Legal Nurse Consultant – Everything You Need to Know

Legal Nurse Consultants are an important part of the legal team at many firms. They help attorneys negotiate the most complicated medical aspects of their cases with insider knowlege gained from years on the front lines of the medical community. Legal nurse consulting can be a rewarding, and potentially lucrative, career path for those with the requisite nursing experience. However, the road to becoming a successful legal nurse consultant is long and occasionally filled with misinformation. For attorneys, a legal nurse consultant can be an invaluable tool in medical malpractice litigation. By helping to focus their efforts on the most important aspects of the case at hand. Below is a primer on everything you need to know about legal nurse consulting. What they do, how much they make, and what they can do to improve a medical malpractice firm’s chances of winning big for their client.

What is a Legal Nurse Consultant?

A legal nurse consultant assists attorneys with complex medical issues that may arise in the course of litigation. Often serving to educate attorneys on a variety of medical issues ranging from standards of care to administrative practices. LNCs will be called upon to review cases for merit, interpret medical records, and assist attorneys with their preparations for depositions, trials, review panels, arbitration, and mediation hearings.

“Legal nurse consulting covers a surprisingly wide range of practice options, education, employment settings, and specialties,” says Wendie Howland, Legal Nurse Consultant and Editor of The Journal of Legal Nurse Consulting. “It’s also important to consider that the term “legal nursing” covers more than nurses who work for or with plaintiff or defense attorneys. [Legal nurse consultants] can also work for insurance companies, financial institutions, and structured settlement companies. Life care planning and work compensation case management are also legal nursing specialties.”. While it’s not required, many nurses interested in becoming legal nurse consultants choose to take certification courses and tests. This includes those offered by the American Legal Nurse Consultant Certification Board. This is in order to gain a better understanding of the legal system and an LNC’s place within it.

What Do They Do?

Legal nurse consultants will usually posses several key skills that make them valuable additions to a law firm’s team. Chief among them is their ability to interpret medical records. Using their training as medical professionals, LNCs are able to quickly evaluate medical records and distill them into comprehensive summaries. Their attorney clients can then quickly read, understand, and put them into action.

In addition to their ability to understand medical records, LNCs can also identify possible breaches in the standard of care in a medical malpractice case. They can help attorneys identity strong cases and prevent them from taking on weaker ones. LNCs provide many other valuable functions, such as determining proximate cause for client injuries, assessing damages, and assisting with case strategy. As Howland explains, “many LNCs do behind-the-scenes work reviewing cases for errors, standards of care breaches, and the like, to assist their plaintiff and defense attorney clients decide on merit. Some are in-house employees, some are independents. Generally speaking, we are RNs hired for our expertise as nurses, because our nursing education and experiences makes us able to understand, investigate, and communicate health-related information in a way that no other profession can match.”

Typical Salary

The earning power of a LNC is highly variable depending upon the circumstances of their employment. However, some manage to build very lucrative practices over time. Legal nurse consultants at any level tend to out-earn their RN counterparts.

• 1 year or less experience – $50,048 to $81,094 year
• Total range – $51,965 – $211,959
• Average – $77,772

There is a high earning potential for the most successful LNCs. However, those interested in entering the field should understand that those high salaries will not be realized immediately. “Unlike the most famous LNC programs that advertise heavily indicate, nurses should not expect to take a course and go to a six-figure income right away,” Howland says. “Though more attorneys are recognizing how much value a legal nurse consultant can bring to the firm’s practice, most LNCs just starting out can count on about at least a five-year period of building their businesses before they can quit their ‘day jobs.’ Some never recoup the cost of those high-price, widely-advertised programs and are paying off the loans for years.”

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Some LNCs also serve as expert witnesses; however, this usually requires that the nurse’s full time employment remains in their area of primary practice. “Credibility in expert witnesses is based on their currency in the field,” Howland says. “So, a nurse asked to testify on a matter related to obstetrical nursing practice should be currently or recently employed in an obstetric clinical area. A wound care expert witness nurse should be actively certified and practicing in wound care. A nurse life care planner writing or critiquing life care plans should be actively practicing in life care planning.”

How To Become a Legal Nurse Consultant

Legal nurse consultants must first become a registered nurse (RN). Becoming an RN requires a two year Associate Degree in Nursing (ADN) or a four year Bachelor of Science in Nursing (BSN). The shorter associates degree programs is the most common way for nurses to obtain their credentials.

After completing their degree, each prospective registered nurse is required to take a licensure examination. It is offered as the National Council Licensure Examination (NCLEX-RN). It is necessary in order to gain his or her license. After becoming an RN, nurses with an interest in moving on to legal nurse consulting should spend at least five years as a practicing registered nurse. This is in order to gain the medical experience that makes LNCs so valuable to their attorney clients.

However, there are few established rules or requirements for becoming a practicing LNC. “As a matter of fact, ‘LNC’ is not a formal designation,” says Howland. “Any RN can add ‘LNC’ to a signature line without any further preparation. Of course, whether his or her knowledge is up to the task remains to be seen. This is why most nurses wishing to pursue this specialty take education to prepare for it.”

For RNs looking to make the transition to LNC work successfully, proper training and ample experience in both medical and legal settings is a necessity. After all, attorneys look to LNCs to guide them through the more complicated and specialized medical aspects of their cases, which requires a depth of knowledge and skill that can only be earned through training and experience. According to Howland, some options for obtaining this training and experience are better than others. “There are several commercial companies that advertise courses of study to prepare nurses for LNC work. They are very pricey, and offer certificates, not certifications, with several different sets of designations. The American Association of Legal Nurse Consultants offers a very cost-effective online course that prepares an aspiring RN for the LNCC certification, the only nursing certification in legal nurse consulting approved by the Accrediting Board for Specialty Nursing Certification.”

Where Do They Work?

One of the major benefits drawing RNs into the world of legal nurse consulting is the flexibility and freedom. LNCs can put their skills to work as an independent consultant, an in-house employee of an insurance company, or as a member of a larger team of LNCs within the largest law firms.

There is no standard when it comes to where and how LNCs are employed, says Howland. “It depends on what they want to do with a practice. For example, an in-house employee has regular hours, generally, and benefits comparable to other professional jobs. An in-house LNC may be a specialist if, for example, a medical malpractice firm specializes in a particular kind of case; in a large firm, there may be several such. In a smaller firm, the LNC would be more of a generalist. Obviously, In-house LNCs cannot be testifying experts for cases in their firms, because that would constitute a conflict of interest.”

Solo practitioners will often work behind the scenes with their attorney clients on particularly challenging or complicated medical cases. Due to their independent nature they are also able to offer their services as a testifying expert witness in their particular medical specialty. While this route does offer the most flexibility for LNCs, it also exposes them to the most responsibility and risk. This is because they are completely in charge of growing their business from the ground up.

Industry Outlook

With more than 15,000 new medical malpractice lawsuits filed every year, there is currently a strong demand for legal nurse consultants and the medical-legal expertise they provide. Furthermore, since the healthcare field in general is predicted to grow faster than any other sector of the U.S. economy in the next decade, it’s likely that there will be more opportunities for legal nurse consultants as well. Virtually every sector of the American healthcare industry has experienced substantial growth over the last ten years. However, there has been a general lack of new jobs created in traditional hospital settings. This could result in increased interest in other nursing careers such as legal nurse consulting, making the field more competitive.

Reliable statistics about the legal nurse consulting industry are not widely available. Although, industry insiders like Howland are able to shed some additional light on the current size of the field and the compensation of its members. “The AALNC has about 2200 members, but not all LNCs are members. I have heard that a ballpark figure for an independent hourly rate is three times the average hourly wage for an expert clinical RN, but this is not set in stone and many legal nurse consultants use other ways to set their fees. Salaried in-house LNC pay depends on geographic area and size of the firm, but seems to run in the $60,000-75,000 range, plus benefits.”