QuestionHi I was hit in May 2007 while at a red light by a man who admitted he wasn't looking while on a cell phone call. There was $9000 in damage to my car. I fractured my ankle, bruised my face and hit my knee very hard on the dash. I had chronic headaches for 4 months. I went to therapy for my ankle and knee all summer. The ankle progressed well and rarely has pain. My knee kept dislocating after the accident and the pain increased even with therapy. In November (two weeks ago) my ortho doc decided to try to resolve the dislocation and did surgery (6" scar now straight down my knee) to fix a tear and tighten the ligament that kept getting weaker with each dislocation. HE used two screws to hold the ligament. I have good health insurance which has been paying the medical bills. I am a single mom of 5 who has now been out of work since May because my job requires me to drive (sales) not to mention wearing dress clothing (heels) was not even possible. My job has now been replaced since it's been 6 mos. I was making $40K a year. My children have not been able to complete all their sports activities because I've not always felt good enough to take them out. I now cannot drive for 6 weeks til my knee heels. Very tough for a mom of 5 with no parents alive!
Please tell me what you would think I would be entitled to. I'd estimate that Blue Cross has paid out about $50K in expenses. The scar on my knee was well done, but I am a 44 year old single professional...I'd be hard pressed to say I'd ever want to wear a skirt again!!
thanks
AnswerHi Cheryl,
That sounds like a horrific accident to experience. I hope you do heal and are restored to good health.
Dr. Settlement is an expert in personal injury insurance claims, and as you can see by my website below, we teach people how to settle their own insurance injury claims at www.SettlementCentral.Com Big or complex personal injury claims are best left to an attorney, though. Yours is such a claim, UNLESS THERE ARE LOWER POLICY LIMITS, in which case you can probably win an award of them on your own.
Let me briefly state that we are not allowed to opine as to valuation of insurance injury claims since many state bar associations consider that to be the practice of law, and there will always be insufficient facts in a forum such as this to even make an educated guess, and finally, the boss here does not want to be exposed to a malpractice lawsuit should I make a bad mistake and value the claim wrong.
Hence, I cannot help with respect to your actual question. But I am going to give you some ideas to go on, and then you can answer some questions and I will be better able to make suggestions for contracting with an attorney so you can get a discount in attorney fees.
Here is what I want to convey as to the relationship between policy limits and your handling the claim yourself. Let’s assume that the claim has a value of $150,000 (without considering mild brain injury or jaw joint injury), including the medical expenses.
If the policy limits of the tortfeasor are only $25,000, then a blind dog with a note in its mouth could settle the claim. So why pay an attorney to do what you can easily do? But if the tortfeasor’s limits are $100,000, then you might have more of a fight to get those limits, but again, why pay an attorney $33,333 to get that for you when clearly you could get an offer for half that on your own?
Now, assume the tortfeasor has limits of $300,000. Here you would need an attorney right from the start. She can marshal the facts and witnesses and doctors and arguments to actually increase the value of the claim and she will earn her fees.
Hence, you can see that in limited circumstances you should go forward with the claim, but in all others, an attorney is necessary.
Here are some considerations I want for you to answer.
#1. Can you guess from the type of car or type of house (address on police report) whether the tortfeasor has high or low limits?
#2. What are your underinsured motorist limits?
#3. How hard did you hit your head? It sounds like a pretty hard whack. I want to hear about this because I do have some information about mild brain injury that I want you to consider and to get back to me about. Here it is.
MILD BRAIN INJURY—POST CONCUSSIVE SYNDROME—POSSIBLE TMJ
So, let’s first address that topic of the most significant potential injury, your traumatic brain injury. Research that term, and especially post concussive syndrome and you will see some of the symptoms of that condition. My bet is that you DO HAVE A MILD BRAIN INJURY. It is untreated for two reasons.
First off, you most likely denied any loss of consciousness, right? Second, if there is no loss of consciousness and no complaints of the symptoms of brain injury, most doctors who are called upon to treat injuries will not make referrals to have the patient tested for brain injury.
Let’s first examine what is a concussion and what is a loss of consciousness. You DID HAVE A CONCUSSION, that much is for sure, since you hit your head. So traumatic brain injury is in play in your claim since you suffered a brain concussion.
Post-concussion syndrome, also known as post concussive syndrome or PCS, is a set of symptoms that a person may experience for weeks, months, or even years after a concussion, a mild form of traumatic brain injury. As many as 50% of patients who have experienced concussion have PCS,[1] and some sources say as many as 90% of patients experience post concussion symptoms.[
People who have had concussions may experience physical, mental, or emotional symptoms. Symptoms can appear immediately or weeks to months after the initial injury.
Physical symptoms can include:
• headache
• dizziness
• impaired balance
• nausea and/or vomiting
• fatigue or sleepiness
• inability to sleep
• decreased libido[8]
• sensitivity to noise or light
• ringing in the ears
• double or blurred vision
• decreased sense of taste, smell, or hearing
Emotional symptoms may include:
• irritability
• anxiety[10]
• restlessness[11]
• depression[12]
• lack of emotion
• emotional lability or mood swings
• lack of ability to tolerate stress or alcohol
• aggression
Cognitive or mental symptoms can include:
• amnesia or difficulty remembering things
• confusion or impaired cognition
• impaired judgment
• slowed cognitive processing
• difficulty with abstract thinking
• difficulty concentrating
• decrease in work performance
• decrease in social skills
LOSS OF CONSCIOUSNESS—not essential to diagnosis of post concussive syndrome, but sometimes the length of time unconscious will be used to judge the degree of the brain injury.
The patient is typically the primary source who is asked the most significant question: Did you lose consciousness as a result of your injury? Most of my clients who actually later recalled that they did not remember moments just after being struck in the head, AT FIRST DENIED ANY LOSS OF CONSCIOUSNESS TO THE POLICE AND TO THE EMERGENCY ROOM.
WHY? First, most people equate loss of consciousness with being unconscious for some time. But in fact, “loss of consciousness” means loss of conscious awareness. Hence, loss of consciousness can range from being briefly dazed to several days of coma. In fact, in order for a brain injury victim to answer such a question, they would have to undergo extensive examination recollecting past events. Any change in mental state can be significant in understanding a patient's condition and if loss of memory (amnesia) occurred immediately before or after the trauma.
When you struck your head on something, probably there was a brief loss of consciousness. Even if you never before reported it, now is the time to correct your records with a letter to your doctor explaining that you DID have a brief loss of consciousness.
Loss of Consciousness http://www.settlementcentral.com/page0134.htm After Accident or Injury
How do you correct records with the medical providers and the insurance adjusters? http://www.settlementcentral.com/page7004.htm Letters to insurance claim adjuster.
This page talks about how to confirm conversations with the insurance adjuster
http://www.settlementcentral.com/page0460.htm with loss of consciousness notify the insurance adjuster as soon as you recall it—do NOT wait until you send your demand letter.
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
TMJ—temporomandibular joint syndrome: possible source for headaches.
This is another term I want you to research. When an accident victim strikes her head, there is a good possibility that the disc in the condyle, or jaw joint disc, can be displaced. One of the consequences of jaw joint displacement is headaches. All too often in my practice, the doctors treated headaches as having originated from cervical problems, when in fact, they were due to a TMJ.
http://www.lectlaw.com/med/med04.htm
http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder
http://www.tmjdoctorofmaryland.com/
There are two at-home ways to see if your jaw joint is moving. First, find the spot in front of the little lobes on the middle of your ears. These are called “tragus”: http://www.infovisual.info/03/048_en.html
Now, put your fingers just in front of the tragus and over the jaw joint and open and close your mouth. If the disc is far out of place, you will feel a click. Better is for someone to stand behind you as you are seated and perform the same test. That person can feel the click if your jaw joint disc is far out of place.
#4. Do you know what your prognosis is? That would be helpful. Also, have you had a plastic surgeon make an opinion as to whether your scars can be revised, and what the cost would be?
Why don’t you give me some more information about the crash and about yourself and your injuries, and the questions above, and I can then be in a better position to give you some meaningful help.
Best wishes,
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
