The morning of August 2, 2016
On August 2, 2016, I got up at 5:00 a.m. to ride with my cycling buddies on a group ride. I turned out of my neighborhood onto a two lane road with a bike lane and rode north with the right of way. I saw headlights coming toward me. A pickup truck turned across my lane into a shopping plaza and struck me.
I have no memory of the impact. I remember the headlights, my internal voice screaming no, and then lying on the pavement while a stranger rolled me onto my side so the blood would drain out of my broken face.
Doctors diagnosed a LeFort III fracture, which means every bone in my face was broken, including my eye orbits and my nose. My jaw broke in several places and needed a metal plate in my chin. The impact tore my lower lip in half, knocked out seven upper teeth, and broke my right collarbone. I spent three weeks in the hospital, nine days in the ICU, five days in a medically induced coma. I woke to find my jaw wired shut, a breathing tube in my throat, and a feeding tube keeping me alive. A week later the pain in my broken jaw forced the surgeons to open my windpipe by performing a tracheotomy. I lived on liquids for two months and needed two years of dental work before I ate normally again.
In 2016, drivers killed 853 cyclists in the United States and injured an estimated 64,218 more, according to NHTSA. I was one of the 64,218.
To the driver, I was an obstacle
Here is the part I keep returning to as a business owner.
At the moment of impact, I was not a father of three children. I was not the CEO of a company with employees and their families depending on me. I was not a lawyer with clients waiting, or a son, or a friend, or a guy who had trained hard all summer. To the driver of the pickup truck, I was an object in his way.
Every client who walks into your firm has been through a similar moment like mine. Someone reduced them to a thing. The whole point of the work you do is to help them recover from all of this by pursuing their personal injury case.
Volume works against you here. Not because your team stopped caring, but because a firm running hundreds of files has a fixed number of hours, and the hours go wherever the pressure is the greatest. When administrative work swallows the day, the client relationship is the first thing to suffer.
What happens after the trauma team finishes
The driver who hit me worked in the plaza he was turning into. He carried a $10,000 policy, and the policy was the whole of his coverage. I had underinsured motorist coverage, and the carrier declined to tender the stacked policies on a clear liability case, so I filed suit. I sat for two depositions. A year and a half later we mediated, and I gave the damages presentation myself so I could look the adjuster and the driver in the eye.
Then came the part nobody prepares an injury victim for. Six figures of medical expenses, much of the dental and cosmetic work sitting outside what my health plan covered. A health insurer with a lien on my recovery. Future medical costs with no reliable way to quantify or schedule them. A large sum of money and a short window to make decisions with permanent consequences.
I have spent my career advising people through exactly this, and the process still felt heavy. I negotiated my own lien. I set up my settlement plan including annuities and a trust. I set money aside for future medical needs. I made every decision I had recommended to clients for two decades, and I made them while recovering from a concussion and a face rebuilt with hardware.
Your client has none of this background. Your client has your firm, and whatever guidance your firm provides at the end of the case.
Where your staff time goes
Think about the last catastrophic case your firm resolved.
Someone on your team requested a conditional payment letter and worked the claims listing line by line to strip out unrelated charges. Someone chased a Medicare Advantage plan nobody knew about until three weeks before disbursement. Someone read an ERISA plan document to determine whether the plan was self-funded and whether the reimbursement language survived McCutchen. Someone sat on hold with a state Medicaid recovery unit. Someone verified whether the client had ever received VA or TRICARE benefits.
Now count the hours. Every one of them came out of the same pool your firm needs for case selection, discovery, depositions, expert workup, damages development, and time with clients.
Lien identification, verification, and resolution look like legal work because the rules are legal rules. The daily reality is administrative. Phone queues, portal logins, faxed authorizations, follow up letters, and a great deal of waiting. Paralegals with real judgment burn their best hours on tasks with no discretion in them, and firms lose good people to the grind.
The compliance pressure went up this year
CMS finalized its Section 111 civil money penalty rule in October 2023. The rule applies to claims resolving on or after October 11, 2024, and CMS began enforcing on October 11, 2025. Starting in January 2026, CMS randomly selects 250 non group health plan records each quarter for a reporting audit, and the agency issued its first penalty notices in March 2026. Penalties run up to $1,000 per day, per claim.
Those penalties fall on carriers and self-insured defendants, not on plaintiff firms. The effect on your firm is indirect and real. Carriers facing audit exposure push harder at settlement, ask for more claimant data, and hold up funding until their file is clean. Your staff absorbs the difference.
On the plaintiff side, the exposure has always been direct. Medicare has the right to recover conditional payments from the attorney who received the settlement proceeds. The MSP statute carries a private cause of action with double damages, and Medicare Advantage organizations have used the statute successfully against law firms. A missed Part C lien surfaces months after disbursement, after the client has spent the money, and the demand lands on your desk.
The work to keep and the work to hand off
Keep the work only your firm does. Case selection. Liability and causation development. Working up damages so the number reflects the whole life your client lost. Negotiation. Trial. The conversations where a frightened person needs a lawyer to explain what comes next.
Hand off the work with no legal judgment. Lien identification. Verification. Auditing charge listings for unrelated treatment. Medicare Secondary Payer compliance and reporting support. Negotiation with recovery contractors who do this all day and know when a firm is guessing.
Specialists move faster on this work because volume teaches them the shortcuts, the right contacts, and the arguments each plan type responds to. My company, Synergy, has done this for trial lawyers since 2008 for exactly this reason. Lien resolution fees are based on a percentage of the savings achieved, and Medicare compliance work is flat fee based, so the economics track the outcome rather than the hours. Several other firms do this work well. The choice of provider matters less than the decision to stop asking your paralegals to do a job the market already can do more efficiently.
Here is a practical starting point. Track how your team spends the next 30 days, in whatever detail you already capture, and separate the hours into legal work and administrative work (like lien resolution). Most firm owners are surprised by the ratio. Then price those administrative hours at what your people are worth and compare the number to what outsourcing costs.
Ten years later
This year on August 2, the anniversary passed quietly. I rode my bike, and I thought about the guys from my group who found me on the pavement and stayed with me until help arrived.
Cyclists still get hit. In 2024, drivers killed 1,103 cyclists nationwide and injured an estimated 52,887. Florida led the country with 208 deaths, the most of any state, and had the second highest fatality rate per capita. Behind each number is a person with a family, a job, and a set of obligations to other people.
One of those people is sitting in your case management system right now, waiting to hear from you.
I do not think the answer is working harder. Firms already work hard. The answer is deciding what your lawyers and paralegals should never touch again, moving the work to people who do nothing else, and spending the hours you get back on the case and on the client. The driver who hit me saw a thing in the road. Your client deserves a firm with the capacity to see a person.
🔧 What Can You Do?
If this feels overwhelming, you’re not alone. Synergy has spent decades helping firms like yours ethically and efficiently resolve complex lien issues. Our team knows the playbook recovery contractors use and how to beat them at their own game.
🔗 Want more insights like this?
If you’re a personal injury lawyer ready to scale, streamline, and move your practice forward exponentially, let’s talk. Join the Peak Practice Community, and learn how Synergy can help you eliminate settlement bottlenecks, resolve complex liens, and maximize recoveries. Learn more here: https://partnerwithsynergy.com/
If you want to grow and scale your law firm more effectively, consider partnering with Synergy for lien resolution. Learn more at: https://partnerwithsynergy.com/services/lien-resolution/why-partner-with-synergy/