San Diego License Attorney is a professional license defense law firm serving clients in and around the San Diego area. The license defense attorneys for the firm have in-depth knowledge and understanding of the licensing process, the relevant laws and regulations, and all the administrative procedures involved in defending a healthcare professional license against any possible disciplinary action. The attorneys are experienced and skilled at successfully defending all types of chiropractic license cases by the California Board of Chiropractic Examiners. We know how to build you a solid defense and have helped our clients retain their chiropractic license in California, or at least negotiate effectively for a lesser form of disciplinary action when it seems to be the best choice.
Chiropractic: An Overview
Chiropractic is a licensed healthcare profession that focuses on the diagnosis and treatment of spine alignment problems, reduce pain, and improve the functionality of the nervous system. Precisely, chiropractic comes from the Greek and means "done by hand." Generally considered an alternative or complementary treatment approach, chiropractic care is becoming more mainstream. Today, chiropractic care is a more accepted treatment for musculoskeletal pain, associated with conditions affecting the backbone and associated muscles. Chiropractors use this hands-on therapy for spinal adjustment and manipulation, which helps restore mobility to body joints and relieve pain, often restricted due to some kind of tissue injury. About two-thirds of the total chiropractic visits are for treatment of acute low-back pain, followed by headache and neck complaints. Most commonly, chiropractic patients are middle-aged and married people.
Most chiropractic practitioners today take a holistic treatment approach and include things like nutrition counseling, stress management, exercise advice, and many other valuable services within the treatment program. Since chiropractors aren’t medical doctors, they require extensive training in chiropractic care and necessary chiropractic certifications to become licensed practitioners. Some chiropractors also do an additional residency to specialize in a particular area. Regardless of the specialty, all chiropractors must also take an exam to obtain a license to practice as a chiropractor in California. In addition to undergoing rigorous education and training to acquire the required skills, the career path of a chiropractic practitioner is also challenging with potentially long hours of demanding physical work.
Every chiropractor works extremely hard and puts in much effort to acquire the required education and skills that help them build a reputation in the community. The license is the heart of a chiropractor’s professional career and reputation and allows them to practice as a chiropractor, build a successful career, and meet your financial obligations.
Unfortunately, even after all the hard work, efforts, and sincere dedication to treating your patients, it is disheartening to know that a single allegation of misconduct or simple mistake on your part can put your chiropractic license in jeopardy. A formal complaint to the concerned licensing agency and board in California can pose a threat to your chiropractor’s license and put your professional reputation and the whole future at risk. Being an accused chiropractor, you will have to face disciplinary proceedings based on a set of complex rules, which are extremely hard to understand for an amateur to put up a successful defense in order to protect their license and sustain their chiropractic practice.
California Board of Chiropractic Examiners: Enforcement and Purpose
The California Board of Chiropractic Examiners or BCE governs and regulates the licensing in the field of chiropractic. With apparently over 14,000 chiropractors doing licensed practice in California, the BCE works as the authority for declaration of regulations, issuance of licenses, as well as investigation and execution of disciplinary actions. The board is also liable to investigate and enforce discipline where a licensed chiropractor has noticeably affected the health, safety, and welfare of the general public in the state of California. The board also ensures the chiropractic practitioners are adequately trained and meet performance standards for treating patients.
The California BCE looks and follows up on consumer complaints regarding professional misconduct, fitness to practice, or violations of professional standards of care by a chiropractor. In fact, based on the BCE’s disciplinary guidelines, the board claims itself to be a consumer protection agency, dedicated to protecting consumers of chiropractic services in California from potentially harmful licensees. Committed to enforce high standards in the chiropractic industry, needless to say, the BCE takes its disciplinary responsibilities and the enforcement of the stringent laws governing chiropractic very seriously. As a matter of fact, the BCS spends almost 70% of its annual budget on its administration and execution activities.
Many chiropractors often make a mistake of believing that the BCE is on their side, which is not true. Claiming itself a consumer protection body, the board keeps a watch over all chiropractors in California, and if found engaged in the act of professional misconduct, it will conduct an investigation and hold them responsible for any alleged misconduct.
The board has a complicated and tricky system of classifying violations and determining the suitable disciplinary action that is stated in good detail in the BCE's Disciplinary Guidelines and Model Disciplinary Orders.
Common Allegations Resulting in Chiropractic Disciplinary Actions
In California, a chiropractor can face discipline due to an accusation of an ethics violation, malpractice, substance abuse. Here are some of the allegations against chiropractors that can cause a disciplinary action:
- Fraudulent, negligent, or incompetent practice
- Use of alcohol or drugs
- Sexual misconduct or improper relationships with patients
- False or improper recordkeeping
- False, misleading or deceptive advertising
- Practicing medicine without a license
- Billing or insurance fraud
- Excessive treatment
- Failure to supervise staff properly
- Making or signing false documents
- Failure to refer a patient to another healthcare provider
- Unauthorized disclosure of patient information
- Unlicensed practice of chiropractic medicine
How BCE Handles the Disciplinary Process
At this point, you will be sent a notice of complaint filed against you and that an investigation on the complaint has been registered. If you are a chiropractor practicing in California, you must contact an experienced license defense lawyer before talking anything about the complaint to the investigators. Any ignorance on your part regarding the investigation initiated by the BCE can be a threat to your license and significantly increase the risk of losing your license forever.
The majority of the BCE investigations in California begin when a written or online complaint against a licensed chiropractor is filed. The complaint can be filed by a previous patient, any member of the patient’s family, professional groups, other licensees, or any government entity. Sometimes, the disciplinary process can also be initiated if a licensed chiropractor has been convicted in a crime.
Once a formal complaint is received by the BCE, its enforcement unit first reviews and analyzes the complaint, along with any supporting pieces of evidence that the plaintiff has provided. Sometimes, the complaint does not involve any grounds for potential disciplinary action and/or falls outside the jurisdiction of the board. If the allegations being made are not within the BCE’s jurisdiction, the complaint is closed. Some examples of disputes not relevant to the board’s jurisdiction may include billing disputes, personality conflicts, or general business practices.
The board typically has jurisdiction over disputes that involve any alleged violation of the Chiropractic Initiative Act, California Business and Professions Code, Health & Safety Code and sections of the California Code of Regulations related to the practice of chiropractic. If the complaint comes under BCE’s jurisdiction and found relevant, it is forwarded to the investigation unit. Herein, the complaints are ranked in order of priority based on the acuteness of the alleged violations. For instance, violations like sexual abuse, fraud, or negligence are kept at the top of the priority list and are immediately referred to the investigation unit. The less egregious violations may be set aside but will eventually be taken on by the board.
At times, a representative of the board’s investigation unit may also want to conduct a session to know about the plaintiff’s side. Moreover, if required, the investigation representative may also contact the chiropractor in question for additional information or documentation.
If convincing evidence is revealed during the investigation, which supports the alleged allegations made by the plaintiff, one of several possible forms of disciplinary actions may be taken by based on the board’s disciplinary guidelines.
- License Revocation. The revocation of licenses includes the loss of your practicing license for an indefinite period. It means your license has been fully canceled and cannot be reinstated. This is the harshest form of penalty that can be imposed by the board.
- License Suspension. Suspension of the license means your license will be out of service for a specified period. You cannot legally practice chiropractic with a suspended license.
- Interim Suspension. An interim suspension means enforcement of a temporary suspension from continuing your practice, generally, till the investigation is complete.
- License Probation. When being investigated or facing disciplinary actions, if you manage to win a legal stay of license revocation and probation, then you may continue your chiropractic practice providing you obey all the probationary requirements.
- Issuance of a Letter of Reprimand.Receiving an admonishment letter from the licensing board simply warns you not to reiterate or continue the alleged misconduct; however, this letter goes on public record database on the board’s website. It may or may not contain an order of certain remedial actions to follow.
- Issuance of a Citation and Fine. Deemed as an "alternative to discipline," a disciplinary action like citation goes on public record, which can be easily accessible to your potential clients and employers. It includes a fine that may vary from hundreds to even thousands of dollars (maximum penalty up to $5,000).
If the complaint is substantiated and the charges in the accusation are clearly proved, the board will list the allegations against you and certainly try to revoke or suspend your license. Although the issuance of a formal accusation by the board, such as license revocation or suspension, is reserved for the most serious violations, yet the board, in general, believes that the revocation should be a possible decision every time grounds for discipline are found to exist.
In cases of issuance of an interim suspension, it is always a good move to consider that first. The process of investigation and reaching a final decision can be time-consuming, and you can’t afford to shut down your practice for that length of time.
If the chiropractor wants to contest against any of the disciplinary actions—formal accusation, abatement notice, citation, or other—by the board, they can challenge the board’s decision to request an administrative hearing. Now the matter will proceed in front of a formal administrative hearing before an administrative law judge, or ALJ, in the California Office of Administrative Hearings (OAH). Like a legal trial, here the board acts like the accusing party and needs to prove the accusation against the chiropractor by showing convincing and clear evidence. Before the hearing, both sides—the BCE and the chiropractor in question—can discover the witness and documents possessed by the opposing side. During the hearing, both parties get a chance to present evidence supporting their respective positions.
At the conclusion of the hearing, the administrative law judge has to issue a proposed decision within thirty (30) days. It should be noted that the "proposed" decision is not intended to be legally binding on the part of the board. The BCE can outright reject the ALJ’s decision and substitute it with its own decision. The board may also accept the judgment in part and not entirely. However, the chiropractor still has an option to show disagreement on the board’s decision and appeal the subject in the California court system. However, it should be noted that a civil court will not be reviewing any factual evidence or consider new evidence, but only the record of the administrative hearing for mistakes made in the application of the laws applicable will be reviewed.
Categories of Violations and Recommended Disciplinary Penalties
There are four general categories of alleged violations used by the board in the determination of appropriate disciplinary penalties:
CATEGORY I include violations that are relatively minor, but potentially harmful. This category of violations is also recommended for repeated minor violations. Examples include: practicing with no valid license, failure to offer proper treatment records upon request, and failure to notify the board of change in the business address. Like any other category of violations, the maximum penalty is revocation of license while the minimum penalty is one to two (1-2) years of license probation.
CATEGORY II includes violations that can result in more serious disregard for chiropractic law, public safety, or ethics. Some typical examples in this category of violations include failure to appear for a hearing, advertising for sexual disorder's treatment, unauthorized disclosure of patient information, making a false statement on the license application, and others. Like any other category of violations, the maximum penalty is revocation of license. The minimum penalty for Category II violations is license probation of three years.
CATEGORY III includes less egregious criminal convictions that are rather serious. This may consist of moral turpitude, sexual relationship with a client, gross negligence, false or fraudulent claims, unauthorized practice of medicine, aiding and/or assisting unlicensed activity, and many more. The minimum penalty for Category III violations includes thirty (30) days suspension followed by five (5) years of probation.
CATEGORY IV is for most serious offenses and has a single penalty of license revocation with simply no other disciplinary alternative. Category IV includes the more egregious criminal convictions, which include physical violence, fraudulent activity, sexual misconduct, excessive treatment, use of a license in relation to sexual acts.
Revocation of a license is also recommended in case the chiropractor in question fails to appear at the disciplinary hearing or failure in filing a notice of defense. If a chiropractor violates the probation terms and conditions from a previous disciplinary order, it can also result in a penalty of revocation. The issued discipline depends on the type of the violation as well as on any aggravating or mitigating factors shown at/before the formal administrative hearing. Only a dedicated, caring, and experienced chiropractic license defense lawyer on your side can protect your rights and advance your interests in an investigation or disciplinary action.
Find a San Diego Licensing Defense Attorney Specializing in Chiropractic Defense
Formal complaints and accusations, or sometimes even a simple mistake can destroy a chiropractor’s professional reputation and career. If you are a chiropractor practicing in and around the San Diego area and facing an investigation, accusation or disciplinary action by the board, don’t wait to seek advice from a good license defense attorney. You will certainly need the expertise and experience of a law firm like the San Diego License Attorney if your license is in danger. We have attorneys who can successfully navigate the ins and outs of a chiropractic license case and successfully argue in your defense to help you win the best possible outcome. Get in touch with our firm at 619-728-7448 to speak to one of our highly qualified legal experts about your chiropractic license case. Don't let a mistake ruin your career; contact us to learn about your legal options.