Legal Nurse Consultants and Paralegals

When I am marketing at an attorney conference, attorneys often say to me, “I have a paralegal. She handles my records. Why do I need a legal nurse consultant?” Attorneys may be confused about the differences between legal nurse consultants and paralegals.

Your ability to market your services is dependent on a skillfully phrased answer to this question. You don’t want to denigrate the paralegal yet you want to explain how your background is different.

I performed research that showed some surprising information about the functions of legal nurse consultants and paralegals. I collected data 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 16 attorneys had 1-29 years of experience.

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

Legal nurse consultants and paralegals – not the same

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.

Rather than being in competition with each other, Legal nurse consultants 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.

Legal nurse consultants 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.

Extracted from Pat Iyer and Deborah D’Andrea, “Working with Legal Nurse Consultants”, in Iyer, Levin, Ashton and Powell, Nursing Malpractice, Fourth Edition.

Pat Iyer MSN RN LNCC is president of The Pat Iyer Group.