Nerve damage from Accidents

Persons who fall down or are in car accidents often do not feel pain in their neck or pain until the next day. Testing for nerve damage/involvement, could include nerve conduction tests, muscle conduction tests, MRI, CT scan, and blood work. A person concerned about nerve damage should probably consult a neurologist (who can administer most of the above tests). Kenneth Vercammen & Associates Law Office helps people injured due to the negligence of others. We provide representation throughout New Jersey. The insurance companies will not help. Don't give up! Our Law Office can provide experienced attorney representation if you are injured in an accident and suffer nerve damage.

Even in a low impact accident, there can be nerve damage. According to medical journal excerpts:

1) "The truth is that all driving can be dangerous. More than 80 per cent of all car crashes occur at speeds less than 40 mph. Fatalities involving non-belted occupants of cars have been recorded at as low as 12 mph. That's about the speed you'd be driving in a parking lot."

Seat belt safety pamphlet, number D)T HS 802 152, distributed by the U.S. Department of Transportation, National Highway Traffic Safety Administration.

2) "The amount of damage to the automobile bears little relation to the force applied to the cervical spine of the occupants. The acceleration of the occupant's head depends on the force imparted, the moment of inertia of the struck vehicle, and the amount of collapse of force dissemination by the crumpling of the vehicle. The inertia of the struck vehicle is related to the weight and the relative ease with which the vehicle rolls or moves forward."

Charles Caroll, M.D., Paul McAfee, M.D., Lee Riley, Jr., M.D.: Objective findings for diagnosis of "whiplash". Journal of Musculoskeletal Medicine, March, 1986, pp. 57-74.

3) "The accident does not need to be severe in order to generate cervical trauma. Using the brakes when the light suddenly turns red and when the neck is too relaxed is enough to cause trauma. The neck may projected backwards even though not violently. The head, which weighs five kilograms and is balanced over the cervical spine, being supported by only two small articular surfaces no greater than a thumbnail, is also thrown backwards pulling the cervical spine with it. In addition, a sudden reflex contraction of the flexors on the neck occurs with a certain delay. We shall not describe all the details of the mechanism of the production of these whiplash injuries..."

It is easy to imagine that the joint injuries are not the same if during a collision, or any other accident, the head is directed along the axis of the impact or if the head is rotated of if the impact is directed laterally. In the final analysis, it is the result of the injury which is important."

Robert Maigne, M.D., Orthopedic Medicine - A New Approach to Vertebral Manipulations, CC. Thomas, 1972, p. 196.

4) "The position of the head at the moment of collision influences the type of injury. This is particularly true of the degree of rotation in relationship to the direction of the impact...the foramen are open equally when the head faces forward but are narrowed on the side toward which the head is laterally flexed or to which the head is turned. Not only will the already narrowed foramen be compressed ligaments will be far more damaging. Rotating the head at the time of collision increases the possibility of more serious injury." Rene Cailliet, M.D., Neck and Arm Pain, 1972, Davis Company, p. 69.

Although no specific studies are available for analysis, some medical authors have suggested the possibility that perhaps collisions that produce little physical damage place the occupants at GREATER risk of injury. The crumpling of metal during a collision is believed to absorb some of the force generated by the impact. Where little damage is produced, it may suggest that none of the force was absorbed by the metal, leaving it to pass through the automobile, thereby exposing the occupants to the full force of the impact.

In early 1989, Dr. Francis Navin, a professor of Civil Engineering at the University of British Columbia and a scientific team of investigators conducted simulated low-speed rear impact studies at the UBC Accident Research Facility in Vancouver to assess vehicle damage and occupant injury from this type of collision. The investigators set up a simulated experiment in which a heavy pendulum was swung at speeds lower than 20 km/h to strike the rear bumper of a Volkswagen Rabbit carrying bolted crash dummies. Later that year, Dr. Navin published his findings at an international conference on experimental safety vehicles in Gothenburg, Sweden.

The results of their studies showed that the test occupants were flung forward and rotated at higher speeds than impact "in an attempt to catch up with the car."

"It was observed that the resulting deflection of the seat-back, with subsequent rebound tends to pitch the occupant forward during impact with the shoulder displacement leading the head. The relative head to shoulder motion is the likely source of whiplash injury, " according to Dr. Navin.

The investigators also noticed an absence of structural damage to the rear bumper of the Rabbits when struck by the pendulum at speeds of up to 15 km/h. This led Dr. Navin to the same conclusion of earlier American studies which demonstrated that rear-end collisions, unlike most other types of collisions, frequently result in "minor car damage with major bodily harm."

Dr. Navin's findings are fully explained in the proceedings of the 12th International Conference of Experimental Safety Vehicles, May 29 - June 1, 1989, Gothburg, Sweden, in the article "Low Speed Rear Impacts and the Elastic Properties of Automobiles", as well as in the Proceedings of the Multi-disciplinary Road Safety Conference VI, June 5-7, 1989, Fredricton, New Brunswick, in the article "An Investigation Into Vehicle and Occupant Response Subjected to Low-Speed Rear Impacts."

1) "Long-term studies show that aches and pains with no evident physical cause persist in 20% to 45% of patients with significant whiplash injuries."

"Roentgenographic studies show that degenerative problems develop after injury in 39% of patients. By comparison only 6% of the general population over age 30 develops degenerative changes over a comparable time. Thus, it would seem that whiplash injuries predispose patients to cervical degenerative osteoarthritis."

Charles Caroll, M.D., Paul McAfee, M.D., Lee Riley, Jr., M.D.: Objective findings for diagnosis of "whiplash". Journal of Musculoskeletal Medicine, March, 1986, pp. 57-74.

2) "From the discussion of the natural history of the degenerative process, it will be appreciated that this process is often a continuing one and therefore we cannot expect a permanent cure from manipulation or from any modality, including operation."

W.H. Kirkaldy-Willis, M.D., Managing Low Back Pain, 1983, Churchill Livingstone, pp. 183.

3) "In addition there are long term effects of injuries [automobile accidents] which do not become evident until years after the insult, for example with osteoarthrosis of joints and epileptic seizures."

Aldman B., Mellander H., Mackay M., The Structure of European Research into the Bio-mechanics of Impacts, in the quarterly journal of the American Association For Automotive Medicine, April, 1986, p. 26.

4) "If the displacement (post-traumatic disc protrusion) is left where it is to get larger or smaller as fortune dictates, it will sometimes take the latter course. Even so, the longer the protrusion lasts, the more time it has to stretch the posterior longitudinal ligament, perhaps irretrievably, thus enhancing the likelihood of further attacks. The prevention of eventual pressure on a root or the spinal cord is clearly the reduction of the displacement (manipulation) when it first appears. In other words, reduction now, repeated as the years go by as often as proves necessary, affords the best --indeed the only--hope of preventing attacks of pain increasing in severity and duration and leading to eventual crippledom in old age."

James Cyriax, M.D., Textbook of Orthopaedic Medicine, Tindall, 8th edition, 1982, p.103.

5) "Disk disruption in milder cervical trauma may be the cause of acute as well as chronic pain syndrome...This type of pain pattern can become chronic over many years without resolving. The areas affected by pain include the neck, inner part of the scapula, shoulder, and arm. This pain is relieved by rest, immobilization, and traction. The pain recurs when the patient becomes active again."

Bohlman HH: Musculoskeletal Disorders, ed. by Robert D. D'Ambrosia, M.D., 1977, J.B. Lippencott Company, pp. 220-222.

This points out that the fear that symptoms associated with traumatic soft-tissue injury will return in the future is an opinion shared by many respected medical authorities, and reported in numerous medical texts, journals, and professional papers. The sequela of post-traumatic injury, especially as it relates to joint function, are well established in the medical literature, and carry a significant predisposition for further dysfunction and painful syndromes. Financial Recovery for persons suffering nerve damage and seriously injured in accidents, both car accidents and fall downs

1. Kenneth Vercammen Helps Injured persons A person who is injured as a result of the negligence of another person is what we in the legal profession refer to as a personal injury claimant. In other words, they have been injured as a result of an accident, and you now wish to prosecute a claim against an opposing party. As the attorney of record, I can bring an action for the injured person. Therefore, I request that all clients do as much as possible to cooperate and help in every way. The purpose of this article is to describe the procedure that we may follow and give you sufficient instructions to enable you to assist us in this undertaking. Needless to say, helping us is just another way of helping yourself.

2. Clients should provide my office with the following 1. Any bills 2. All Hospital or doctor records in your possession 3. Car Insurance Declaration Sheet if you were in a car accident 4. Car Insurance Policy if car accident 5. Photos of damage to any property 6. Photos of accident site 7. Major Medical Insurance Card 8. Paystub if lost time from work

3. Attorney- Client Confidential Relationship First, I want to thank our clients for giving me the opportunity to assist them in their case. I am a legal professional and I have great pride and confidence in the legal services that I perform for clients during our relationship as attorney-client. If you have concerns about your case, please call my office at (732) 572-0500. We feel that this case is extremely important-not only to you, but to this office as well. This is not simply a matter of obtaining just compensation for you, although that is very important. We take professional pride in guiding our clients carefully through difficult times to a satisfactory conclusion of their cases.

4. Submission of Bills to Car Insurance and Major Medical If you are in a car accident, you should submit your medical bills to your own car insurance company first. Your car insurance is required by New Jersey law to provide PIP (Personal Injury Protection) benefits under the No Fault Law. This means your car insurance company, not the careless driver, pay the majority of medical bills. If you do not own a car, but live with someone who owns a car, we can try to help you submit medical bills to their car insurance company.

If this is not a car accident, submit all bills immediately to your major medical. Please provide car and major medical insurance information to each doctor, MRI facility and treatment provider. Please request they submit bills and attending physician reports to car insurance and major medical. There is now minimum deductibles under the PIP Law. There is an initial $250.00 deductible, and thereafter your car insurance company pays 80% of medical bills under a medical fee schedule established by the State Dept. of Insurance. Your primary treating doctor must also follow "Care Path". Submit portions of bills the car insurance does not pay to your major medical carrier (ex- Blue Cross, Connecticut General). The Law Office of Kenneth Vercammen can provide a more detailed brochure explaining how car insurance works.

Never give a signed statement to the claims adjuster representing the other driver's insurance company. The same goes for a phone recording. They may be used against you in court to deny your claim. Speak with your personal injury attorney first.

WHILE YOUR PERSONAL INJURY CASE IS PENDING:

It is important that you -- 1. DO NOT discuss your case with anyone except your doctors and attorney. 2. DO NOT make any statements or give out any information. 3. DO NOT sign any statements, reports, forms or papers of any kinds. 4. DO NOT appear at police or other hearings without first consulting with your attorney. INFORM YOUR ATTORNEY PROMPTLY of any notice, request or summons to appear at any such hearings. 5. Refer to your attorney, anyone who asks you to sign anything or to make any statement or report or who seeks information concerning your case. 6. Direct your doctor and other treatment providers not to furnish or disclose any information concerning your case to any entity other than your insurance company without YOU AND YOUR ATTORNEY'S WRITTEN PERMISSION. 7. You may have insurance coverages such as liability, collision, accident, Blue Cross, Blue Shield or Major Medical which require prompt attention. However, be sure to have your treatment providers send bills immediately to all of your insurance companies. 8. Notify your attorney promptly of any new developments. Small things may be important. Keep your attorney informed. 9. Maintain accurate records of all information and data pertaining to your case. 10. If you or any witnesses should move, be sure to notify your attorney of the new address.

5. Diary We want you to keep a diary of your experiences since your accident. In addition to this daily record, we also ask you to start describing a single day in the course of your life. In other words, describe what you do when you get up in the morning, the first thing you do after you go to work, what type of work and effort you put into your employment, what activities you engage in after work, etc. In other words, we need you to describe the changes in your working life, your playing life, your life as a husband or wife or child or parent. In your written description of your day, we would appreciate your explanation in the greatest detail possible and in your own words how the accident and subsequent injuries have affected your life, your personality, and your outlook. And remember that suffering does not entail mere physical pain; suffering can be emotional and can be transmitted to your family, friends, and co-workers. When you have completed this description, please return it to this office in the enclosed envelope. Keep a diary of all matters concerning this accident-no matter how trivial you think it may be. You should include notes on the treatments you receive, therapy, casts, appliances, hospitalization, change of doctors, change of medication, symptoms, recurrence, setbacks, disabilities and inconveniences. If you have any doubt about the propriety of including some particular information, please call the office and let us assist you.

6. Record expenses You can also begin to set up a system for recording the expenses incurred in conjunction with your claim in minute detail. Medical and legal expenses are a strong part of the value of your lawsuit, so good records of these expenses must be kept at all times. From time to time, however, there will be expenses incurred that you must keep track of yourself. We ask you to make every effort to avoid any possible error or inaccuracy as jurors have a relentless reverence for the truth. Keep your canceled checks and your list of expenses together, for we will need them at a later date. Your attorney will keep track of your legal expenses, which may include costs of filing, service of process, investigation, reports, depositions, witness fees, jury fees, etc.

7. Investigation and Filing of Civil Complaint in Superior Court Procedurally, the following events occur in most personal injury cases. First, your attorney must complete our investigation and file. This will involve the collection of information from your physician, your employer, and our investigator. We will need your Doctors to provide us with copies of all bills, medical records and possibly a medical report. When we feel that we have sufficient information to form an opinion as to the financial extent of your damages, we will commence negotiations with the opposition for a settlement. If the insurance company will not make an adequate offer, then a Complaint and Case Information Statement is prepared by your attorney. It is filed in the Superior Court, Law Division. Your attorney then will prepare a summons and have the defendants personally served with the Summons and Complaint. The defendant, through their insurance company, must file an "Answer" within 35 days.

8. Interrogatory Questions and Discovery The Answer is followed by a request for written interrogatories. These are questions that must be answered by each party. The Superior Court has set up certain "Form" Interrogatories which are contained in the Rules of Court. Generally, written interrogatories are followed by the taking of depositions, which is recorded testimony given under oath by any person the opposition wishes to question. The deposition is just as important as the trial itself. In the event you are deposed during the course of this action, you will receive detailed instructions as to the procedure and will be requested to watch a videotape. After taking depositions, the case will be set down for an Arbitration. If the parties do not settle after the Arbitration, the case will be given a trial call date. Altogether, these procedures may take from six months to several years, and your patience may be sorely tried during this time. However, it has been our experience that clients who are forewarned have a much higher tolerance level for the slowly turning wheels of justice.

9. Doctor/Treatment It will help your case to tell us and your doctors about any injury or medical problems before or after your accident. Good cases can be lost by the injured person's concealing or forgetting an earlier or later injury or medical problem. Insurance companies keep a record of any and all claims against any insurance company. The insurance company is sure to find out if you have ever made a previous claim. Tell your doctors all of your complaints. The doctor's records can only be as complete as what you have given. Keep track of all prescriptions and medicines taken accompanied by the bills. Also save all bottles or containers of medicine.

10. Bills Retain all bills which relate to your damages, including medical expenses, hospital expenses, drugs and medicines, therapy, appliances, and anything needed to assist you in your recovery. If possible, pay these bills by check or money order, so that a complete record may be kept. If this is not possible, be certain to obtain a complete receipt with the bill heading on it, to indicate where the receipt came from and the party issuing it.

11. Evidence Be certain to keep anything that comes into your possession which might be used as evidence in your case, such as shoes, clothing, glasses, photographs, defective machinery, defective parts, foreign substances which may have been a factor in your accident, etc. Be sure to let the office know that you have these items in your possession.

12. Photographs Take photographs of all motor vehicles, accident site, etc., that may be connected directly or indirectly with your accident. Again, be sure to let the office know that you have such photographs.

13. Keep your attorney advised Keep this office advised at all times with respect to changes in address, important changes in medical treatment, termination of treatment, termination of employment, resumption of employment, or any other unusual change in your life.

14. Lost wages Keep a complete record of all lost wages. Obtain a statement from your company outlining the time you have lost, the rate of salary you are paid, the hours you work per week, your average weekly salary, and any losses suffered as a result of this accident. Where possible, also obtain other types of evidence such as ledger sheets, copies of time cards, canceled checks, check stubs, vouchers, pay slips, etc.

15. New information In the event that any new information concerning the evidence in this case comes to your attention, report this to the Attorney immediately. This is particularly true in the case of witnesses who have heretofore been unavailable.

16. Do not discuss the case The insurance company may telephone you and record the conversation or send an adjuster (investigator) who may carry a concealed tape recorder. You should not discuss your case with anyone.

Obviously, we cannot stress too strongly that you DO NOT discuss this matter with anyone but your attorney or immediate, trusted family. You should sign no documents without the consent of this office. Remember that at all times you may be photographed and investigated by the opposition. If you follow the simple precautions which we have set out in your checklist, we feel that we will be able to obtain a fair and appropriate amount for your injuries. If you get any letters from anyone in connection with your case, mail or fax them to your attorney immediately.

17. Questioning If any person approaches you with respect to this accident without your attorney's permission, make complete notes regarding the incident. These notes should include the name and address of the party, a description of the person, and a narrative description of what was said or done. Under no circumstances should you answer any question(s). All questions should be referred to your attorney's office.

18. Investigation by Defendant Insurance Company Permit us to reiterate at this time that the opposition's insurance company will in all probability have a team of lawyers and investigators working diligently to counter your claim. During the course of their investigation, it is quite possible that they may attempt to contact you through various (and sometimes, devious) methods. Please do not make their jobs any easier for them by answering their questions.

We cannot emphasize too strongly that you should refrain at all times from discussing this matter with anyone--and that includes your employer, your relatives, your neighbors, and even your friends. Of course, there are exceptions to this rule.

If there are friends or neighbors or relatives who know all of the facts and circumstances surrounding the accident and can be of assistance to you, then they should be referred to this office so that their natural sympathy can be channeled into an effective asset for you.

Insurance companies pay money to claimants when they are satisfied there are both liability and damages that support a recovery. They can be expected to thoroughly investigate the facts of the accident and any past injuries or claims. The insurance company will obtain copies of all of the claimant's past medical records.

19. The value of a case depends on the Permanent Injury, medical treatment and doctor's reports Undoubtedly, you have questions as to how much your case is worth. We are going to be frank: The fact of the matter is there can be no answer to this question until we have completed the investigation in your case. Once we complete our investigation, of course, we can make a determination as to the amount of the defendant's liability, if any, and even at that we will only be at a starting point. After that, we must obtain all necessary information concerning your lost wages, your disability, your partial disability, your life changes, and your prognosis. You may rest assured of one thing, however, and that is the fact that your case will not be settled below its true value, that is the fair compensation for the injuries you have received. You may also rest assured that no settlement agreement will be entered into without your consent.

Conclusion We appreciate that this is a great deal of information to absorb. We also appreciate that our requests for client's assistance have been numerous. However, we are certain that our clients appreciate having this information from the outset. Each request and bit of information given here represents an important part in recovering full value for your injury. Therefore, we respectfully request your full cooperation. If you have questions or concerns regarding these instructions, we encourage you to feel free to contact the office at any time.