Practice Development for Medical Expert Witnesses
Beryl Vaughan, Consultant
Nationwide

Email go@forensicexpertpro.com or Call (415) 302-9589

Setting the Right Fee for Medical-Legal Work

Exemplar: Forensic Psychiatry and Psychology

Application: Medical-Legal Work for Expert Witnesses in Varied Specialties

By Beryl Vaughan

4 Factors That Drive Fees

Skill. Will a jury hear and understand what you have to say? That is what attorneys are looking at first. It’s the endgame. But 90% of the work of an expert witness occurs before trial and usually never goes to trial.

The best service you can offer is a solid report: you describe and consider as much information as possible, and your conclusions are well formed and easy to parse.

A good report can impact settlement which is one reason it is so important to attorneys on all sides of a case. Ditto a thorough IME that reveals new information. Lastly, verbal and written communication skills ensure a jury will hear what you have to say; your report is an indicator of your skill.

Credentials and Experience. Self-evident, sure. Planning how you will acquire that experience should be intentional and practical. You are looking at a lifelong career.

Unique Expertise.  Ironically, many doctors don’t know they have unique expertise and therefore don’t communicate it to attorneys. This is a missed opportunity that can drive a fee schedule that is too low.

Demand. Bear in mind that there is more demand in the judicial system than available medical experts.

If you are that rare bird that excels beyond the pale, then your fees will be well-deserved outliers. If you are like most doctors nearer the median, here are some rules of thumb based on my many conversations with experts and attorneys. As you will see, there is no reliable or definitive data, sadly.

Psychiatrists: Board-Certified Forensic Psychiatrists, Med-Legal Fellowship-Trained

  1. $400 < 6 months post Fellowship, $450-500 post Board-Certification in Forensic Psychiatry and < 2 years and <7 cases. Move to #2 if you have (a) subspecialty training in an additional field such as Child & Adolescent, Geriatric, etc. and/or (b) case-specific experience such as Threat Assessment, and/or (c) reputation for unusually excellent report writing and testimony.
  2. $500-$750 Mid-Career year 4-10ish years of experience with many cases and testimony experience. There seems to exist a plateau generally between between years 6-10 post Board-Certification. All figures  assume a solid reputation and skill.
  3. $650+ thereafter. Fees reflect experience, area of expertise, testimony and reputation; excludes outliers.
  4. $800+ extensive testimony experience in a range of cases, specialized knowledge (e.g., PTSD, addiction factors, Testamentary Capacity.)

Testimony is 30-50% higher than the base fee. 


Physician: Medical Expertise (not Psychiatry) and Medical-Legal Experience; No Dedicated Med-Legal Training

There is no Board-Certification in a Medical-Legal subspecialty other than Forensic Psychiatry.

I believe medicolegal expert physicians can benefit from Continuing Legal Education or CLE (the legal version of CME). Non lawyers can join many Bar Associations and attend CLE events. You can also subscribe to, and read, legal publications, attend seminars, webinars, public programs, and conferences about expert witness and medical-legal assessment. Partner with colleagues, join forensic organizations, and pursue mentorship.

Fees paid to physicians in a field other than Forensic Psychiatry are notoriously undocumented.

It is the Wild West.

Doctors often set their own fees or ask no more than one or two other colleagues what they are charging, before choosing a fee. Some specialists earn more than others. This more often reflects the kinds of cases that go to court. I’m going to take a stab, but it is my experience there is easy way to set a fee besides testing. Set a fee and if there’s no pushback, increase it until there is.

Non Psychiatry Medical Specialists in Medicolegal work:

  1. $450-$600 < 3 years and <10 cases, depending on rarity and years of clinical expertise in their field.
  2. $600-$850 Mid-Career, plateau at years 6-10. Surgeons and specific specialties are not reflected.*
  3. $850+ for experience 20+ years and >40 cases >30 trial testimony. Fees reflect experience, area of expertise, testimony and reputation; excludes outliers.

Testimony is 30-50% higher than the base fee. 

*Anecdotally, I find greater demand for EM physicians, Child and Adolescent Psychiatrists, Orthopedic and Rehabilitation specialists, and anesthesiologists.  You can check malpractice insurance trends to see which areas of medicine are at risk for allegations of malpractice or negligence.

Further, physical injuries are a common focus of litigation. Back and neck injuries explain the demand for orthopedists, rehab medicine and PT Expert Witnesses because their testimony is necessary for juries to determine damages based on their understanding of injury recovery.

Some Experts are in demand because there are not enough specialists in their field, or it requires nuanced training. For example, there are very few doctors Board-Certified in both Child Psychiatry and Forensic Psychiatry, but there are many custody cases, and Parental Alienation allegations. Wrongful death cases are, understandably, likely to go to court. If there is a death while a patient is under medical care, then anyone who touched that treatment will be scrutinized and the proper expert witness sought.


Licensed Forensic Psychologists (PhD or PsyD) with Forensic Medical-Legal Expertise

  1. $250-$400 < 5 years. Go to #2 if you hold Board-Certification in Forensic Psychology or Neuropsychology from the ABPP, or exceptional training in Threat Assessment.
  2. $400-$500 = 4-8 years’ experience, plateau mid-career
  3. $600 = 8+ years, fluidly estimated
  4. Fees reflect experience, area of expertise, testimony and reputation; excludes outliers at the top of their field who may charge more than $600/hour

Testimony is 30-50% higher than the base fee. 


How I Arrived at These Figures: Sources, Deduction and Robust Hearsay

Disclaimer: Estimates are based on my unofficial, but significant experience supported by first-person reporters, legal documents, and intersecting professional research data.

Sources

  1.  Dozens of forensic psychiatrists, psychologists, physicians in a range of specialties, diverse clinical settings–private practice and hospitals, and healthcare providers who specialize but are not physicians.
  2.  Hundreds of lawyers[i]
  3.  Depositions, Expert Disclosures, and Billing documents produced during Discovery; Experience reported in CVs and Rule 26 Disclosures. For example, doctors are usually asked their fee early in a deposition-a good way to know what your colleagues are charging. Also, doctors usually must produce their invoices in Document Production during the discovery phase of a lawsuit.
  4. Information from the American Board of Psychiatry and Neurology and the American Psychological Association.  No other medical specialty Boards collect information relevant to medical-legal practice.

Commonly Cited Data From 3 Sources

  1. The Bureau of Labor Statistics (BLS) Occupational and Employment Statistics (OES)[ii] is the most widely cited data source in articles about what a forensic psychiatrist or psychologist charges. Ditto any other medical specialty applied in a legal matter. Unfortunately, it is useless.
  • Makes no distinction between clinical and forensic practice.
  • Salaried positions are included which doesn’t impact setting a fee in private practice.
  • No adjustment for trainees or those in fellowship.
  • Mean numbers do not distinguish a split practice, though forensic work is usually a portion of overall income alongside clinical work.

BLS numbers are off for forensic work by as much as a factor of 10. We can all agree no forensic psychologist charges $42/hour. Data supplied by the BLS specifically for 2016-2019 is taken apart in the Endnote below. Due to COVID outliers, 2020-2021 are not included. Data for 2022 is not yet available. [iii]

2. 2009 survey by the American Psychological Association.

  • References the BLS stats.
  • Only 5% of 711 respondents (35!) identify as forensic psychologists.
  • The APA categorizes forensic psychology with “Direct Human Services – Other Psychological Subfields.” [iv]

3. Surveys from Private Expert Witness Directories.

  • 2021 survey of Experts in an array of fields, conducted by SEAK, a private Expert Witness Directory.  The data set is a moving target and the sample small. Inherent biases exist (Respondents are only those who have paid to list with SEAK). The moving target problem is this: respondents may report their fees applied to an unlimited selection of expertise categories. In other words, if you add up all respondents from all categories, you do not arrive at the total number of respondents.  A radiologist who charges $600/hour might report that rate as a radiologist, as an imaging expert, as an oncology radiation specialist. A physician in only one of these fields might conclude $600/hour is the average when, in fact, another specialist in only one of those fields might charge $800/hour. It is my opinion the results of this survey are unreliable for fee-setting purposes.
  • 2017 survey of 1,030 Experts in an array of fields, conducted by SEAK. 6% of respondents self-identify as forensic psychiatrists (32) or forensic psychologists (29). Inadequate and possibly biased sample.[v]
  • 2018 survey by ExpertPages, a private Expert Witness Directory; sample of 700 respondents; no breakout for forensic psychiatrists or psychologists. Unable to identify sample. In 2019 they released a new survey which must be requested from them directly. [vi]

Credentials that Make a Difference

Board-Certification. I state this because I have encountered medical-legal experts who are not Board-Certified in their specialty. Board-Certification has a value.

Cross-over Training, Certification, Fellowship. Doctors who can address more than one area of healthcare are better suited to a complicated case and those are the most interesting and profitable. For example, certification in a unique medical procedure or use of a medical device in treatment is another way to enhance your credentials.  One client of mine is qualified to treat a condition with a DEA regulated medication. Another is certified in Transgender Health. The former has testified in addiction cases and the latter testified in a case involving a transgender teen facing enforced separation from support and family. 

Forensic Psychiatry, Board-Certified: Mid-career doctors with 6-10 years’ experience.

In 2019 4% of all Board-Certified Psychiatrists also held Board-Certification in Forensic Psychiatry.[viii]  The American Board of Psychiatry and Neurology issues statistics annually which are cited in its Annual Reports and Reports of Board-Certifications by Subspecialties, and overviews. [vii] [Charts appear at the bottom of this article and can be found on the ABPN Facts and Statistics website page.]  December 21, 2021 the ABPN reported 1,473 active Board-Certified Forensic Psychiatrists up from 1,321 in 2019. In 2019 I surveyed earlier statistics and it appeared there were three groups of doctors: well-established Forensic Psychiatrists over the age of 60 who attained Board-Certification in Forensic Psychiatry between 1994 and 2002. 1994 is when one could attain Board Certification in the subspecialty “Psychiatry with Added Qualifications in Forensic Psychiatry.” Until 2002, there was no Fellowship requirement. In fact, there was a small rush of established doctors to gain the Board-Certification before 2002, creating a cluster of older doctors offering medical-legal services in Psychiatry.  In 2002, Fellowship programs slowly began to be available and the growth in Board-Certifications between 2002 and 2009 was not significant. After 2009, the numbers began to increase more rapidly to a galloping 10% per exam year (odd years.)[ix]

Roughly Half of Forensic Psychiatrists have been Board-Certified for less than 10 years. I posit this explains a plateau in fees among doctors with 6-10 years’ experience in the “mid-career” range.

I would not be surprised to learn the approximately 1400 inactive Board-Certifications to reflect that cluster of Certificates issued prior to 2002, i.e. doctors in practice for many years and now retired.[x]

Multiple Specialties: True for Psychiatrists and Psychologists

Physicians: Medical Board-Certifications. Board-Certification in multiple medical specialties can command a higher fee—especially if they intersect in commonly litigated matters. Certainly, multiple Board-Certifications reflect more medical training. But from a medico-legal perspective, a combination of medical specialties is helpful in cases where medical factors are complex or even interdependent.

Notoriously, preexisting conditions, pain, medications and comorbidity require a multi-faceted assessment.

For example (a) Personal injuries in PI cases where a plaintiff develops a dependence on pain medication could make specialization in Forensic Psychiatry and Addiction Medicine relevant. (b) A testamentary capacity case might benefit from a doctor skilled in Forensic Psychiatry and Internal Medicine, Geriatric Medicine or Brain Injury Medicine to assist the trier of fact depending on the facts. 

Psychologists. Multiple Board-Certifications is more unusual in Psychology, but specialty training is available. Unlike Medicine, Board-Certification in Forensic Psychology issued by the American Board of Professional Psychology (ABPP)[xi] is held by only 293 Psychologists, down 27 from 2018.[xii]  Board-Certification in Neuropsychology and Child and Adolescent Psychology are other options for specialty training.  Given the number of licensed psychologists, forensic psychology postgraduate programs and psychologists practicing forensic psychology, Board-Certification is unique but not requisite by any means. 

If you don’t have Board-Certification in Forensic Psychology, you are in the majority.

If you are Board-Certified in Forensic Psychology or another subspecialty you are among an elite group with specialty training and, like any specialized credential, a higher fee may be justified.

Education

You can obtain a PhD or PsyD in Psychology from almost every University in the Country. There are only a few, however, that offer forensic-focused postgraduate programs. There is a value if the program is well-respected. If the program is well-respected but not well-known, and you feel your training indicates a higher fee, I recommend educating attorneys on a website or article.

Less Well-Known Credentials That Can Impact Fees

Specialty Forensic Assessment, Especially Driven by Occupational Considerations sometimes require specific Certification. Here are a few.

  • HIMS (Drug and Alcohol Monitoring for commercial Pilots-FAA). Available to: Psychiatrists and Neuropsychologists can apply.[xiii]
  •  Military and Government Approved Contractors. Psychiatrists and Psychologists.
  • Medical Review Officer MRO (a physician trained to interpret labs in drug testing programs). Psychiatrists can apply.[xiv]
  • Risk of Violence aka Threat Assessment training and certification. Can include use of designated threat assessment testing and tools; may accompany a Fitness for Duty evaluation. Psychiatrists and Psychologists.[xv]
  • Fixed fee structure (court-ordered evaluators and Workers’ Compensation Examinations usually come with a base fee that is inflexible.) This fee can be more or can be less than your usual rate. Psychologists and Psychiatrists.

Geography

The CV of a $500/hour Expert in New Mexico looks very similar to the CV of a $500/hour Expert in Michigan.

That said, the out-of-state Expert can add as much as $5,000 to the cost of their services if they must be “flown in,” and that factors into an attorney’s decision.

Supply and Demand.  Geographic access to forensic experts overrides the cost of flying in an expert. For example, as of this writing, Alaska has no Board-Certified Forensic Psychiatrist in residence.

The ABPN “VerifyCERT™ Certification and Status Verification Tool” allows you to look up numbers of Board-Certifications in a Specialty or a particular person by either State or name, respectively. It is a tool I recommend to attorneys as part of their due diligence to ensure an expert has the Board-Certification they claim to have.[xvi]

The American Psychological Association charts the location of licensed Psychologists (sorry no Forensic subspecialties documented).[xvii] and the ABPN can tell you how many Board-Certified Forensic Psychiatrists are practicing in a given state.

Quantifiable Factors in Fees: Take Charge of What You Charge

Forensic Experience

  • Testimony at Deposition and/or Trial. It takes time to master unflustered testimony under fire, relevant to the fee increase from early-career to mid-career doctors. Early in your career, you might not increase your testimony fee (the standard, otherwise).
  • Specialization. A rare specialization will bump up the hourly rate, especially if credentialed (Board-Certification).
  • Respected work-product: well-written reports and a sharp eye with records review. Pay attention to attorney feedback and implement accordingly.
  • Academic Appointments. (1) Expert Witnesses are first and foremost educators, (2) an academic appointment reinforces that you are an expert in your field.
  • Public Service and Volunteer Work. These speak to your character in a field where character counts.
  • Prestige schools are great but not as important as where you received your forensic training (Fellowship or Forensic Psychology or Criminology Programs).
  • Specialty Training (see above).

Bragging Rights

Awards, appointments and affiliations.  Membership in a respected professional organization and serving on specialty subcommittees.

  • Board and leadership positions for professional organizations.
  • Government appointments. A client of mine was appointed by the state Governor to a body that advises about matters that intertwine criminology and mental health. Another is appointed to the State’s Accreditation Commission for academic programs in his profession.
  • Publishing, public speaking and media presence.

Publishing.  If you have a specialization, publishing demonstrates and underscores you are truly an expert on that topic. If you are not, don’t publish. Stick to peer-reviewed and professional publications.  

Public Speaking. Public Speaking is the verbal version of publishing, with the added benefit that more people will understand what you have to say. Fees reflect demand and demand reflects visibility and an understanding of your expertise.

Media Presence. If a legitimate news outlet seeks you for commentary, I recommend you thoughtfully consider if it is the right decision to accept. You can introduce your knowledge base and professional reputation to a broader population. This speaks to the “reputation” factor that drives fees. But, if you are not comfortable in the public eye, don’t do it.

Forensic Psychiatrists and psychologists get more media face time than almost any other forensic scientist. Thanks to the media, the field enjoys a relatively new and well-deserved respect and trustworthiness. Whenever the news interviews a forensic doctor after a heinous crime, the public learns someone like you is the right expert to turn to. Remember: members of the public include jurors, judges and attorneys.[xviii]

Setting your own fee. Make no assumptions.

90% of my clients come to me undercharging, in my opinion. Most are worried about increasing their fee. So far, knock on wood, rates I recommend have proven to be a non-issue for attorneys and put the expert on an equal footing with colleagues.

Magical Thinking, Emotional Thinking, Institutionalized Thinking

Magic: “I don’t think I can justify a higher rate so I won’t.”  If you’ve set your fee based on no outside information of any kind, that’s magical thinking. 

Emotions: Fear is a powerful motivator. Some doctors tell me they think they will lose cases if they charge “too much.” Low self-esteem is sometimes the “hidden” driver behind such a statement.

Because you fear it, doesn’t mean it’s true or, as a wise person once said to me “feelings are not reality.”

Set your fee, state it to attorneys, and be silent.

Prepare to be uncomfortable the first few times you do this. It gets easier.

Institutionalized Thinking is a little different.

Women are more likely to charge less than their male counterparts even though attorneys won’t expect a ‘discount’ from a woman. I expect this is the case of other marginalized people.

Attorneys care about the strategy of their case and the Expert’s gender, race, or any factor can matter or not. I recommend you not second guess the attorney when setting your rates.

Breaking the Taboo: Talking to Colleagues About Money

I encourage my clients to consider their colleagues to be…..colleagues. Networking and information-sharing makes the profession better, introduces transparency between practitioners, and a sense of fairness in fee-setting. There is a societal taboo against talking about money. I think you do yourself a disservice if you bow to the taboo.

Professional Warnings About Fee Structure

No Contingency

No Liens

Tread carefully: No Flat fees

Discounts: Thoughtful decision

Contingency and Liens mean having a dog in the fight. 

The implication your income and opinion are interdependent will damage your reputation at best and could stop your career in its tracks. How much you charge could become a moot point.

“Contingency” describes an arrangement whereby payment is contingent on whether or not a party prevails in a lawsuit. It is an acceptable arrangement for attorneys such as Personal Injury Law where attorneys are  paid a percentage of an award and earn nothing if their client “loses.”

Contingency payment is not acceptable for any Expert Witness and can result in the disqualification of an Expert’s testimony. Per the American Academy of Psychiatry and the Law “Ethics Guidelines for the Practice of forensic Psychiatry” (2005),

“Contingency fees undermine honesty and efforts to attain objectivity and should not be accepted.”

American Academy of Psychiatry and the Law “Ethics Guidelines for the Practice of forensic Psychiatry” (2005), [xix]

Liens, unlike contingency, are payment of fees secured by plaintiff’s property, but like contingency, there is a direct relationship between the Expert’s fee and the case outcome.

“In Straughter v. Raymond IV (C.D. Cal. 2011) 2011 WL 1789987…plaintiff gave the expert a lien against his personal property and against any recovery in the case because of his inability to afford her hourly rate. That constituted “a de facto contingency fee arrangement.”

Ventura, Luis. San Diego County Bar Association “Ethics Corner[xx]

Flat Fees

Occasionally a doctor will report charging a flat fee. I believe it does not raise to the level of best practices, ethically and practically.

Flat fees are most common in fields where profit is made by spending less than the fee collected. For an Expert Witness, the question is raised “did the expert put full effort into coming to their conclusions or did they cut corners to make a profit?”

As far as I know, it’s not against the law.  Raise above that bar.

An expert evaluation is what it is. There is no vested interest.  In fact, your opinions may be a hindrance to the case. It’s not your problem!

Discounts

Doctors reduce their fees all the time, for example for court-appointed work, pro bono, for financially strapped clients like non-profit organizations, public defenders, cases where they want to gain trial experience, even at the expense of  a discount.

How to Handle Challenges on the Stand

In generic litigation, a discount might be perceived as a cutting a deal. Wording is essential in your retention contract. Don’t say there’s a reduction, just state your fee. If o/c asks in court if your fee is less, you just say “yes.” If they ask why? Reply “Like my colleagues, I retain the right to reduce my rates from time to time.  My opinions are objective and unbiased.” A pretrial conference with the attorney is the time to discuss how to handle the question.

If you have a question about how much you charge, or how much you should charge, call me.

ENDNOTES

[i] Attorney response to fees disclosed is revealing and factor into my estimates. Watch for these responses when you talk to an attorney about your fees: surprise (pleasantly or negatively shocked), no surprise at all, acceptance, resignation, arguing or an attempt to negotiate. Look at trends over the course of a number of conversations with attorneys. Skill in detecting malingering is helpful.

[ii]    U.S. Bureau of Labor Statistics, Occupational and Employment Statistics, https://www.bls.gov/oes/home.htm#

When I began my research to see what my clients were reading on the internet, I found dozens of articles quoting the Bureau of Labor Statistics, like these Houston Chronicle online articles “How much does an average forensic psychologist earn in a year?” (Thompson Jayne, Houston Chronicle, 2018) and “How much does a forensic psychiatrist make?” (Henderson, William, Chron, Undated).

What you need to know about BLS Statistics

Categories include “Psychiatry, All Other” and “Psychology, All Other.” Forensic Psychiatry and Forensic Psychology are not documented by the BLS. Regarding clinical work:

No distinction is made between trainees clocking hours for licensure in a forensic setting (low or no pay).

The ‘mean’ can’t distinguish between a forensic rate charged 100 hours a year and a psychotherapy rate for another 1500 hours the same year.

The mean incorporates salaried positions that pay low but come with high-value benefits. In fact, straight-out-of-school jobs are often salaried in the corrections system or mental health hospitals.

There is no accommodation about fees set by judicial or government bodies. (Courts, Workers Comp., even insurance).

[iii]    Reported by the BLS for 2016-209, mean hourly wage:

“Psychiatrists, 29-1223.  “Diagnose, treat, and help prevent mental disorders. Excludes “Clinical and Counseling Psychologists” (19-3033) and “School Psychologists” (19-3034)” 

[Unclear why they reference psychologists—see stats about Psychologists below. Ed.]

2019 $105.98/hour https://www.bls.gov/oes/current/oes291223.htm (congratulations on the raise since last year. 3 cents!)

2018 $105.95 https://www.bls.gov/oes/2018/may/oes291066.htm

2017 $103.89 https://www.bls.gov/oes/2017/may/oes291066.htm

2016 $96.26 https://www.bls.gov/oes/2016/may/oes291066.htm

“19-3039 Psychologists, All Other”

  1. $47.23.  https://www.bls.gov/oes/current/oes193039.htm
  2. $45.97 https://www.bls.gov/oes/2018/may/oes193039.htm

2017: $44.92 https://www.bls.gov/oes/2017/may/oes193039.htm (sorry about the pay cut from 2016)

2016 $45.51 https://www.bls.gov/oes/2016/may/oes193039.htm

I encourage you to follow the links to learn more about the BLS geographic data and collection process.

[iv]   Finno, Ariel A., Michalski, Daniel, et al., “Salaries in Psychology 2009 Report of the 2009 APA Salary Survey,” APA Center for Workforce Studies – April 2010 https://www.apa.org/workforce/publications/09-salaries/report.pdf

[v] SEAK Expert Witness Fee Summary Report, by request, https://seak.com/expert-witness-fee-data-form/

[vi] The ExpertPages 2019 Fees & Practices Survey (Part 1), by request for download at https://expertpages.com/news/survey2019_1.htm

[vii] ABPN Facts and Statistics, https://www.abpn.com/about/facts-and-statistics/

5 Year Pass Rate Summary (2019). https://www.abpn.com/wp-content/uploads/2020/04/ABPN-Pass-Rates-5-Year-Summary-2019.pdf

Certificates issued by Year https://www.abpn.com/wp-content/uploads/2020/04/Certifications-by-Year-Subspecialties-2019.pdf

ABPN Annual Reports including Subspecialties

2019 https://www.abpn.com/wp-content/uploads/2020/05/ABPN_2019_Annual_Report.pdf

2018 https://www.abpn.com/wp-content/uploads/2019/05/ABPN_2018_Annual_Report.pdf

2017 https://www.abpn.com/wp-content/uploads/2018/04/2017_ABPN_Annual_Report.pdf.

2016 https://www.abpn.com/wp-content/uploads/2017/03/2016_ABPN_Annual_Report.pdf

[viii] Ibid

[ix] Ibid

[x] “ABPN Certification the Subspecialty of Forensic Psychiatry,” American Academy of Psychiatry and the Law (forensic arm  of the APA). https://www.aapl.org/abpn-certification.

[xi] “Specialty Guidelines for Forensic Psychology,” American Psychological Association https://www.apa.org/practice/guidelines/forensic-psychology Aug. 2020

[xii] Per confirmation from the American Board of Professional Psychology dated 8/16/20

[xiii] HIMS Aviation Medical Examiners monitor drug and alcohol use in commercial pilots. A team of a psychiatrist and neuropsychologist are generally tasked with the evaluation. “HIMS is specific to commercial pilots and coordinates the identification, treatment and return to the cockpit of impaired aviators. It is an industry-wide effort in which companies, pilot unions, and FAA work together to preserve careers and further air safety.

“Drug and Alcohol Monitoring” FAQ, Federal Aviation Administration. https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/DA_Monitoring_Programs_and_HIMS_FAQs.pdf and

“Guide for Aviation Medical Examiners,” Federal Aviation Administration, https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/saspec/

[xiv] Medical Review Officers.  “Drug Testing,” Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/workplace/drug-testing

[xv] Learn more: Buchanan, Alec, M.D., PhD, Binder, Renee, M.D., Norko, Michael, M.D., Swartz, Marvin, M.D. “Resource Document on Psychiatric Violence Risk Assessment, APA Resource Document. American Psychiatry Association, October 2011 https://www.psychiatry.org/psychiatrists/search-directories-databases/library-and-archive/resource-documents

[xvi] American Board of Psychiatry and Neurology VerifyCERT™ Certification and Status Verification Tool. https://application.abpn.com/verifycert/verifyCert.asp?a=4&u=1

[xvii] Lin, L., Conroy, J., & Christidis, P. (2020, January). Which states have the most licensed psychologists? Monitor on Psychology51(1). http://www.apa.org/monitor/2020/01/datapoint-states,  https://www.apa.org/monitor/2020/01/datapoint-states

[xviii] Criminal Minds: FBI Behavioral Analysis Unit

[xix] “Ethics Guidelines for the Practice of Forensic Psychiatry, American Academy of Psychiatry and the Law, Adopted May 2005. https://www.aapl.org/ethics.htm

[xx] Ventura, Luis E. “Paying an Expert Under a Contingency Fee Arrangement Is a Major No-No.” Legal Ethics Corner (Blog), San Deigo County Bar Association, 2020. https://www.sdcba.org/index.cfm?pg=Legal-Ethics-Corner-10-11

[xxi] “Ethics Questions and Answers Opinions of the AAPL Committee on Ethics Adopted by AAPL Council May 19, 2013” “Question 6] (Excerpted) An attorney has asked me to do a forensic examination on a Lien, in which I would collect my fee only if the case is successful. Is this ethical? Answer – If your fee or its collection is contingent on the successful outcome of a
trial, it is unethical as explained under AAPL Guidelines Section IV, honesty and
striving for objectivity. It also is unethical under AMA, Opinions of the Council on
Ethical and Judicial Affairs, sections 6.01 and 9.07. …According to AMA
Opinions of the Council on Ethical and Judicial Affairs, section 8.10, however, a
lien may be filed as a means of assuring payment in states where there are lien
laws, providing the fee is fixed in amount and not contingent on the amount of the
individual’s settlement against a third party. Since your lien would be dependent
on the outcome of the case it would be unethical. ” https://www.aapl.org/docs/pdf/Ethics%20Questions%20and%20Answers.pdf

 

Never accept liens or fees paid on contingency[xxi]

If you only receive payment if the case is “won,” then you lose all reputation for objectivity. How can a jury rely on your findings if they are tainted by a motivation to be paid “for the opinion?” It is unethical and unwise to have a contingency or lien arrangement with the retaining attorney.
How much do Forensic Psychiatrists and Psychologists Charge? What you need to know to set an appropriate fee.

Forensic Psychiatrists

Board-Certified Forensic Psychiatrists (ABPN) estimated charge $350-$1,000/hour:

  1. $350-$450 “Board-Certified” < 3 years
  2. $450-$650 Mid-Career, plateau at years 6-10
  3. $650+ for experience 20+ years. Fees reflect experience, area of expertise, testimony and reputation; excludes outliers

Forensic Psychologists

Licensed Psychologists (PhD or PsyD) with forensic expertise estimated charge $250-$600

  1. $250-$400 < 4 years
  2. $400-$500 = 4-8 years’ experience, plateau mid-career
  3. $600 = 8+ years fluidly estimated
  4. Fees reflect experience, area of expertise, testimony and reputation; excludes outliers at the top of their field who may charge more than $600/hour

Testimony is 30-50% higher than the base fee.

How I Arrived at These Figures: My Sources, Deduction and Robust Hearsay

Disclaimer: Estimates are based on my unofficial, but significant experience supported by first-person reporters, legal documents, and intersecting professional research data.

  1.  Speaking with dozens of forensic psychiatrists, psychologists
  2. Speaking with dozens of lawyers[i]
  3. Fees and experience reported in Depositions, Expert Disclosures, and Billing documents produced during Discovery; Experience reported in CVs and Rule 26 Disclosures.
  4. Information from the American Board of Psychiatry and Neurology and the American Psychological Association.

Commonly Cited Data From 4 Sources

  1. The Bureau of Labor Statistics (BLS) Occupational and Employment Statistics (OES)[ii] is the most widely cited data source in articles about what a forensic psychiatrist or psychologist charges. Unfortunately, it is useless.
  • Makes no distinction between clinical and forensic practice.
  • Salaried positions are included which doesn’t impact setting a fee in private practice.
  • No adjustment for trainees or those in fellowship.
  • Mean numbers do not distinguish a split practice, though forensic work is usually a portion of overall income alongside clinical work.

BLS numbers are off for forensic work by as much as a factor of 10. We can all agree no forensic psychologist charges $42/hour. Data supplied by the BLS specifically for 2016-2019 is taken apart in the Endnote below. Due to COVID, 2020-2021 information are outliers. 2022 BLS data not yet released.[iii]

A. 2009 survey by the American Psychological Association.

  • References the BLS stats.
  • Only 5% of 711 respondents (35!) identify as forensic psychologists.
  • The APA categorizes forensic psychology with “Direct Human Services – Other Psychological Subfields.” [iv]

B. Two (private) Expert Witness Directory Surveys.

  • 2017 survey of 1,030 Experts in an array of fields, conducted by SEAK, a private Expert Witness Directory. 6% of respondents self-identify as forensic psychiatrists (32) or forensic psychologists (29). Inadequate and possibly biased sample.[v]
  • 2018 survey by ExpertPages, a private Expert Witness Directory; sample of 700 respondents; no breakout for forensic psychiatrists or psychologists. Unable to identify sample. In 2019 they released a new survey which must be requested. [vi]

Outliers are discussed.

Credentials that Make a Difference

Physicians

Board-Certification: Forensic Psychiatry 

$450-$650/hour mid-career doctors with 6-10 years’ experience.

The American Board of Psychiatry and Neurology issues statistics annually which are cited in its Annual Reports and Reports of Board-Certifications by Subspecialties, and overviews. [vii] [Figures available on ABPN Facts and Statistics website or on most devices appear at the end of this article.]

In 2019 4% of all Board-Certified Psychiatrists also held Board-Certification in Forensic Psychiatry.[viii]

Per the ABPN, as of the last biennial exam October 2019, reported in the current Annual Report, of 1,321 active Board-Certified Forensic Psychiatrists, about 10% were Board-Certified in 2019, 10% in 2018, 10% in 2017, marching steadily backwards to about 2009. (Exams are given during odd years, following a one-year fellowship.)[ix]

50% of doctors have been Board-Certified for less than 10 years. I posit this explains a plateau in fees among doctors with 6-10 years’ experience in the “mid-career” range, based on my experience and due in some part to this distribution.

I would not be surprised to learn the nearly 1300 inactive Board-Certifications to reflect a cluster of Certificates issued in and prior to 1999, the last year you could obtain Board-Certification without the Fellowship requirement. In fact, many doctors had been in practice for years before Board-Certification was even available in 1994.[x]

Multiple Specialties: True for Psychiatrists and Psychologists

Physicians: Medical Board-Certifications. Board-Certification in multiple medical specialties can command a higher fee—especially if they intersect in commonly litigated matters. Certainly, multiple Board-Certifications reflect more medical training. But from a medico-legal perspective, a combination of medical specialties is helpful in cases where medical factors are complex or even interdependent.

Notoriously, preexisting conditions, pain, medications and comorbidity require a multi-faceted assessment.

For example (a) Personal injuries in PI cases where a plaintiff develops a dependence on pain medication could make specialization in Forensic Psychiatry and Addiction Medicine relevant. (b) A testamentary capacity case might benefit from a doctor skilled in Forensic Psychiatry and Internal Medicine, Geriatric Medicine or Brain Injury Medicine to assist the trier of fact depending on the facts. 

Psychologists. Multiple Board-Certifications is more unusual in Psychology, but specialty training is available. Unlike Medicine, Board-Certification in Forensic Psychology issued by the American Board of Professional Psychology (ABPP)[xi] is held by only 293 Psychologists, down 27 from 2018.[xii]  Board-Certification in Neuropsychology and Child and Adolescent Psychology are other options for specialty training.  Given the number of licensed psychologists, forensic psychology postgraduate programs and psychologists practicing forensic psychology, Board-Certification is unique but not requisite by any means. 

If you don’t have Board-Certification in Forensic Psychology, you are in the majority.

If you are Board-Certified in Forensic Psychology or another subspecialty you are among an elite group with specialty training and, like any specialized credential, a higher fee may be justified.

Education

You can obtain a PhD or PsyD in Psychology from almost every University in the Country. There are only a few, however, that offer forensic-focused postgraduate programs. There is a value if the program is well-respected. If the program is well-respected but not well-known, and you feel your training indicates a higher fee, I recommend educating attorneys on a website or article.

Less Well-Known Credentials That Can Impact Fees

Specialty Forensic Assessment, Especially Driven by Occupational Considerations sometimes require specific Certification. Here are a few.

  • HIMS (Drug and Alcohol Monitoring for commercial Pilots-FAA). Relevant to Psychiatrists and Neuropsychologists can apply.[xiii]
  •  Military and Government Approved Contractors. Psychiatrists and Psychologists.
  • Medical Review Officer MRO (a physician trained to interpret labs in drug testing programs). Releva nt to Psychiatrists can apply.[xiv]
  • Risk of Violence aka Threat Assessment training and certification. Can include use of designated threat assessment testing and tools; may accompany a Fitness for Duty evaluation. Relevant to Psychiatrists and Psychologists.[xv]
  • Fixed fee structure (court-ordered evaluators and Workers’ Compensation Examinations usually come with a base fee that is inflexible.) This fee can be more or can be less than your usual rate. Relevant to Psychologists and Psychiatrists.

Geography

The CV of a $500/hour Expert in New Mexico looks very similar to the CV of a $500/hour Expert in Michigan.

That said, the out-of-state Expert can add as much as $5,000 to the cost of their services if they must be “flown in,” and that factors into an attorney’s decision.

Supply and Demand.  Geographic access to forensic experts overrides the cost of flying in an expert. For example, as of this writing, Alaska has no Board-Certified Forensic Psychiatrist in residence.

The ABPN “Verify Cert” tool allows you to look up by Board-Certification Specialty and both/either State and name.[xvi]

The American Psychological Association charts the location of licensed Psychologists (sorry no Forensic subspecialties documented).[xvii] and the ABPN can tell you how many Board-Certified Forensic Psychiatrists are practicing in a given state.

Quantifiable Factors in Fees: Take Charge of What You Charge

Forensic Experience

  • Testimony at Deposition and/or Trial. It takes time to master unflustered testimony under fire, relevant to the fee increase from early-career to mid-career doctors. Early in your career, you might not increase your testimony fee (the standard, otherwise).
  • Specialization. A rare specialization will bump up the hourly rate, especially if credentialed (Board-Certification).
  • Respected work-product: well-written reports and a sharp eye with records review. Pay attention to attorney feedback and implement accordingly.
  • Academic Appointments. (1) Expert Witnesses are first and foremost educators, (2) an academic appointment reinforces that you are an expert in your field.
  • Public Service and Volunteer Work. These speak to your character in a field where character counts.
  • Prestige schools are great but not as important as where you received your forensic training (Fellowship or Forensic Psychology or Criminology Programs).
  • Specialty Training (see above).

Bragging Rights

Awards, appointments and affiliations.  Membership in a respected professional organization and serving on specialty subcommittees.

  • Board and leadership positions for professional organizations.
  • Government appointments. A client of mine was appointed by the state Governor to a body that advises about matters that intertwine criminology and mental health. Another is appointed to the State’s Accreditation Commission for academic programs in his profession.
  • Publishing, public speaking and media presence.

Publishing.  If you have a specialization, publishing demonstrates and underscores you are truly an expert on that topic. If you are not, don’t publish. Stick to peer-reviewed and professional publications.  

Public Speaking. Public Speaking is the verbal version of publishing, with the added benefit that more people will understand what you have to say. Fees reflect demand and demand reflects visibility and an understanding of your expertise.

Media Presence. If a legitimate news outlet seeks you for commentary, I recommend you thoughtfully consider if it is the right decision to accept. You can introduce your knowledge base and professional reputation to a broader population. This speaks to the “reputation” factor that drives fees. But, if you are not comfortable in the public eye, don’t do it.

Forensic Psychiatrists and psychologists get more media face time than almost any other forensic scientist. Thanks to the media, the field enjoys a relatively new and well-deserved respect and trustworthiness. Whenever the news interviews a forensic doctor after a heinous crime, the public learns someone like you is the right expert to turn to. Remember: members of the public include jurors, judges and attorneys.[xviii]

Setting your own fee. Make no assumptions.

90% of my clients come to me undercharging, in my opinion. Most are worried about increasing their fee. So far, knock on wood, rates I recommend have proven to be a non-issue for attorneys and put the expert on an equal footing with colleagues.

Magical Thinking, Emotional Thinking, Institutionalized Thinking

Magic: “I don’t think I can justify a higher rate so I won’t.”  If you’ve set your fee based on no outside information of any kind, that’s magical thinking. 

Emotions: Fear is a powerful motivator. Some doctors tell me they think they will lose cases if they charge “too much.” Low self-esteem is sometimes the “hidden” driver behind such a statement.

Because you fear it, doesn’t mean it’s true or, as a wise person once said to me “feelings are not reality.”

Set an appropriate fee for your experience and qualifications, state it to attorneys, and be silent.

Prepare to be uncomfortable the first few times you do this. It gets easier.

Institutionalized Thinking is a little different

Women are more likely to charge less than their male counterparts even though attorneys won’t expect a ‘discount’ from a woman. I expect this is the case of other marginalized people.

Attorneys care about the strategy of their case and the Expert’s gender, race, or any factor can matter or not. I recommend you not second guess the attorney when setting your rates.

Breaking the Taboo: Talking to Colleagues About Money

I encourage my clients to consider their colleagues to be…..colleagues. Networking and information-sharing makes the profession better, introduces transparency between practitioners, and a sense of fairness in fee-setting. There is a societal taboo against talking about money. I think you do yourself a dis

Never accept liens or fees paid on contingency [xxi]

Why? If you only receive payment if the case is “won,” then you lose all reputation for objectivity. How can a jury rely on your findings if they are tainted by a motivation to be paid “for the opinion?” It is unethical and unwise to have a contingency or lien arrangement with the retaining attorney.

Professional Warnings About Fee Structure

No Contingency

No Liens

Tread carefully: Discounts, Flat fees

Contingency and Liens mean having a dog in the fight. 

The implication your income and opinion are interdependent will damage your reputation at best and could stop your career in its tracks. How much you charge could become a moot point.

“Contingency” describes an arrangement whereby payment is contingent on whether or not a party prevails in a lawsuit. It is an acceptable arrangement for attorneys such as Personal Injury Law where attorneys are  paid a percentage of an award and earn nothing if their client “loses.”

Contingency payment is not acceptable for any Expert Witness and can result in the disqualification of an Expert’s testimony. Per the American Academy of Psychiatry and the Law “Ethics Guidelines for the Practice of forensic Psychiatry” (2005),

“Contingency fees undermine honesty and efforts to attain objectivity and should not be accepted.”

American Academy of Psychiatry and the Law “Ethics Guidelines for the Practice of forensic Psychiatry” (2005), [xix]

Liens, unlike contingency, are payment of fees secured by plaintiff’s property, but like contingency, there is a direct relationship between the Expert’s fee and the case outcome.

“In Straughter v. Raymond IV (C.D. Cal. 2011) 2011 WL 1789987…plaintiff gave the expert a lien against his personal property and against any recovery in the case because of his inability to afford her hourly rate. That constituted “a de facto contingency fee arrangement.”

Ventura, Luis. San Diego County Bar Association “Ethics Corner[xx]

 

Flat Fees [xxi]

A fee for a “standard” IME and report, perhaps a short records review is one model of billing.

I recommend against it for a simple reason: a flat fee means the difference between your effort and your income is profit. If they are not one and the same, then you have a problem.

Even if your flat fee is less than your hours spent, a jury is unlikely to hear it or care.

Bill for your time: hours spent x fees charged. No ambiguity.

 

Flat Fees

I believe a flat fee does not raise to the level of best practices, ethically and practically.

Flat fees are most common in fields where profit is made by spending less than the fee collected. For an Expert Witness, the question is raised “did the expert put full effort into coming to their conclusions or did they cut corners to take home more money?”

As far as I know, it’s not against the law.  Raise above that bar.

An expert evaluation is what it is. There is no vested interest.  In fact, your opinions may be a hindrance to the case. It’s not your problem!

If you have a question about how much you charge, or how much you should charge, call me.

     

    Endnotes

    [i] Attorney response to fees disclosed is revealing and factor into my estimates. Watch for these responses when you talk to an attorney about your fees: surprise (pleasantly or negatively shocked), no surprise at all, acceptance, resignation, arguing or an attempt to negotiate. Look at trends over the course of a number of conversations with attorneys. Skill in detecting malingering is helpful.

    [ii]    U.S. Bureau of Labor Statistics, Occupational and Employment Statistics, https://www.bls.gov/oes/home.htm#

    When I began my research to see what my clients were reading on the internet, I found dozens of articles quoting the Bureau of Labor Statistics, like these Houston Chronicle online articles “How much does an average forensic psychologist earn in a year?” (Thompson Jayne, Houston Chronicle, 2018) and “How much does a forensic psychiatrist make?” (Henderson, William, Chron, Undated).

    What you need to know about BLS Statistics

    Categories include “Psychiatry, All Other” and “Psychology, All Other.” Forensic Psychiatry and Forensic Psychology are not documented by the BLS. Regarding clinical work:

    No distinction is made between trainees clocking hours for licensure in a forensic setting (low or no pay).

    The ‘mean’ can’t distinguish between a forensic rate charged 100 hours a year and a psychotherapy rate for another 1500 hours the same year.

    The mean incorporates salaried positions that pay low but come with high-value benefits. In fact, straight-out-of-school jobs are often salaried in the corrections system or mental health hospitals.

    There is no accommodation about fees set by judicial or government bodies. (Courts, Workers Comp., even insurance).

    [iii]    Reported by the BLS for 2016-209, mean hourly wage:

    “Psychiatrists, 29-1223.  “Diagnose, treat, and help prevent mental disorders. Excludes “Clinical and Counseling Psychologists” (19-3033) and “School Psychologists” (19-3034)” 

    [Unclear why they reference psychologists—see stats about Psychologists below. Ed.]

    2019 $105.98/hour https://www.bls.gov/oes/current/oes291223.htm (congratulations on the raise since last year. 3 cents!)

    2018 $105.95 https://www.bls.gov/oes/2018/may/oes291066.htm

    2017 $103.89 https://www.bls.gov/oes/2017/may/oes291066.htm

    2016 $96.26 https://www.bls.gov/oes/2016/may/oes291066.htm

    “19-3039 Psychologists, All Other”

    1. $47.23.  https://www.bls.gov/oes/current/oes193039.htm
    2. $45.97 https://www.bls.gov/oes/2018/may/oes193039.htm

    2017: $44.92 https://www.bls.gov/oes/2017/may/oes193039.htm (sorry about the pay cut from 2016)

    2016 $45.51 https://www.bls.gov/oes/2016/may/oes193039.htm

    I encourage you to follow the links to learn more about the BLS geographic data and collection process.

    [iv]   Finno, Ariel A., Michalski, Daniel, et al., “Salaries in Psychology 2009 Report of the 2009 APA Salary Survey,” APA Center for Workforce Studies – April 2010 https://www.apa.org/workforce/publications/09-salaries/report.pdf

    [v] SEAK Expert Witness Fee Summary Report, by request, https://seak.com/expert-witness-fee-data-form/

    [vi] The ExpertPages 2019 Fees & Practices Survey (Part 1), by request for download at https://expertpages.com/news/survey2019_1.htm

    [vii] ABPN Facts and Statistics, https://www.abpn.com/about/facts-and-statistics/

    5 Year Pass Rate Summary (2019). https://www.abpn.com/wp-content/uploads/2020/04/ABPN-Pass-Rates-5-Year-Summary-2019.pdf

    Certificates issued by Year https://www.abpn.com/wp-content/uploads/2020/04/Certifications-by-Year-Subspecialties-2019.pdf

    ABPN Annual Reports including Subspecialties

    2019 https://www.abpn.com/wp-content/uploads/2020/05/ABPN_2019_Annual_Report.pdf

    2018 https://www.abpn.com/wp-content/uploads/2019/05/ABPN_2018_Annual_Report.pdf

    2017 https://www.abpn.com/wp-content/uploads/2018/04/2017_ABPN_Annual_Report.pdf.

    2016 https://www.abpn.com/wp-content/uploads/2017/03/2016_ABPN_Annual_Report.pdf

    [viii] Ibid

    [ix] Ibid

    [x] “ABPN Certification the Subspecialty of Forensic Psychiatry,” American Academy of Psychiatry and the Law (forensic arm  of the APA). https://www.aapl.org/abpn-certification.

    [xi] “Specialty Guidelines for Forensic Psychology,” American Psychological Association https://www.apa.org/practice/guidelines/forensic-psychology Aug. 2020

    [xii] Per confirmation from the American Board of Professional Psychology dated 8/16/20

    [xiii] HIMS Aviation Medical Examiners monitor drug and alcohol use in commercial pilots. A team of a psychiatrist and neuropsychologist are generally tasked with the evaluation. “HIMS is specific to commercial pilots and coordinates the identification, treatment and return to the cockpit of impaired aviators. It is an industry-wide effort in which companies, pilot unions, and FAA work together to preserve careers and further air safety.

    “Drug and Alcohol Monitoring” FAQ, Federal Aviation Administration. https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/DA_Monitoring_Programs_and_HIMS_FAQs.pdf and

    “Guide for Aviation Medical Examiners,” Federal Aviation Administration, https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/saspec/

    [xiv] Medical Review Officers.  “Drug Testing,” Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/workplace/drug-testing

    [xv] Learn more: Buchanan, Alec, M.D., PhD, Binder, Renee, M.D., Norko, Michael, M.D., Swartz, Marvin, M.D. “Resource Document on Psychiatric Violence Risk Assessment, APA Resource Document. American Psychiatry Association, October 2011 https://www.psychiatry.org/psychiatrists/search-directories-databases/library-and-archive/resource-documents

    [xvi] American Board of Psychiatry and Neurology VerifyCERT™ Certification and Status Verification Tool. https://application.abpn.com/verifycert/verifyCert.asp?a=4&u=1

    [xvii] Lin, L., Conroy, J., & Christidis, P. (2020, January). Which states have the most licensed psychologists? Monitor on Psychology51(1). http://www.apa.org/monitor/2020/01/datapoint-states,  https://www.apa.org/monitor/2020/01/datapoint-states

    [xviii] Criminal Minds: FBI Behavioral Analysis Unit

    [xix] “Ethics Guidelines for the Practice of Forensic Psychiatry, American Academy of Psychiatry and the Law, Adopted May 2005. https://www.aapl.org/ethics.htm

    [xx] Ventura, Luis E. “Paying an Expert Under a Contingency Fee Arrangement Is a Major No-No.” Legal Ethics Corner (Blog), San Deigo County Bar Association, 2020. https://www.sdcba.org/index.cfm?pg=Legal-Ethics-Corner-10-11

    [xxi] “Ethics Questions and Answers Opinions of the AAPL Committee on Ethics Adopted by AAPL Council May 19, 2013” “Question 6] (Excerpted) An attorney has asked me to do a forensic examination on a Lien, in which I would collect my fee only if the case is successful. Is this ethical? Answer – If your fee or its collection is contingent on the successful outcome of a trial, it is unethical as explained under AAPL Guidelines Section IV, honesty and striving for objectivity. It also is unethical under AMA, Opinions of the Council on Ethical and Judicial Affairs, sections 6.01 and 9.07. According to AMA Opinions of the Council on Ethical and Judicial Affairs, section 8.10, however, a lien may be filed as a means of assuring payment in states where there are lien laws, providing the fee is fixed in amount and not contingent on the amount of the
    individual’s settlement against a third party. Since your lien would be dependent
    on the outcome of the case it would be unethical. ” [Emphasis added]  https://www.aapl.org/docs/pdf/Ethics%20Questions%20and%20Answers.pdf