Legal nurse consultants (LNCs) are valued members of legal teams, providing guidance during discovery by lending their expertise to the assembly of medically accurate and factually persuasive information used in legal cases involving medical malpractice, wrongful death, injury, or that are otherwise related to medical issues. The American Legal Nurse Consultant Certification Board has established that LNCs can, among other things:
- Assist with screening new cases for medical merit
- Identify and elaborate on established standards of care
- Locate causation and describe damage
- Conduct research and summarize medical literature
- Assemble timelines of medical events and discover discrepancies
- Provide education on medical facts and issues to legal parties
- Determine damages unfolding from medical aspects of a case
- Locate and retain expert witnesses or act as an expert witness
- Assist in composing and analyzing all manner of legal documents, including complaints, answers, depositions, trial briefs, etc.
- Facilitate client, attorney and witness communication
- Assist with many more legal tasks that require the specialized expertise of a registered nurse
While it is not necessary to obtain certification for a registered nurse to act as a medical consultant in a legal case, attorneys most often seek LNCs with additional certification from either the American Legal Nurse Consultant Certification Board (ALNCCB) or from the National Alliance of Certified Legal Nurse Consultants (NACLNC). While many LNCs work full time as legal consultants for corporations, law firms, or operate independent consulting firms of their own, most consult on a part-time basis, augmenting their existing income as an RN or advanced practice registered nurse.
As such, obtaining certification and continuing education in legal nurse consulting is a common pathway by which nurses expand the scope of their professional expertise and acquire additional income.
Legal Nurse Consultant Pathways and Prerequisites
The American Association of Legal Nurse Consultants Member Needs Assessment Survey (most recently published in 2005) notes that 59 percent of LNCs held bachelor degrees, 27 percent held master’s degrees and 26 percent held associate’s degrees. At the very minimum, a registered nurse seeking to serve as an LNC should have specialized training and practical experience in the area of medical practice for which they offer consultation services. However, attorneys are most eager to work with LNCs with the training necessary to become familiar with the institutions, procedures, and language of the legal realm.
LNCs should also possess a sharp, intellectual curiosity and a creative, flexible intellect in order to successfully assist in building legal cases. The American Association of Legal Nurse Consultants (AALNC) publishes a self-assessment tool for prospective LNCs that includes these questions:
- Are you a strong inductive and deductive thinker?
- Are you able to handle multiple tasks under pressure?
- Are you able to convey complex medical concepts to laypersons with confidence?
- Are you comfortable questioning the assumptions of medical doctors and lawyers when warranted?
Different certification entities require different prerequisites for pursuing LNC certification. The American Legal Nurse Consultant Certification Board (LNCC), which awards the certification of Legal Nurse Consultant Certified, requires the following:
- Current, unrestricted RN license
- Evidence of 2000 hours of legal nurse consulting work in the past 5 years
- Passing of the LNCC certification examination or 60 contact hours (billable hours spent in contact with attorneys and clients) that meets criteria established by the Board
The National Alliance of Certified Legal Nurse Consultants (NACLNC), which awards the certification of Certified Legal Nurse Consultant (CLNC), requires that registered nurses simply maintain an active RN license in the United States or Canada and complete at least the basic CLNC Certification Program.
Legal Nurse Consultant Certification
There are two main certifying bodies for legal nurse consultants:
The American Legal Nurse Consultant Certification Board offers the Legal Nurse Consultant Certified (LNCC) credential. The objective of this certification is to document individual professional performance against a predetermined standard of knowledge about legal nurse consulting. LNCC® is the only certification recognized by the American Association of Legal Nurse Consultants (AALNC) and accredited by the American Board of Nursing Specialties (ABNS).
The scope of the LNCC® examination includes a measure of one’s ability to:
- Assemble healthcare records and research relating to a particular case in order to establish issues of standards of care, causation, and damages
- Facilitate communication between clients, expert witnesses, and attorneys
- Draft and compose texts that can be utilized in legal proceedings
- Conduct self-directed research to educate oneself on the specific medical questions of issue in a particular case
- Collaborate with clients to construct case strategy as cases move from discovery to adjudication
- Testy as an expert witness
The LNCC® exam’s content mostly covers medical malpractice (27-21 percent), followed by personal injury (19-23 percent), product liability/toxic tort (10-14 percent), and workers’ compensation claims (12-16 percent). Other content areas of the examination include risk management, life care planning, administrative health law, elder law, and criminal and forensic issues.
The Certified Legal Nurse Consultant (CLNC®) Certification is the official certification of the National Alliance of Certified Legal Nurse Consultants (NACLNC), which is the largest association of legal nurse consultants in the nation. The CLNC® Certification is trademarked by the U.S. Patent Office and recognized in the legal community as a professional certification.
The CLNC® Certification Examination requires both a demonstration of knowledge/comprehension (59 percent) and application/analysis (41 percent). A successful exam-taker should be able to, among other things:
- Demonstrate understanding of the litigation process and the role of the CLNC in that process
- Apply knowledge of the sciences and theories of liability commonly used in medical-related cases
- Demonstrate knowledge of malpractice, personal injury, products liability, and workers’ compensation/labor and industries claims
- Deploy strategies for detecting tampering with medical records
- Demonstrate knowledge of managed care litigation, the role of expert witnesses, contract formulations, as well as legal and ethical principles
- Display knowledge of self-marketing strategies and interviewing techniques
- The American Association of Legal Nurse Consultants is a non-profit membership organization founded in 1989 dedicated to fostering professional growth for registered nurses practicing as legal nurse consultants. The AALNC offers the certification of Legal Nurse Consultant Certified (LNCC), as well as Webinar series, recertification, and continuing education online.
- The National Alliance of Certified Legal Nurse Consultants (NACLNC®) is the largest and oldest professional organization for legal nurse consultants. Founded by Vickie L. Milazzo, RN, MSN, JD, often considered the founder of the profession of legal nurse consulting. The NACLNC® provides certification as a Certified Legal Nurse Consultant (CLNC) and facilitates continuing education workshops and an annual convention bringing together CLNC professionals from across the spectrum of legal nurse consulting.
Legal Nurse Consultant Works Settings and Salaries
The legal nurse consultant profession is unique among nursing specializations because it can be pursued as a part-time occupation in addition to an existing full-time nursing career. In fact, according to the American Association of Legal Nurse Consultants Member Needs Assessment Survey (most recently conducted in 2005), most LNCs practice part time (48 percent). Of those, almost 30 percent work as consultants less than 5 hours a week, while 24 percent work between 5-10 hours a week. Even so, those working fewer than 10 hours a week are still able to add up to $10,000 in additional income per year.
Legal nurse consultants work in a wide range of both medical and legal settings, engaging in an array of challenging tasks. Forty-seven percent of LNCs report running an independent practice. Nineteen percent work directly for law firms, while seven percent work for hospitals, and another six percent work for consulting firms.
Of LNCs who practice full time, 13 percent earn salaries in excess of $90,000 a year, 16 percent earn between $80,000 and $60,000, and 22 percent earn between $60,000 and $50,000 per year. Of the LNCs earning more than $90,000 yearly, most either work for consulting firms (22 percent) or operate independent practices (27 percent).