Court of Appeals Holds Chiropractors May Offer Expert Testimony Regarding Motor Vehicle Accidents

Infinity Physical Therapy, LLC v Meemic Insurance Company

• Docket No. 365767

• Opinion Published: January 30, 2025 (Feeney, P.J., Swartzle and Cameron, JJ.)

• Wayne County Circuit Court

Holding: Chiropractor may offer expert testimony on causation regarding injuries following motor vehicle accident as long as the testimony falls within the scope of the Public Health Code’s limitation on chiropractic care.

Facts: Plaintiff provided physical therapy to a patient involved in a motor vehicle accident in March 2019 and a second accident in November 2019. The patient assigned her right to no-fault benefits to Plaintiff. Plaintiff sued defendant insurer to recover payment for the physical therapy treatment related to the March 2019 accident. Before trial, the defendant filed a motion in limine asking the trial court to prohibit testimony from the physical therapist as well as a chiropractor who treated the patient to establish that the need for the physical therapy was causally related to the motor vehicle accident. The trial court concluded that the physical therapist could testify about the services provided and the reasons for providing treatment but could not testify about causation. The trial court further ruled that the chiropractor could not testify about “(1) causation, (2) medical diagnoses made by a medical doctor; (3) ‘the origin of any medical problem’ that Alhussein was claiming; (4) ‘the relationship of any medical treatment, outside of chiropractic care, to the accident’; or (5) the necessity of physical therapy in this case.” Based on the lack of causation testimony, the trial court granted summary judgment in favor of defendant.

On review, the Court of Appeals recognized that a chiropractor is qualified to testify about matters within the scope of his profession and practice. Under the Public Health Code, MCL 333.16401(1)(e)(i), the practice of chiropractic includes:

The diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as they relate to subluxations, misalignments, and joint dysfunctions. These diagnoses shall be for the purpose of detecting and correcting those conditions and disorders or offering advice to seek treatment from other health professionals in order to restore and maintain health.

In addition, under MCL 333.16401(1)(e)(ii), the practice of chiropractic includes “[t]he evaluation of conditions or symptoms related to subluxations, misalignments, and joint dysfunction through” physical examination; taking and reviewing patient information; and performing, ordering, or using certain tests. Further, under MCL 333.16401(1)(e), the making of a limited diagnosis is within a chiropractor’s scope of practice.

Key Appellate Ruling:  Expert testimony establishing causation from a chiropractor is admissible as long as the testimony falls within the scope of recognized chiropractic practice under the Public Health Code.

Given the permitted scope of practice under the Public Health Code, the Court of Appeals determined that the trial court abused its discretion in prohibiting the treating chiropractor from serving as an expert witness with respect to causation. The testimony must be limited to those conditions and disorders and related diagnostic determinations permitted by the Public Health Code. The Court of Appeals noted that the trial court’s grant of summary disposition was based on its “erroneous rationale” for excluding chiropractic testimony and did not preclude the possibility that the trial court might still find the proffered testimony inadmissible under MRE 702 on different grounds, “but it may not do so for the sole reason that he would be offering testimony on causation as a chiropractor.”

Key Appellate Ruling: Expert testimony establishing causation not permitted by physical therapist because the Public Health Code does not permit physical therapists to identify or diagnose medical conditions or etiologies.

With regard to the offered causation testimony from the physical therapist, the Court of Appeals affirmed the trial court’s decision to limit the testimony to services provided and reasons why such services were provided. Again relying on the Public Health Code’s provisions for the practice of a physical therapist, the Court explained that MCL 333.17801(1)(d) provides that the “[p]ractice of physical therapy does not include the identification of underlying medical problems or etiologies, establishment of medical diagnoses, or the prescribing of treatment.” Accordingly, causation testimony from a physical therapist was properly excluded by the trial court. The Court of Appeals vacated the trial court’s order of summary disposition and remanded to the trial court.