To become a licensed chiropractor in California, a person must study extensively, undergo thorough training, and incur substantial expenses, let alone sit for a series of exams to become licensed and board-certified. However, despite all this effort, a chiropractor can lose their license much faster than it took them to obtain it. Like other medical professionals, a chiropractor can lose their license if they are accused of professional misconduct.
If you are a chiropractor and have been accused of professional misconduct, you can be subject to disciplinary action, including punitive fines and license revocation or suspension if found guilty. Working with an experienced chiropractic license defense lawyer to navigate the administrative or legal process can help you avoid these penalties and eliminate or minimize the possibility of your actions robbing you of your career and future.
At Monterey License Attorney, we have extensive experience defending chiropractors accused of unprofessional conduct. You can rely on us to expertly defend your license during accusations, investigations, hearings, and appeals. Irrespective of the misconduct you are accused of committing, we will dedicate our time, resources, and expertise to ensuring you obtain the most favorable outcome. To speak to us about defending your license, contact us for a free consultation.
Board of Chiropractic Examiners' Duties
The California Board of Chiropractic Examiners (BCE) is a consumer protection agency under the California Department of Consumer Affairs. This agency regulates state-licensed chiropractors and those seeking a chiropractic license, and its primary duty is to protect chiropractic consumers from potentially harmful chiropractors.
Because of its responsibility, the board can subject a chiropractor to disciplinary action based on the unprofessional conduct complaints against them or if the chiropractor has been found guilty of an offense considered substantially associated with the chiropractic practice.
BCE has an intricate system of classifying professional misconduct and crimes and determining the proper disciplinary action against at-fault chiropractors.
Possible disciplinary actions the board may take include the following:
- Fines—The fine can be hundreds or thousands of dollars. The maximum penalty is five thousand dollars.
- Citation—Even though it is deemed an alternative to discipline, a citation is a public record. That means possible employers and clients can view it.
- Letter of reprimand—Whereas a letter of reprimand simply warns a chiropractor not to continue with or repeat the supposed crime, it becomes a public record on the board's website.
- License probation—if a chiropractor's license is placed on probation, they can continue practicing provided they comply with the probationary conditions.
- Interim suspension—This is a temporary suspension. It prevents the chiropractor from continuing to practice chiropractic medicine during investigations.
- License suspension—This disciplinary action involves the guilty chiropractor losing their license for a given period. A chiropractor cannot lawfully practice on a suspended license.
- License revocation—This is the most severe form of punishment. It involves the chiropractor losing their license indefinitely.
To accomplish its responsibility to protect consumers, the BCE has set up rules codified under the Board of Chiropractic Examiners Disciplinary Guidelines and Model Disciplinary Orders.
The Complaint Process
Reviewing a chiropractor's conduct and determining whether to impose disciplinary action starts when a patient, a patient's family member, a professional group, another chiropractor, or a public entity submits a complaint to the BCE against the chiropractor. The complaint process can sometimes begin if a chiropractor is found guilty of an offense.
Before anything else, the BCE must establish whether the complaint it has received falls under its jurisdiction. After it has confirmed that it has jurisdiction, it will conduct a cursory review, which may disclose that the allegations hinge on a personality conflict or an unsupportable claim and may be thrown out. But should the complaint pass the cursory investigation, there will be a more comprehensive analysis.
At this point, the board will notify the chiropractor that a notice of complaint has been filed against them and that it has launched an investigation into the complaint.
There will be a preliminary probe into the accusations, and the BCE may decide that the allegations against the chiropractor are not factually accurate or that there is no evidence to support them, resulting in the file being closed with findings that the submitted complaint had no merit. Note that the investigation can also reveal evidence that the accusations have merit, although not to the extent that warrants proceeding with the review. In this case, the board will close the file with merit.
The preliminary investigation may entail an investigator visiting the professional under investigation to gather information.
It is crucial not to voluntarily give out any information if you are under investigation, as it could be used against you and result in the BCE pursuing formal action. An experienced chiropractic license defense lawyer can be effective at this point, resulting in your file being closed without any disciplinary action. They can also provide the support you require to navigate the board's investigation process.
If the accusations have merit and the board decides to continue investigating the complaint, it may resolve to address the issue in-house. If it finds the chiropractor guilty of the accusations against them, it might issue a reprimand, citation, fine, or any other appropriate disciplinary action.
You will need a lawyer's help at this point in the process, as they may negotiate a disciplinary action that the board will not widely publish to consumers and patients, thus preserving your reputation.
Should the board determine that the issue needs more comprehensive investigation, it will send the case to the attorney general's office for legal action that might result in the revocation or suspension of the chiropractor's license. The attorney general will then schedule a hearing presided over by an ALJ (Administrative Law Judge) who works for the California Office of Administrative Hearings. This hearing is like a formal trial.
As the accusing party, through the attorney general's office, the BCE must demonstrate its case with clear, convincing evidence. Before the hearing, both sides can engage in the discovery process, where they can exchange witness information and documents. Both sides are also allowed to submit evidence in support of their respective stand at the proceeding. The ALJ then reviews evidence from the chiropractor and the attorney general's office and hears testimony during the proceeding.
Note that you can present evidence without or with representation by a lawyer. However, it is recommended that you hire an experienced attorney to represent you so that you stand a chance of obtaining the best possible outcome.
Once the hearing is over, the ALJ has thirty days to issue a recommendation. It is termed a "recommendation,” as it is non-binding for the board. That means the board may not follow this recommendation and comply with its independent decision. Or, it can accept the recommendation in part or whole.
Factors the ALJ will consider when making their recommendation include the following:
- Whether a patient or the public suffered actual harm.
- The kind of harm that could potentially have arisen from the misconduct.
- Whether the chiropractor currently faces one or more complaints.
- Whether the chiropractor involved has any record of discipline or penalty on their professional record.
- If a criminal conviction occurred years ago and if the chiropractor obeyed all the probation terms.
- The severity and nature of the misconduct.
- Evidence of the chiropractor having undergone rehabilitation (for example, for drug or alcohol abuse).
- Whether the chiropractor gained financially from their misconduct.
- Whether the misconduct was accidental or intentional,
- The degree of incompetence or negligence the misconduct indicates, if any.
If the disciplinary action by the BCE is overly punitive or unfair, or if the chiropractor just disagrees with it, they can appeal the board's decision. Appealing entails requesting that the superior court with jurisdiction over the case review the board's decision.
Note that the review by the superior court only seeks to establish whether or not the whole process was done fairly and no mistakes were committed. It does not result in an independent analysis of the presented evidence, allow the presentation of new evidence, or hear the case afresh.
If you have had your license revoked or suspended, you could file for reinstatement or modification after a given period.
Prevalent Actions That Constitute Professional Misconduct for Chiropractors
Different actions constitute professional misconduct for chiropractors practicing in California. Some actions considered professional misconduct and therefore justifying disciplinary action from the BCE include the following:
- Incompetence, gross negligence, or fraudulent practice.
- Practicing chiropractic care without a license.
- Failure to refer a patient to another healthcare provider.
- Alcohol or drug abuse, including driving under the influence—even though many people argue that a DUI should not be associated with chiropractic care, the reasoning here is that a person with enough problems with drugs or alcohol that they would drive while intoxicated can jeopardize a patient's wellbeing.
- Signing or fabricating false documents.
- Failure to properly supervise staff.
- Practicing medicine with no license.
- Insurance or medical billing fraud, including overbilling and inappropriate billing.
- Deceptive, misleading, or false advertising.
- Improper, false, deficient recordkeeping.
- Sexual misconduct and inappropriate client relationships.
- Excessive treatment.
- Disclosing patient information without authorization.
- Conviction of a misdemeanor or felony offense substantially associated with the chiropractic functions or duties—the measure of what is and is not a significantly related offense is not governed by strict guidelines and might vary based on the facts surrounding the conviction.
- Referral rebates or referral fees.
- Kickback payment schemes.
- Practicing impaired.
- Use of spinal manipulation instead of vaccination.
- Actively engaging in acts of theft.
- Intentional reporting of misleading statements.
Violation Categories and Proposed Disciplinary Actions
Generally, there are four categories of violations the board uses to determine the appropriate disciplinary action to impose, as follows:
Category one: This includes relatively minor, yet potentially harmful, violations. The category also covers repeated minor misconduct. Examples include failure to provide correct treatment records on request, failure to tell the BCE of business address changes, and practicing without a valid license. Like other categories of misconduct, the ultimate disciplinary action is license revocation, whereas the minimum action is placing the license on probation for up to two years.
Category two: This class includes actions that can lead to more severe disregard for chiropractic guidelines, ethics, or public safety measures. Examples of violations under this class include failing to attend a hearing, disclosing a patient's information without authorization, and misleading advertising. Like other categories of misconduct, the maximum disciplinary action is license revocation. The minimum disciplinary action is three-year license probation.
Category three: This class comprises less egregious but severe criminal convictions. They may include crimes involving moral turpitude, gross negligence, sexual conduct with clients, fraudulent or false claims, aiding and abetting unlicensed activity, unauthorized practice of medicine, et cetera. The minimum disciplinary action for this category of violations includes 30 days of license suspension and, after that, license probation for five years.
Category four: This includes the most severe crimes and carries a single disciplinary action of license revocation. There are simply no disciplinary alternatives for violations in this category. This category comprises the most egregious convictions, including convictions for fraudulent activity, physical violence, excessive treatment, sexual misconduct, and using a chiropractic license for sexual acts.
License revocation is also proposed if the involved chiropractor fails to attend a disciplinary proceeding or file a notice of defense. Should a chiropractor violate probation terms from a past disciplinary order, they may also be subject to license revocation. The imposed disciplinary action is based on the nature of the misconduct and any mitigating or aggravating circumstances exhibited before or at the formal administrative proceeding.
Only a devoted, caring, and skilled attorney can defend your legal rights and fight for your interests if you face disciplinary action and penalties.
Find an Experienced License Defense Lawyer Near Me
At Monterey License Attorney, we understand how important your professional license is. We also know how difficult the process of review by the BCE can be if a complaint has been filed against you and how the imposed penalty can substantially impact your career and life if you are found guilty.
If you face any accusations that put your license at risk, you want to have a skilled lawyer by your side for guidance, legal advice, and representation. We have extensive experience handling chiropractic-related matters.
We have helped licensed chiropractors and those seeking a chiropractic license in Monterey with all their license needs and legal defense when facing accusations of professional misconduct. Contact us at 831-296-1191 to set up a cost-free consultation and learn more about our work and how we can help you with your case.
