Treatment of Accident Injuries: Physical Therapy

There are as many physical therapy regimens as there are doctors prescribing this form of treatment. Basically, the regimens include passive treatment such as heat application, cold application, ultrasound, and massage, as well as active treatments, such as exercises. The passive treatments are commonly used during the initial recovery phase after the patient has undergone a bed rest. Again, the objective is to reduce the pain and increase mobility.

Active or exercise treatments may be beneficial in several ways. First, after a period of inactivity, it is important to increase mobility slowly and carefully so as to avoid straining the affected area.  Secondly, exercises can strengthen the stomach and back muscles, improving the patient’s posture and helping to resolve the condition and avoid recurrence. Third, participation in an active program with a therapist can go a long way toward convincing a patient of his or her ability to resume normal activities without being re-injured.  Many people who suffer a neck or back injury in an accident are extremely apprehensive about resuming their normal activities.  A controlled and monitored exercise program can be truly therapeutic in this regard.

Many chiropractors and osteopaths also recommend the use of a cervical pillow to ensure that the cervical spine is maintained in alignment if a patient rests or sleeps. Chiropractors generally recommend against sleeping in the prone position, as it may resultt in excessive rotation stress in the upper cervical spine.

Do you need legal representation for your injury case?

One of the first questions that a person who is injured in an auto accident asks himself is whether he should handle the claim himself or retain an injury lawyer. And… if to hire a lawyer, how to find the right one – how to find an honest, aggressive legal professional who will obtain fair compensation and do a thorough job representing you? Choosing a lawyer can be a challenging task, especially in San Francisco, where there are literally hundreds and hundreds of personal injury lawyers.

Generally, a small accidents with minimal property damages and mild, soft tissue injuries injuries from which you completely recover within a month or so do not justify hiring an attorney unless the third-party insurance company of the driver at fault simply denies liability or are otherwise being unreasonable about settling your claim, not willing to compensate you for your basic medical expenses and for the time missed from work.

Otherwise, if you document your injuries, medical treatment and loss of wages well, you should be able to obtain fair compensation in your insurance settlement without the necessity of paying anywhere between 25% and 40% of your recovery to the attorney.

However, if you suffered a serious injury to one or more parts of your body in an auto accident, which is likely to have residual effects in the future or possibly for the rest of your life which has and will affect various aspects of your life and your ability to enjoy the typical social and professional activities, it is in your best interest to hire a reputable, knowledgeable, personal injury lawyer for a number of compelling reasons:

  1. Assessing your injury claim. An experienced personal injury attorney will help you understand the legal issues involved in your specific personal injury claim. Is the injury serious? Is it a permanent or temporary injury? Who was at fault? Was there an uninsured or underinsured motorist involved? Is there any third party responsibility? Do you have pain and suffering? Should you try to negotiate with the insurer yourself? Do you have to accept his settlement offer? Do you know what your case is worth (the insurance company does and won’t tell you)? A good lawyer will tell you whether it makes sense to sue in small claims court, to sue for a larger amount in state court or to settle out of court.
  2. Obtaining additional evidence, information and reports. A good personal injury attorney will know what kinds of evidence to look for (i.e., medical and vocational evidence, police reports, etc.) and will investigate and interview potential witnesses for statements to gather all the necessary records and other evidence to prove the extent and the gravity of your injuries and to prove liability of the other party of it’s in dispute.
  3. Provide legal education to find a possible shortcut to resolving your injury claim. If representing yourself works better for you, consider using an attorney as a legal coach to help you (1) understand the personal injury law that applies to your case; (2) find the evidence that best supports your case; (3) understand the relative strengths and weaknesses of your claim; (4) understand the litigation process and customs unique to your local courts; (5) draft or review paperwork; (6) identify opportunities for a settlement to your personal injury claim; or (7) represent you if at some point you feel you can no longer go it alone.
  4. Negotiate. If there is an unresolved dispute, there will be negotiations with a claim adjuster who is a professional negotiator. You’d be wise to hire an attorney to negotiate on your behalf and to protect your interests, as both insurance companies and insurance defense lawyers take the arguments of a lawyer much more seriously than those of a lay person who is trying to handle his own injury claim.
  5. Represent you in court. An experienced lawyer can help you file a personal injury lawsuit against the party with whom you have a dispute. If your opponent has a lawyer, then by all means, you need to get one as well, as a lay person does not have the knowledge and experience to deal with the opposite size, following the many complicated court rules and procedures.
  6. Relieving you of the hassle associated with handling your own injury claim – your most important job after being involved in an injury accident is making sure that your recover and get back to the normal course of your life. From the moment you hire an attorney, you are relieved of the trouble of handling many of the issues associated with your claim, as most, if not all, the work will be done by your lawyer.

So, the bottom line is this: if your injuries are insignificant, you didn’t miss a lot of time from work and the insurance company being reasonable with you, then you should settle your claim and move on with your life.

If your injuries are serious and require careful treatment and evaluation and are likely to affect your future, it is highly recommended that you retain a personal injury lawyer to represent your interests, to negotiate on your behalf and possibly fight for a fair recovery in court.

California Injury Law: Medical Billing and Settlement Damages

Since the Hanif v. Housing Authority (1988) and Nishihama v. City and County of San Francisco (2001) cases have been decided, the insurance companies have successfully argued over and over that the personal injury claimants should not be entitled to recover damages based on the actual charges for the necessary medical services received, but only for those actually billed to the private health insurer.

In other words, if you have been injured in an accident, have received emergency room care and other medical care totalling $20,000 in medical expenses, but your health insurance provider (such as Blue Cross) that has a special arrangement with the hospital, reduced the bill to $8,000, the third party insurance company for the driver at fault would normally argue that your damages should be based on the latter figure of $8,000 rather than actual billing charges.

However, this argument on reduction of damages might not have much validity any longer. In a recent case Olsen v. Reid, filed on 6/23/2008, the above case decisions and their logic has been condemned and practically shattered by the fourth district appellate court. The court passionately supported the rationale of the long standing “collateral source rule” in California, which states that the recovery of the victim in an injury case should not be reduced just because some of the damages were coverd by a collateral source (such as health insurance company).  The court criticized Hanif and Nishihama decisions, insisting that it is appropriate for the jury at an injury case trial to hear evidence as to the full amount of the injured claimant’s damages and not the reduced amount that was billed.

The forth district emphasized that the more recent cases held that if an injured party receives some compensation for his injuries from a source wholly independent of the tortfeasor (for example, the driver at fault), such payment should not be deducted from the damages which the plaintif would otherwise collect from the defendant.

This recent decision significantly weakens if not eradicates, at least for now – until and unless the California Supreme Court makes a ruling on this issue, the Hanif/Nishihama argument that the insurance companies like to use to reduce their settlement offers.

Chiropractic Traetment After an Injury Accident

I work closely with several great chiropractors in San Francisco, who have a thorough understanding of the human muscle tissue and the mechanics of joints and nerves,  and who do an outstanding job relieving the pain symptoms of many people injured in car accident, motorcycle accident and other injuries. However, it is very important to be aware of the general perception of chiropractors in the community and particularly in the insurance business. Whether the skepticism toward them is fair or not, is not the question. The reality is, at least today, that the medical opinion of chiropractors, although has a weight, is significantly inferior to that of an M.D. (medical doctor) or especially a surgeon (such as orthopedic surgeon) or a neurologist.

Why is this information important?  – Many people who suffer serious injuries in car accidents or other injury incidents go to see a chiropractor shortly after sustaining an injury, undergo 3-4 months of chiropractic treatment and don’t bother to see any other physicians. This is common and significant mistake, especially in cases involving serious injuries, because only receiving a chiropractic treatment is likely to dramatically reduce their potential settlement with the insurance company or any recover through a court action. The insurance company will necessarily argue that the claimant wasn’t injured as badly, because if he were, he would have gone to see a “real” doctor. Remember, it’s not how badly you are injured but it’s what you can prove that determines the outcome of your injury case.

Therefore,  if you suffer an injury, it’s very important that you see a medical doctor shortly after the incident. The doctor will likely refer you for further evaluation, such as MRI, Cat Scan, etc.., and will recommend that you see a specialist, such as orthopedic surgeon, neurosurgeon or another specialist as might be necessary. You may supplement your treatment with seeing a chiropractor, but if you sustained a serious injury, chiropractic treatment should never be the only medical care you receive.

When the insurance company offers to pay your medical expenses

It is not uncommon for the insurer of the driver at fault to send the injured party a letter denying liability, but at the same time offering or even encouraging the person who was hit by their insured to submit his medical records and bills, so that the insurance company can pay the same bills. Usually, these payments are made under the medical payments coverage in the insurance policy up to the stated limit.

When the insurer makes payments under the med-pay coverage, this doesn’t mean that they accept or deny liability, but any such payments will be offset against future recovery, should the injure case settle. If you are offered to have your medical bills paid by the other driver’s insurer, you should feel free to accept that coverage. However, you should also make sure that you don’t sign any release documents that would waiver your rights to proceed with your personal injury action later.

If you have any questions about your medical expenses incurred as a result of an injury accident in San Francisco Bay Area or Sacramento areas, contact experienced personal injury lawyer who will answer your questions competently and attentively at absolutely no charge or obligation.

Releases of Liability for Injuries in California

Many gymnasiums and other facilities where there is a risk that  customer will suffer an injury, have those customers sign a release of liability which is supposed to release the business from any and all liability for injuries and damages sustained by the customer/visitors while on premises. However, not all releases are valid and enforceable as the power of the release to preclude and injury claim depends on the scope of the release and its applicability to the particular incident.

Generally, in order for a release of liabilty to be held enforceable and prevent an injured from having a legal action for personal injuries (1) the release must be clear, unambiguous and explicit in expressing the intent of the parties; (2) the act of negligence that results in injury must be reasonable related to the object or prupose for which the release is given; and (3) the release must not contravene public policy.

The second element is the one that is subject of contention and litigation. To illustrate, in one case the court considered a situation where a vistor of a car race signed a release that purported to release the facility from any injuries sustained by the viewers as a result of the automobile racing. One visitor was injured when one monitor located in the area fell on his head after he tried to adjust it. The court concluded that because the release was not intended to release the premises form this kind of injuries and was only limited to injuries related to the automobile race and the dangers that the race cars directly pose to the viewer, the release did not apply to the claimant’s injuries, and he was allowed to proceed to recover damages.

However, in other case, a gym customer was not allowed to recoverfor injuries sustained when he slipped and fell in the shower, because, as the court pointed out, the release executed by the customer with that gym, provided that the customer releases the facility from liability for any and all injuries, whether related to exercising or not, while on premises.