Dennis BeaverMay 20, 2022 • By Dennis Beaver 

There is a lot to like about Texas. Texans are known for being down-to-earth, helpful and friendly. Texas-style BBQ is famous worldwide. And who hasn’t heard “Deep in the Heart of Texas?”

However, it ranks high among those states with the most vehicular deaths, Houston winning a prize for the greatest number of red light wreck fatalities.

“That’s why I would always count one … two … three before driving into an intersection when my light turned green,” “Art” wrote, adding, “and, you can’t imagine how many red light runners I saw during those three seconds!”

Retains Personal Injury Law Firm – LOP

One day, while counting, the driver behind him was texting, failed to slow down, and the resulting collision totaled both cars leaving Art with severe neck and lower back trauma.

“His insurance company said that I caused the accident by not promptly driving off when my light turned green! On top of that, while I had auto medical payments insurance, the limits were not adequate for my needs. Complicating things, there was talk that workers compensation should be involved as there was a question of my being on the clock or on my own time when the accident occurred.

“So, I hired a Houston attorney – whose ad I saw on television – and he assured me there would be no problem in getting the care I needed. ‘We will send our Letter of Protection (LOP) to the doctors you treat with. This assures them of being paid when the case settles,’ they told me, but none of the physicians I have seen will take my case as long as I am represented by this law firm.

What’s going on?”

How a Letter of Protection is Supposed to Work

A Letter of protection, also called a medical lien is commonly defined as:

– A contract between the lawyer, physician and client/patient;

– That assures payment for professional services provided to the patient when there is a financial recovery, by settlement or by trial.

– The treating physician agrees to wait for payment until the case is resolved;

– If there is no monetary recovery – the client who was injured is still obligated to pay the doctor’s bill.

That’s fairly straightforward, wouldn’t you agree? In fact, ethics opinions of the State Bar of Texas – and just about every other State Bar – make it clear that the LOP creates a fiduciary relationship in which the lawyer is obligated to protect the financial interest of the treating physician.

‘We Pay ourselves First!’

But then just spend a few minutes talking with attorney Rebecca Pennington, who is office manager at Med Center Pain Management in San Antonio, Texas, and you too will wind up shaking your head in disbelief wondering how some lawyers can justify completely ignoring their legal obligation to protect the doctor’s financial rights the LOP creates.

“I just read your article ‘When Lawyers Refuse to Pay a Client’s Bill’. Our pain management clinic in San Antonio sees a large number of personal injury patients. The LOPs have, in the past couple of years, become almost meaningless. They are NOT letters of protection. In fact, they disclaim any responsibility to pay. Here is typical wording from an LOP we received today:

THIS FIRM IS NOT ASSUMING RESPONSIBILITY FOR THE PAYMENT OF FEES OR SERVICES RENDERED TO OUR CLIENT. However, if compensation is recovered on our client’s behalf, your fees will be reimbursed from any money recovered, provided said recovery is reasonable. Whether or not such recovery is reasonable shall be determined at the sole discretion of this law firm.

“They are saying, ‘We don’t have to pay you, doctor, unless we want to!’

“This is so unfair, so wrong! Do you have any insights into how to handle this sort of non-LOP? It seems this has become the norm, and our clinic is considering refusing to accept PI cases now. It’s a waste of time to have bills in the thousands for very expensive procedures only to recover less than enough to pay for the medical assistant’s time, much less to pay the doctor or cover cost of meds and equipment. Thanks for any input you might have.”

I have seen LOPs from several Texas lawyers that make one thing clear. They pay themselves first and in full. The physicians must, on a pro rata basis, reduce their bills, but the lawyers impose no such requirement on themselves!

Every request I had to speak with attorneys whose LOPs have similar language was ignored.

Difficult for Patients to Find Doctors Who Will Treat Them

My reader told me that he has had referrals to several physicians, and none will treat him if he remains with the same law firm. Attorney Pennington confirmed that many physicians are rejecting attorney referrals with LOPs for the same reasons.

Texas is not alone with these issues. Florida is a carbon copy and in many instances, far worse.

And the remedy? On condition of anonymity, a Texas legal ethics law school professor told me, “Part of the problem is greed – by physicians who are charging several times what is a reasonable fee – and lawyers who ignore their legal obligation under the LOP. It is time for the State Bar and Medical Board to get involved and set proper standards.”

One more thing: Medical payments coverage isn’t all that expensive and high limits of PIP coverage, if available in your state, can be money well spent.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.