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Legal Nurse Consultant

A legal nurse consultant works to bridge the gap between the legal and the medical fields. The American Association of Legal Nurse Consultants (AALNC 2016) describes these professionals as “licensed registered nurses who perform a critical analysis of clinically related issues in a variety of settings in the legal arena.” The range of employment environments include law offices, independent practices, government agencies, patient advocacy groups, insurance companies, HMOs, consulting firms, and business & industry legal departments.

The AALNC adds a detailed breakdown of the job responsibilities in this interdisciplinary career. In broad terms, legal nurse consultants are medical professionals who operate as part of a legal team, often acting as medical experts and assisting lawyers and other professionals. They interpret charts & patient diagnoses; analyze pertinent medical information; prepare chronological case histories & medical discussions for legal documents; help assess damages; evaluate a plaintiff’s medical needs & costs; interview clients & help identify expert witnesses; provide consulting services; and even testify in court. LNCs work in a variety of strategic roles, addressing topics of litigation such as workers’ compensation, risk management, civil rights, personal injury, forensic & criminal cases, medical malpractice, and employment discrimination, to name a few.

For those considering working at the intersection of the legal and medical fields in a dynamic, high-growth career, this guide provides a detailed discussion of the career outlook, salary prospects, and steps to becoming a  legal nurse consultant.

Legal Nurse Consultant Career Outlook

Legal nurse consultants occupy a niche career and therefore traditional data sources such as the Bureau of Labor Statistics (BLS) do not provide an analysis of projected job growth in this field. That said, LNCs typically become registered nurses prior to training in the legal field. Furthermore, they must be registered nurses to qualify for voluntary professional certification through the American Association of Legal Nurse Consultants (AALNC), which is discussed below.

The BLS (Dec. 2015) predicts that there will be an explosion in job opportunities for registered nurses nationwide; between 2014 and 2024, there’s expected to be a 16 percent increase in openings for RNs, much faster than the average growth anticipated across all occupations during that time (7 percent). With the addition of 439,300 fresh RN positions across the country in the coming decade, there are expected to be a wealth of opportunities in the field, including for legal nurse consultants.

Legal Nurse Consultant Salary

As mentioned above, legal nurse consultants typically become registered nurses prior to receiving legal training or seeking professional LNC certification. The Bureau of Labor Statistics (BLS May 2015) found that the 2,745,910 RNs employed around the country had an annual average salary of $71,000 or $34.14 per hour. In more granular terms, these healthcare professionals had the following salary percentiles:

  • 10th percentile – approximately $46,360 ($22.29/hr.)
  • 25th percentile – approximately $55,320 ($26.59/hr.)
  • 50th percentile (median) – $67,490 ($32.45/hr.)
  • 75th percentile – approximately $82,490 ($39.66/hr.)
  • 90th percentile – approximately $101,630 ($48.86/hr.)

Although the BLS did not have data specifically on legal nurse consultants, PayScale—a site which relies on self-reported wages—offered a breakdown of its responding LNCs. PayScale (Sept. 2016) found that its LNCs made an average annual salary of $72,511, just above the BLS salary average for RNs. Additionally, PayScale found the following salary percentiles among its 245 LNC respondents:

  • 10th percentile – $51,000
  • 25th percentile – $61,000
  • 50th percentile (median) – $72,511
  • 75th percentile – $83,000
  • 90th percentile – $96,000

An additional 188 LNCs chose to respond with hourly salaries and they had the following wage percentiles:

  • 10th percentile – $29.00/hour
  • 25th percentile – $35.00/hour
  • 50th percentile (median) – $55.00/hour
  • 75th percentile – $100.00/hour
  • 90th percentile – $130.00/hour

PayScale (2016) also found that the highest reported salary for a legal nurse consultant was just over $212,000. Not surprisingly, the figures tended to vary based on level of experience as well. Here were PayScale’s (2016) median annual salaries among responding LNCs broken into four categories of experience:

  • Entry-level LNCs, 0-5 years (179 respondents): $78,000
  • Mid-career LNCs, 5-10 years (77 respondents): $77,000
  • Experienced LNCs, 10-20 years (146 respondents): $82,000
  • Late-career LNCs, 10-20 years (102 respondents): $88,000

Interestingly, there was a slight dip between salaries of entry-level and mid-career professionals, but it may be due to the relatively small sample size in the mid-career category.

Additionally, the American Association of Legal Nurse Consultants (AALNC) published a Member Needs Assessment Survey in 2004, which had some salary projections in the career based on experience and industry of employment. Please note that this is an old survey and the data is here strictly to show evidence of a general trend in the LNC profession.

The 2004 Member Needs Survey found that 28 percent of legal nurse consultants who had been working in the industry for one to three years earned between $50,001 and $60,000, while approximately the same percentage of legal nurse consultants who had been working in this capacity for more than 12 years were earning over $90,000. This survey supports PayScale’s finding that experience may have a significant effect on the earning capacity of someone in this position.

Finally, the 2004 AALNC survey went on to explore the salary ranges of legal nurse consultants based on their industry of employment. Interestingly, the business industry and government were generally the top-paying employers for LNCs, although it’s difficult to gauge without a more detailed breakdown of survey respondents:

  • Business industry – 58 percent earn between $60,001 and $80,000
  • Consulting firms – 55 percent earn over $60,001
  • Government – 77 percent earn between $50,001 and $80,000
  • HMO – 50 percent earn between $10,001 and $20,000, while the other 50 percent earn between $40,001 and $50,000
  • Hospital – 38 percent earn between $50,001 and $60,000
  • Insurance company – 84 percent earn between $50,001 and $70,000
  • Law firm – 64 percent earn between $40,001 and $70,000

Finally, it’s important to note that as with the PayScale data, these figures were based on surveys of self-reported responses. That said, this discussion can provide an overview of salary trends in the legal nurse consulting profession.

How to Become a Legal Nurse Consultant

 Many aspiring legal nurse consultants choose to pursue a nursing education and RN licensure prior to their legal training. Others may get an education in criminal justice or legal studies before becoming RNs. Still others pursue an LNC certificate or training program, a list of which is provided by the American Association of Legal Nurse Consultants (AALNC). Here is one possible path to becoming a legal nurse consultant:

  • Complete high school (or obtain a GED) – To begin, all aspiring legal nurse consultants must complete high school or obtain a GED. Furthermore, those who have an interest in working as a legal nurse consultant should also take (and excel in) courses focusing on science and mathematics, including those in biology, chemistry, physics, calculus, trigonometry, statistics, and related electives.
  • Complete an accredited nursing program (2 – 4 years) – Upon graduation (or attainment of a GED), an aspiring legal nurse consultant must then enroll in a nursing program. At this stage, aspiring legal nurse consultants can choose to pursue a four-year bachelor’s degree in nursing (BSN) or a two-year associate degree in nursing (ADN). Although admission standards vary, potential students should expect to submit records of ACT and/or SAT scores, official high school transcripts, personal statements (500-600 words), letters of recommendation, and an application fee. Some programs may require candidate interviews as well. Aspiring RNs are advised to seek out nursing programs accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). In general, the curriculum for these programs will include a number of similar courses, including those in biochemistry, biology, anatomy, kinesiology, physiology, laboratory courses, as well as other science-related electives. It’s important to note that both BSN and ADN programs require hands-on clinical training.
  • Pass the NCLEX and get certification as a registered nurse (up to 1 year) – Once an individual has successfully completed one of the aforementioned programs, he or she must register for and pass the National Council Licensure Examination (NCLEX), which is offered by the National Council of State Boards of Nursing (NCSBN). Those who pass are then eligible to receive a RN license issued by one’s State Board of Nursing and by extension, to begin work as a registered nurse. To maintain RN licensure, states typically require nurses to take continuing education and garner professional experience.
  • Obtain experience as a RN (timeline varies) – After passing the licensing examination and becoming a registered nurse, an individual then has the ability to gain experience working in the field. The type of job available upon completion of one of a nursing program depends on a number of factors, including availability, connections developed during school, specialized training, and more. At this stage, it may also be advisable to begin one’s legal training either through an employer or one of many optional LNC training programs.
  • Get training in legal nurse consulting (timeline varies) – Although this step is optional, a formal education program may assist the aspiring legal nurse consultant with the transition into this field. In general, the AALNC—the sole certification authority in this field—does not endorse any specific program for aspiring legal nurse consultants, and no formal LNC education program is required to practice. That said, aspiring legal nurse consultants may benefit from participating in paralegal programs, legal seminars or conferences, or one of the legal nurse consulting courses and mentoring programs nationwide as described by the AALNC. Many of these may culminate in the awarding of a certificate that demonstrates the holder’s proficiency in the field of legal nurse consulting; again, while this is not required to practice as an LNC, it may be looked highly upon by future employers. Additionally, it can help to fulfill the 2,000 hours of legal nurse consulting required to pursue voluntary national certification through the AALNC.
  • Pursue national credentialing through the American Legal Nurse Consultant Certification Board (ALNCCB) – At this stage, it is optional to complete a Legal Nurse Consultant Certified (LNCC®) program. Although it’s a voluntary credential, it may be advisable in order to enhance one’s earning and employment prospects. The ALNCCB was established by the AALNC in 1997, and its LNCC® certification program is accredited by the American Board for Specialty Nursing Certification (ABSNC). To qualify, candidates must have active RN licensure, five years of experience in nursing, and at least 2,000 hours of practice as a legal nurse consultant during the previous five years. Additionally, LNCC candidates must pass a comprehensive examination. For a detailed examination of qualifying experience, check out the ALNCCB’s Eligibility Criteria. These credentials are valid for five years and may be renewed with the submission of proof of continued RN licensure, 2,000 LNC practice hours, and either proof of 60 qualifying contact hours or a passing score on the exam.

Legal Nurse Consultant Tasks and Responsibilities

So what exactly does a legal nurse consultant do on a daily basis? And furthermore, does this vary depending on one’s industry or the workplace setting?

Naturally, not all legal nurse consultants will retain the same type of routine responsibilities over the course of their careers. There are some tasks that legal nurse consultants perform on a relatively regular basis, which include the following:

  • Organizing and analyzing medical records and related litigation documents
  • Conducting interviews with clients
  • Assisting lawyers and legal staff in the development of case management and trial strategies
  • Helping with depositions and during trial, including developing and preparing exhibits to be displayed
  • Finding and preparing evidence to be used during a trial
  • Attending independent medical examinations when requested
  • Acting as a liaison among lawyers, healthcare providers, experts, and clients
  • Identifying standards of care as they relate to cases involving alleged medical malpractice, as well as causation and damage issues
  • Assisting in the determination of the merits or potential defensibility of a case

The responsibilities of a legal nurse consultant also vary based on his or her work environment or industry. By illustration, a legal nurse consultant employed in a law firm may be asked to summarize medical records, conduct medical literature searches, communicate with expert witnesses, and prepare medical documents to be used by the attorneys throughout the course of a case. A legal nurse consultant who works at an insurance company, by contrast, may instead be asked to perform a variety of case management tasks, or act as a utilization review specialist, medical bill auditor, policy development coordinator, or even a claims adjuster.

Finally, some LNCs work full-time in their roles as legal consultants, while others may work more traditional nursing jobs while earning extra income on the side, working hourly or part-time providing LNC services.

In sum, the qualifications and job responsibilities of legal nurse consultants vary, and aspiring LNCs are advised to contact educational programs or industries of interest to see what they can offer.

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