LNC Engagement Letters: What to Include

An engagement letter is the written agreement between you and the attorney or company that hires you: who the client is, what you will do, what it costs and how the work ends. Every case should have one, signed before records arrive. Below are the parts most letters cover and the question each one should answer. Have an attorney who represents you (not the retaining firm) review your template once, and again whenever a client sends its own agreement for you to sign.

Why the letter matters

Most disputes between consultants and firms come down to four things: what was in scope, what was owed, whether the consultant was going to testify, and what happens to the records. A clear engagement letter settles each one in advance. It also helps the attorney: it documents that you were retained by counsel, which can matter for how your work is treated in discovery, and it shows that your fee does not depend on the outcome.

The client and the matter

• Who the client is. Usually the law firm or attorney, not the patient or injured party. On defense work it may be the defense firm or the insurer. Name the entity and the person who can authorize work.
• Who pays. The firm, the carrier or a claims administrator, with a billing contact.
• The matter. A case reference you both use. Leave patient names out of the letter unless the client wants them; a matter name or number works.

Your role

State whether you are retained as a consulting (non-testifying) expert or a testifying expert, and how a change will be handled. Roles shift: a nurse who reviewed the case quietly may later be asked to testify, which changes what may be discoverable and usually your rate. The letter should say that a change of role is agreed in writing. See legal nurse consultant vs. nurse expert witness for how the two roles differ.

Scope of work

Name the deliverables: a merit screen, a chronology, a standard of care review, a report, deposition support. Then add:

• The record set the scope is based on, by page count or description, and what happens when more records arrive.
• What is excluded. Causation, the physician standard of care and legal conclusions are typically outside a nursing review. Saying so at the start avoids an awkward request later.
• Revisions. How many rounds are included, and that new questions are new scope.
• Deadlines, and that they depend on receiving complete records on time.

Fees and payment

Set your numbers from your own market and experience; the rates guide describes how consultants usually structure them. One line belongs in every letter: your fee is for your time and work, not for any opinion or result. Fees for experts that depend on the outcome are widely treated as improper. Ask your attorney how the rules apply where you work.

Confidentiality and records

• That you will keep the records and the attorney's communications confidential and use them only for this matter.
• How records are sent and stored (see sharing medical records securely).
• Whether a business associate agreement or a protective order applies, and that you will follow it (see HIPAA and BAAs for legal nurse consultants).
• What happens to the records and your work product when the matter ends: returned, destroyed, or kept for a stated period. Ask the attorney; if you testify, you may need your file later.
• Whether you may use AI or other software on the records, and which tools.

Conflicts and independence

Include a statement that you checked for conflicts and found none, or disclosed what you found, and that you will report any conflict that appears later. The conflicts guide lists what to check. Add that your opinions will be your own, based on the records and the standard of care. Never sign a letter that promises a particular opinion.

Ending the engagement

Either side should be able to end the engagement in writing. State what is owed for work done to that point, what happens to a deposit, and when records are returned. If you would withdraw as a testifying expert close to a deadline, the attorney needs to know how much notice you will give.

Insurance, liability and the fine print

Client agreements, especially from insurers and large firms, sometimes include indemnification, limitation of liability, insurance requirements or a choice of law. These clauses change your risk in ways that are easy to miss. Read them, ask an attorney before you sign, and ask your insurance broker whether your coverage meets any requirement in the agreement (see liability insurance for legal nurse consultants).

What to avoid

• A scope described only as "review the case".
• Unlimited revisions or open-ended "support as needed".
• Any wording that ties your fee or your opinion to the result.
• Starting work on a verbal agreement "until the paperwork catches up".

On NurseTide Legal

When a firm hires you through the marketplace, your proposal is where you set out scope, price and timing, so write it with care (see writing proposals that get accepted). On hourly engagements the firm pays a deposit that the platform holds and settles against your logged time when the case closes. Read the platform terms too, and if a firm or carrier sends its own agreement or a BAA as well, review it like any other contract. For clients you find yourself, use your own engagement letter; see running your own practice.

Next step

Create your consultant profile: list your rates, and put the scope, price and timing in writing in every proposal you send.

General information for legal professionals, not legal advice. Rules and deadlines vary by state; check the statute and local rules that govern your case.