Auto Insurance Claims: auto insurance claim congenital problem versus lit up by accident, l5 s1 disc, auto insurance claim


Question
my husband was involved in an auto accident 3 weeks ago wherein he was hit on the right and left side rear by two seperate vehicles.  he didn't have any immediate pain however later that evening he complained of a severe headache and back pain. i took him to ER where they just gave him a shot, took some xrays, wrote a prescription for pain meds, and told to f/u with his primary care physician. I made an appointment with his primary care for the following Wednesday (that was the earliest avail. appt.). he wasn't satisfied with the x-rays taken by the ER and ordered him to have a Thoraic spine x-ray and CT of head.  He then told him to make an appt. with a recommended chiropractic/rehabilitation center.  after his first two visits, they sent him back for a lumbar spine (5 views) which showed "small anterior osteophytes on L2, L3, and L4 indicating mild bony degenerative changes".  My husband is still experiencing pain in his back, which occasionally shoots down his leg to his foot.  He's never had any back, leg or foot pain before.  He's 30 years old, a former athlete and professional dancer so he's been in good health.  Oh the transcription also said "the L5-S1 disc space is very small, probably due to the congenital partial sacralization of the transverse processes".

Do you think that this accident aggravated an area that was eventually going to be a problem in his later years? do you suggest that he see an Orthopedic Surgeon?  The Chiropractor thinks that with consistent treatment and rest that he should see a decrease in pain at some point, but his opinion is that this accident triggered a chain reaction.  My husband is back to work at a distribution center however, he doesn't do any lifting, but he is on his feet doing a lot of walking for about 8-10 hours a day.

Answer
Dear Nikki,

Your husband apparently did have a congenital problem that was lit up by accident trauma.  As such, he is entitled to full damages for the difference in his quality of life and pain and suffering AT THE BASE (before the accident) versus the END RESULT (what he has, is, and will be suffering in terms of decreased enjoyment of life and pain and suffering and likelihood of future medical complications and possible surgery).  

Wow--that is a mouthful, so go back and read it slowly.  So, yes, every state DOES have a jury instruction on the topic of full payment for preexisting conditions that are lit up by a tortfeasor.

You have asked only ONE part of the puzzle: whether an orthopedist can help now.  Here is how I would approach it.  

For long term care, and possible surgery, the orthopedist would be an excellent solid base to both good medical care and in support of a financial recovery.  BUT, just be forewarned that the patience of orthopedists runs low for continued care of non-surgical pain cases: as they might say to one another: "if we can't make our living by cutting on them, what good is it to hold hands with them?"

http://www.settlementcentral.com/page8010.htm insurance claim support is better with a chiropractor than an orthopedist, BUT, the latter DOES have more horsepower when it comes to shaking some money from the insurance tree.  Thus, you use them both. AND, with the continued radiation of pain, I would also ask for a referral to a neurologist.

In summary, I think that you go to an orthopedist and let him document the fact that this is a preexisting ASYMPTOMATIC condition that was lit up by the accident trauma.  To do this, BRING A WRITTEN outline of all the activities your husband used to do without pain.  DO NOT JUST SUMMARIZE, but give specific details, in both work and personal life.  THAT ought to get the ball rolling with the orthopedist inasmuch as he will be forced to acknowledge that the condition was ASYMPTOMATIC before the accident trauma.  

That ought to get you and your husband started on the right road to both good health ideas AND a solid base for your personal injury insurance claim settlement.

If you are going to try to do this insurance settlement yourself, you may write to me again and I will give you a number of pages to start with for background on how to proceed on a do it yourself basis.  These would be from my website (below).

Best wishes for a speedy recovery for your husband,

Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com