Sean Callagy - Attorney and Entrepreneur: paramus law firm

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Tuesday, February 23, 2016

Interlaminar vs. Transforminal Injections | Callagy Law

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.

When disputing the use of a Transforaminal Injection as opposed to an Interlaminar Injection, Transforminal Injections have proven to present less risk to the patient and be more cost effective for a provider.

Specifically, regarding the differences between Interlaminar and Transforaminal Injection Approaches, studies have clearly established the following:

The interlaminar approach is the most common way of performing an epidural injection for all indications in anaesthesia […]This can be done with or without fluoroscopic guidance, but one of the many queries with regard to the varying efficacy of epidural steroid in studies has been the uncertainty of whether, by caudal or interlaminal route, the steroid has been accurately placed at the required site.

(See, “Epidural Steroids,” by Neil Collighan and Sanjeeva Gupta MD)

On the other hand:

The transforaminal approach is a selective injection aimed at a specific level and is always done under fluoroscopic guidance. […] Both the interlaminar and transforaminal approaches can be used at the cervical, thoracic, and lumbar levels. The benefits of the transforaminal approach, when performed by an experienced clinician, may include decreased risk for dural puncture with delivery of smaller volumes of steroid to the appropriate site of considered pathology. (emphasis added). [Id.]

In fact, in one recent study, the researcher concluded:

Transforaminal injection [is] superior in its ability to reach the site of pathology while being able to use even smaller doses of steroids. While the increased technical difficulties are noted to perform this method, his study showed better outcomes after a series of epidural steroid injections [with] the transforaminal approach followed by the caudal approach as a reasonable secondary approach.”[Id.]

Additionally, there is an established difference in cost effectiveness between the intralaminar method and the transforaminal:

Evaluation of the cost effectiveness of epidural injections including transforaminal steroid injections for the management of chronic low back pain revealed […] cost effectiveness of caudal epidural steroids at $3,635.00 and transforaminal steroids at $2,927.00 per year.

(See, “Transforaminal Lumbar Epidural Steroid Injections,” by Laxmaiah Manchikanti, MD)

Furthermore, with respect to the efficacy of the various injection methods:

the transforaminal epidurals appear to be clinically effective with a favorable outcome and cost effectiveness, compared not only to blind interlaminar epidural steroid injections and fluoroscopically directed caudal epidural steroid injections but also to numerous other modalities of treatment.”[Id.]

As stated above the Transforminal approach presents less risk of a dural puncture with the delivery of smaller volumes of steroid to the appropriate site of injury. The studies also showed better outcomes after repeat series of epidural injections via the Transforaminal approach as opposed the Interlaminar approach. Based on these recent studies and that fact that Transforminal injections represent a saving of up to $800 a year clearly demonstrate that the Transforminal approach is a better option for the health of the patient and for the treating provider.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $185,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

Learn More About Callagy Law Here:

Interlaminar vs. Transforminal Injections | Callagy Law #CallagyLaw, #Injections, #Interlaminar, #MajorMedical, #MedicalRevenueRecovery, #ParamusLawFirm, #Pip, #SeanCallagy, #Transforaminal

Monday, February 1, 2016

Over-Specialization Can Adversely Affect American Healthcare

Is over-specialization creating more problems than good in our American Healthcare system?

Cardiologists, Oncologists, Urologists. One could go on and on naming the different types of specialists that comprise the medical profession. Although it is comforting to know that should a medical emergency arise there are dedicated professionals with years of specialized study and experience to help with nearly any particular ailment, there is a dangerous trend emerging in the United States healthcare system. Not only is there a projected physician shortage in the coming decades, but there is an even greater shortage of non-specialized, primary care physicians.

Primary care physicians, as the name suggests, are the doctors we rely on for check-ups, physicals, and other general medical care. Alarmingly, fewer and fewer medical school graduates are choosing primary care for their residency training programs. To highlight this trend, between 1975 and 2010 the number of physicians in the United States has more than doubled, while during this same span there has been only a 10% increase in primary care physicians. This, coupled with a growing US population, has made it increasingly difficult to find a primary care physician.

There are a multitude of factors causing this trend. One factor is earning potential. During residency training, there is not a significant pay difference. But, over a lifetime a specialist could earn upwards of $10 million more than a primary care physician. A second factor is quality of life and prestige. To many, the prospect of working and living in cities like New York or Boston, at a prestigious hospital like New York Presbyterian or Massachusetts General as a top surgeon, is surely more alluring than working in Des Moines or El Paso at a local, rural hospital as a geriatrician. While there are additional problems, including federal residency funding, that feed into the primary care shortage, unless there are critical changes made in the US healthcare system this alarming trend will continue.

Thankfully, there are efforts on the part of many schools and legislatures to address the problem of the primary care shortage. Medical schools at the University of Wisconsin and the University of Washington, for example, offer rural medicine programs that offer incentives such as reduced tuition and preferential admission. Many states are also empowering licensed nurse practitioners (LPNs) to provide primary care to ensure that all state citizens have access to medical care regardless of location. While these efforts represent the sort of action needed to tackle the problem of overspecialization, there is much more to be done.

Learn More About Callagy Law Here:

Over-Specialization Can Adversely Affect American Healthcare #CallagyLaw, #Cardiologists, #LawOfficeOfSeanRCallagy, #NjLawFirm, #Oncologists, #ParamusLawFirm, #SeanCallagy, #Specialties, #Urologists

Wednesday, January 6, 2016

Section 20 Settlements | Callagy Law

The purpose of this post is to help assist healthcare providers and owners with questions they have concerning their business or relevant knowledge in the field. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.

Section 20 Settlements

According to N.J.S.A. 34:15-20, the parties to a workers’ compensation claim petition may settle the claim where (1) jurisdiction, liability, causality and/or dependency are disputed; (2) the parties wish to resolve the claim with a lump sum settlement; (3) the parties consent to the settlement; (4) the parties are represented by Counsel; and (5) a judge of compensation determines that the settlement is fair and just under the circumstances. Notably, once the settlement is approved, it shall have the force and effect of a dismissal of the claim petition and shall be binding on the employee and employee’s dependants. Id. Such settlements are commonly referred to as “Section 20 Settlements” based on N.J.S.A. 34:15-20. In relevant part, N.J.S.A. 34:15-20 states:

34:15-20. Dispute; submission to division; order approving settlement.

…

After a petition for compensation or dependency claims has been filed, seeking compensation by reason of accident, injury or occupational disease of any employee, and when the petitioner is represented by an attorney of the State of New Jersey, and when it shall appear that the issue or issues involve the question of jurisdiction, liability, causal relationship or dependency of the petitioner under this chapter, and the petitioner and the respondent are desirous of entering into a lump-sum settlement of the controversy, a judge of compensation may with the consent of the parties, after considering the testimony of the petitioner and other witnesses, together with any stipulation of the parties, and after such judge of compensation has determined that such settlement is fair and just under all the circumstances, enter “an order approving settlement.” Such settlement, when so approved, notwithstanding any other provisions of this chapter, shall have the force and effect of a dismissal of the claim petition and shall be final and conclusive upon the employee and the employee’s dependents, and shall be a complete surrender of any right to compensation or other benefits arising out of such claim under the statute.

Parties should be aware of the availability of Section 20 settlements when defending/pursuing workers’ compensation claims as an option to avoid protracted litigation. Indeed, Section 20 Settlements are particularly appealing where the costs of defending against or pursing a claim are not sensible in light of the value claim. However, when entering into a Section 20 settlement, the parties should be mindful of the fact that such a settlement will likely bar any subsequent claims by the petitioner and such employee’s dependants.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $175,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

Learn More About Callagy Law Here:

Section 20 Settlements | Callagy Law #CallagyLaw, #NjLawFirm, #ParamusLawFirm, #SeanCallagy, #Section20Settlements, #Settlements, #WorkersCompensation

Tuesday, November 17, 2015

New AND FREE to Share - Why Not with Sean Callagy #18

Why Not Follow THIS ONE Success System #18

Dear Kindred Spirits,

We all have dreams, wants, and needs. In our Why Not world, we put these into three categories: money, time and fulfillment.

When I first began my journey of learning about how to produce results, I remember feeling two things, and neither worked for me.

First, I felt completely overwhelmed. If you looked for answers, the self help section of the book store, this was in the pre-internet days, was completely overwhelming. You stared at a wall of books on every topic imaginable. It would take a lifetime to read all of the books staring you in the face.

Today, it far worse. It would take you 100 lifetimes to read all the books on the internet designed to help you get better at something.

Second, I thought that every book on personal development I read, or system I bought, didn’t seem to have a full and complete system. So, finally I would decide on which book, but it would only lead me to many other books.

Even if the book claimed to be one full system, however, and was not pointing to other books, it didn’t have all the answers. More importantly it was not one complete system to follow.

Based on these two feelings, I decided that I would take all of this information, and all of the amazing mentoring and teaching I had received, and I would create one success system to help people produce the results they wanted.

This system has helped me create a life that is the life I wanted in terms of the three core wants people have: money, time and fulfillment. We always want more, but if you would have asked me at twenty-one years old if I would sign up for my life today, I would have done it in a heartbeat. This system has served me well, and allowed me to build four successful companies, one an eight figure and growing revenue producer, while maintaining a work life balance where I’ve missed less than five games that my children have played in out of more than 1,500, other than when their games conflicted with each other. Work, while tremendously important to me, has been built in a way to support my time and fulfillment goals in an amazing and optimal way.

This same system has allowed me to help hundreds of other people produce more time, money and fulfillment for them.

Maybe most significantly, my Results Formula, as I call it has allowed me to do things with extraordinarily rapid speed. Some people even tell me they think I have special powers, whatever that means.

I do not have “special powers”. I simply follow advanced science for achieving results through one amazing complete system that allows me to know and understand if I am moving closer to ANT result I want, or further away.

The system is complete and allows for determining where the challenge lies if a result isn’t produced.

Maybe most importantly, the system is based on non-linear exponential growth for all areas of our lives. This is why you will receive ever increasing exponential results in exchange for spending less time on trying to produce your results.

If you are not moving closer to your results, you will quickly be able to determine the reason. This applies whether the goal is to make more money, have more fun, win more games, have a higher batting average, find more customers, build a better relationship, be a world class public speaker, make a great cake, buy a beach house, travel to beautiful places multiple times a year, or whatever.

Yes, the system is REAL. The system Callagy Results Formula is also tremendously valuable.

AND, I am giving the three key ingredients away to you for free.

Why am I doing this?

First, I like helping people.

Second, I am building my brand by giving away massive value. What is my brand? I would hope it is someone is as good as anyone on the planet at helping people produce results that allows them to achieve their money time and fulfillment goals.

This system includes all of it, and isn’t a “Secret” that claims to allow you to just wish for things and make them appear, although I do believe in the Law of Attraction, but I also believe in leveraging our actions and processes to produce our results far faster than people would ever believe.

So, what is the Callagy Results Formula? Tune in to today’s Why Not Huddle to learn the answer…….

AND, please share this letter, AND the Why Not Huddles. Please!

I am also in the process of writing my first book: Why Not? The First Book of Personal Development. I would appreciate your help in checking in on me and holding me accountable. My goal is to literally create the first book everyone should read who wants more from their life, which is basically, everyone.

If you want to find the Why Not Huddle, “like” the Callagy Law Facebook page and you will receive the Huddle daily. BUT, it is even easier if you also subscribe, for free, on YouTube to the Why Not Huddle on the Sean Callagy YouTube channel.

See you on the Why Not Huddle!

Please post your comments or questions, or contact me at scallagy@callagylaw.com.

Have an “At Cause” day!

In Your Service,

Sean Callagy

Please subscribe on YouTube and spread the word.

You can see all of our WHY NOT – HUDDLE videos by clicking here and subscribing! If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

The Daily Why Not Huddle is for you if you want to exponentially increase your money, time, or fulfillment. The Why Not Huddle with business coaching expert, successful entrepreneur, and attorney Sean Callagy provide the essential daily ingredients for you to create and achieve your destiny.

New AND FREE to Share - Why Not with Sean Callagy #18 #CallagyCoaching, #CallagyLaw, #Entrepreneur, #Entrepreneurship, #LegalFunFact, #ParamusLawFirm, #SeanCallagy, #SeanRCallagy, #Success

Thursday, November 12, 2015

Callagy Law Library TV - Episode #15, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

Callagy Law Library – TV is an original series from Sean Callagy, President and Founder of Callagy Law; to help the general public with every day legal questions and information. For more information about Sean Callagy, Callagy Law, or any questions you have, please email scallagy@callagylaw.com

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

In this article / video, Sean Callagy will focus on topics to help people better their legal knowledge of vital information. Clients often come to Sean Callagy’s team with questions about their businesses, ranging from contracts, disputes, and other common legal issues in the business world. Our mission is to answer any legal questions and provide information to anyone who may need it. If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

Callagy Law Library TV - Episode #15, #‎AskSeanCallagy‬ #Askseancallagy, #CallagyLaw, #LawOfficeOfSeanRCallagy, #LegalNews, #Motivation, #NjLawFirm, #ParamusLawFirm, #SeanCallagy, #SeanRCallagy, #Success

Monday, October 19, 2015

Drafting Contracts To Avoid Litigation Later

Businesses need to be proactive in choosing vendors and drafting and finalizing contracts to protect themselves from expected and even far-fetched litigation risks. The risk of contracts leading to litigation may be the last thing on the minds of busy employees who are on deadline to get projects moving. However, businesses need to be mindful of avoiding unnecessary risk in writing contracts as well as monitoring the progress of these agreements.

Front-end or Back-end Investment

In drafting (or writing) contracts as well as negotiating contracts there are tradeoffs in how much time and effort the parties should expend in setting highly precise terms versus more generic or vague terms. While it may be easier to use more generic terms that can be applicable for multiple contracts, it is risky because those generic terms may lead to confusion and conflict between the two contracting parties.

To avoid litigation, it may be advantageous to put more time into negotiating and simply discussing terms up front to avoid confusion later between the two businesses. When parties use only vague terms they push issues into the back end which generally means that the disputes end up in litigation.

Businesses need to think long and hard about whether they are willing to take the potential risk of costly litigation in the event of contract litigation.

Litigation can be very time-consuming in addition to financially costly so business leaders need to take the overall inconvenience and risk of this into account when preparing contracts. So, investing in the front-end, while inconvenient and time-consuming, can more predictable than the risk, even if it is relatively unlikely, of litigation at some unknown time in the future.

Maintaining Good Records is Also Key

In addition, it is important to keep good records regarding business relationships and contracts. The contract itself with signed versions should be kept in a safe and accessible location whether that is in hard copy files or electronically.

Also, records showing invoices, payments made, and other relevant information about the contract are important to show whether or not your business, or the other party, is adhering to the terms of the contract. Even documents such as emails or notes from meetings between the two contracting parties can be helpful in determining what the parties actually meant in drafting contracts or how those obligations may have evolved over time. All of these records are potentially important in determining liability as well as damages.

Of course, keeping good business records is simply a good practice for all sorts of other reasons as well. Good business records are important for tax purposes as well as for monitoring revenue, costs, and the overall health of the business.

Contact a Knowledgeable Attorney Now for Guidance

In order to make sure that you are minimizing litigation risk and know exactly what you are getting into when you are negotiating a contract with another business partner, contact one of the knowledgeable lawyers at the Callagy Law firm.

Learn More About Callagy Law Here:

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