What Is My Baltimore Car Accident Case Worth?

What Is My Baltimore Car Accident Case Worth?

As I’ve mentioned in many past blog posts, I treat many patients involved in Baltimore car accidents. After taking a thorough past medical history, evaluating chief complaints, and beginning treatment, one of the questions I am most frequently asked is “what is my Baltimore car accident case worth?” When I first started in practice I had no idea how to answer the question. As a medical provider I did not want to give an opinion on the value of a case. That is, I only treat patients and their symptoms. How could I possibly know?

If you look up case values on the internet, attorneys and insurance companies often list a formula to determine the value of a personal injury case. The formula is something like this:

Past Medical Expenses + Future Medical Expenses + Past Lost Wages + Future Lost Wages + Pain and Suffering = Total case value

Although I’ve been in clinical practice for approximately six years I can say that my answer to this question has not changed much at all. I still tell patients that I do not know the value of their case (in dollars) because it does not concern me. I encourage them to not worry too much about the monetary value of their claim either. The only thing that I can control when a patient is under my care is the treatment that I render on any given visit and in some capacity, how a patient heals.

When the question comes up about case value I like to re-direct the conversation back to the topic of activities of daily living. If you remember, these are activities that we either must do, or enjoy doing that can be made more difficult or impossible as a result of musculoskeletal pain. The question should not be what is the case of my value (in dollars) but rather, what is the value of my life and my daily routine? How valuable is it that I can be the person I was before the car accident and that I can “move on” and not be reminded for the rest of my life of this motor vehicle collision?

How much would you enjoy waking up each day if you woke up with searing back pain? How much would you enjoy going to work if bending to get into your car and sitting caused you numbness down a leg? How much would you miss carrying your newborn child if neck pain and looking down caused you hand numbness? How much would you enjoy reading a book to your child if sitting a chair caused back spasms?

Obviously the “quality of life” questions are endless, but it stands to reason that regardless of the monetary value of your personal injury claim, the quality of life interruption that you may be experiencing is way more important.

To be clear, I understand that money “makes the world go ’round” but it is not the most important thing following a Baltimore auto accident. Without a physical and emotional recovery, all the money in the world can not make you “whole” again.

If you really must know the value of your Baltimore auto accident claim, I would recommend contacting one of the many Baltimore auto accident attorneys that can better answer that question. If, on the other hand, you are concerned about making a complete recovery and resuming your life as quickly as possible with as few complications as possible, please contact Mid-Atlantic Spinal Rehab & Chiropractic. We would be happy to help you feel better and go back to living your life, which is the true “value” of a Baltimore auto accident claim.

Dr. Gulitz

Length of Treatment Following a Baltimore Car Accident

As a Baltimore Chiropractor that spends a considerable amount of time treating patients injured in Baltimore car accidents I often get asked by patients how long they should expect to be treating for their injuries. It is a complex question that is often hard, if not impossible, to answer on the first visit. That is, when patients first come into the office for an evaluation it is usually several hours to several days following their injury. Often their conditions will get slightly worse before they get better as their body begins to heal.  Additionally, these patients may be severely medicated if they went to a hospital following their injury, so it is difficult to accurately assess their “true” levels of pain and discomfort. Research suggests that human metrics are way more important in determining injury severity than are vehicle metrics. That is, it stands to reason that all things being equal, a previously healthy 16 year old male may not be injured as much as a 75 year old male with diabetes and heart disease.

I don’t like to set hard and fast parameters for my patients in terms of how much care they need. I let their treatment “do the talking.” If they are making their appointments, if their subjective pain levels are improving within the first 3-4 weeks of care by at least 50 percent, and if they are able to resume their activities of daily living without much interruption, then chances are they will not require much treatment and will be released to home care shortly. Typically for these patients care lasts anywhere from 4-8 weeks, on a declining frequency basis. They may start at 3 visits per week but by the time they are close to being released, they may only be treated in the office about once per week or once every other week as they continue to resume their activities outside of the office.

If, on the other hand, a patient is not making their treatment visits, is not performing the stretches that we have assigned for them to perform at home, and has other comorbidities that delay wound healing (smoking, diabetes, heart disease, etc.) then it stands to reason that the length of care that the injured patient requires would be longer.

The purpose of this blog post is to alert you to the fact that it is impossible to predict, particularly early on following an injury, the exact amount of time that it takes for a patient to be dismissed from therapy. Keep in mind, even once dismissed from treatment in my office, a patient will continue to go on and heal, as healing is a long process.

There are some chiropractic clinics that treat all patients the same. They treat all motor vehicle collision patients with the same therapy, for the same number of visits, without regard to their age, pre-existing health conditions, or restrictions. These clinics will routinely tell their patients that they need 16 visits. How they can predict such a specific number is beyond me. This type of blanket treatment often leads to misdiagnosis, suboptimal care, and disgruntled clients who are left “holding the bag” by remaining in pain and having had their time wasted.

Mid-Atlantic Spinal Rehab & Chiropractic combines both chiropractic care and rehabilitation activities to help facilitate healing in our injured clients. We also work closely alongside Dr. Kevin Carr M.D. of Carr Medical Specialties to co-treat our patients to make sure that they get the best care medically and physically.

If you, or someone you know, has suffered injuries as a result of a Baltimore car accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Top 5 Chiropractic Myths

As a Baltimore Chiropractor that has spent my entire professional life treating patients with chiropractic care and physical therapy modalities it recently dawned on me that although I know and understand what chiropractic care is all about, many of my current and perspective patients may not. There are a lot of mistruths and misunderstandings about Chiropractic care. Typically this is why my office offers a free consultation, to let potential patients ask any questions that they would like in order to determine if they are in the right place. As a result of the success of my last blog post about the Top 5 Whiplash myths, I’ve decided to put together (in no particularly order) what I view to be my Top 5 Chiropractic myths. So here they are.

1) Once you go to the Chiropractor you will “always have to go.” Admittedly many patients feel relief of their neck and back pain symptoms with a short course of therapy and choose to return for additional treatment on a recurring basis, but you do not have. I see many patients who are experiencing an acute bout of neck or back discomfort that is able to become eliminated after only a few visits and then they stop presenting for care until, or unless, they need me again. There are no contracts to sign, no long term treatment plans, and no “guilt” associated with discontinuing treatment. Like a fisherman, we “catch and release” and a patient’s desire to come back after their initial treatment is completely up to them.

2) Chiropractic care is unsafe. There have been many research articles demonstrating both the safety and efficacy of chiropractic care for acute and chronic neck and back pain. And while there are the occasional sensationalistic stories about patients having negative outcomes under chiropractic care, the incidence of cataclysmic injury while under the care of a licensed and trained Chiropractor is so small as to be nearly negligible.

3). Chiropractic care is expensive. Like most health care providers we accept many means of payment for our treatment. These include fee-for-service (cash), health insurance, worker’s compensation payments, and auto insurance for personal injury cases. Typically the costs for services rendered are presented to an insurance company who will pay our bill. The out of pocket cost to a patient is determined by an insurance company’s plan, just like it would be at a family physician’s office. Many of the common insurance plans have chiropractic benefits that you are already paying for when you pay your monthly premiums. Care is not expensive, at least not more than a copay would cost you at your family physician’s office. Additionally, research has shown that for patients experiencing lower back pain care is about 20 percent less expensive than for those initiating care in a traditional medical setting.

4). I can crack my own back, I don’t need to see a chiropractor. Many patients ask me some variety of this statement each day. I remind them that the joints that they are able to cavitate or “crack” on their own are typically joints that are already hypermobile- that its, they are moving too much. Chiropractors are trained to palpate and adjust hypomobile fixated joint segments. So while it may be true that you hear joints cracking on your own, typically these are joints that are already moving appropriately and should not be adjusted. Chiropractors are trained to seek out and manipulate joints that are truly fixated.

5). Chiropractors break bones when they adjust you. Patients are often confused about what the “cracking” sound is. Research tells us that is is the sound of dissolved carbon dioxide and nitrogen gases in synovial joints that rush out of solution with an appropriate joint adjustment. This is similar to the popping sound that a bottle of champagne makes once the cork is popped, or to a can of soda once the top is opened. It is not the sound of bones being broken. While it is theoretically possible to apply enough force to break a bone, instances of broken bones within chiropractic offices are extremely rare and special efforts are made to prevent such outcomes.

I am sure that there are many more chiropractic myths out there. If you would like more information on any of these myths or if you would like me to “debunk” some more, feel free to comment and I would be happy to address any Chiropractic myths that you may have.

In the meantime, if you, or anyone you know requires Chiropractic care for neck pain and back pain please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Top 5 Whiplash Myths

As a Baltimore chiropractor that spends the majority of my time rendering Baltimore whiplash treatment to those injured in Baltimore auto accidents, there is a lot of misinformation regarding whiplash injuries. In no particular order here are my top 5 whiplash myths that I intend to dispel.

#1) Patients who “tense up” are more likely to be injured than those who are loose (i.e. drunk drivers).

This is not true. The majority of cervical spine (neck) pain following acute whiplash comes from the pain fibers in the facet joint capsules. Tensing up and clenching muscles actually prevent facet joint jamming in some instances, thereby causing decreased injury when a patient clenches up. While there will still likely be muscle straining or tearing, the pain is often less severe than a series of sprained facet joint capsules.

#2) The faster one of the two vehicles is going (in a 2 car crash) the more severe the injuries for the occupants must be.

This one is not true. The so called “delta V” or change in velocity between both the target and bullet vehicles has no scientific correlation to occupant injury. Better predictive factors for injury are the change in acceleration rate of the occupants, also known as “jerk.” High rates of jerk can cause very severe injuries even in relatively low speed crashes.

#3) Men and women are equally likely to be injured in a crash.

Most crash test studies are performed on so called “50th percentile” men and women dummies. For men, this is roughly a 5’8” 175 pound man. How many men do you know that fit this exact criteria? Any deviation from this height and weight make it hard, if not impossible, to accurately predict relative injury risk following a crash. I do not know the qualifications for a 50th percentile woman, but the same logic holds. In any event, human metrics (age, sex, height, weight, and any pre-existing health conditions are more predictive indicators than are sex alone).

#4) You can not have been injured if your car is not damaged.

This one is fairly pervasive in the industry. Defense attorneys like to pretend that non-damaged target vehicles indicate that it is impossible for claimants to have been injured. Scientific research has demonstrated that there is no correlation between property damage of a vehicle and injury risk. In fact, many bumpers are built to not deform at low speeds, thereby paradoxically transferring energy that should be used to crush the bumper onto the vehicle’s occupants, and causing MORE injury!

#5) Whiplash patients/claimants are only in it “for the money.” If there is no money on the line, no one reports whiplash injuries.

Every country in the world handles the legal side of whiplash claims differently. Even in some countries that do not allow for financial renumeration following non-faulted whiplash injuries there are still injuries reported with similar frequencies as there are in the United States.

Whiplash is a real problem especially in Baltimore. If you, or someone you know has suffered from a whiplash injury and requires treatment please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to dispel any myths and get you on the road to recovery!

Dr. Gulitz

Apportionment of Baltimore Auto Accident Injuries

As many of my avid blog followers already know, I spend a good amount of my time treating and therefore blogging about injuries associated with Baltimore auto accidents. Typically the mechanisms of these injuries are fairly straight forward (front end impact, rear-end impact, side swipe, T-bone, etc) and the resultant injuries are fairly straight forward (neck pain, back pain, headaches, whiplash, etc.). However, as I eluded to in my previous blog post about injuries to rat intervertebral discs, injured patients do not live in a bubble or vacuum. That is, they are healing from the moments immediately following their injuries up until around a year after their initial injury, whether or not they are still undergoing care. That is, they can be thought of as “pre-weakened” following their initial injuries. In the vast majority of situations the injured patients are able to make complete recoveries given enough time and therapy. However, some of my patients are not so fortunate. I would estimate that approximately 3-5% of my patients that are treating for motor vehicle collision injuries will be injured in a subsequent crash within six months.

For reasons discussed in the previous blog post, this is a bad thing. Patient’s injuries do not “reset to 0”. Instead, the secondary set of traumatic forces will usually injure the patient to a level that was worse than before their first crash. So while I am willing to treat them for their second injury, they are often disheartened to realize that they usually feel worse after their second crash and that their response to therapy after the second injury is usually slower and more painful than after the first crash.

A reality that all treating providers must face especially while treating personal injury patients (auto accidents, slips and falls, worker’s compensation patients) is dealing with apportionment of injuries. That is, the insurance company or responsible third party who is paying for care for the injured claimant wants to know what injuries they are legally responsible for paying for and which injuries pre-dated their legal involvement in the claim.

For instance: Let’s say I have a patient that had a non-faulted crash on January 1, 2015. Their complaints were: headaches, neck pain, mid back pain, and lower back pain (all non-complicated). Presuming this patient had no prior injuries to these body parts, I will draw a conclusion that the crash on January 1 caused their injuries and I will treat them until they resolve or get as well as possible (Maximum medical improvement).  However, lets fast forward two months. Lets assume that their headaches, neck pain, and mid back pain have resolved and they are having lower back pain about 2-3 days per week. Now, they get in ANOTHER non-faulted crash. The insurance company or the responsible third party will want to know the EXACT level of pain that the patient was having prior to the second crash. And rightfully so. Why would they want to pay for care that is not their responsibility?

Most providers need to ask a specific series of questions on EVERY visit to best characterize their patient’s injuries. I want to know all of the subjective levels of pain frequency and severity for each injured area. So for each of the above patient’s complaints: I would want to know the frequency and severity of the patient’s headaches, neck pain, mid back pain, and lower back. I want to know three basic subjective characteristics of each complaints:

• Days per week/month: How many days per week are you experiencing this pain?
• Daily Frequency: On days with pain, what percentage of awake time are you experiencing pain?
  • Constant (76-100% of awake time)
  • Frequent (51-75% of awake time)
  • Intermittent (26-50% of awake time)
  • Occasional (1-25% of awake time)
• Pain Scale: 0-10 level of pain when experienced

By asking these specific questions for each injured body part on each visit, it makes it very easy to apportion injuries in light of new injuries. This has allowed me and my staff to successfully separate and allow for injury claims to settle because our notes are clear and succinct. While I can not speak for other offices that treat the same types of injuries that we do, I suspect that they do not spend the time and attention to their paperwork and their clients that we do.

If you, or someone you know, has been injured in a Baltimore auto accident (or perhaps multiple Baltimore auto accidents) please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz