Beware the Physician’s Lien

Make sure that your state permits you to file a physician’s lien for services rendered, before you provide services.

Two Nebraska chiropractors provided services to an accident victim and then filed physician liens under Neb. Rev. Stat. § 52-401, which provides that “any…physician, nurse, or hospital performing professional services of any nature, in the treatment of, or in connection with an injury, possesses a lien upon any sum awarded as damages or settlement proceeds from the person causing the injury to the injured person.”

Although the trial court awarded the patient’s lawyer attorney’s fees, it refused to honor the physician’s liens and the chiropractors appealed. The appellate court agreed with the lower court and stated that the chiropractors were not entitled to a physician’s lien on the grounds that they were not physicians.

The court further held chiropractors were not included as a covered class under the physician lien statute because “chiropractor” is not specifically mentioned among the health professionals included in the statute. The court reasoned that if the Nebraska legislature wanted to protect chiropractors’ liens, it would have specifically done so. Nelsen v. Grzywa, No. A-99-1254, 2000 WL 1528958 (Neb. Ct. App. Oct. 17, 2000)

If you find yourself practicing in Nebraska or in some other state that does not recognize a physician’s lien with respect to chiropractic services, don’t give up. Obtain a lien agreement from the patient and the lawyer in your lien agreement. By doing so you will make the lawyer personally responsible to you by having him or her sign such a letter. You are also making the patient responsible for payment to you in the event that you are not paid your entire fee. The lawyer would also find him/herself in the uncomfortable position of having to explain this to the patient in the event that you were not fully paid.

The following is proposed language for your lien agreement:

Patient hereby gives a lien to Doctor as against all proceeds derived from the Case (whether by settlement, judgment or otherwise) to secure payment of all fees owed to Doctor by Patient (or by Attorney, if such fees arise from this Case), as of the time such proceeds are received. Patient hereby directs Attorney to honor said lien and to pay such sums as are secured thereby directly to Doctor, as soon as possible after any proceeds are received.

Patient hereby expressly recognizes that, even though this Lien has been given, Patient still remains personally responsible for all the Doctor’s fees and that payment of them must be made by him/her regardless of whether any money is received as a result of this Case.

Before Attorney distributes any money received as a result of this Case, Attorney agrees to make a written request and Doctor agrees to provide (within 30 days of Attorney’s request) a written statement of the Patient’s outstanding account balance including interest thereon.

If you have any questions with regard to the above or with respect to any other legal heath care issues, please feel free to FAX your questions to Deborah A. Green, Esq., at 954-971-3787 or call 954-971-7778 or e-mail at [email protected]. In future issues, she will be answering those questions which are of interest to the broadest audience.

Ms. Green has been a practicing attorney since 1977. She is admitted to the practice of law in the State of New York and Florida and is a member of the American Health Lawyers Association, the New York State Bar Association Health Care System Design Committee, the New York State Bar Association Health Care Providers Committee, the American Bar Association Health Law Section and the Florida Bar Health Law Section. She has formed numerous multi-discipline practices throughout the country.


Because this column is being presented to you by an attorney, it would not be complete without a disclaimer. This column is provided subject to and governed expressly by the terms of this disclaimer. This column is provided for educational purposes only. The accuracy or timeliness of the information presented herein is not warranted. The information presented herein is not intended to be advice as to a specific fact pattern with which you may be presented.  Accordingly, please note that the information contained herein is not being presented as legal advice with respect to any matter and that no attorney-client relationship is hereby established.

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