David Reich, DC

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.

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.

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.

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 normals. Spinal surgical intervention techniques including ordering diagnostic studies using MRI, CT and digital motion x-ray.

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.

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.