What Happens When Opposing Counsel Challenges Your Chronology

The Cross-Examination Scenario

You've submitted your IME report. The chronology is 50 lines long. You've cited every entry. You've verified every citation. You're confident.

Then you get to court. Opposing counsel stands up. They have your chronology in front of them. And they start asking questions.

This post shows you what happens when opposing counsel challenges your chronology — and how to defend it.

The Three Types of Challenges

Challenge 1: "Where Did You Find That?"

The question: "Dr. [Name], you state that the plaintiff reported pain 8/10 on February 15th. Where did you find that?"

What they're testing:

• Do you have a citation?
• Can you find it quickly?
• Is the citation accurate?

How to respond:

• "That's in Dr. Smith's progress note, dated February 15, 2024, at page 45 of the records."
• Be specific. Don't say "somewhere in the records."

If you don't have a citation:

• "I'd need to review the records to locate that specific entry."
• This undermines your credibility.

How to prepare:

• Ensure every line has a citation
• Know your chronology well
• Have the records organized and accessible

Challenge 2: "That's Not What the Record Says"

The question: "Dr. [Name], you state that the MRI shows a disc herniation. But the MRI report actually says 'disc bulge,' not 'herniation.' Do you agree that's a different finding?"

What they're testing:

• Did you read the record accurately?
• Are you overstating the findings?
• Can you admit an error?

How to respond:

• If you're wrong: "You're correct. The MRI report says 'disc bulge.' I used the term 'herniation' in error. The correct finding is a disc bulge."
• If you're right: "The MRI report at page 52 states 'left paracentral disc herniation at L4-5.' I'm referring to that finding."

How to prepare:

• Read the records carefully
• Use precise terminology
• Be prepared to admit errors

Challenge 3: "You Missed This"

The question: "Dr. [Name], you didn't include the plaintiff's prior treatment for low back pain in 2018. Why did you omit that?"

What they're testing:

• Did you review all the records?
• Did you cherry-pick favorable evidence?
• Can you explain the omission?

How to respond:

• If you missed it: "I did not include that treatment because it was not in the records provided. If there are additional records, I'd be happy to review them."
• If you intentionally omitted it: "I reviewed the 2018 treatment. It was for mechanical low back pain, which resolved. I didn't include it because it's not relevant to the current claim."
• If it's not in the records: "I don't see that treatment in the records I reviewed. Can you point me to the specific page?"

How to prepare:

• Review all records thoroughly
• Document what you reviewed
• Be prepared to explain omissions

The Cross-Examination Playbook

Play 1: The "Gotcha" Question

The setup: Opposing counsel asks a question designed to catch you in an error.

Example:

• "Dr. [Name], you state that the plaintiff had no prior treatment for low back pain. But the family doctor note at page 12 says 'history of low back pain in 2018.' Did you miss that?"

How to respond:

• If you missed it: "You're correct. I did not see that entry. I'd like to review it now."
• If you saw it but interpreted it differently: "I saw that entry. The note says 'history of low back pain in 2018,' but there's no documentation of treatment. I interpreted that as a history, not prior treatment."

Key: Stay calm. Admit errors if they occurred. Explain your interpretation if it's reasonable.

Play 2: The "Overstatement" Question

The setup: Opposing counsel suggests you overstated a finding.

Example:

• "Dr. [Name], you state that the plaintiff is 'severely impaired.' But the functional capacity evaluation shows they can lift 20 pounds. Do you agree that's not 'severely impaired'?"

How to respond:

• "I used the term 'severely impaired' to describe the plaintiff's functional limitations relative to their pre-injury capacity. The FCE shows they can lift 20 pounds, but their pre-injury job required lifting 50 pounds. That's a significant limitation."

Key: Define your terms. Explain your reasoning.

Play 3: The "Inconsistency" Question

The setup: Opposing counsel points out an inconsistency in your chronology.

Example:

• "Dr. [Name], your chronology says the plaintiff reported pain 8/10 on February 15th, but the physiotherapy note says they were 'moving comfortably.' How do you explain that inconsistency?"

How to respond:

• "That's a good question. The pain report of 8/10 was at 9 AM, and the physiotherapy note was at 2 PM. The plaintiff may have taken medication between those times. The inconsistency is noted, but it doesn't necessarily mean the pain report was inaccurate."

Key: Acknowledge the inconsistency. Provide context. Don't dismiss it.

Play 4: The "Missing Evidence" Question

The setup: Opposing counsel suggests you ignored evidence.

Example:

• "Dr. [Name], you didn't include the surveillance video showing the plaintiff playing golf. Why not?"

How to respond:

• "I was not provided with surveillance video. If it's available, I'd be happy to review it."
• If you were provided it: "I reviewed the surveillance video. It shows the plaintiff playing golf on one occasion. I didn't include it in the chronology because it's not a medical record, but I considered it in my assessment of functional capacity."

Key: Be honest about what you reviewed. Explain what you considered.

Play 5: The "Causation" Question

The setup: Opposing counsel challenges your causation opinion.

Example:

• "Dr. [Name], you opine that the plaintiff's low back pain is causally related to the MVA. But the MRI shows degenerative changes. How can you rule out that the pain is from degeneration, not the MVA?"

How to respond:

• "The MRI does show degenerative changes, which are common in people of the plaintiff's age. However, the plaintiff had no low back pain before the MVA. The pain started immediately after the MVA. On a more probable than not basis, the MVA aggravated the pre-existing degenerative condition, causing the current pain."

Key: Acknowledge alternative explanations. Explain why your opinion is more probable.

How to Prepare for Cross-Examination

1. Know Your Chronology

• Review it before the hearing
• Know the key entries
• Know where to find each citation

2. Know the Records

• Have the records organized and accessible
• Know where to find key documents
• Be prepared to locate specific pages quickly

3. Anticipate Challenges

• What are the weak points in your chronology?
• What might opposing counsel challenge?
• Prepare responses

4. Be Honest

• If you made an error, admit it
• If you don't know, say so
• Don't defend the indefensible

5. Stay Calm

• Cross-examination is designed to rattle you
• Stay professional
• Don't get defensive

The Golden Rules of Cross-Examination

Rule 1: Listen to the Question

• Don't anticipate
• Listen carefully
• Answer only what's asked

Rule 2: Answer Briefly

• Don't volunteer information
• Answer the question, then stop
• Don't explain unless asked

Rule 3: Don't Guess

• If you don't know, say so
• If you need to check the record, say so
• Don't speculate

Rule 4: Don't Argue

• You're not there to win an argument
• You're there to provide evidence
• Let the attorney argue

Rule 5: Be Professional

• Stay calm
• Be respectful
• Don't get rattled

Key Takeaways

1. Opposing counsel will challenge your chronology. Be prepared.
2. Three types of challenges: "Where did you find that?", "That's not what the record says", and "You missed this."
3. Know your chronology and the records. Be able to locate citations quickly.
4. Anticipate challenges and prepare responses.
5. Be honest. Admit errors. Don't defend the indefensible.
6. Stay calm. Listen. Answer briefly. Don't guess. Don't argue. Be professional.

What's Next?

In our next post, we'll begin our Prompt Listicles series with "60 AI Prompts for IME Physicians Reviewing Medical Records" — practical prompts for your practice.

This post is part of our series on defensible medical record review. For more, see our 60 AI Prompts for IME Physicians Reviewing Medical Records.

Questions for Readers:

• Have you been cross-examined on your chronology? What was the experience like?
• What's the most challenging question you've faced?
• How do you prepare for cross-examination?