A legal nurse consultant (LNC) uses their nursing knowledge and clinical experience to provide expert insight into legal cases involving healthcare issues.
An LNC might review medical records to determine whether the standard of care was met in a medical malpractice case or provide context around causation in a personal injury case.
The LNC might provide expert testimony in court or work behind the scenes to produce educational information for the attorney. Or they might write reports for a legal team to help them understand a specific condition or treatment process relevant to a legal situation.
Legal nurse consulting is a great career choice for nurses who want to be their own boss, as most LNCs work as independent contractors. This allows LNCs to set their own hours and choose their own clients. Similar to freelance health and medical writing, this is an excellent career choice for nurses who enjoy running their own businesses.
What does a legal nurse consultant do?
An LNC works with an attorney or legal team on cases involving medical issues. The LNC uses their clinical experience and nursing knowledge to provide clarification and expert insights into issues like clinical documentation, causation of injuries, deviations from standards of care, and how healthcare teams work together to care for patients.
A key part of this job is the medical chronology. In nurse terms, this refers to the patient’s medical records. When taking on a case, the LNC might receive thousands of pages of medical records. It’s the LNC’s job to take this stack of information and translate it into a manageable report that the attorney can understand.
The LNC begins by reviewing every single line of the medical record to identify information that is relevant to the case. The LNC pulls these passages into a single “chronology,” typically accompanied by a report, that the attorney can use as part of their case development.
Maryjane Duquette is an LNC in Maine who also hosts the podcast Just Culture. In her words, “You might get 10,000 pages of records. We review them, summarize the important points for the attorney, and identify the relevant points. We bring 10,000 pages down to 30 pages that the attorney can manage.”
LNCs may also prepare reports about common conditions or treatments for a legal team, summarize or interpret clinical documentation through written reports, or even provide testimony as an expert witness during a trial.
LNCs must also engage in marketing, relationship-building, and other entrepreneurial tasks. This might include tasks like:
- Building a website
- Managing the books and paying self-employment taxes
- Obtaining a business license
- Maintaining a social media presence on LinkedIn
- Reaching out to potential clients
- Managing a team of subcontractors
- Attending networking events with attorneys
- Preparing educational materials for legal teams
How LNCs help patients
A legal nurse consultant serves as a patient advocate in the legal field.
It’s critical that someone with a medical background is involved in preparing the medical chronology. Nurses are particularly well-positioned to recognize when standard procedures aren’t followed or if something like staffing ratios could have impacted patient outcomes.
Nurses can also read between the lines to recognize what’s not in the chart. Maryjane gives the example of when a nurse charts something like, “Doctor notified. No new orders given.” While an attorney might not see anything unusual about this documentation, most nurses recognize the unwritten “…but they should have been.”
Randy Loveless is the owner of Loveless Legal Consulting, a legal nurse consulting firm in Arizona. Randy gives another example of how nurses can provide critical insight into legal cases. In one such case, a patient was struck by a vehicle while walking and suffered a number of severe injuries that impacted the rest of their life.
Randy’s clinical experience provided critical insight that the attorney could use as they developed their case, resulting in a much higher settlement for the plaintiff.
|An attorney can look up the standard of care. But they can’t look up those insider points, like staffing ratios. We can anticipate orders. We can read between the lines of nurse documentation. This is what makes us valuable.”|
Who hires legal nurse consultants?
Most LNCs work as freelancers or contractors. If they own their own business, this requires them to find clients and negotiate contracts. Other LNCs work as subcontractors for an agency. The agency finds the clients and assigns them to contractors. The agency takes a cut of the fee in return for finding clients and managing the relationship with the attorney.
There are also two main types of work that LNCs perform. Some focus solely on behind-the-scenes work, like preparing chronologies. Others serve as expert witnesses. This requires answering questions under oath and being cross-examined by the opposition. Expert witness work typically pays (very) well.
|“The biggest complaint that I hear from other LNCs is an inability to get attorneys to hire you. One way to combat this is to have a heavy presence on Linkedin. I have been able to grow my business in big ways, simply by being active on Linkedin.”|
Background and experience for legal nurse consultant
To be successful as a legal nurse consultant, it’s important to have a few years of bedside experience. However, there isn’t one particular area of clinical practice that is more useful than another.
What’s most important is simply building an understanding of how nurses think, what it’s like to work in the clinical environment, and the standards of care that are common to all nursing specialties.
Maryjane is emphatic that “any nurse can do this.” However, she is clear that you must love writing and be able to manage large projects.
She continues, “My average report is 30-40 pages. You have to be disciplined to sit there and summarize those cases. And also enjoy detective work. That’s essential to what we’re doing.”
A Bachelors of Science in Nursing (BSN) is helpful but not required. However, it is useful to have advanced education in research and writing, which a BSN (or a bachelors in any field) can provide.
|“Flexibility is the best part. I can flex hours and projects around my kids and family obligations.”|
Certification options for legal nurse consultants
The field of legal nurse consulting is not regulated by a certifying body, and technically anyone with an RN can perform legal nurse consulting duties. However, training can help you understand how to perform specific tasks common in this industry, like how to prepare medical chronologies and how to interact successfully with attorneys.
The American Association of Legal Nurse Consultants (AALNC) does offer a Legal Nurse Consultant Certification (LLNC). The exam costs between $360 and $495, depending on whether or not you are a member of the AALNC. To be eligible, you must have a minimum of 5 years of clinical experience as well as 2000 hours of documented experience in an LNC role during the last five years.
The AALNC also offers continuing education, including an LNC professional course starting at $3,828, depending on the upgrades you choose.
Individual LNCs also offer courses to help people learn about the profession and build their businesses.
One popular training program is offered by LegalNurse.com, which provides various certification “packages” ranging in price from $3,497 to $15,000.
Legal Nurses Rock is another popular program that costs approximately $13,000.
Maryjane says it took her about six months to complete her training. She states, “I wouldn’t even recommend one program over another. Do the research and find one that speaks to you.”
Randy completed his LNC training in 2019. He says, “There are many programs out there that will try to convince you that you need a certification. It doesn’t mean they’re bad, but the fact is that certification is not required to be an LNC. Nurses love certifications, but in the LNC world, attorneys are not typically aware of certifications, nor do certifications typically provide any advantage to the LNC.”
Randy continues, “Attorneys want to know that you are an experienced nurse who understands the medical world and can interpret medical records. Having knowledge of the legal world is advantageous as well. This, though, can be achieved very effectively without formal certification. I have never come across any attorney who showed any interest in LNC certification. In fact, I have only had one attorney ask about certifications at all. ”
There’s also more to being a successful LNC than simply doing good legal nurse consulting work. It’s also important to understand how to run a business, including marketing, bookkeeping, and managing contracts. These freelance and entrepreneurial skills can be learned (or hired out) through many different sources.
Some LNCs work for agencies like Randy’s so they don’t need to worry about finding clients or maintaining a website. Others hire a mentor or coach to help them build their business skills. For example, Randy recently launched his own LNC mentorship program called Catalyst Coaching and Mentoring, which helps new and mid-level LNCs grow their business through 1:1 coaching and mentoring.
|“I am my own boss and have a work-life balance like never before. I am available for my children and home more than ever before. And, I can prioritize my attention as needed if illness hits or business gets busier.”|
How much do legal nurse consultants earn?
One of the best parts of legal nurse consulting is growing your career on your own terms and setting your own definition of success.
Many LNCs start consulting as a side gig, taking on a few cases in addition to clinical work. As far as income potential, this is like taking an extra shift.
Randy says, “You still need to be really good at it if you want repeat cases. These are the people I subcontract out to.”
Mid-level LNCs work full-time as consultants and usually earn between $30-$60 per hour, depending on the case and their experience. At this stage, it’s reasonable to earn between 65-125k per year once you have experience, according to Randy.
Many entry-level and mid-level LNCs work as subcontractors for larger firms. This allows individual contractors to focus on the actual LNC work instead of worrying about marketing or finding new clients.
At the next level, LNCs can run their own business or even hire their own subcontractors to help with the workload. They are responsible for developing relationships with attorneys and legal firms, finding clients, and building trust with their clients.
In addition to their LNC work, they may develop their own courses or products. The income potential at this level can vary widely based on what you offer and the relationships you build with both attorneys and your subcontractors.
|“I’ve never felt like more of a patient advocate than I do in this role, but I also get to advocate for my profession when claims are unfounded.”|
Pros and cons of working as a legal nurse consultant
There are many benefits to working as an LNC, particularly for those who want more control over their careers and who enjoy entrepreneurial work.
Some of the benefits of being an LNC include:
- Flexibility – work when you want, take breaks for family or other responsibilities as needed
- Work from home
- Be your own boss
- Determine your own definition of success
- The opportunity to be creative and develop solutions for client problems
- The opportunity to serve as a patient advocate
This type of work does have its downsides, though, and can include long hours and low pay, especially when you’re just getting started. Several experienced LNCs reported that it takes about a year of hard work to fully establish yourself as an LNC.
Some downsides of working as an LNC might include:
- Financial risk of starting a new business
- Highly technical writing
- Projects can be very large and require the ability to understand how to break down tasks into manageable components
- Steep learning curve in the beginning (though most LNCs say that once you master the basic skills, it’s not difficult)
- Must understand (or be willing to learn) how to market and run a business
- If you freelance or work as a contractor, you won’t receive benefits like PTO, retirement, or health insurance
Randy says “It’s not for everyone. Some don’t have the drive that it takes to stick with the work. If you’re not willing to be your own boss, if you can’t force yourself to do the work, even when you don’t feel like it, you can fail.”
It’s also important to have strong communication skills. Maryjane explains, “You have to love writing. It’s not fun writing. It’s very dry, research-based writing, even more so than scientific or academic writing. You have to be okay with that.”
Some nurses worry about finding clients or dealing with attorneys. It’s true that this process can feel overwhelming at first. Maryjane says, “Finding clients is as scary as you make. You have to be willing to put yourself out there, to meet new people, and to make new connections. This whole business is about connections. The more people you meet, the more relationships you build.”
|“Attorneys can be scary, but I just remember back to the scariest doctor from when I was new grad. I survived that, I can survive this.” – Maryjane Duquette|
Are you interested in working as a legal nurse consultant?
Legal nurse consulting is a meaningful and flexible career that is perfect for nurses who want to be in complete control of their careers and who have an eye for detail. It also provides a valuable opportunity to serve as a patient advocate and educate others about the nursing profession.
If legal nurse consulting doesn’t sound quite right – or if you prefer a more standard employment agreement that comes with a benefits package – then utilization review/utilization management, data abstraction, or clinical documentation integrity might be a better fit.
In the meantime, check out the Nurse Fern job board for the latest opportunities in remote nursing jobs!