Can a person sustain a permanent injury when they are involved in a low-speed collision?
Can a person sustain a permanent injury when they are involved in a low-speed collision? This blog will be dedicated to the myth that a permanent injury cannot occur from a minor collision.
The most common term we hear is the word “whiplash” following a car accident. Whiplash refers to a cervical sprain/strain injury to the soft connective tissues. In a typical rear end collision, the vehicle is accelerated forward and trunk and shoulders follow. Initially the head remains still and then it is forced into extensions as the trunk and shoulders move forward. The head then accelerates forward into forced flexion. In a typical rear end collision, whiplash refers to a stretching and tearing to the muscles of the neck.
Allstate, New Jersey Manufacturers and GEICO Insurance companies have all segmented such injuries into a category they call “M.I.S.T” — minor impact soft tissue. They maintain that a cervical sprain/strain occurring from a low-speed collision cannot result in a permanent injury.
One of the difficulties in proving a permanent injury from a minor impact collision is the lack of objective diagnostic testing. Most soft tissue injuries are followed by subjective non-specific complaints of pain. The legitimacy of the subjective complaints cannot be verified through an objective test.
For both the attorney trying to prove permanency from the minor impact collision and the doctor treating the patient for ligamentous injury proving the injury starts with the history and ends with consistency.
Taking an accurate history of the accident is critical. A detailed history allows both attorney and doctor to begin legitimizing the injury by understanding the impact on the person, not on the vehicle.
The history does not begin with the accident, it starts with the general health of the injured party prior to the accident. Learn if the party had any prior accidents, determine if the party had ever treated for soft tissue pain in the past. This information will help identify the level of pain the injured had before the accident and its acceleration as a result of the accident.
According to orthopedic surgeon Jason Baynes of NJ Pain-Orthopedic Rehabilitation Group:
“Upon his initial examination, it is necessary to go through a thorough patient history regardless of the reason for an appointment. In a motor vehicle accident, slip and fall case, or work related injury it is imperative for the patient to disclose all pertinent information so that the physician can have an understanding of the mechanism in which the patient sustained their injury. If the mechanism is indicative of an injury that could be brought on by the accident that it is clear that the direct cause of the injury was the accident. However, if the patient states a mechanism that is not very traumatic but also states that they have had previous pain in that area prior to the accident due to a pre-existing condition, then we as physicians will be able to call the injury and exacerbation of a previous injury as well as distinctly identify any new injuries.
If you should sustain a soft tissue injury, the healing process that can take anywhere from 4 weeks to 6 months. Patients who have damage to ligamentous or cartilaginous structures may need to undergo surgery to get back to 100%, but many injuries will heal with therapy and rest.
The normal protocol of treating injuries that are exacerbations of pre-existing conditions will be treated as new injuries since the patient’s pain and function is usually worse after the accident then before. The patient will be recommended to a therapist and to have appropriate imaging done to best understand the nature of their injury so they move forward in their healing process.”
Dr. James Prete, D.C. of 590 Medical, LLC has a similar opinion: “The most important interaction between a patient and doctor is the medical history.
By facilitating the interview, patients can make this process more precise diagnosis and treatment.
Chief Complaints: It helps if you are able to state concisely your chief complaint, symptom or problem. This will focus the discussion. Sometimes, there is more than one symptom, or combination of symptoms. For instance, if a patient’s neck hurts from a motor vehicle accident and their knee was also affected but doesn’t hurt as much, you still let the doctor know of all symptoms even if you don’t think it’s injured. Let the doctor be the judge.
Documentation: While the description of your complaint should be verbal, there are certain routine facts that every doctor should have. A written list of these would help.
Demographics: It is helpful indicate at the top of any list your age, sex, occupation, ethnic background. Include any insurance information.
Medications: A list of your current medications is essential.
Other Treatments: Have you received any other treatments? Your doctor will want to know what has been tried in order to plan your management. (i.e. hospital visit after accident or injury)
Previous Illnesses: This should include the important illnesses, injuries you have had in the past, especially those that have led to disability, hospitalization, or surgery. Also, indicate doctors who treated you for these illnesses, injuries because your doctor may wish to contact them.
Ensure at the time of the visit that your doctor has vital information for the complaint including x-rays, electrocardiograms, lab results, hospital records, and reports of previous health encounters such as emergency department. Attention to such details and ensuring their communication can help your doctor help you.”
Proving that pain is real begins by its definition. The American Medical Association adopts the definition of pain by the International Association for the study of pain. In “The Guides to the Evaluation of Permanent Impairment, Fifth Edition,” the authors state: “Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
Medical regards supporting the party’s injuries and treatment are critical to legitimize the injuries. Medical records document the party’s complaint and support the trail of pain suffered by the victim. As these injuries are mostly subjective the medical documentation can prove if there was ever any improvement in the party’s condition. These same records can show if the treatment provided any change in the pain or lifestyle of the injured.
Your medical records will provide objective evidence of your injury. They establish: (1) spasm; (2) swelling; (3) history; (4) doctors findings including prognosis and diagnosis; (5) your subjective complaints; and (6) that the injury is consistent with the mechanism of the injury.
At some point the insurance company is going to send you to one of their doctors for an evaluation. This evaluation is called a defense medical examination. The defense medical doctor will opine that ether; (1) the accident did not cause the injuries; or (2) the injuries are either resolved, trivial or as a result of a pre-existing condition. Either way the defense medical doctor will opine that your injuries are not permanent.
The defense medical opinion should not dissuade the prosecution of the case. Just as the defense doctor will rely on medical literature to support his/her finding there is equal literature available to plaintiff to support permanency. In “Soft Tissue Index: Essential Medical & Crash” studies by Charles G. Davis and David N. Finley (Litigation One Publishing), the authors state the results of their studies that: “A substantial number of injuries are reported in crashes of little or no property damage. Property damage is an unreliable prediction of injury. There is no established minimum threshold of significant spine injury. The greatest explanation for injury from traumatic loading of the spine is individual susceptibility to injury.” Id at 46
The defense doctor is not the best expert in your case. You are the best expert of your case. No one knows your case better than you. How the accident occurred; where you were sitting in the car; were you leaning ahead at the point of impact; were you looking to the right or left upon impact; did you brace for impact; did your age or infirmity make you more susceptible to injury. These factors and the exact details of your accident have to be reported to your medical provider. They establish consistency regardless of what the defense doctor opines.
Remember it is not the impact on the car that matters rather it is the impact on your life. Your health prior to the accident; the facts of the accident and your medical documentation all have to work in unison to establishes consistency which establishes legitimacy and combined establish permanency.
If you were involved in a low speed impact collision, please contact Jersey City personal injury lawyer Anthony Carbone. We have been handling these cases for more than 26 year and we are ready to help you maximize your damages.