Why You Need the “Hard” Facts

Soft-tissue injury cases constitute a significant portion of personal injury litigation in the United States today. A majority of soft-tissue injuries occur from rear or side-impact collisions at speeds of 20 MPH or less. Since in many of these cases there is only minimal property damage, it is often assumed that they cannot result in serious, permanent injuries and that anyone who files a claim is attempting to obtain a large settlement for a “minor” injury. Yet despite these widely held perceptions, some victims of low-impact collisions continue to experience a broad range of persistent symptoms most frequently involving the neck, head, shoulders, and lower back for months or even years after the accident.

Unfortunately, many people (i.e. insurance companies and jurors) consider soft-tissue injuries as highly suspect because the extent and severity of the injury is not always obvious and cannot usually be documented by X-rays or other objective diagnostic tests. Successful resolution of soft-tissue injury cases is, to a large extent, dependent upon maximizing medical proof of damages which is often difficult to establish without objective, clear-cut medical proof of a significant injury. So how can you maximize medical proof in soft-tissue injury cases?

To develop an effective strategy in soft-tissue litigation, you first need to understand the complex nature of many of these injuries. That doesn’t necessarily mean that you have to immerse yourself for hours in intricate medical treatises which describe in painstaking detail the biomechanics or pathophysiology of soft-tissue injuries. At a minimum, however, you should be familiar with several authoritative, peer-reviewed journal articles published in the medical literature which describe the many possible underlying causes of the wide range of physical and emotional symptoms associated with soft-tissue injuries. Why should you, as an attorney, bother with even a few medical journal articles? Isn’t this one of the primary reasons why you retain a qualified medical expert? Or you can rely on Morrison Sherwood personal injury law firm on this matter.

Here’s just one compelling argument that you can’t afford to neglect. Most patients who sustain a soft-tissue injury in a low-impact collision are examined initially by an emergency room (ER) physician and are then referred to a family doctor for further follow-up and treatment. The ER physician may be a resident or intern who had only minimal, or worse, no experience in “working up” patients who sustain low-impact soft-tissue injuries. Many times even experienced ER physicians look no further than for obvious clinical signs of injury such as a radiograph showing a definite dislocation or fracture.

Often overlooked during the routine physical exam of a patient who has sustained a soft-tissue injury are less obvious “hidden” causes such as a closed-head injury or temporomandibular joint dysfunction (TMJD) which may account for the patient’s persistent complaints of recurrent headaches, neck pain, jaw pain and visual or auditory disturbances. Unless the initial evaluation was done by a specialist such as a neurologist who is “tuned-in” to screen for the possibility of a closed-head injury or an oral surgeon who is trained to recognize the symptoms of TMJD, the chances of linking the patient’s persistent physical symptoms to a specific underlying cause may be significantly diminished. If your client continues to experience neck, shoulder, head, jaw, or lower back pain despite the lack of any objective medical evidence that may account for these symptoms, you need to take charge and ensure that he/she is evaluated by one or more medical specialists.

Another major area that may be neglected or overlooked in patients with soft-tissue injuries who continue to experience chronic pain is the psychological or emotional component that may be associated with these injuries. People react to chronic pain in different ways. Some are able to cope with pain better than others and can move on with their normal lives. Others, however, may suffer from periods of anxiety or depression, lose their appetite, find it difficult to concentrate at their job, and experience difficulty in sleeping. In such cases, it may be necessary to refer the patient to a neuropsychiatrist or a clinical psychologist who is trained to diagnose the source of the patient’s emotional problems and implement an effective treatment. Remember, it may only be classified medically as a “soft-tissue” injury but that tissue is part of a human being whose psychological well-being may be adversely affected as a result of this negative experience.

One final point is deserving of mention if you litigate a fair number of soft-tissue cases. You need to develop and maintain a positive relationship with the medical professionals who are involved in the management of your client’s case. In preparing these doctors to provide expert testimony, you need to ensure that they are not only familiar with the patient’s case history but also that their expert opinions are supported and substantiated by the medical literature. But don’t expect the doctor to do the research for you.

There are literally thousands of peer-reviewed journal articles published in the medical literature related to soft-tissue injuries resulting from motor vehicle accidents. You need to be aware of the fact that most clinical doctors are office-based physicians who just don’t have the time, resources, or inclination to keep-up with this vase amount of literature. So it’s up to you to prepare your experts by ensuring that the research gets done and then presenting the doctor with the most authoritative, peer-reviewed journal articles to substantiate his/her expert testimony.

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