Total Settlement: $17,000. Settlement is before deduction for attorney’s fees and expenses. Most cases result in a lower recovery. It should not be assumed that your case will have as beneficial a result.
Settlement Date: August 2015
Bodily Injury (BI) Liability insurers/ Claims Adjuster:
State Farm Mutual Automobile Insurance Company/ Jim Mallie
Liberty Mutual Insurance
Date of Incident: 8/23/2013
AGE, SEX, OCCUPATION OF CLIENT: 21 years old, Student.
CAUSE OF INJURY: Cathy* was injured when a driver carelessly failed to stop for traffic ahead and caused a three car collision. She suffered multiple injuries, which will be addressed below.
State Farm and Liberty Mutual insured the negligent driver and owner.
LIABILITY: Clear. It was our position that liability is clear.
On the date of the crash, Cathy was stopped for traffic ahead on State Road 874 (north bound) when a driver failed to stop and crashed into her vehicle, causing a three car collision. The officer investigating the scene of the crash cited the other driver for careless driving and recreated the scene of the crash with the following drawing.
The impact was hard. The following photographs taken at the scene, show the damage to the vehicles involved. The other driver was driving the grey vehicle shown below. The police officer estimated that the careless driver was going 55 miles per hour at the time of the crash.
The next photos show the extensive damage to the rear and side of Cathy’s vehicle. When she was hit, she lost control of her vehicle. The passenger side of her car struck the concrete barrier.
The next photos show the extensive damage to the rear and side of Cathy’s vehicle. When she was hit she lost control of her vehicle and hit the concrete barrier with the passenger side of her car.
Nature of Injury:
On impact, Cathy felt a sharp pain go through her neck as her head snapped forward and back. She injured her cervical and lumbar spine. Cervical refers to the neck. Lumbar refers to the lower back.
She still experiences constant pain. Cathy was diagnosed with a 1mm disc herniation at C3-4, a disc bulge at C4-5, and a right-sided 1mm disc herniation at C5-6, with evidence of cervical torticollis, as well as a disc bulge at L4-5.
Medical Treatment/Medical Facilities:
Baptist Health – Urgent Care
As stated above, it was a hard impact. Cathy felt immediate pain. She was in a state of shock. Initially, she could not move her arms or toes for a while.
She remembers a state trooper saw the collision and he stayed on the scene to direct traffic. Paramedics were called and they gave her first aid.
She did not want to go to the hospital without her father, who was already on his way to the scene, so she declined being taken by ambulance. Her car was towed. Her father picked her up and took her to Baptist Medical Plaza at Country Walk Urgent Care, a division of Baptist Health.
Cathy’s urgent care examination was positive for acute pain, which was noted as an 8 on a scale from 1-10.
My thoughts: Complaints of pain generally increase the full settlement value of a car crash case. A higher number on the pain scale tends to increase the claim’s full value. An 8 is a high number on the 1 to 10 pain scale.
She had thoracic and lumbar spine pain. Thoracic refers to the midback area.
Cathy also had reduced range of motion of the spine. Tenderness was present. X-rays were taken to rule out any fractures. Cathy was injected 60 mg of Toradol (60 mg IM).
Toradol treats pain and inflammation. It is a nonsteroidal anti-inflammatory drug (NSAID). Other examples of NSAIDs are Motrin, Advil and Aspirin.
The urgent care physician also ordered prescriptions of ibuprofen 600 mg, Flexeril 10 mg, and Percocet 5 mg/325 mg, for pain and muscle spasms. Flexeril is a muscle relaxer.
Percocet contains a combination of acetaminophen and oxycodone. Oxycodone is an opioid pain medication. An opioid is sometimes called a narcotic.
Cathy was put on a hard neck collar. A neck collar is also called a cervical collar or neck brace. Cathy was advised to wear it for three days and stay home from work.
She was instructed to avoid demanding activities, to use ice for 15-20 minutes 4-6 times daily, and to follow-up with a physician.
We requested the urgent care records from the hospital. We sent them to State Farm and Liberty Mutual claims’ adjusters. We also requested and sent them the hospital bills.
Dr. Wilkerson
Upon release from the hospital, Cathy followed all instructions. She rested, avoided movements that could aggravate her condition and took the prescribed medications. However, her symptoms did not go away. Instead, they worsened. She missed three days from work.
Cathy sought care with Dr. Wilkerson, a Coral Gables, Florida orthopedic doctor who is on her healthcare insurance list of participating providers.
My thoughts: Bodily injury (BI) liability insurers may assign more value to a claim if an injured person finds his or her doctor on their own, as opposed to getting referred by an attorney. If your Florida attorney refers to a doctor, expect the defense lawyer to make this a big issue at the trial.
For example in Carnival v. Jimenez,112 So. 3d 513, 520 (Fla. 2d DCA 2013), Jimenez slipped and fell. She sued Carnival Cruise Line.
Carnival’s attorney made the fact that her attorney referred her to a doctor a big issue at trial. Learn more about that case and other slip and fall cases against Carnival Cruise line.
Back to Cathy’s (my) case…
She called Dr. Wilkerson’s office and was seen in the next available appointment, on September 25, 2013.
My thoughts: This appointment was her second medical visit. It was about 1 month after her initial medical treatment at the urgent care. The State Farm claims adjuster may have reduced his settlement value of the claim due to the gap in treatment.
At the time of her evaluation, Cathy’s symptoms included headaches, nose bleeds, and constant pain throughout her spine. These symptoms affected her activities of daily living. Bending, sitting or standing for long periods aggravated her pain.
Dr. Wilkerson ordered x-rays, which showed a loss of the cervical and lumbar lordosis. He prescribed her Mobic and Skelaxin 800mg. Mobic is a nonsteroidal anti-inflammatory drug used to treat pain or inflammation caused by arthritis. Skelaxin is a muscle relaxant.
He ordered therapy. At the time of her initial evaluation for therapy, her level of pain was noted as an 8-9 on a scale from 1-10. Her doctor also recommended an MRI of the cervical and lumbar spine, to rule out herniations.
The MRIs were scheduled for October 8, 2013. Cathy’s cervical MRI revealed a right-sided 1mm disc herniation at C3-4, a disc bulge at C4-5, and a right-sided 1mm disc herniation at C5-6, with evidence of cervical torticollis.
My thoughts: I know one orthopedic doctor who says that a 2 millimeter herniation is on the border of being normal. He says that 2 to 3 millimeters is basically microscopic and borderline normal without any other issues.
You also have to look at whether there is a high intensity zone, annular tear or some other structural abnormality. If the defense doctor argues this, this may decrease the case settlement value.
Torticollis is a condition in which the head becomes persistently turned to one side, often associated with painful muscle spasms. Some cases of torticollis or cervical dystonia appear to be linked to head, neck or shoulder injuries. Therefore, some cases of cervical torticollis may be caused by a car crash.
The following image taken from her cervical MRI shows the herniations at C3-4, C5-6 and the loss of normal lordosis of the cervical spine.
Cathy’s lumbar MRI also showed positive findings. It revealed a disc bulge at L4-5.
On October 11, 2013, Dr. Wilkerson discussed the MRI findings with Cathy. He instructed her to continue with her therapy and to keep taking Skelaxin to help reduce the pain and muscle spasms.
He also gave her a prescription for Medrol (corticosteroid hormone tables). Medrol treats inflammation, flare-ups of ongoing illnesses, and many other medical problems.
Due to the severity of her symptoms, on January 6, 2014, Dr. Wilkerson referred Cathy to Dr. Hobbs for pain management evaluation and injections to her spine. The risks of the different procedures were discussed at length.
After considering the risks, Cathy initially opted to continue with her conservative care. This means that Cathy did not to have the injections.
Cathy’s physical therapy consisted of range of motion exercises, massages, electrical muscle stimulation, ultrasound and progressive strengthening exercises.
Cathy was under Dr. Wilkerson’s care until May 12, 2014. At the time of her last orthopedic evaluation she was still symptomatic. Her symptoms were right neck pain with muscle tightness, and lower back pain. She was instructed to continue with her current care and medications. Dr. Wilkerson again recommended injections.
We requested and sent State Farm and Liberty Mutual the Dr. Wilkerson’s records and bills, and the therapy records from Ocean Blue Physical Therapy. Cathy received her last therapy session on June 9, 2014.
Dr. Hobbs
On May 15, 2014, Cathy was examined by Dr. Hobbs, from The Center for Quality Pain Care. At the time of her visit Cathy described her pain as intense (a 7, 8 and 9 on a scale from 1-10), achy, sharp, and throbbing, located on both sides with muscle tightness.
The record shows that Cathy also had trouble sleeping due to the pain. Her examination revealed positive findings, including pain, tenderness and limited range of motion of the spine. Cathy received trigger point injections.
Trigger point injections are an effective treatment modality for inactivating trigger points and providing prompt relief of symptoms from myofascial pain syndrome. Myofascial pain syndrome is a common painful muscle disorder characterized by myofascial trigger points.
Dr. Hobbs summarizes the procedure as follows:
- Left & right cervical paraspinals trigger point injection
- Left & right upper trapezius injection
- Left & right rhomboids trigger point injection
Cathy explains that the six injections she received were painful and done without an anesthetic. She asked her doctor if he could use a numbing agent. He used a spray, but she explains that it did not help much, since it only felt cold and did not numb the area. She felt pain with every injection. She cried from the pain.
Cathy was also afraid of needles, but she went through with the procedure because she was having extreme pain and therapy was not giving her complete relief. Cathy did not feel immediate relief after the injections, until a few days later.
Sadly, the effects were only temporary. When the pain came back, it came back strong. She felt even worse and she had to start all over again. She continued with her therapy, which she now does at home.
We requested Dr. Hobbs medical records and sent them to State Farm.
The records from Dr. Hobbs are enclosed.
Medical BIlls:
As a result of the collision, the total billed medical charges were:
Baptist Health: $2,894.00
Radiology Associates: $153.00
Urgent Care Phys. of Country Walk: $266.00
Ortho. Specialist of S. Miami/Dr. Wilkerson: $10,895.00
The Center for Quality Pain Care/Dr. Hobbs: (Pending*)
CMI South: $3,700.00
Total……… $17,908.00* (not including bill from Dr. Hobbs)
The above total reflects the billed charges. It was not what we had to pay from the $17,000 settlement. At the time of the incident Cathy had Personal Injury Protection (PIP) coverage through State Farm. Since she was driving a car, PIP paid $10,000 of her bills. Her $10,000 in PIP benefits exhausted.
She had healthcare coverage through a Miami-Dade County self-funded policy. They claimed a lien of over $1,100. In Florida, health insurance plans through the county are required to reduce their lien by attorney’s fees and costs. This is one of the 11 benefits of hiring an injury lawyer in a Florida car accident case.
We are paying the health insurer $750.00 to settle its lien. Other than my attorney’s fees and costs, that was the biggest expense that came out of Chanel’s portion of the settlement.
Future Medical Treatment:
Her doctor(s) stated that Cathy will need more treatment as her condition is permanent in nature. Dr. Wilkerson and Dr. Hobbs both agree she will need additional trigger point injections. They have also recommended Epidural injections.
Cathy is considering her options. At this time she is afraid and reluctant to have Epidural injections because of the risks associated with it. When she spoke with both Dr. Hobbs and Dr. Wilkerson, they explained that the procedure carries risks, including infection and paralysis.
She has been advised that with age, her condition will likely to deteriorate and she may have no other choice than to undergo additional procedures and therapy as needed in an effort to alleviate the pain.
LIFE EXPECTANCY:
Approximately 64.3 years.
INTANGIBLE DAMAGES:
Cathy is a very pleasant young lady. She was only 21 years old at the time of the collision. As a result of the crash Cathy has suffered not only physically, but also financially and emotionally. This collision has been a source of stress. Cathy worries about her future prognosis and how it will affect her ability to enjoy life and participate in physical activities most people her age are able to do without pain.
When the collision happened she had just started school. As a student, she is required to sit for hours during her classes. The pain made her uncomfortable.
She had difficulty concentrating during classes due to muscle spasms and pain. Sitting for more than 25 minutes made her stiff. Taking notes was difficult. She had to adjust the way she sat.
She had to sit at an angle. She had to get up during class and stretch out, which caused her embarrassment, because it attracted unwanted attention. She felt severe pain when she moved her neck, so she wore the neck brace the first few days during her classes. Sitting while doing homework at home also aggravated her spasms and pain in her neck.
To this day, Cathy continues to suffer from the injuries she suffered as a result of this collision. She still does the exercises she learned during therapy, three times a week. She uses Icy Hot and takes baths with Epson Salts, to help relax the muscles.
She still takes pain medications. She has a massager she uses at home. She cannot sit still for any prolong periods. Again, she worries she will have to live in pain for the rest of her life.
Settlement
Cathy wanted to settle the case and move on with her life. The total settlement was for $17,000.
*The name used above is not the client’s real name.
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