MACM

FORENSIC REHABILITATION, LIFE CARE PLANS…NEED HELP WITH THAT?
about us

DR. IRMO MARINI

Irmo Marini, PhD, CRC, CLCP, FVE is a certified life care planner, certified rehabilitation counselor, and registered forensic vocational expert. Dr. Marini has over 23 years’ experience in developing life care plans, future wage or earnings losses, and providing vocational expert testimony in Social Security cases. He is a professor in the School of Rehabilitation at the University of Texas- Rio Grande Valley. Dr. Marini has over 85 refereed journal publications, 40 book chapters, and seven co-authored and co-edited books on counseling and disability related issues. He is the recipient of over 12 university and Professional Association awards in teaching, research, and service. Dr. Marini is former Chair of the Commission on Rehabilitation Counselor Certification, and former President of the American Rehabilitation Counseling Association. Marini & Associates has offices in McAllen, Texas and Las Vegas, Nevada, and has worked with cases in over a dozen states, Mexico, and Canada.

COMPANY HIGHLIGHTS

  • INVOLVED IN VERDICT DECISIONS TOTALING OVER $300 MILLION
  • TESTIFIED IN BOTH STATE AND FEDERAL COURT
  • LIFE CARE PLANNER IN THE SECOND LARGEST MEDICAL MALPRACTICE VERDICT IN ARKANSAS TORT HISTORY
  • LIFE CARE PLANNER AND VOCATIONAL EXPERT IN ONE OF THE TOP 20 TEXAS JURY VERDICTS AWARDED IN 2009
  • SE HABLA ESPANOL
  • ALL ASSOCIATES HAVE OR ARE WORKING TOWARD THEIR MASTERS’ DEGREE IN REHABILITATION COUNSELING
  • BROAD EXPERIENCE IN WORKING WITH LIFE CARE PLANS AND VOCATIONAL EARNINGS LOSS FOR PERSONS WITH CHRONIC PAIN AND LOW BACK INJURIES, TRAUMATIC BRAIN INJURY, SPINAL CORD INJURY, CEREBRAL PALSY, AMPUTATIONS, BURNS, BLINDNESS, BRACHIAL PLEXUS AND OTHER UPPER EXTREMITY INJURIES
  • CASES OVER THE LAST FIVE YEARS HAVE AVERAGED APPROXIMATELY 50% PLAINTIFF, 50% DEFENSE
  • FORMER EDITOR OF THE JOURNAL OF LIFE CARE PLANNING AND CURRENT EDITORIAL BOARD MEMBER

OUR SERVICES

LIFE CARE PLANNING
Overview
One of the services Marini & Associates offers is developing long-term comprehensive medical life care plans designed to outline a client’s long-term needs including the purpose, frequency, timing and costs of such services. In preparing the plan, treating specialists are consulted for their recommendations regarding prognosis and future treatment. These opinions are then priced at going rates for services and incorporated into the life care plan. The end result is a document which is comprised of a detailed and researched analysis of all services, therapies, adaptive equipment, drugs and supplies, diagnostic/educational needs, recommended aggressive medical treatment, aids for independent living, home modifications and/or renovations, and transportation needs. The analysis comes complete with timelines, replacement items, recommending source and cost analysis. Life care plans are prepared using the same methodology approved by both the educational and certifying body of this specialty.

Standard Procedure in Developing Plans

Typically, once an attorney has contacted our office and preliminarily discussed the merits of their client’s case, we can determine at that time whether or not we may be of assistance. If both parties agree this to be the case, all medical records and available depositions are mailed to one of our offices where we will review the records and subsequently arrange through your office for and in person evaluation of your client generally conducted at their home. Interviews typically take between 2-4 hours depending on the case and clients or their guardians provide further information during this time. Informed consent is signed so our office can communicate with treating specialists for prognosis and recommended future services needs. Following this, the life care plan begins to be developed as consultations occur and costs of services, medications and supplies, assistive technology and therapies are researched. The average length to completion of the plan is generally a minimum of eight weeks after the interview which can be arranged fairly quickly. Delays can occur when treating specialists do not respond to consultative questions in a timely manner. In rare instances we may be able to complete a plan sooner.

Related Services in Life Care Planning

We will develop life care plans for both plaintiff and defense attorneys, insurance companies or families upon request. We can also review or analyze opposing life care plans and either provide verbal feedback about the plan, prepare a short report on the strengths/weaknesses of the plan, or upon request, develop an opposing life care plan. Finally, because life care plans contain a myriad of services, equipment, etc., our office provides free post-settlement assistance in providing further information on where/how to acquire items or services in the plan.
ASSESSING PERSONAL INJURIES
Overview

The area of Personal Injury assessment pertains to cases where clients have sustained a non-catastrophic injury such as from a car accident, however, the extent of their injuries is severe enough that it precludes them from performing past work or impacts them temporarily. Examples of such injuries might include whiplash where the cervical neck nerve roots are damaged, herniated lower back discs most commonly L4-5, or fractured limbs from impact. When clients are unable to return to their former job, they must be vocationally assessed for remaining skills/abilities to perform work in the economy. A Transferable Skills Analysis (TSA) is also conducted to see what types of jobs an individual may be able to perform considering his/her age, education, medical limitations, past work experience and aptitude potential.

Standard Procedure in Assessing Personal Injury Damages

Following the same methodological procedures for life care plans, we first discuss with the retaining attorney issues related to the case such as client age, education, most recent work experience and wages, and medical prognosis. If it appears we can assist in the case, we request all available medical records, tax returns or W-2s for the last three years worked, and all depositions be forwarded to one of our offices. From this point, we arrange to interview the client and depending on client demographics such as age and work experience, we may vocationally evaluate the client in the areas of scholastic aptitudes, achievement, manual and fine dexterity, and career interests. Following the interview, research is conducted considering national and regional jobs, mean and median national and local wages, labor market analysis and transferable skills analysis. The summation is all incorporated into the client’s report, specific details of which are reported below.

Report Composition

The final report contains basic demographic information about client’s personal and family history, work history, educational history, medical history, current medical and living conditions, testing results (if relevant), and the vocational assessment. The report contains two major elements generally reported by vocational experts; any loss of opportunity or labor market access loss and any potential loss of earning capacity or wage loss. Wage loss versus earning capacity loss are two distinctly different terms that are calculated depending on the clients past work history.
ASSESSING WORKERS’ INJURIES
Overview

The area of assessing Workers’ Compensation Injuries pertains to cases where clients have sustained a non-catastrophic injury at work and the extent of their injuries make it questionable as to whether they will be able to return to their former job. Examples of such injuries might include herniated lower back discs most commonly L4-5, carpal tunnel syndrome, crush injuries, fractured limbs, etc. When clients are unable to return to their former job and their former employer has no other jobs the client can safely or is qualified to perform, then an exploration of the remaining labor market options must be conducted. This is by vocational experts conducting a Transferable Skills Analysis (TSA) in relation to the clients age, education, medical limitations, past work experience and aptitude potential’s. Unfortunately, too many such cases are settled based on a physician’s medical impairment rating (i.e., 10% loss to the body as a whole) which has absolutely no bearing on individual’s true vocational handicap. A 48 y/o construction worker earning $10.50 per hour with less than a high school education for example, who has four toes amputated and receives an 11% loss of use of that lower extremity does not truly reflect that person’s impairment. In this situation, the client will likely be permanently relegated to sedentary and some light work, however, due to his lower education, there are fewer job options available, and the majority pay between minimum wage and $7.00 per hour. In this instance, the client has truly sustained an approximate 35% – 55% vocational disability rating which more accurately portrays his work options.

Standard Procedure in Assessing Personal Injury Damages

The same methodological procedures used in our other evaluations and involve discussing with the retaining attorney the merits of the case, obtaining available medical records and tax returns or W-2s for the past three years. We then arrange to interview the client and may/may not perform vocational testing depending on client characteristics. We evaluate the client’s age and work experience, aptitudes and conduct a labor market analysis for available job options and wage remuneration, then compare this with his past wages or potential earning capacity. The summation is all incorporated into the client’s report, specific details of which are reported below.

Report Composition

The final report contains basic demographic information about client’s personal and family history, work history, educational history, medical history, current medical and living conditions, testing results (if relevant), and the vocational assessment. The report contains two major elements generally reported by vocational experts; any loss of opportunity or labor market access loss and any potential loss of earning capacity or wage loss. Wage loss versus earning capacity loss are two distinctly different terms that are calculated depending on the clients past work history.
MEDICAL RECORD SUMMATIONS
Overview

Although some attorneys have a Rehabilitation Counselor or Registered Nurse on staff, many do not, and with the volume of catastrophic, personal or work injury cases that come in, so to does volumes of medical records to be reviewed and summarized. Marini & Associates do not review medical records to detect fraudulent hospital billing, however we will upon request, summarize the essential information from available medical records and present this summary in the form of a chronological report of services rendered. What we typically include in medical record summations is the following: date of services or report; signing physician; diagnostic tests and results; specific diagnoses or prognosis; services to be rendered and a summary of those services, medications prescribed, and other relevant information. You may view two different summarized medical histories by clicking either the life care plan sample or vocational assessment report sample on this web site.

ASSISTIVE TECHNOLOGY

Specific to developing comprehensive catastrophic life care plans, there is often a need for various durable medical equipment, adaptive aids and other forms of assistive technology designed to assist the person in becoming more independent. Marini & Associates remain current and have training or experience with the literally thousands of assistive technology devices available on the market. Through trade shows, educational conferences, academic classes and actual use of some of the technology, we can assist in determining clients’ assistive technology needs. Also pertinent to prescribing such equipment, other factors are considered such as natural wear and tear of equipment, replacement parts such as batteries, cylinders, electrical components, etc. We often work with local and equipment specific professionals such as certified Assistive Technology Providers (ATP) through the Rehabilitation Engineering Association of America (RESNA). Assistive technology is used for assisting injured clients to become more independent in the home, at work, and/or throughout the community.

Typically recommended technology for persons with various types of disabilities is available. Persons with spinal cord injuries for example often benefit from manual and/or electric wheelchairs, standing frame chairs, transfer lifting devices, van modifications, adaptive sports equipment, environmental control units, specialized desks and alternative keyboarding options for computers, etc.

In our reports, we will include the technology name, where it can be purchased, the cost, and typical replacement component timelines and costs. We also offer free consultation on such devices post-settlement.

OUR TEAM

Dr. Irmo Marini
PhD, CRC, CLCP
Dr. Marini is a certified life care planner, rehabilitation counselor, and vocational expert with the Social Security Administration. He has a graduate degree in clinical psychology from Lakehead University in Ontario, Canada, and a PhD in rehabilitation from Auburn University, Alabama. Dr. Marini is recipient of numerous University and National Association awards including distinguished career in teaching, research, and education. He has seven co-authored/co-edited books on disability and counseling, over 90 peer-reviewed journal publications, 55 book chapters, and over 100 national and international presentations. He is former chair of the Commission on Rehabilitation Counselor Certification, and former Pres. of the American Rehabilitation Counseling Association.
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Tommy L. Barbosa
M.S., CRC, LPC
Mr. Barbosa has a Masters in Rehabilitation Counseling from the University of Texas – Pan American. He is a program coordinator for South Texas Chronic Pain Institute and as a Licensed Professional Counselor, Mr. Barbosa specializes in chronic pain management and psychotherapy, treating individuals with post traumatic stress disorder, major depression, panic disorder who have sustained work related injuries. He is currently a consultant at Marini & Associates and assists in vocational assessments and life care planning.
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Bernard Preston
M.S., CRC, CLCP
Mr. Preston has a Master’s degree in Rehabilitation Counseling from the University of Texas -Pan-American, and is a certified life care planner and certified rehabilitation counselor. As an Associate, Mr. Preston has developed a life care plans and vocational damage reports for over 10 years for plaintiff and defense firms. He also currently serves as a vocational expert with the Social Security Administration. Mr. Preston is employed by the City of Las Vegas Office of Community Services as a Sr. Inclusion Specialist. He also works as a Job Placement Specialist placing persons with disabilities. Mr. Preston has 3 peer-reviewed journal publications in forensic rehabilitation and several presentations.
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Laura Villarreal
MS, CRC
Laura Villarreal is a Master’s graduate of the Rehabilitation Counseling program at the University of Texas Rio Grande Valley. She is also a Certified Rehabilitation Counselor. Laura has worked as an intern at the South Texas Behavioral Center, specializing in both inpatient and outpatient care. She is currently a consultant at Marini & Associates and assists in vocational assessments and life care planning.
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Rigel Pinon
Rigel Macarena Pinon is currently a second-year PhD student in Clinical Rehabilitation Counseling program at the University of Texas-Rio Grande Valley. She has worked as an education coach for Project Hire, helping young adults with cognitive and physical disabilities attain a post-secondary education and employment. She is also a volunteer for Court Appointed Special Advocates (CASA) where she presents at conferences and has court testimony experience working with attorneys and judges, advocating for the foster youth in the Rio Grande Valley. Rigel is also an active member of the National Federation for the Blind where she does outreach with community members who are blind, teaching/putting on workshops regarding technology, and hosting conferences. Ms. Pinon is currently a forensic rehabilitation associate with Marini and Associates and assists in vocational assessments, labor market analyses, and life care planning.
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