Do Legal Nurse Consultants and Paralegals Understand Each Other?

Research showed some surprising information about the functions of legal nurse consultants (LNCs) and paralegals. Legal nurse consultants assist the legal team by using their nursing knowledge of the healthcare system. They may testify as expert witnesses, summarize medical records as consultants, locate expert witnesses, calculate costs of future medical care, and perform a whole host of other services. Paralegals have completed a course of study, and may work on medical cases. They act as assistants to the attorney by handling some of the legal procedures.

Data was collected from paralegals, LNCs, and attorneys in order to define the most common activities performed by paralegals and LNCs. The 76 paralegals ranged from students to those with 19 years of experience. |

The 27 LNCs had 0-9 years of experience. The perceptions of 16 attorneys who had 1-29 years of experience were also elicited.

Each person was asked to review a list of functions and indicate if each function was an activity which a paralegal or LNC (or both) could perform.

Despite wide differences in experience and perspectives, a consensus emerged among all of the groups. The most commonly identified legal nurse consultant activities were:

1. Identify medical management issues
2. Identify medical issues not addressed or explained in the records
3. Identify malingerers
4. Point out potential medical complications of injuries
5. Identify medical malpractice

The most common activities attributed to the role of the paralegal were:

1. Obtain medical records
2. Identify costs causally related to the accident
3. Organize medical records
4. Summarize medical records
5. Identify missing records

Paralegals were more easily able to identify functions of their own profession than they were able to define the role of the legal nurse consultant, and vice versa. Experienced paralegals and the attorneys identified more functions of the LNC than did less experienced paralegals. One of the conclusions of this data was that rather than being in competition with each other, LNC and paralegals perform important functions that complement each other. For example, analysis of key medical issues by a LNC cannot occur without the appropriate retrieval and organization of medical records by a paralegal. The identification of costs associated with an injury can be competently performed by a paralegal, allowing the legal nurse consultant to use medical expertise to focus on the clinical issues in the case.

LNCs and paralegals complement each other's skills. As part of the legal team, they can work effectively together. The paralegal is best used for job responsibilities that draw on his or her legal background as an adjunct for the attorney. The LNC is best used for responsibilities that draw on the nurse's expertise with medical issues.

Patricia Iyer MSN RN LNCC performed this research. She is president of Med League at and editor of Nursing Malpractice, 4th edition, 2011. This articled was extracted from Pat Iyer and Deborah D'Andrea, "Working with Legal Nurse Consultants", in Iyer, Levin, Ashton and Powell, Nursing Malpractice, Fourth Edition, 2011. Get your copy here.

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