Orthopedic, Neurological, And Psychiatric
DME Nurse Observer Services

Orthopedic and neurological DME

Q: Where do you provide services?

A: Michael Haiby, RN provides defense medical examination nurse observer services in Los Angeles, Orange County, and throughout Southern California as well as Central and Northern California (on occasion we are also sent to California State cases where the DME has been agreed to be performed outside of California).

Q: Do you require a retainer to be paid in advance of an appointment?

A: No retainer is required in advance. The invoice for services is provided to the law firm along with the report and audio recording upon completion of the exam.

Q:  What ‘body parts’ are DMEs performed?

A:  Well, you have to start the discussion by remembering that Section 2032 Code of Civil Procedure is referred to as Section 2032 Code of Civil Procedure for Physical and Mental Examination; therefore, you might say that DMEs come in two different types:

1. Defense Mental Examinations (i.e. Section 2032 Psychological/Psychiatric Examinations)—note that the abbreviation DME fits for a Defense Mental Examination.
2. Defense Medical Examinations (i.e. Section 2032 Physical Examinations)—note that the abbreviation DME fits for a Defense Medical Examination.

So what is a ‘Medical Examination’?—the answer is any injury to the plaintiff themselves that is NOT psychiatric or psychological in nature (i.e. a physical injury).  So what is a physical injury?—anything from a scar to a dental injury to a broken bone to the all encompassing ‘soft tissue injuries’ (these could be said to include injuries to the cervical spinal nervous system area, and lower back injuries that might include injury to the lumbar spinal nervous system area), to dog bites (puncture wounds), injuries to the urethra (these are rare, but very bad injuries), eye injuries, injuries to the auditory function areas of the body (hearing loss and/or dizziness—balance problems), mold injuries (very complicated physical problems involved with these).  One way to think about it is to think about the doctors.  Go back up a row of this discussion and the Mental Examinations are conducted by a psychologist or a psychiatrist (or sometimes both).  Then you’ve got (look at my list above) Physical Examinations which are conducted by (again, look at the list) a very wide variety of doctors—plastic surgeons, dentists, neurologists, orthopedists who specialize in spinal surgery and neurosurgeons as well, urologists, ophthalmologists, ear nose and throat specialists (ENTs), rheumatologists, pulmonologists and allergy specialists, the occasional podiatric surgeon and/or podiatrist, the occasional chiropractor.  Of course, sometimes it is pediatrician, a rehabilitation specialist, rarely but we’ve seen cardiologists, gastroenterologists, the very occasional vocational expert, the pain management specialist, rarely an endocrinologist (you’d be surprised how many patients develop type 2 diabetes following their personal injury cases or have their type 2 diabetes greatly worsened), the (I always think it is a ‘made up specialty) physiatrist…  Of course, about 84 percent of DMEs are conducted by an orthopedist of one form or another.  About 12 percent of DMEs are conducted by a neuro (neurologist or neurosurgeon).  Only about 2 percent of DMEs are Mental Examinations—lets see, that leaves about 2 percent of DMEs being conducted by a ‘random’ specialist here and there.  By I digress—BODY PARTS:  Neck very commonly, lower back (much more common that mid or upper back) ears, teeth, ears, shoulders, elbows, forearms, wrists, hands, fingers, hips but not that often, knees commonly, feet and ankle, etcetera, etcetera…  Injuries run the gamut from the scar to the herniated nucleus pulposus (HNP), nerve impingement, nerve ‘damage,’ fractures, disuse syndrome following injury, pain, pain, pain (is pain a body part, no I realize but if you forget it in this discussion obviously, I am doing a disservice to the fundamental problem with many of these injuries).  When one reads the above, it is likely to think about ‘diagnostic tests’ but I can tell you that the VAST MAJORITY of the personal injury attorneys would NEVER consider having their plaintiff submit to an x-ray ordered by a defense medical examiner.  I’ve NEVER seen a personal injury attorney allow their plaintiff submit to an MRI ordered by a defense medical examiner.  I’ve never been to a DME (and my experience is UNRIVALED) where we let a doctor numb a plaintiff (simple eye drop by an ophthalmologist being the exception), stick a ‘tube’ in a plaintiff’s orifice, we don’t let the urologist stick their finger up our plaintiff’s asses, we don’t allow needles being stuck in our plaintiffs so they then can be ‘electrified’ (nerve conduction testing), etcetera, etcetera, so you can see, that what one might think of as a diagnostic test is oftentimes very limited with these examinations.  Having said that, we DO allow, LOTS of diagnostic tests:  strength testing (like grip strength testing), testing of sensation, hearing, eyesight, observation by the doctor, percussion by the doctor, palpation, auscultation, etcetera, etcetera—if I’ve bored you then I apologize (not really…).  I forgot hair (sounds silly but you’d be possibly surprised that we’ve seen multiple cases of plaintiff’s who had their scalps burned when getting their hair done), these are really scalp injuries.  Speaking of scalp injuries—the doctor is NOT supposed to cut the kids head open by going ‘too deep’ during a cesarean section and using the ‘forceps’ to ‘extract the baby from the vagina is always a recipe for negligence (of course these case would be done by an obstetrician).  Which raises the question of medical malpractice cases—what is the percentage of DMEs done for medical malpractice cases versus personal injury cases you ask (you were going to ask me, weren’t you) and my answer would be about 1 percent and the ‘why’ of this, I can only speculate as a layperson in that my perception is that there are a lot more slip and falls and car crashes, falling off of ladders/scaffolding, dog bites (there aren’t that many bad dog bites), etcetera (personal injuries and the small amount of psyche exams done for different reasons) and there are not that many medical malpractice cases (medical malpractice cases are filed much less often than personal injury cases—my layman’s knowledge believes this may well involve, of course, the medical malpractice ‘CAPs’).

Q: Are you familiar with defense psychiatric examinations?

A: Yes. Specifically in providing the plaintiff’s audio recording of the mental examination.

Q: What are the types of DMEs you are experienced with?

A: Of course, the majority of these are orthopedic and neurological; however, I have attended examinations performed by numerous other specialties such as dental, plastic surgery, ophthalmology, etc.

Q: What educational preparation have you had to assist attorneys with a DME?

A: In 2006, I completed the American Bar Association Accredited University of California at Riverside extension Legal Nurse Consultant Certificate Program

Q: What are your fees?

A: Please see my website page Fee Schedule, and feel free to contact me for any questions you may have.

Q: How many DME's have you attended as the nurse observer?

A: See the current total number of DME's that I have attended on my website’s Home Page for this information.

Q: Is a psychiatric examination discussed in the Code of Civil Procedure?

A: Yes, for instance: 2032.010(c) A mental examination conducted under this chapter shall be performed only by a licensed physician or by a licensed clinical psychologist who holds a doctoral degree in psychology and has had at least five years of postgraduate experience in the diagnosis of emotional and mental disorders.

Q: What are the most frequent types of physical examinations that you attend?

A: I would say that for a defense medical examination, about 85% are orthopedic, about 10% are neurological, and then about 5% are of different specialties.

Q: How do you receive assignments?

A: I prefer email at LNCassist@aol.com but feel free to call me on the phone at my home office phone number of (661) 252-3435, and then the cell phone number is (661) 414-6972. For your reference, my fax number is (661) 252-3434.

Q: What makes you uniquely suited as the plaintiff attorney representative at defense medical examinations?

A: 9 years service in the United States Army medical corps, followed by 16 years as a floor nurse in the acute care hospital setting, then University education as a legal nurse consultant, and I’ve had years of experience providing services to attorneys.

Q: What specialty nursing certifications make you very qualified to be a nurse observer?

A: I am an Orthopedic Nurse Certified (ONC) and a Certified Medical-Surgical Registered Nurse (CMSRN).

Q: Have you ever worked in any hospital specialty areas that involve your DME attendances?

A: Yes. For instance, I spent 16 years working on the primary neurological unit in an acute care hospital.

Q: What is the other term for a psychiatric DME?

A: These are also known as mental examinations.

Q: Where's Your Orthopedic DME In Los Angeles County?

A: Agoura Hills, Alhambra, Arcadia, Artesia, Avalon, Azusa, Baldwin Park, Bell, Bell Gardens, Bellflower, Beverly Hills, Bradbury, Burbank, Calabasas, Carson, Cerritos, Claremont, Commerce, Compton, Covina, Cudahy, Culver City, Diamond Bar, Downey, Duarte, El Monte, El Segundo, Encino, Gardena, Glendale, Glendora, Hawaiian Gardens, Hawthorne, Hermosa Beach, Hidden Hills, Hollywood, Huntington Park, Industry, Inglewood, Irwindale, La Cañada-Flintridge, La Habra Heights, La Mirada, La Puente, La Verne, Lakewood, Lancaster, Lawndale, Lomita, Long Beach, Los Angeles, Lynwood, Malibu, Manhattan Beach, Maywood, Monrovia, Montebello, Monterey Park, North Hollywood, Norwalk, Palmdale, Palos Verdes Estates, Paramount, Pasadena, Pico Rivera, Pomona, Rancho Palos Verdes, Redondo Beach, Rolling Hills, Rolling Hills Estates,Rosemead, San Dimas, San Fernando, San Gabriel, San Marino, Santa Clarita, Santa Fe Springs, Santa Monica, Sierra Madre, Signal Hill, South El Monte, South Gate, South Pasadena, Tarzana, Temple City, Torrance, Valencia, Vernon, Wallnut, West Covina, West Hollywood, Westlake Village, Whittier, Barnes City, Belmont Heights, Long Beach, Eagle Rock, Hollywood, Hyde Park, San Pedro, Sawtelle, Tropico, Glendale, Tujunga, Venice, Watts, West Hollywood, and Wilmington.

Q: Where’s Your Psychiatric Defense Medical Examination In Orange County?

Where’s your psychiatric DME in Orange County?: Aliso Viejo, Anaheim, Brea, Buena Park, Costa Mesa, Cypress, Dana Point, Fountain Valley, Fullerton, Garden Grove, Huntington Beach, Irvine, Laguna Beach, Laguna Hills, Laguna, Niguel, Laguna Woods, La Habra, Lake Forest, La Palma, Los Alamitos, Mission Viejo, Newport Beach, Orange, Placentia, Rancho Santa Margarita, San Clemente, San Juan Capistrano, Santa Ana, Seal Beach, Stanton, Tustin, Villa Park, Westminster, Yorba Linda. AND although there are a lesser number of these, we attend psychiatric exams as well.

Q: Where’s Your Riverside County Neurological DME?

A: Riverside County: Beaumont, Blythe, Calimesa, Canyon Lake, Cathedral City, Coachella, Corona, Desert Hot Springs, Eastvale, Hemet, Indian Wells, Indio, La Quinta, Lake Elsinore, Menifee, Moreno Valley, Murrieta, Norco, Palm Desert, Palm Springs, Perris, Rancho Mirage, Riverside, San Jacinto, Temecula, Wildomar

Q: Where’s Your San Bernadino County Ortho Defense Medical Examination?

Adelanto, Apple Valley, Barstow, Big Bear Lake, Chino, Colton, Fontana, Grand Terrace, Hesperia, Highland, Loma Linda, Montclair, Needles, Ontario, Rancho Cucamonga, Redlands, Rialto, San Bernadino, Twentynine Palms, Upland, Victorville, Yucaipa, Yucca Valley, Amboy Angelus Oaks, Arrowhead Farms, Baker, Baldwin Lake, Big Bear City, Big River, Bloomington, Bluewater, Cadiz, Cedar Glen, Crafton, Crestline, Daggett, Declezville, Devore, Devore Heights, Earp, Forest Falls, Goffs, Helendale, Hinkley, Hodge, Joshua Tree, Johnson Valley, Kingston, Kramer Junction, Lake Arrowhead, Landers, Lenwood, Lucerne Valley, Lytle Creek, Mentone Valley, Mount Baldy Village, Mountain View Acres, Muscoy, Nebo Center, Newberry Springs, Nipton, Oak Glen, Oak Hills, Oro Grande, Phelan, Pinion Hills, Red Mountain, Running Springs, Rice, Rimforest, San Antonio Heights, Skyforest, Spring Valley Lake, Sugarloaf, Searles Valley, Trona, Twentynine Palms Base, Twin Peaks, Valley of Enchantment (VOE), Wonder Valley, Wrightwood, Yermo.

Q: Where’s Your Ventura County Psyche Exam?

Camarillo, Fillmore, Moorpark, Ojai, Oxnard, Port Hueneme, Santa Paula, Thousand Oaks, Simi Valley, Ventura.

Q: Where’s Your Santa Barbara County Neuro Exam?

Bellton, Carpinteria, Goleta, Guadalupe, Lompoc, Santa Maria, Solvang, Santa Barbara.

Q: Where’s Your San Diego County Nurse Observer Orthopedic Independent Medical Examination?

Carlsbad, Chula Vista, El Cajon, Escondido, Oceanside, San Diego, San Marcos, Vista, Coranodo, Del Mar, Encinitas, Imperial Beach, La Mesa, Lemon Grove, National City, Poway, Santee, Solano Beach

Q: Do I Cover Kern County?

I cover the Kern County towns of Bakersfield, Delano, Arvin, California City, McFarland, Ridgecrest, Shafter, Tehachapi, Wasco, Maricopa, Taft, Oildale, Lamont, Rosamond, Rosedale, China Lake Acres, Edwards AFB, Ford City, Frazier Park, Golden Hills, Greenacres, Greenfield, Kernville, Lake Isabella, Lebec, Lost Hills, Mojave, North Edwards, Pine Mountain Club, South Taft, Stallion Springs, Taft Heights, Weedpatch, Weldon, Wofford Heights, Cherokee Strip, Derby Acres, Dustin Acres, Edmundson Acres, Fellows, Fuller Acres, Inyokern, Johannesburg, Keene, Lake of the Woods, McKittrick, Mettler, Mexican Colony, Mountain Mesa, Old West Ranch, Onyx, Pumpkin Center, Randsburg, Smith Corner, Squirrel Mountain Valley, Tupman, Valley Acres.

Q: Where Is Your San Luis Obisbo County Orthopaedic Examination?

Arroyo Grande, Atascadero, Grover Beach, Morro Bay, Paso Robles, Pismo Beach, San Luis Obisbo, California Valley, Cholame, Halycon, Harmony, Pozo, Avila Beach, Blacklack, Callender, Cambria, Cayucos, Creston, Edna, Garden Farms, Lake Nacimiento, Los Berros, Los Osos, Los Ranchos, Nipomo, Oak Shores, Oceano, San Miguel, San Simeon, Santa Margarita, Shandon, Templeton, Whitley Gardens, Woodlands.

Q: Where’s Your Imperial County DME?

El Centro, Brawley, Calexico, Calipatria, Holtville, Imperial, Westmorland.

Q: Where’s Your Monterey County Neurologic Defense Medical Examination?

Carmel-by-the-Sea, Del Rey Oaks, Gonzales, Greenfield, King City, Marina, Monterey, Pacific Grove, Salinas, Sand City, Seaside, Soledad.

Q: Where Is Your Fresno County Orthopedic DME?

Auberry, Big Creek, Biola, Calwa, Cantua Creek, Caruthers, Centerville, Clovis, Coalinga, Del Rey, Dunlap, Easton, Firebaugh, Fort Washington, Fowler, Fresno, Friant, Highway City, Huron, Kerman, Kingsburg, Lanare, Laton, Malaga, Mayfair, Mendota, Mercey Hot Springs, Minkler, Monmouth, Old Fig Garden, Orange Grove, Parlier, Prather, Raisin City, Reedley, Riverdale, Rolinda, San Joaquin, Sanger, Selma, Shaver Lake, Squaw Valley, Sunnyside, Tarpey Village, Three Rocks, Tollhouse, Tranquility, West Park

Q: Where Is Your Inyo County Neuro DME?

Big Pine, Bishop, Calavada Springs, Cartago, Darwin, Dixon Lane-Meadow Creek, Furnace Creek, Homewood Canyon, Independence, Keeler.

Q: Where Is Your Tulare County Psychological Defense Medical Examination?

Porterville, Visalia, Dinuba, Exeter, Farmersville, Lindsay, Tulare.

Q: Where Is Your Kings County Neuropsychiatric Independent Medical Examination?

Hanford, Lemoore, Avenal, Corcoran.

Q: is Your San Benito County Nurse Observer Attendance Ortho DME Need?

Hollister, San Juan Bautista, Aromas, Paicines, Tres Pinos, New Idria, Llanda

Contact us now to schedule attendance at your client's DME anywhere in Los Angeles County, Orange County, and throughout Southern California.