulated by the dorsal horn of the spinal cord. Interprofessional communication and compliant documentation of the pain management phase of care was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Lehi, Utah, 2021

2021 Spine Management Confernce- West - Physical Examination Workflows- Cervical Spine, Detailed review of cervical spinal physician examination with emphasis on clinical triage between anatomical and biochemical sources of spine pain. Neurological evaluation of the neck and surrounding structures was reviewed including pathological reflexes, assessment of vascular compromise and myelopathic findings. Detailed patient screening was stressed and its correlation to physical examination, red flags and relative vs. absolute contraindications to chiropractic care was presented. Patient positioning and efficient processes were reviewed and demonstrated. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Physical Examination Workflows- Thoracic and Lumbar Spine and Pelvis, Outlines of Thoracic, lumbar and pelvis examination were presented. Neurological evaluation of the lumbar spine and surrounding structures was reviewed including pathological reflexes, assessment of cauda equina syndrome and triage processes for neurologically compromised patients. Detailed screening was stressed and its correlation to physical examination, red flags and relative vs. absolute contraindications to chiropractic care was reviewed. Patient positioning and efficient processes was reviewed and demonstrated. Details relating to lumbar spine and pelvic orthopedic testing was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Interprofessional Communication and Reporting, Review of electronic health record workflows were presented and discussed with emphasis on CPT compliant and efficient reporting. The importance of communication with the patient's other healthcare providers was outlined and discussed. Specific needs of the primary care physician, pain management physician and spine surgeon were outlined and reviewed. Details of simplified vocabulary and necessity of thoroughness were emphasized. Administrative workflows ensuring regular and continued communication of clinical documentation was provided. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Patient Communication, Communication techniques were discussed with emphasis on patient comprehension to increase compliance and reduce patient anxiety. Details were presented on simplification of complex medical terminology to ensure understanding at the initial visitation as well as throughout the patient's care plan. Conversational interaction and dissemination of health information at the appropriate comprehension level was provided. Proper reporting and interprofessional communication were emphasized in a wholistic approach to supporting the patient's needs. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Confrence-West - Intervertebral Disc Morphology, Detailed discussion of the morphological descriptions of intervertebral disc pathology in the cervical, thoracic, and lumbar spine was presented. Differential diagnosis of disc bulge, herniation, protrusion, extrusion, and sequestration were presented. Attention was given to the five grades of annular fissure associating circumferential, radial, and transverse morphology. High intensity zone (HIZ) was discussed in detail as well as its correlation to acute inflammatory fluid. Specific MRI images were presented and correlated to consensus driven definitions of intervertebral disc pathology. Pre-existing degenerative changes in the human spine such as disc osteophyte complex, spondylosis, increased innervation of the intervertebral disc and endplate changes were discussed and correlated to acute findings on MRI. In depth discussion of the difference between morphology and etiology of intervertebral disc pathology was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Ligamentous Response to Traumatic Injury, Anatomical review of spinal ligaments including nerve supply and formation of scar tissue past injury was presented. Function and histological composition were detailed and clinically correlated too physiological thresholds. Injury thresholds were also outlined and compared to the AMA Guides to the Evolution of Permanent Impairment 5th and 6th edition. Detailed review of radiographic findings in the cervical and lumbar spine in the presence of ligamentous injury was reviewed and presented. Clinical criteria supporting the diagnosis of ligament injury and ligament laxity including patient history, physical examination, radiographic findings, and advanced imaging was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Casuality and Spinal Ligamentous Injury, Detailed outline of acute versus chronic spine injury findings were presented. Reliable grading systems for phases of spinal degeneration was reviewed and discussed. Scientifically validated measuring process for intervertebral disc height and the 5 Grades of spinal degeneration proposed by Kettler were outlined. Specific discussion was presented in the differential diagnosis of ligament laxity due to degenerative process and acute ligamentous injury in the functional spinal unit with specific examples of radiographic and advanced imaging findings. Clinical correlation with Modic I, Modic II and Modic III endplate changes including cadaver specimens was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Differential Spinal Tissue and Spinal Injury Triage, Review of spinal tissue types and their response to physical stress and injury was presented. Prognostic factors in patient management were presented in relation to injury to spinal musculature, nerve tissue, ligamentous tissue, intervertebral disc, and bone. Tissue based triage, patient and interprofessional communication was emphasized and stressed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

2021 Spine Management Conference- West - Innervation of Spinal Structures, Specific reviewed of the anatomical innervation of pain generating structures in the human spine was presented. Scientific chronology of nerve supply discovery was presented and discussed. Increased innervation of the degenerating interverbal disc was presented and supported with contemporary scientific evidence. Spinal ligamentous structures as pain generating entities were also reviewed including anterior longitudinal ligament, posterior longitudinal ligament, supraspinous ligament, interspinous ligament and facet capsule. Clinical correlation to patient history, physical examination and imaging findings was emphasized with specific discussion on interprofessional triage and patient management. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City, Lehi, Utah, 2021

Clinical Grand Rounds – Compensatory Lower Back Pain Due to T2 Biomechanical Pathology , case review of spinal biomechanical engineering study in the care plan of non-responsive lower back pain. Review of medical care plan, epidural steroid injections and past medical history. Patient centered approach to full spine assessment in non-responsive chronic lower back pain with associated primary spinal mechanical lesion identified in upper thoracic spine. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2019

Clinical Grand Rounds – Differentiating Pre-existing vs Causally Related Spinal Injury using MRI , case review of traumatic injury to the cervical spine with underlying pre-existing traumatic injuries. Physical examination, neurological and orthopedic testing was clinically correlated to mechanism of injury, plain film radiographs and MRI studies. Comparison of T1, T2 and STIR views were reviewed in relation to intervertebral disc bulge, intervertebral disc herniation, Modic 1, Modic 2 and Modic 3 changes. Comparative review of causally related versus pre-existing changes was demonstrated. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2019

Clinical Grand Rounds –Traumatic Cervical Disc Herniation with Pre-existing Cervical Spinal Fusion–a case review of traumatically induced multi-level cervicaldisc herniation with below a pre-existing spinal fusion, Review of case history, physical examination findings, plain film radiographs, cervical spine MRI with particular attention paid to osteophyte and modic changes. Interprofessional communication both verbally and through proper evidence-baseddocumentation was emphasized and discussedfocusing on acute versus chronic spinal injury. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2019

Documentation in Medical Collaborative Cases, Concluding an E&M report in cases involving medical primary care providers of medical specialists that have complicated case histories, significant risk factors, and inconclusive findings. Triage and management of complicated cases requiring the clinical evaluation, advanced imaging and electrodiagnostics. Academy of Chiropractic, Cleveland University Kansas City, Chiropractic and Health Sciences, Long Island, New York, 2019

MRI Spine Interpretation and Protocols, Contemporary acquisition protocols including slice thicknesses and sequences inclusive of the ordering process. Interpretation of axial, sagittal and coronal views in T1, T2 and stir views inclusive of the disc, spinal cord, extra-dural and intra-dural pathology. Academy of Chiropractic, Cleveland University Kansas City, Chiropractic and Health Sciences, Long Island, New York, 2019

Ethics and Medical Collaboration , Having referral relationships with emergency rooms, neurosurgeons, orthopedic surgeons, pain management specialists, neurologists, neuroradiologist and medical primary care providers based upon clinical dilemmas that processed after a thorough history, examination and imaging if clinically indicated to conclude diagnostic dilemmas. Utilizing evidence-based protocols and acquisition of images and treatment pathways, collaborating with medical specialists and primaries to conclude and accurate treatment plan Academy of Chiropractic, Cleveland University Kansas City, Chiropractic and Health Sciences, Long Island, New York, 2019

Documentation in a Medical – Legal and Insurances, Constructing and concluding an E&M (99202-99205) report that accurately reflects the history, clinical findings and management of trauma cases that concurrently meets the needs of both the carriers in the courts and ethical relationship that concurrently matches the standards of both contemporary academia requirements and a contemporary literature-based standard. Academy of Chiropractic, Cleveland University Kansas City, Chiropractic and Health Sciences, , Long Island, New York, 2019

Trends in Spinal Treatment, Migration of spinal care for mechanical spine issues from hospitals and medical specialists to trauma qualified chiropractors based upon published outcomes. Utilizing imaging studies in spinal biomechanics, pain models and clinical outcomes to determine a conclusive diagnosis, prognosis and treatment plan for triaging in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Neurology of Spinal Biomechanics, Understanding the normal of spinal biomechanics and the neurotransmitters required for homeostasis. The interconnected role of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors in maintaining sagittal and axial alignment in the presence of mechanical pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

MRI Age-Dating of Herniated Discs, The literature, academic and clinical standards to age-date herniated discs. The clinical correlation the pain patters with advanced imaging finings of bone edema, spurs based upon the Piezoelectric effect fo remodeling, high signal on T2 weighted images, Vacuum Discs and disc heights in determining the time frames of the etiology of the spinal disc pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Creating Ethical Collaborative and Medical-Legal Relationships, Understanding the timely triage necessities based upon clinical and imaging outcomes and the documentation required for collaborative physicians to continue care. Ensuring that the documentation is complete, reflective of services rendered and clear for third party consideration in an admissible format to considered in a medical-legal environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Central Innervation of Spinal Biomechanical Engineering, Understanding the lateral and ventral horn’s innervations of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors and the pathways through the spinal thalamic tracts through the periaqueductal region, the Thalamus into the Occipital, pre-frontal, sensory and motor cortexes and the efferently back through the Thalamus to disparate regions in creating spinal homeostasis, Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Identifying Spinal Pathology of MRI, Utilizing T1, T2, STIR and Gradient studies in determining myelomalacia, intra and extra-dural tumors and systemic disease patterns affecting the spinal cord. When to use contrast post-operatively in identifying discal structures vs. adhesions on postoperative advanced imaging. MRI Interpretation of herniated, circumferential bulges, focal bulges, protruded, extruded, comminuted, sequestered and fragmented discs. When to consider a neurosurgical consultation based upon the correlation of imaging and clinical findings. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Computerized Mensuration of Spinal Biomechanical Pathology, Understanding the algorithmic interpretation of spinal biomechanical pathology in a 3-D model and creating treatment plans, impairment ratings and teaching models based upon the vertebral motor unit angles. Determining sagittal and axial alignments in creating a normative baseline for treatment goals and outcomes. PACE Approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Neurosurgical-Chiropractic Collaboration on Spinal Pathology, Utilizing x-ray, MRI and other modalities of advanced imaging in conjunction with spinal biomechanical failure and clinical evaluation to collaboratively create treatment protocols for patients in both the operative and non-operative cases. Determining the boundaries of scope of care for both the chiropractor and neurosurgeon based upon a definitive diagnosis of the mechanical vs. an anatomical lesion. PACE Approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Documentation and Ethics in Medical-Legal Relationships, Creating ethical relationships based upon accurate documentation reflective of the casually related condition of the injured. Ensuring accepted credentials of the doctor based upon Voir Dire standards reflected in an admissible curriculum vitae. How to present demonstrative documentation in the courts reflective of the patient’s pathology. PACE Approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Coding, Documentation and Compliant Coding, Ensuring the correct codes are utilized in an evaluation and management encounter. The correct elements are utilized to support the level of E&M coded along with a self-audit program to ensure ethical billing occurs. Guidelines for history of present illness, primary complaint, review of systems, family, social and past histories are discussed and how to document the same. PACE Approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2019

Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, Triaging the injured and differentially diagnosing both the primary and secondary complaints. Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2018

Spinal Trauma Pathology, Ligament Anatomy and Injury Research and Spinal Kinematics, Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal biomechanics of the spine. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Spinal Trauma Pathology, Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal grey matter, thalamus and cortices involvement. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Spinal Trauma Pathology, Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Spinal Trauma Pathology, Clinical Grand Rounds, The review of case histories of mechanical spine pathology and biomechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Spinal Trauma Pathology, Research Perspectives, The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Evidenced Based Care in a Collaborative Setting; Primary Spine Care 5, A literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendations. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, College of Chiropractic, Long Island, New York, 2018

Current Literature Standards of MRI Spine Interpretation; Primary Spine Care 5, MRI Spine Interpretation of the spine. How to triage a trauma and non-trauma with advanced imaging and document the necessity. We will also cover the basics of MRI Spine Interpretation inclusive of all types of herniations and bulges. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, College of Chiropractic, Long Island, New York, 2018

Spine Brain Connection in Pain Pathways; Primary Spine Care 5, MRI Spine The spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential pathology as sequella. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic’s role. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, College of Chiropractic, Long Island, New York, 2018

Bio-Neuro-Mechanical Mechanism of the Chiropractic Spinal Adjustment; Primary Spine Care 5, The biological, neurological and mechanical mechanisms and pathways from the thrust to the lateral horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, College of Chiropractic, Long Island, New York, 2018

Mild Traumatic Brain Injury/Traumatic Brain Injury/Concussion, Differentially diagnosing mild traumatic brain injury vs. traumatic brain injury and the clinical and imaging protocols required to conclude an accurate diagnosis for head trauma. Texas Chiropractic College, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2018

Medical-Legal-Insurance Documentation, Accurate and compliant documentation of history and clinical findings inclusive of functional losses, loss of activities of daily living, duties under duress and permanent loss of enjoyment of life. Prognosing static vs. stable care, gaps in care both in the onset and in the middle of passive care with a focus on detailed diagnosing. The integration of chiropractic academia, the court system and the insurance reimburser’s requirements for complete documentation. Texas Chiropractic College, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2018

Stroke Anatomy and Physiology: Brain Vascular Anatomy, The anatomy and physiology of the brain and how blood perfusion effects brain function. A detailed analysis of the blood supply to the brain and the physiology of ischemia. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Stroke Anatomy and Physiology: Stroke Types and Blood Flow, Various types of stroke identifying ischemia, hypoperfusion, infarct and penumbra zones and emboli. Cardiac etiologies and clinical features as precursor to stroke with associated paradoxical emboli and thrombotic etiologies. Historical and co-morbidities that have etiology instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, College of Chiropractic, Buffalo, New York, 2018

Stroke Principles of Treatment an Overview for the Primary Care Provider, Stroke type and treatments performed by vascular specialists. The goals of treatment with the physiology of the infarct and penumbra zones and the role of immediate triage in the primary care setting. Detailing the complications of stroke and future care in the chiropractic, primary care or manual medicine clinical setting. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Clinical Evaluation and Protocols for Identifying Stroke Risk, Clinical Evaluation and Protocols for Identifying Stroke Risk, The neurological history and examination for identifying stroke risks with a focus on supra and infratentorial regions, upper and lower motor lesions, cranial nerve signs, spinal cord pathology, motor and sensory pathology and gait abnormalities. Examining genetic and family histories along with dissection risk factors. Stroke orthopedic testing and clinical guidelines pertaining to triage for the primary care provider. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Interprofessional Hospital Based Spine Care, Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues. Texas Chiropractic College, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2018

Orthopedic Testing: Cervical Spine, Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division,, Buffalo, New York, 2018

Orthopedic Testing: Cervical Spine - Part 2, Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Orthopedic Testing: Lumbar Spine, Integration of lumbar orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Orthopedic Testing: Clinical Grand Rounds, How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2018

Triage and Management of the Trauma and Non-Trauma Patient, Differentially diagnosing spinal issues in the trauma and non-trauma patient inclusive of spinal disc pathology utilizing x-ray, MRI, CAT Scan and clinical evaluations. Collaborative triaging protocols with neurologists, neurosurgeons, orthopedic surgeons, pain management and primary medical care providers with both mechanical and anatomical spinal pathologies. Academy of Chiropractic, PACE Approved for the Federation of Chiropractic Licensing Boards, Long Island, New York, 2018

Connective Tissue Pathology, Spinal Biomechanics as Sequella to Trauma, MRI Spine Interpretation, Ordering Protocols & Triaging the Injured, The latest research on the 6 ways to age-date disc herniations and bulges from trauma inclusive of disc pathology nomenclature. MRI ordering protocols, inclusive of Dixon format and fat-suppressed images. The neurology and pathology of connective tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure. Contemporary evidenced-based building blocks for triaging and in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Spinal Biomechanical Engineering Digitizing, Integrating automated mensuration into creating treatment plans and determining maximum medical improvement. A literature-based study of normal vs. abnormal motor until function. Determining ligamentous laxity, alteration of motion segment integrity and pathological stress units and whole person impairment based upon the literature and academic standards. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Science of the Chiropractic Spinal Adjustment and Vertebral Subluxation, The literature-based definitions of both the mechanisms the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that is the arbiter for normal vs. abnormal function. The physiological mechanisms of how the chiropractic spinal adjustment affects the peripheral and central nervous systems. Subluxation degeneration/Wolff's Law was detailed from a literature perspective combined with the mechanism of subluxation (bio-neuro-mechanical lesion). A literature perspective why long-term chiropractic care is clinically indicated as usual and customary to effectuate demonstrable biomechanical changes in the spine. An evidenced-based perspective of why physical therapy is a poor choice for spine as a first referral option for any provider inclusive of the literature. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Documentation, Collaboration, and Primary Spine Care, An academic basis for documentation that is usual and customary across professions in collaborative care. Maintaining ethical medical-legal relationships based upon Voir Dire and Duabert standards with ensuring an inclusive report. Ensuring Primary Care Status based upon academic standards. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Documentation of the Trauma and Non-Trauma Case, Documenting primary and associated complaints, past history, allergies, medications, review of systems, previous treatment, family-social medical histories, previous tests and results, history or previous injuries and illnesses, on the job questionnaire, auto accident questionnaire, vital examination, neurological examination, orthopedic testing, test orders, prognosis and treatment plans. A detailed review of current CPT coding requirements for the proper documentation of E/M visits to properly code for billable patient services. Focused attention was paid to the performance of comprehensive patient history, physical examination, review of systems as well as determining the level of clinical decision making. Analysis of a properly organized E/M report was reviewed to demonstrate proper organization and language use. PACE Approved for the Federation of Chiropractic Licensing Board, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Interprofessional Reporting and Case Documentation, analysis of case flow, patient chart organization and EMR workflows to optimize the success and satisfaction of the patient encounter, feasibility of accurate and timely documentation as well as strategies to provide timely interprofessional clinical communication. Focus was provided on patient, primary care and medical specialty communication beginning at the initial visitation all the way through to the release from care. An internal compliance review to ensure complete documentation based upon the E/M level billed. PACE Approved for the Federation of Chiropractic Licensing Board, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018

Pain Management, Large and Small Nerve Fiber Electrodiagnostic Exams, Correlation to Radiographic and MRI Imaging Examinations, The neurology and pathology of neural tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure. American Association of Sensory Electrodiagnostic Medicine, ACCME, Little Rock, AR, 2018

Clinical Applications of Electrodiagnostic Exams of Upper and Lower Extremities utilizing Small Pain Fiber Nerve Conduction Exams, Utilizing Small Pain Fiber Testing to identify the source of chronic spinal and peripheral pain. Contemporary research on anatomy and physiology of pain fibers. American Association of Sensory Electrodiagnostic Medicine, ACCME, Little Rock, AR, 2018

Contemporary Approaches to non-invasive pain management, Low back neurologic and orthopedic examinations, Pain neurophysiology, Pharmaceutical approaches to pain management, Electrotherapeutic pain management techniques. Fibromyalgia and small nerve fiber electrodiagnostic exams American Association of Sensory Electrodiagnostic Medicine, ACCME, Little Rock, AR, 2018

Small Pain Fiber Nerve Conduction Exam, Testing protocols and demonstration of clinical competency American Association of Sensory Electrodiagnostic Medicine, ACCME, Little Rock, AR, 2018

Primary Spine Care Symposium – Medical-Legal Documentation, The contemporary documentation required in a medical-legal environment that is evidenced based and meets the standards of the courts and academia. Utilizing the scientific data to support a diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professional’s credentials. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

Primary Spine Care Symposium – Interprofessional Spine Care, Clinical analysis of anatomic versus biomechanical spine pain and clinical triage protocols., Relating current research trends in the Whole Spine Model of patient including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for sagittal balance in the human spine and current methods of assessment. Patient centered approach to Evidenced Based Spine care with a focus on diagnosis, prognosis and triage of the spine pain patient. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

Primary Spine Care Symposium – Physiology and Anatomy of Spinal Manual Adjusting, Understanding the role of mechanoreceptors, proprioceptors and nociceptors with facets, ligaments, tendons and muscles in aberrant spinal biomechanics. MRI and imaging studies of decompressing via a chiropractic spinal adjustment of the bio-neuro-mechanical lesion and its effects on the central nervous system both reflexively and supratentorally. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

Primary Spine Care Symposium- Connective Tissue and Spinal Disc Pathology, The morphology and pathology of connective tissue, inclusive of spinal disc disorders and prognosticating wound repair with permanency implications. Disc bulge, herniation, protrusion and extrusion classifications based upon contemporary literature and how to age-date disc pathology. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

Primary Spine Care Symposium – Epidemiology of Spine Pain, Review of the current Centers for Disease Control [CDC} data on the frequency of musculoskeletal pain in the United States population with emphasis on pain of spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance of spinal biomechanics. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

Accident Reconstruction: Terms, Concepts and Definitions, The forces in physics that prevail in accidents to cause bodily injury. Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury. PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2017

Accident Reconstruction: Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident. PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2017

Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site. PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2017

Accident Reconstruction: Research, Causality and Bodily Injury, Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints. PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2017

Spinal Biomechanical Engineering Analysis, Normal vs. abnormal coupling motions in a mechanical model utilizing engineering principles in a predictive model. Applying the cartesian nomenclature to normal and pathological sequella of the human spine. PACE approved for the Federation of Chiropractic Licensure Boards, Melville, NY, 2017

Spinal Biomechanical Engineering Clinical Application, Creating treatment plans based upon predictive models in determining what is corrective vs. management of pathological spinal biomechanical behavior. PACE approved for the Federation of Chiropractic Licensure Boards, Melville, NY, 2017

MRI Spine Interpretation and Spinal Biomechanics, Bulging, herniated, protruded and extruded disc contemporary nomenclature, analysis and differential diagnosis. Connective tissue physiology and pathology with aberrant biomechanical permanent sequelae, Texas Chiropractic College, Academy of Chiropractic, Melville, NY, 2017

Contemporary Literature in Spinal Biomechanics, Normal vs. pathological biomechanical spinal motion both in a single motor unit and coupling actions. Interdisciplinary approach to mechanical spine issues and evidenced based care paths, Texas Chiropractic College, Academy of Chiropractic, Melville, NY, 2017

Documentation of Spinal Trauma, Interdisciplinary approaches in documentation of spinal related injuries inclusive of connective tissue disorders and biomechanical failure. Clinically correlating history, imaging, advanced imaging and clinical findings to conclude an accurate diagnosis, prognosis and treatment plan, Texas Chiropractic College, Academy of Chiropractic, Melville, NY, 2017

Contemporary Literature of the Chiropractic Spinal Adjustment, The bio-neuro-mechanical scientific foundation of spinal lesion and the neurological pathways, both in the lower and upper motor neuron pathways. The autonomic sequella of the vertebral subluxation and the effects of the correction and maintenance of those lesions, Texas Chiropractic College, Academy of Chiropractic, Melville, NY, 2017

MRI Spine Interpretation, herniated, bulged, protruded, extruded and sequestered discs; morphology and pathology., MRI diagnostic and analytic sequencing of T1, T2 and STIR. Post traumatic pathology inclusive of spinal cord and nerve root abutment and compression. Accurate documentation of all MRI findings. PACE approved for the Federation of Chiropractic Licensure Boards, Academy of Chiropractic, Saddle Brook, NJ, 2017

Primary Spine Care Qualified, This qualification includes graduate chiropractic education in healthy and traumatically altered spinal morphology inclusive of osseous, connective tissue and neurological structure, function and pathology. This certifies you are qualified in assessing predictive models in spinal biomechanics and devising engineering paradigms for treatment plans to maximize spinal homeostasis in an evidenced based conclusion. In addition, this qualification acknowledges your expertise in triaging the injured and coordinating collaborative care from the trauma through conclusion of rehabilitation. Academy of Chiropractic Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2017

Impairment Rating, The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocation and functional loss are also detailed in relation to impairment ratings. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017

Spinal Biomechanical Engineering: Cartesian System, The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering & Organizational Analysis, Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering: Cervical Pathobiomechanics, Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanics in Trauma, To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnosing normal versus abnormal facet motion along with case studies to understand the clinical application. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering: Cervical Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Primary Spine Care - Central Nervous System Processing of Pain and Physiology, Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanoreceptors and proprioceptors. The effects of neuropeptides on the hypothalamus, pituitary and adrenal axis when treating patients. Texas Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, New York, 2016

Primary Spine Care – MRI, Bone Edema and Degeneration, The effects of trauma on spinal vertebral segments and the short and long term sequella to morphology. Identifying and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfeiffer changes Texas Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, New York, 2016

Primary Spine Care – Hospital and Emergency Room Care, Identifying spinal lesions inclusive of cord and root lesion through examination and advanced imaging in creating an accurate diagnosis, prognosis and treatment plan to effectively triage in collaboration and coordination with medical specialists and emergency department physicians. Differentially diagnosing and triaging disc degenerative bulges, traumatic disc bulges, protrusion herniations, extrusion herniations and fragmented herniations along with managing traumatically induced pain as sequella to degenerative disc trauma Texas Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, New York, 2016

Documentation and Evidence in a Medical-Legal Practice, The role of scientific research conclusions with contemporary documentation to effectively support the necessity for clinically indicated care. The role of timely evaluations and re-evaluations in coordinating care inclusive of history, physical and evaluation report and concludes with the correlation of the SOAP note and HCFA that correlates the conclusion of the evolutionary findings. Coordinating research and clinical findings with primary care providers and medical specialists in the rehabilitation process inclusive of insurance requirements and contemporary MRI research nomenclature. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Boca Raton, Florida, 2015

Certification in Manipulation Under Anesthesia (Re-Certification) and Medication Assisted Manipulation, Southern California University of Health Sciences, Montvale, New Jersey, 2015

Primary Spine Care with Interdisciplinary Collaborative Care, Triage of patients based upon MRI findings of disc herniation, disc bulge, protrusion, extrusion or sequestrations and spinal cord or nerve root negative sequella, clinical findings of neuro-compressive pathologies and neurodiagnostic findings of EMG-NCV, SSEP, VEP, BAER, VEP and V-ENG findings. Texas Chiropractic College, New York State Department of Education Board for Chiropractic, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Islandia, New York, 2015

Primary Spine Care, Neurophysiological central and peripheral nervous systems mechanisms of pain with integrated higher cortical functions of the thalamus, cingulate, amygdala, pre-frontal, motor and sensory cortexes. Trauma and chronic pain care effecting mechanoreceptors, nociceptors and proprioceptors through adjustive therapy based upon evidenced based care and current literature verification Texas Chiropractic College, New York State Department of Education Board for Chiropractic, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Islandia, New York, 2015

MRI Protocols Clinical Necessity, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images., Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequellae, including bulge, herniation, protrusion, extrusion and sequestration. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards., Buffalo, NY, 2015

MRI Interpretation of Lumbar Degeneration/Bulges, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration., With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Central canal and cauda equina compromise interpretation with management. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards., Buffalo, NY, 2015

MRI Interpretation of Lumbar Herniations, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations., With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards., Buffalo, NY, 2015

MRI Interpretation of Cervical Degeneration/Bulges, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration., With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards., Buffalo, NY, 2015

MRI Interpretation of Cervical Herniations, MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations., With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2015

MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc., MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolisthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards., Buffalo, NY, 2015

Certification in MRI Interpretation, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2015

Evidence Based Interprofessional Collaboration-Primary Spine Care, Chiropractic as primary spine care based upon the literature conclusions and the documentation requirements to support those conclusions in an ethical collaborative environment inclusive of hospitals, emergency rooms, primary care medical doctors and medical specialists. Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing Boards, Texas Chiropractic College, Las Vegas, Nevada, 2015

Contemporary Literature Review of the Chiropractic Adjusting Mechanism-Primary Spine Care, The latest scientific evidence of the effects of the chiropractic spinal adjustment on the central nervous system, both upper and lower motor neurons. A comparative analysis of chiropractic vs. other modalities and therapies. Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing Boards, Texas Chiropractic College, Las Vegas, Nevada, 2015

Spinal Biomechanical Engineering, Triage and Documentation, Utilizing principles and algorithms of spinal biomechanical engineering to analyze chronic and trauma patients in creating diagnostic, prognostic and treatment protocols. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Elmhurst, New York, 2014

Evidence Based Practice, Triage and Documentation, Understanding and applying scientific literature in trauma patients to create diagnostic, prognostic and treatment protocols. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Elmhurst, New York, 2014

MRI Bulge, Herniation, Protrusion and Extrusion Interpretation, Differentially diagnosing disc Bulges, Herniations, Protrusions and Extrusions via MRI utilizing protocols of the American College of Radiology and T1, T2, STIR, Floor line and 3-D sequencing. Differentiating between pathology and trauma related findings Federation of Chiropractic Licensure Boards, Saddle Brook, New Jersey, 2013

Spinal Biomechanical Engineering, Differential diagnosis of pathobiomechanics in the cervical, thoracic and lumbar spines as a sequellae to micro and macrotrauma and chronic biomechanic instabilities. Understanding the clinical implications of long term biomechanical failure in resultant disc pathology, ligament pathology and osseous pathology Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Boca Raton, Florida, 2013

MRI Spine Interpretation, Bulge, herniated, protruded, extruded, sequestered discs, differential diagnosis and clinical triage implications. MRI physics and slice protocols Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Boca Raton, Florida, 2013

MRI Interpretation of Herniations and Bulges, MRI slices, views, T1, T2, Stir, Axial, Stacking, FFE, FSE and Sagittal images in the interpretation of lumbar degeneration with the co-morbidities, and complications of stenosis, pseudo-protrusions, cantilevered vertebrae, Schmorl’s nodes and herniations. Spinal cord and canal compromise interpretation with management Academy of Chiropractic Post-Doctoral Division, NJ Office of the Attorney General, Division of Consumer Affairs, State Board of Chiropractic, Iselin, New Jersey, 2013

Documentation and Triage in Trauma, ICD-9 and CPT requirements in coding for the traumatically injured including integrating electronic health records including informed consent, evaluation and management, testing orders. The utilization of research in medical reports for both the trauma and non-trauma patients. Clinical coordination of care and reporting to healthcare and legal providers New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Medical-Legal Research and the Documentation of Causal Relationship, Prognosis and Treatment of the Traumatically Injured, Review of current research published in peer reviewed medically indexed journals focusing on traumatic injuries and how current literature affects the diagnostic conclusion and how to formulate treatment plans New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Biomechanics of Spinal Trauma and its Relationship to Pre-Existing Injuries and Degenerative Changes, Whiplash associated disorders and the biomechanics of side impact vs. rear impact with emphasis on traumatic forces and body position, the mechanism of whiplash injury phases with their relationships to physiologic tolerance to trauma, specific diagnosis of disc pathology and annular tear, disc herniation, fracture, ligamentous injury and instability. Details of spinal nerve root stretching injury and dimensions of the spinal canal during whiplash was outlined particular to significant spinal injury resulting from low level accelerations including pediatric spinal trauma and physiological normal. Spinal surgical intervention techniques including ordering diagnostic studies using MRI, CT and digital motion x-ray New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

MRI Spine Interpretation of Disc Bulge and Herniation, Spinal MRI findings related to degenerative changes vs. traumatic changes of the intervertebral disc by using definitions provided by the American Society of Neuroradiology. Anatomy of the intervertebral disc, spinal cord, nerve roots and spinal ligaments correlated to T1, T2, STIR sagittal, stacking and axial images. Anatomical MRI differentiation of normal, degenerative and traumatic changes New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Electrodiagnostics Interpretation, EMG/NCV, Somato-sensory evoked potentials, brain stem auditory evoked potential and visual evoked potential utilization, physiology and interpretation, electrodiagnostic testing as a clinical component in part of the neurological work-up of the traumatically injured patient in both the peripheral and central nervous system. Inductions and contraindications to electrodiagnostic procedures. The utilization of electrodiagnostics in concluding radiculopathy, myelopathy and plexopathy and determining recent trauma or chronic pathology New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Admissibility Standards of the Medical Expert in Trauma, Documentation requirements of the courts in a medical-legal case including causality, bodily injury and persistent functional losses, ethically reporting of functional loss as it pertains to the integrity of the joint and activities of daily living and implications of chronicity, reporting of normal findings, maximum medical improvement and the release of the patient in the medical-legal arena New Jersey State Board of Chiropractic Examiners, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Physical Diagnosis and Low-Tech Rehabilitation, Physical evaluation protocols and review of orthopedic, neurologic and chiropractic examination protocols to arrive at an accurate diagnosis, prognosis and treatment plan. Differential diagnosis and establishing medical necessity for advanced imaging studies and electrodiagostic testing New York Chiropractic College, Hazlet, New Jersey, 2011

MRI Spine Interpretation, Spinal MRI findings related to degenerative changes vs. traumatic changes of the intervertebral disc by using definitions provided by the American Society of Neuroradiology. Anatomy of the intervertebral disc, spinal cord, nerve roots and spinal ligaments correlated to T1, T2, STIR sagittal, stacking and axial images. Anatomical MRI differentiation of normal, degenerative and traumatic changes CMCS Management, Inc., Union, New Jersey, 2011

Foundational Laboratory Analysis, Review of specific blood tests and panel, indications for testing and interpretation of results. Application of blood testing results in formulating a nutritional supplement program for treatment of various health conditions and to maintain proper chemical balance in the human body Texas Chiropractic College, Uniondale, New York, 2011

MRI History and Physics, Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Terry Button PhD, Medical Physicist, Long Island, New York, 2010

MRI Spinal Anatomy and Protocols, Normal anatomy of axial and sagittal views utilizing T1, T2, 3D Gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, Neuroradiologist, Long Island, New York, 2010

MRI Disc Pathology and Spinal Stenosis, MRI interpretation of bulged, herniated, protruded, extruded sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, Neuroradiologist, Long Island, New York, 2010

MRI Spinal Pathology, MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metasasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, Neuroradiologist, Long Island, New York, 2010

MRI Methodology of Analysis, MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, Neuroradiologist, Long Island, New York, 2010

MRI Clinical Application, The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Magdy Shady MD, Neurosurgeon, Long Island, New York, 2010

Triaging the Trauma Patient, Clinically correlating causality and bodily injury in determining through clinical evaluation a conclusive diagnosis and treatment plan. Integrating neurological conductive studies and evoked potentials with MRI’s in concluding the final diagnosis when differentially diagnosing critical care vs. rehabilitative care as a sequella to trauma Academy of Chiropractic Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education Board for Chiropractic, Brentwood, New York, 2010

MRI Interpretation in the Trauma Patient, Interpreting MRI’s of the cervical, thoracic and lumbar spine utilizing standards of the American College of Radiology and the American Society of Neuroradiology. Differentially diagnosing herniation, bulged, protruded, extruded and fragmented discs and their relationship to trauma vs. degeneration Academy of Chiropractic Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education Board for Chiropractic, Brentwood, New York, 2010

Managing the No-fault “PIP” Practice Under 2010 PIP Laws & Regulations, Review of current issues with regard to PIP/AICRA regulations as it regards to coding, fee schedule, decision point review, ability to order, read and interpret MRI findings Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Legal Issues Associated with New Scope of Practice, Review of current issues with regard to new scope laws, including the ability to provide dietary/nutritional counseling, prescribe/dispense nutritional supplements, utilize modalities/therapies without adjusting, treat extremities, and order additional diagnostic test/studies Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Documentation Designed to Protect Your Practice, Telling the story of medical necessity while protecting from post payment audits Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Leading the Wellness Revolution, Utilizing today’s modern chiropractic strategies to reduce growing health care costs in the US Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Nutrition & Blood Chemistries – Keeping It Simple & Effective to Improve Outcomes, Utilizing lab results to accurately provide proper vitamin and supplement therapies Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Safety of Chiropractic, Chiropractic safety and risk factor overview based on best practices guidelines chapter 4 including the risk benefit ratio of chiropractic intervention Association of New Jersey Chiropractors, New York Chiropractic College, East Brunswick, New Jersey, 2010

Diplomate, American Academy of Medical Legal Professionals, 2010

MRI Normal Anatomy & Protocols, Spinal anatomy of all MRI views utilizing T1, T2, 3D gradient, stacking and STIR sequences of imaging. Advanced protocols of MRI examination with multiple sequences to create concurrent diagnostic findings CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, DABR-NR, Neuroradiologist, Ronkonkoma, New York, 2009

MRI Disc & Spinal Cord and Spinal Canal Pathology, MRI interpretation of spinal disc pathologies as a result of trauma and degenerative factors and resultant neurological compromise. Spinal cord and spinal canal pathologies and space occupying lesion interpretation CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Robert Peyster MD, DABR-NR, Neuroradiologist, Ronkonkoma, New York, 2009

Accident Reconstruction and Ensuing Bodily Injury, Understanding the forces involved in crashes and the transference of those forces from the bullet car to the target car. Quantifying those forces to determine bodily injury and calculating speed, distance, time and drag factors in determining causality and direction of forces CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Ronkonkoma, New York, 2009

AMA Guides to the Evaluation of Permanent Impairment 6th Edition, Clinically coordinating spinal pathology with neurological and functional sequelae including station & gait, migraines, sexual dysfunction, sleep & arousal disorders, paroxysmal disorders, radiculopathic disorders and central nervous system disorders CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Ronkonkoma, New York, 2009

MRI Interpretation of Herniated Disc and Spinal Cord and Root Encroachment, MRI interpretation of herniated, protruded, extruded, bulged and sequestered discs and their relationship to the spinal cord and spinal nerve roots and the clinical correlation to spinal adjustments, manual spinal therapy and joint mobilization Magdy Shady MD, Neurosurgeon, Neuro-Trauma Surgery, CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Ronkonkoma, New York, 2009

MRI Interpretation of Spinal Cord, Spinal Disc and Spinal Canal Disorders, MRI interpretation of herniated, protruded, extruded, bulged and sequestered discs & spinal stenosis as sequelae of ligamentous hypertrophy, congenital malformation, spinal cord pathology. Clinical necessity and contraindications Robert Peyster MD, DABR, CAQ-NR, Neuroradiologist, CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education, Ronkonkoma, New York, 2009

Diplomate, American Academy of Medical Legal Professionals, American Academy of Medical Legal Professionals, 2008

Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Department of Education Board for Chiropractic, Long Island, New York, 2008

Diagnostics, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department Board for Chiropractic, Long Island, New York, 2008

Crash Dynamics and Its Relationship to Causality, n extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G's of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department Board for Chiropractic, Long Island, New York, 2008

MRI, Bone Scan and X-Ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department Board for Chiropractic, Long Island, New York, 2008

Neurodiagnostic Testing Protocols, Physiology and Indications for the Trauma Patient, Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual (V-ENG) interpretation, protocols and clinical indications for the trauma patient CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department, Board for Chiropractic, Long Island, New York, 2008

Documentation and Reporting for the Trauma Victim, Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department, Board for Chiropractic, Long Island, New York, 2008

Documenting Clinically Correlated Bodily Injury to Causality, Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm CMCS Post-Doctoral Division, New York Chiropractic Council, New York State Education Department, Board for Chiropractic, Long Island, New York, 2008

Interpreting Spinal Trauma; MRI Interpretation, MRI History including the development of NMR and its evolution to present day MRI. Normal anatomy of axial and sagittal images utilizing T1 and T2 sequences. MRI interpretation of herniated, bulging, protruded, extruded, sequestered and fragmented discs. Clinical correlation of MRI findings to arrive at an accurate patient diagnosis New York Chiropractic College, Bloomfield, New Jersey, 2007

Certification in Manipulation Under Anesthesia (MUA), Los Angeles College of Chiropractic, Southern California University of Health Sciences, Saddle Brook, New Jersey, 2006

Certification in Fitness and Sports Training Program (FAST), Pneumex, Inc., Sandpoint, Idaho, 2005

The Pneu-Back System for Back Pain, Clinical theory and application in the treatment of back pain/disc disorders utilizing the Pneumex Unweighting system and protocols Pneumex, Inc., Sandpoint, Idaho, 2005

The Pneu-Back System for Scoliosis, Clinical theory and application in the treatment of scoliosis utilizing the Pneumex Unweighting system and protocols. Pneumex, Inc., Sandpoint, Idaho, 2005

Certification in Diagnostic Nerve Conduction Velocity (NCV) Testing, New York Chiropractic College, 2004

EMG Interpretation and Neurodiagnostic Nerve Conduction Velocity (NCV) Testing, New York Chiropractic College, Bedminster, New Jersey, 2004

Meeting the Needs of the Elite and Professional Athlete, Multiple module certificate course encompassing theory, application and protocols necessary to treat the advanced, competitive athlete CEPA (Care of the Elite and Professional Athlete), Philadelphia, Pennsylvania, 1999

Back Injury Prevention, Multiple module certificate course in low back pain diagnosis and management, back injury prevention and aerobic exercise safety instruction Southeast Back Institute, Davenport, Iowa, 1986

Erhardt X-Ray Series, 120-hour multiple module certificate course in the reading and diagnosis of spinal and skeletal pathology, anomalies and disorders Palmer College of Chiropractic, Davenport, Iowa, 1986

Spinal Biomechanical Engineering Principles and Application, Integrating spinal biomechanics and pathobiomechanics through digitized analysis. The comparison of organized versus disorganized compensation with regional and global compensation. Advanced analysis and integration of pathobiomechanics as sequella to trauma in clinical practice and documentation. Academy of Chiropractic, Recognized by the Federation of Chiropractic Licensing Boards, Las Vegas, Nevada, 2013

Evidenced Based Practice, Integrating indexed peer reviewed research as evidence into clinical practice related to trauma and the creation of a diagnosis, prognosis and treatment plan. Academy of Chiropractic, Recognized by the Federation of Chiropractic Licensing Boards, Las Vegas, New Jersey, 2013

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