QuestionQUESTION: I was rear ended on the interstate near Lexington KY on 2-6-2010. I suffered a whiplash injury to my neck and a tear in a tendon in my rotator cuff. I have an attorney and I have seen a orthopedic surgeon and a neurosurgeon. Both said surgery is not necessary. They both stated that I should recover in 4-6 months. I was in physical therapy before I saw them as prescribed by my primary care doctor. The therapist prescribed 6 weeks of therapy. It is helping me. I have been released by all the doctors and my therapy ends next week after an evaluation. I want to settle with the understanding that I will be healed in 6 months. If after the therapist evaluates me and they say I should continue therapy I would like that included in the settlement and I will be willing to waive all future claims. I would like the claim to include my pain and suffering for the recovery time the doctors said. I already have medical bills in excess of $8000. What do you think my claim may be worth?
ANSWER: In your area, your claim may be worth $15K - $18K on up to $25K or more, depending on the actual injuries you can document. It is generally known that soft tissue injuries reach "MMI", maximum medical improvement, within 3 months at a usual and customary therapy rate of 3 times per week. You would ask for pain and suffering ($5K - $8K, depending on whether the costs are customary on your medicals), all your necessary medical at customary costs ($8K), and future medical, which may be disputed as "not necessary", again depending on the level of documentation and credibility your medical records reflect.
It is extremely difficult to evaluate the value of an injury claim without having your medical history, current billing, prognosis, diagnosis, claims history, physical attributes, and so forth in front of me. I cannot accurately give you a solid value without doing a thorough review myself. With that being said, take the information I have provided as simply an opinion from a licensed adjuster, it is not legal advice, and I believe your attorney should be able to explain these things to you with more clarity by taking into consideration the specific venue tendencies of Lexington, KY juries.
I hope this helps.
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QUESTION: The rough estimate you gave of $15k - $18k on up to $25k, does that include the $5k - $8k for pain and suffering? I also have documented a tendon tear in my left shoulder rotator cuff. Is that considered a soft tissue injury?
I do understand that you need actual documents in front of you to make a more credible evaluation.
Thank you for your time, effort and help,
AnswerI did attempt to include all of the damages, but a torn rotator cuff, although still a "soft tissue" injury is more easily documented and should command a little more attention/compensation. I would say your pain and suffering should be at least 1.5 times the amount of your actual "documentable" and reasonable medical expenses. Future medical, and the speculative nature of "pain and suffering" is always a tricky area for an attorney and for an adjuster. I believe the key to an equitable settlement is to determine the worth of your injury in your own mind, and then negotiate based on that figure. You will have to trust your attorney to a certain extent and rely on him/her to capture the entire scope of your damages in his/her demand. The wild card on your case is the pain and suffering. The more support your medical providers can give that will indicate physical pain during the healing process, the easier it would be to convince a jury your pain and suffering was / is substantial. Your lifestyle can play a part as well. How old are you? Are you active . . . like to you play sports, have a dog you walk, have kids you have to tend to still, work at a job that requires lifting. . . you get the idea.
JP
