February 27, 2025
The Michigan Court of Appeals published decision in Infinity Physical Therapy, LLC v Meemic Ins. Co., addressed whether chiropractors and physical therapists may testify regarding causation and whether treatment was reasonable and necessary. The Court concluded that while a physical therapist may not do so, a chiropractor may in fact offer such testimony.
Fatima Alhussein was involved in a motor vehicle accident in March 2019. Ms. Alhussein received physical therapy from Ahmed Zaki and chiropractic treatment from Khaled Zaki. She assigned her rights to no fault benefits to Plaintiff, which was owned by Ahmed.
Plaintiff sued Defendant for no fault benefits for the physical therapy treatment related to the March 2019 accident. Defendant filed motions in limine to limit Ahmed’s and Khaled’s testimony regarding causation and whether treatment was reasonable and necessary. Plaintiff argued that a chiropractor could testify about causation as a licensed medical professional. Defendant argued that Plaintiff needed to establish that physical therapy was necessary, which Khaled could not establish as a chiropractor. Plaintiff acknowledged that there were no claims for chiropractic bills. Plaintiff also conceded that Khaled did not have the foundation to testify that physical therapy was appropriate in the case.
The trial court held that Ahmed could testify about the physical therapy services and the reasons for providing treatment. However, the court specifically ruled that he could not testify about causation. The trial court also granted Defendant’s motion as to Khaled, holding that he could not testify about causation, medical diagnoses, origin, relationship of the treatment (outside of chiropractic) to the accident, and necessity of the physical therapy.
Defendant then moved for summary disposition arguing that without Ahmed’s and Khaled’s testimony, there was no genuine issue of material fact regarding causation or whether Alhussein’s physical therapy was reasonable and necessary. The Trial Court agreed with Defendant. It held that neither Khaled nor Ahmed was “qualified to offer an expert opinion on medical causation or a diagnosis,” or prescribe physical therapy. Plaintiff appealed.
The Court of Appeals noted that a “chiropractor is generally qualified to testify about matters within the scope of his profession and practice,” citing Corbin v Hittle, 34 Mich App 631, 636; 192 NW 2d 38 (1971) and the Public Health Code, MCL 333.26401(1)(e)(i). The Court further noted the practice of chiropractic includes the “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. MCL 333.16401(1)(e)(ii). Referencing MRE 702, which does not limit medical expertise strictly to medical doctors, the Court also noted a chiropractor may make a limited diagnosis within their scope of practice. The Court pointed to various other states that have addressed and allowed expert testimony of chiropractors, which it found persuasive (though not binding).
Ultimately, the Court of Appeals found the trial court abused its discretion with its broad limitation of chiropractor Khaled’s testimony. While the trial court properly determined that Khaled could not offer expert opinion about a diagnosis made by a physician, Khaled could testify about a diagnosis within his practice. A chiropractor may testify about the cause of the condition or disorder to the extent that cause can be reliably linked to a condition or disorder within the scope of MCL 333.16401(1)(e)(i).
On the other hand, the Court found the trial court did not err by prohibiting physical therapist Ahmed from offering expert testimony on causation. The Court noted that the practice of physical therapy does not include the “identification of underlying medical problems or etiologies, establishment of medical diagnoses, or the prescribing of treatment.” MCL 333.17801(1)(d). The trial court properly limited Ahmed’s testimony, therefore, to the services he provided and why he provided those services.