This is the question I hear most often.

Unlike a forensic radiologist or cardiologist, only Psychiatrists and Psychologists can receive accredited training in application of their healthcare specialty to law. They can become Board-Certified in the subspecialty. Therefore, data-gathering in these fields is available where it is not in other areas of medicine.

That’s why this article is a case study.

Complementary Article: Setting the Right Fee in Med-Legal Work.

Most of this article is helpful to any medical specialist who wants to build a practice as an expert witness. Call me (415) 302-9589 or contact me to discuss nuances of your practice.

Determining Your Fee

While I go into more detail below, here’s what you need to know.

Is a Fee the Same as a Salary as an Expert Witness?

No.  Expert Witness work is strictly a fee-based service. There is a good reason for this: you must be unbiased and objective. This is the heart of serving justice and due process. A salary implies a fixed annual compensation, i.e. whether you spend 10 hours on a forensic report or 3, you earn the same. This is counter to the ethical job of a disclosed expert witness. You spend 10 hours? You get paid for 10 hours. A different case requires 3 hours of your time? You get paid for 3 hours.

HOURLY FEES NOT SALARY GUIDE THE COMPENSATION OF AN EXPERT WITNESS. 

Don’t Confuse These Salaried Jobs With Expert Witness Fees.

• Worker’s Compensation Forensic Evaluators: Paneled Workers’ Compensation evaluators are paid an inflexible hourly fee for an expert. Just started? Done it for 20 years? Doesn’t matter. Testifying in the WC case? Not important. The fee is set.
• WC Treaters. Worker’s Compensation treatment is a different fish from forensic assessment. They are not the same. This article article is not about salaries or fees payable to treaters.
• Corrections.  Your medical work with incarcerated individuals can come up with med-legal application. E.g. someone in jail awaiting trial is treated by you. You are later asked to testify including at sentencing or, after time served you may be present at a Probation Hearing. Forensic Psychiatrists, forensic psychologists, GPs and other healthcare providers may work in the corrections system in a salaried capacity. They are not a privately retained expert witness. 
• Hospitals and Private Clinicians. If you are a treater, then later asked to serve as an expert witness, you have a conflict of interest. If you serve as a privately retained expert witness about someone not your patient, then you bill hourly. Your hospital job might be salaried but that salary is not relevant to your med-legal work.

In the Medical-Legal Arena You Receive an Hourly Fee

Your fee will reflect:

• How easy it is to find you
• How easy it is to reach you*
• Your demonstrated knowledge
• Your area of expertise (supply, demand > legal allegations)
• The quality of your reports (get feedback and improve)
• Times you’ve testified
• How many attorneys know you
• The number of inquiries you receive from attorneys

*Surprisingly, attorneys report they often retain the first Expert who takes their call.

“Official” Data Isn’t Reliable

No legitimate survey has been carried out to report fees charged by forensic medical professionals in any specialty, including psychiatrists and psychologists.

I cross-reference among sources to arrive at fees reported.

Rates Can Be Determined Differently

I report my findings below based on:

1. Legal documentation of fees–e.g. invoices produced during Discovery;
2. First-hand reports–what doctors have told me personally
3. Deduction and extrapolation from “hearsay” aka networking, speaking with colleagues, and cross-referencing what my clients hear from their colleagues in medical-legal fields.

Dollars and Sense

My experience:

Medical-Legal Experts charge between $250/hour to $1200/hour. How’s that for a range!

Let’s take a closer look:

The lower range reflects, for example:

• PhD of PsyD Licensed Psychologist, (vs. an MD or DO who can charge more)
• Nurse Practitioner or Nurse Specialist with Medical-Legal experience and specialist training
• Physician fresh out of residency, pre-Board-Certification, and without testimony experience

Higher Range:

• MD or DO, PhD with extensive specialized expertise (e.g. Threat Assessment, or Oncology Protocol)
• Multi-specialization
• Reputation among a community of attorneys

My experience is that fees fall in the ranges below and for the reasons given. They are the mean (not the average). I explain later how I derive the information and factors that push the numbers into higher or lower outliers.

• $400-450/hour  MD/DO
  • 1-3 years of experience. 6 Months post Board-Certification, reassess these fees in light of new experience.
  • Training and Board-Certification in a single area of medicine (I group Forensic Psychiatry with Psychiatry)
  • have testified fewer than 5 times.  
  • If you have unique training, or added qualifications, a higher rate for the first year of practice may be justified.
• Add 25%
  • 4-5 years of experience
  • Have testified more than 5 times (deposition and/or trial)
  • Are developing a solid reputation with a cohort of attorneys
  • If you have testified more than approximately 10 times, a rate of $500-650 may be appropriate. This warrants a conversation so I can best advise you if an increase is justified.
• $600-800/hour
  • Mid-career doctors (6-10 years) who meet all of the above plus
  • Have testified more than 30 times (deposition and/or trial)
  • Have significant respect among most attorneys with whom they have worked: local attorneys, in a specific area of law with cases anywhere else in the country, specialty expertise. Examples: Standard of Care in medical-malpractice cases, mass torts, medical product liability, Disability/Prognosis in Personal Injuury cases, or a number of other specialties.
• $1,000-$1,300/hour
  • A doctor at the top of their field in their area of specialty expertise
  • Excellent reputation
  • Ease during testimony
  • Have testified many dozens of times with positive feedback: Jurors listened attentively and factored the Expert testimony into their decisions.
  • Outside of Court: the Expert is respected for thorough and well-written reports of findings. This becomes relevant in settlement negotiations.
• Add-on for Testimony
  • Testimony is always billed at a higher rate than the Expert’s base rate (about 40% or so to the figures above.)

Determining Income: For Data Geeks

There exist fairly useless Bureau of Labor Statistics data and 2 private surveys conducted by expert witness directories. I go into detail in the article Setting a Fee in Forensic Psychiatry and Psychology. How to Determine Your Hourly Rate. I use Forensic Psychiatry and Psychology as an exemplar, but the results are consistent with my research in other areas of medicine.

The private survey respondent samples are small. In the Department of Labor data, the statistics are misleading because they identify general medical professions, but not medical-legal or forensic subspecialties.

Most importantly, in no research did I find if the annual income reflects full-time or part-time work. Nor did it break out “income” to reflect the division between forensic and clinical work. In other words, a doctor who spends 300 hours a year in their medical-legal practice and reports a total income that includes clinical work, there is no way to parse the information. Not helpful.

FYI, the Department of Labor, Bureau of Labor Statistics data is often cited in the press about income for medical-legal Expert Witnesses, despite significant flaws. If you find articles designed to answer your questions about income in this field, check the sources.

I believe forensic physicians, in any specialization, do not make as much income from their forensic practice as they could. I mean more billable hours and larger cases. Obtaining cases is a function of digital and “real life” outreach to attorneys. This produces calls. Calls drive retention. Retention and scope of work drive hours. Big cases mean the hours are easier to bear: one “fact” set, one set of Claims, your focused, unbroken attention to a single case. It is less stressful work.

Don’t Undersell Your Competition. Whatever you decide to charge, don’t intentionally try to charge less than your colleagues just to get work.

Don’t Offer Discounts.  Your services are not available on Groupon.

Charge less: Worthless? If you cut your rate because you want more work, it could make it easier for attorneys to assume your reduced rate is a reflection of inadequate qualifications.

What You Can Do Now

Keep Building on Your Experience and Knowledge Base. 

• Pursue expertise in specialty interests.
• become a student and teacher
• write (for your website, publications, give webinars and interviews, present) about those specialty interests.  There are many: PTSD in combat, Surgical Error, Hospital Billing Fraud, Boundary Violations Between Treater and Patient, Failure to Diagnose–I’ve seen hundreds of areas of specialization–always multiple for a given practitioner. What makes you tick is not a feature of another colleague in forensic work.  Your unique knowledge is what makes you the right Expert for a particular case and makes another person the wrong Expert for that case.
• Get testimony experience. Pursue it aggressively. Cases that are likely to go to trial are of unique value to you.

Bottom Line to your Bottom Line

Income is limited to how often you are retained and how many hours are needed for each case. Thus, income is driven by demand.

Demand is generated through action.