August 20, 2022


A lien is a document that is an agreement between you, your patient, and their attorney. This document is sometimes called a "letter of protection." The lien is an agreement that the patient will pay the doctor at the conclusion of the settlement.

When a new patient comes in, you have them sign the lien that you have on hand. The one I use is from Michael Coates, Esq from, but that was when he had a free tier for his membership. has a letter of protection you can download.

The lien will have the practice name, the date of injury, and the patient name. At the end of the document, will be a spot for the patient to sign, the attorney to sign, and the doctor to sign.

The lien give the attorney a fiduciary responsibility to pay the doctor bills when the case settles. And if the attorney can't recover the full amount of all medical bills and other costs in the case, the attorney needs to demonstrate the full breakdown of the intended payouts before any reductions of case fees are negotiated.

The lien I use attaches a 10% per annum interest charge on the total bill. The lien I use also says that when the attorney bills the patient's medpay, then the total amount goes to providers first to pay down the bill.

Steps to use a lien

  1. New patient comes in and fills out paperwork.
  2. The lien is presented to the patient, and they are to sign it. The doctor signs it too.
  3. The lien is then faxed and/or emailed to the attorney's office.
  4. Email attorney to make sure they received it.
  5. Make sure you get a copy of the signed lien for the patient's file. If the attorney does not sign it or marks it up with their own terms, consider charging the patient out of pocket for care, as that attorney has made it clear that they will be difficult to work with.

Resources from personal injury attorneys in California who work with chiropractors.'s lien. Shawn Steel's lien and the lien from Chirocode is written in the language of the patient, while Coate's lien is written in a third party language.'s lien collection kit. If you believe that we are living in a simulation, and the attorneys and the State Bar, and the small claims court system are just part of the programming, then congratulations, because Shawn Steele and Alexander Eisner have given you a three step process to recover your owed funds.

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