Missouri Injury Law Blog

If some one causes a car accident that results in an injury, to what extent are they responsible for the injury? What if the injured person sustains further injury through subsequent malpractice by the emergency room doctors? what if they get an infection int he hospital which leads to a much more serious condition than the injury caused in the car accident? Also, what if the person involved in a car accident already had a medical condition which made their injury worse, such a as bad back or recent surgery that had not healed?

Subsequent Injury:

Under Missouri personal injury law, the person that caused the initial injury, also referred to as the original tortfeasor, is legally liable for subsequent injury through negligent medical care. So for example, the original tortfeasor caused a car crash in Missouri, the victim suffered a broken leg and was taken to the hospital where they catch a staph infection or other nasty bug, the original tortfeasor (the negligent driver) is responsible not only for the broken leg but the subsequent infection, regardless if it was caused by medical negligence or not. The only defense to the subsequent infection would be a "failure to mitigate damage defense" basically an accusation that the victim somehow caused the subsequent injury (the infection in this example) themselves or failed to prevent it when they easily could have. So in the infection example, if there is evidence that the victim failed to properly care for their would after being sent home, that could be a defense. But generally subsequent negligence is not a defense and the driver is responsible for injuries, such as infections, that can occur after the car accident.

See Baldwin v. Gaertner, 613 S.W.2d 638, 640 (Mo Banc 1981), stating:

An original tortfeasor may be liable for any additional damages resulting from the negligent treatment of an injury by a physician, but the physician, who has played no part in causing the original injury, will be liable only for the additional harm caused by his or her own negligence in treatment

A case dealing with this issue we currently are handling:

We represent a bike rider that was hit by an O'Reilly AutoParts truck while he was riding on the sidewalk. The bike rider was rehabilitating his knee by bike riding as he had a knee replacement just a few weeks earlier. So when he was hit by the truck his knee was injured much more than if he had a healthy knee. Additionally, while in the hospital repairing his knee injury, he caught a staph infection in his knee which resulted in several weeks spent in the hospital. The truck driver that caused the St Louis bike accident is also responsible for the additional medical treatment from the infection.

Pre-Existing Conditions:

Additionally, many people ask me about a negligent driver's responsibility for a pre-existing condition. Some people feel that if a victim of a car crash already had a pre-existing condition (example, disc herniation and previous back surgery) and the accident makes that condition worse, that the driver should not be responsible because if the victim did not have that pre-existing injury then the accident would not have hurt them as bad. Some people feel that you are responsible for the injury regardless if the victim was more susceptible to injury through a pre-existing condition or not. Under Missouri law they are responsible for the victim regardless if they have a condition that makes them more susceptible to injury than the average person.

Missouri follows the "Eggshell Skull Doctrine" , meaning you take your victim as you find them. The fact they have some condition or pre-existing injury that makes them more susceptible to injury is not a defense. So in the Missouri bike injury case above, the truck driver cannot defend the case by claiming a biker without a recent knee surgery would not have been hurt as badly, additionally, the truck driver cannot claim they are not responsible for the subsequent infection, as it is foreseeable that a hospital admission for a bike injury could result in an infection, even if it is because of medical negligence.

Ben Sansone is an experienced Missouri trial lawyer based in St Louis and handles injury law and accident cases throughout Missouri and Illinois. Call for a FREE CONSULTATION (314) 863-0500 or e-mail us.

Hit and run accidents, or the official term "leaving the scene of an accident", are all too common in my experience, at least as a Missouri car accident lawyer; I see people severely injured and even sometimes killed by hit and run drivers. This is one reason why I keep the maximum amount of uninsured motorist coverage on all my cars, to protect myself and my family. I strongly recommend that everyone have high uninsured motorist policy limits as hit and run a accident are becoming more common. An unidentified driver is an uninsured motorist under Missouri law. See "Uninsured Motorist 'UM' Claims".

Recently, a St Louis county police officer hit another vehicle while off duty but driving a county patrol car; he fled the scene of the car accident. See "St. Louis County Police Officer accused in hit and run wreck". Under Missouri law leaving the scene of an accident is a class A Misdemeanor if the collision only caused less than $1000 in property damage, if the property damage is greater than that or an injury resulted, then a hit and run is a Class D Felony. See Missouri Statute 577.060.1: "Leaving the scene of a motor vehicle accident."

Why do people run from the scene of an accident? Usually it is because they are drunk and do not want to face the penalties of DWI, also they may be unlicensed, have warrants for their arrest, or simply do not have insurance. No matter what the reason, hit and run cases must be dealt with harshly, and jurors have a very strong reaction to drivers whether identified or not, who run from accidents leaving innocent injured victims. Sometimes leaving the scene means no one able to call 911 to get the hurt people help, sometimes this delay in getting 911 help results in death. Especially because most of these hit and run incident happen late at night or on rural roads, so if the victims are knocked out there is no one available to call 911.

According to www.deadlyroads.com a hit and run victims advocacy group, the top reasons for hit and runs are described as follows:

"To break it down, I call some of the most common reasons "DUSA"(Driving in the USA)

D - Driving impaired (drinking, drugs), drowsy, distracted
U - Unlicensed driver or car, suspended or revoked, uninsured
S - Self preservation (status to protect, scared), stolen vehicle, street racing
A - Aggressive driving(road rage), amorality, Age (youthful immaturity)"

This St Louis County police officer probably has experience responding to hit and run accidents and knows the deadly consequences delay in emergency personnel responding can cause. The police are being very quiet about how they are handling this situation, but this officer should be dealt with harshly. Why did he flee the accident? was he drunk? what other reason would he have for not reporting this?

Recent witness reports state:

"I saw him come blowing through a stop sign," .... "You just brace yourself for impact-and then he just stopped. I had to reverse and go around the officer." The witness lived on the same street as the officer and saw him pull into his driveway and then stated, "then we looked down the street and saw the guy and his wife -she's trying to get him out of the seat by the arm-was dragging him and everything." See "New witness comes forward in St. Louis Co. officer hit-and-run case"

I find this outrageous, if the driver was not a cop they would have been immediately arrested and charged with leaving the scene and probably investigated for DWI. So right now, you have a possible drunk cop that left the scene of the accident and an arrest has not even been made. If his physical condition was related to anything else but drugs or alcohol I guarantee you would have already heard a statement from the police that he went to hospital and was treated for a heart attack, seizure, or something that could explain his physical condition; but that is not the case here. St Louis County cops looking after their own and not the citizens they are supposed to serve. The police are still staying silent about the case other than to acknowledge that is occurred.

Related St Louis area hit and run car accident blog posts:

St. Louis Child Dead and Another Injured After Hit-and-Run Accident

Drunk driving accidents are one of the leading causes of needless injury and death in Missouri, Illinois, and across the country. Our St Louis law firm unfortunately sees the carnage caused by this reckless behavior through the injury and wrongful death cases that we handle that often involve drunk drivers.

Sometimes, the drunk drivers got extremely drunk at a bar or restaurant, left that bar and then caused the car crash. So what responsibility should the bar have, assuming you can prove they were over-served? In Missouri and Illinois if the driver was "visibly intoxicated" and the bar continued to serve them, they could be liable for the injuries caused to others on the road. See Missouri Dram Shop Law, proof drunk driver was "Visibly Intoxicated".

Some states still don't have those laws on the books; therefore, the bar can over-serve a driver and throw their hands up to the family of someone killed by a drunk driver and say, "we can't control what they do". Nonsense! They can prevent needless deaths by simply refusing to serve patrons that are visibly intoxicated, or even call a cab for them or encourage them not to drive or turn their keys over if they want another drink.

The fight to impose liability on bar owners is currently going on in Maryland, a state that currently does not have laws on the books holding bar owners responsible. See, Maryland court considers liability of bars in drunken-driving crashes.

I read this article and felt it is necessary to dispose of some myths from the insurance industry that is fighting this law. Int he article the bar owners are claiming: "They say they can't control the actions of someone who leaves their premises. In addition, they say the prospect of being blamed for a customer's drunken-driving crash would raise insurance premiums for them, raise prices for customers and lead some businesses to shut their doors."

True, they cannot control the actions of someone who leaves their premises, but they can control if they are over-served at their bar. No one is trying to hold business owners responsible for a drunk driver that chooses to get ridiculously drunk in the parking lot or somewhere else.

More importantly, the family of the victim or the injured person must prove that the driver was visibly intoxicated and was still served at the bar. This is not easy, but the insurance industry makes it sound like liability is automatic against the bar just of a drunk driving crash happens. Most cases it is difficult to prove the driver was "visibly intoxicated": and then served continuously, it is a very tough burden to prove.

Why is it so hard to prove? Usually no-one knows where the drunk driver came from, then when you find out, and surveillance tape is gone, if it ever existed. Then you have to find witnesses at the bar who can say they remember the driver before they left and that they were visibly intoxicated. Additionally, usually the witnesses were drunk themselves and thus their recall is sketchy at best.

So in the few cases where there are witnesses and clear evidence the bar employees knowingly over-served a drunk person, then let them walk out and drive, and that person causes a car crash; why not hold them responsible? The vast majority of drunk driving injuries, no-one knows where the intoxicated driver got drunk at and it is never an issue because of that.

So to the business owners out there they want to shirk responsibly for knowingly let an inebriated driver leave and drive off and likely kill someone, I say hire a good lawyer because we are coming for you! You would not put a gun in the hand of a drunken patron at 2:00 in morning, so why load that gun for them by over-serving them and get paid for doing it.

It is not difficult, don't serve people that are visibly drunk, if you do, ask a simple question: Do you have your car keys? .... yes .... well, if you want another drink here give them to me and I will give them back to you in the morning or hand them to the cab driver when he picks you up.... Don't want to hand over your keys? I cannot serve you another drink, thank you for coming in. -- Will probably save a life.

St Louis Attorney Ben Sansone is an experienced drunk driving accident lawyer, with millions in verdicts and settlements against drunk drivers and on behalf of injured victims and their families. Hurt by a drunk driver? Relative killed by a drunk driver? Call us today (314) 863-0500 for a free consultation.

Related Articles:

Drunk Driving Deaths in Maryland Heights Missouri - Wrongful Death Lawsuit Filed

St. Louis Child Dead and Another Injured After Hit-and-Run Accident

$2.3 Million Judgment - Missouri Drunk Driving Accident

Concussions or mTBI (Mild Traumatic Brain Injury) are typically not visible on post injury imaging, such as MRIs or CAT Scans. In fact 85% of all head injury cases, from mild to severe, are not visible on an MRI or CAT Scan. This is because the damage to the brain is on a microscopic level. Even though this damage is not visible on scans, the symptoms can be severe, persistent, and even permanent.

As a Missouri injury attorney, I have dealt with hundreds of head injury cases from severe to mild. The serve ones are obvious, their is blunt trauma to the head and brain that causes damage that is visible to the naked eye. But a mTBI is difficult to diagnose objectively as all the symptoms are subjective, that is, reported by the patient and that is the basis of the diagnosis. In almost every instance the auto insurance lawyers immediately play the malingerer card and call the victim a liar, but in nicer words.

This may be changing, as advancements in imaging technology and what the doctors are looking for may lead to objective evidence in even mTBI cases and concussion cases. See, "Brain Imaging After Mild Head Injury/Concussion Can Show Lesions" from the American Academy of Neurology (2013, March 12). Teh researchers stated, "

Advanced imaging showed that -- of those 104 people with imaging evidence of hemorrhage -- 20 percent had microbleed lesions and 33 percent had tube-shaped linear lesions. Microbleeds were distributed throughout the brain whereas linear lesions, which were found mainly in one area, were more likely to be associated with injury to adjacent brain tissue

The investigators hypothesized that the linear lesions seen on MRI may represent a type of vascular injury that is seen in brain tissue studies of people with more severe TBI. "If that theory is confirmed, it may provide an opportunity to develop treatment strategies for people who have suffered a mild TBI," said Parikh.

In addition to better imaging, such as functional MRIs, and better image interpretation, people suffering form concussions will be less likely to be called liars by their insurance companies and recognized as having a real injury. Most people would be surprised to know, that the majority of sports related concussions are diagnosed solely on the complaints of the athlete. Symptoms most commonly reported, headache, dizziness, balance, cloudy thought, sleepy, and memory problems. Also common are black outs and retrograde amnesia.

Concussions and Car Accident:

As a St Louis car accident attorney, I see concussions on a routine basis and know the importance of follow up treatment. Treatment for concussions is generally supportive, meaning they cannot cure it, just treat the symptoms. Treatment of these symptoms is very important as it helps support the claim of concussion and stops the defense from claiming you are not suffering form concussion because if you were you would have sought medical treatment.

Additionally, reporting symptoms to a doctor helps validate your current complaints. Jurors take medical records as authoritative, even though the records simply are a refection your complaints to the doctor and the doctor's affirmation that you made that complaint.

Follow up with your family doctor, a neurologist, and a neuropsychologist to fully evaluate and assess a head injury. If you have been hurt in a car accident or suffered a head injury, call the head injury lawyers at Sansone / Lauber today for a free consultation. (314) 863-0500.

Some good news for injured employees across the state of Missouri happened last week when the Senate passed a bill that would serve to bolster the state's second injury workers' compensation fund by increasing the amount employers must pay into the fund. The fund will now be replenished by having employers temporarily double the fee they must contribute.

The measure passed overwhelmingly, 32-2, and will now move on to the House. Though supporting the fund is great news, as a whole the law was a bit of a mixed bag for workers as it also included a damage cap. Sadly, should this measure go on to pass the House it will mean that some of the most seriously injured workers will not be able to bring high dollar cases against their employers. The measure also hopes to control expenses of the fund by limiting future coverage only to those workers who are permanently and totally disabled. Employees who suffered only partial disabilities would have to be covered only through traditional workers' compensation insurance policies purchased by employers.

The legislation also contains language which will clarify which occupational diseases will now be dealt with through the workers' compensation system. It would also create a benefit for those workers suffering from certain diseases caused by work-related exposures to toxins. The bill would require the Missouri Second Injury Fund to pay more than $150,000 to those workers who suffered from certain diseases while those workers dealing with the horrors of mesothelioma after a career of working with asbestos would get an enhanced benefit totaling nearly $600,000.

The second injury fund exists as a last line of defense for those workers who have been disabled on the job due to serious workplace injuries. A law passed in 2005 by Republican legislators capped the amount of money employers would pay into the fund; something that has meant the fund's resources became stretched, threatening its long-term survival. At the end of 2012, the fund was perilously close to insolvency, with a remaining balance of only $3.2 million and unpaid obligations of more than $28 million.

Currently there are 30,000 cases in a backlog that must be dealt with. Each case represents an injured worker and his or her family that desperately needs the money to survive. Thousands of workers are struggling as they wait to collect the settlements they counted on to help pay bills following serious workplace injuries. Though the new legislation contains several troubling measures, if it works to stabilize the fund and pay out settlements to the thousands of workers in desperate need of them, then it's a small step in the right direction.

As Saint Louis workers' compensation attorneys we routinely see the devastating aftermath of accidents at the workplace and worry about protections for employees being diminished. If you've been the victim of such an accident and need help navigating confusing legal waters, contact our skilled Missouri injury lawyers today.

Source: "Mo. Senate passes bill to reform Second Injury Fund," by Greta Weiderman, published at BizJournals.com/StLouis.

See Our Related Blog Posts:

Major workers' comp/whistleblower bill passes Missouri legislature

Missouri Second Injury Fund Going Broke........

The 7th Amendment to the United States Constitution guarantees an individual's right to a trial by a jury of his or her peers, meaning the people in their community. This right is very clear, yet the politicians in Missouri who always pound their chests about not infringing and the 2nd Amendment (which I absolutely agree with); have no problem trashing the 7th amendment to try to protect negligent doctors and hospitals (really insurance companies) at the expense of innocent victims and the taxpayers. That's right, the tax-payers, because when a victim is severely injured, denied compensation because of malpractice caps and tort "reform" laws, the malpractice insurance company makes more money and the victim is often forced to turn to Medicaid, Medicare or other governmental assistance. For a very clear article about this see St Louis Post Dispatch Article:
"Right to trial protects patients from negligent doctors".

Insurance companies in Missouri have gone on the offensive and are now lobbying Missouri legislators to put liability limits for medical malpractice cases in place after the Missouri Supreme Court struck down the previous cap last year. In the coming months and years you will hear, once again, all the debunked myths about doctors fleeing the state, being forced out of practice, etc... See: Tort Reform Myths

A law passed by state legislators in 2005 capped noneconomic damages in medical malpractice lawsuits at $350,000. The measure was meant to put limits on growth in medical liability lawsuits. Prior to that, the limits were $579,000 (adjusted for inflation) for non-economic damages against each defendant for each negligent act. The state Supreme Court heard a case last year on the 2005 limits and determined that the cap was unconstitutional.

The Supreme Court voted 4-3 to overturn the cap, citing Missouri's Bill of Rights which says that the then existing right to trial by jury shall remain inviolate. Given that at the time the Bill of Rights was enacted in 1820, citizens of Missouri had a right to seek damages for medical malpractice claims, the Supreme Court decided that limits on the amount of damages that would restrict a jury's fact-finding role would violate the constitutional guarantee.

Doctors have aligned with insurance companies to pressure legislators to reinstate the damages cap. They claim that the limit helped the medical community in the state by removing some of the risks associated with hugely inflated med mal verdicts. The cap helped lower medical malpractice insurance premiums and doctors claim that kept more doctors in business in the state, lower costs to consumers in the process.

The proposal before legislators would act as an end-run around the Supreme Court's decision. Lawmakers would eliminate the common-law right to sue over medical malpractice and instead create a statutory right to bring such lawsuits. By abolishing the common-law right to bring such lawsuits, the previous $350,000 cap could be put in place.

Those opposed to such a cap on damages argue vehemently that negligent doctors should not be protected from their own misconduct. Damage caps do nothing to prevent filing frivolous damage claims and only come into play once a jury has decided that a defendant was negligent and that the injured plaintiff suffered real harm. The caps only serve to protect negligent defendants from having to be totally accountable for the damage they caused. See: "Preventable Medical Errors - Leading Cause of Death in the United States"

The fact is that medical mistakes lead to the preventable deaths of 100,000 people each and every year across the country. This horrifyingly high figure places it as one of the leading causes of death in the United States. Those that are responsible for causing such extreme harm should be held responsible for the actions, not have an arbitrary cap put in place protecting them in ways their unsuspecting patients never were.

Medical negligence lawyer Ben Sansone is located in St Louis (Clayton) Missouri and handles medical negligence cases across all of Missouri and Illinois. For a free consultation please call (314) 863-0500 or contact us online.

Source: "Mo. House panel considers medical liability limits," by The Associated Press, published at KAIT8.com.

See Our Related Blog Posts:

Missouri Supreme Court - Medical Malpractice Damage Caps Unconstitutional in
Negligence Actions BUT NOT Wrongful Death Actions

One of the first things I do with new accident client is tell them to either take down their Facebook page or stop posting it as people will say or post private things on Facebook that can seriously effect a an injury claim. The same can go for doctors apparently now too!

A St. Louis, Missouri OB-GYN is in hot water after posting extremely sensitive personal information about a patient on Facebook. The doctor, Amy T. Dunbar, posted revealing information about her patient, including that the woman had suffered a stillborn birth.

Dr. Dunbar raised the ire of many women after going on Facebook to complain about a patient she said was routinely late for appointments. Dunbar posted a comment to her nearly 500 friends asking whether, given her patient's constant tardiness, she should respond by showing up late to her delivery.

The full message said: "So I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasound and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?" Later in the conversation thread the doctor revealed information concerning the patient's stillborn baby.

The conversation was revealed after someone posted a screenshot of the exchange on a Facebook page created for pregnant women at St. John's Mercy Medical Center, a site known as "Mercy Moms To Be." The hospital, located here in St. Louis, released a statement saying that Dunbar has not been fired and that leadership within the hospital would be discussing the matter with Dr. Dunbar. Hospital administrators say that they agree Dunbar's comments were inappropriate and will be reviewing the full statement to decide whether she violated the patient's privacy. The hospital says it will not reveal how it intends to punish Dunbar, but says it will use this as a teaching moment to educate staff about the inherent problems associated with social media, especially in the context of especially thorny medical privacy issues.

The problem of doctors violating patients' privacy by using social media is a growing one that the medical professional is starting to become aware of. A survey conducted in 2009 that was published in JAMA revealed that 60% of medical school deans said there had been incidents of med students posting unprofessional online conduct. Specifically, violations of patient confidentially were reported in 13% of such incidents.

Last year the American Medical Association released guidelines that were meant to guide doctors through appropriate use of social media. The guidance said physicians should be very careful when interacting with patients online and that doctors should follow the same strict rules regarding professionalism whether conversations are taking place online or offline. Medical ethicists are saying doctors should view posting on social networking sites in the same way they view conversations taking place hospital elevators. In either place it is strictly forbidden to discuss private cases in public.

Hospitals are taking note of the problem given that studies have shown that violating patients' privacy through social media sites can do more than result in an ethics investigation. Instead, such breaches are increasingly leading to firings and lawsuits by patients who had their privacy violated.

Medical negligence lawyer Ben Sansone is located in St Louis (Clayton) Missouri and handles medical negligence cases across all of Missouri and Illinois. For a free consultation please call (314) 863-0500 or contact us online.

Source: "Fury sparked as ob-gyn posts personal patient info on Facebook," by Lee Moran, published at NYDailyNews.com.

See Our Related Blog Posts:

Defective Defibrillator Sparks Fear Among Missouri Heart Patients

Fear of Lasting Damage from Concussions Sparks Debate over Youth Sports

Hybrid and electronic cars' relation to pedestrian and/or cycling injuries

Hybrids and electronic vehicles may not be the biggest thing in automobiles right now but they are slowly getting some steam in as far as popularity is concerned. Today, more and more celebrities are purchasing and have been going around these politically-correct statements on wheels. These celebrities are showing their own way of taking care of the environment by going around town these green machines. However, despite the many benefits that these technological wonders offer, they are being tagged as one of the major causes of pedestrian accidents involving people with disabilities

What make hybrids and electric car more dangerous for pedestrians and cyclists?

Hybrids don't rely much on the internal combustion engines to propel it in short-distance city travels or cruising. In fact, you will never (or will have a really hard time to) know if a hybrid car is near you until somebody tells you, or you get struck by it. This gets worse when you are dealing with an electronic car. Since it doesn't have an engine that burns fuel, it barely emits a sound. Because of this, blind people or those with hearing problems wouldn't really be able to do something to detect the presence of a hybrid or electric vehicles.

Blind people or people with hearing impairments have been getting involved in accidents with hybrid or electronic cars. Though the number of injuries won't really cause panic over people and various organizations, one has to acknowledge the fact that these cases should be looked into by the government, and that something should really be done to make these vehicles safer, especially to pedestrians and cyclists.

How can hybrids and electric cars be made safer for pedestrians and cyclists?

After a careful assessment of the data it has gathered, the Department of Transportation's National Highway Traffic Safety Administration (NHTSA) came up with the conclusion that hybrids and electrics should emit a sound to alert and help give a warning to motorists that a hybrid or an electric vehicle is fast approaching. This way, pedestrians and motorists alike will be more aware about the presence of such vehicles, making them ready to take the needed precautions avoiding accidents.

The sounds, as the NHTSA requires, car makers to come up with sounds that are detectable under a range of street noise and ambient background sound, when the vehicle is traveling under 18 miles per hour. If the vehicle travels at 18 miles per hour and up, the vehicle will be making sufficient noise so that pedestrians and bicyclists the vehicle must emit sounds that are enough so drivers can notice and avoid these vehicles. An automaker will then be given a range of choices for the sounds that it can choose the vehicles they will produce. The sound should have certain characteristics that meet the minimum requirements. Finally, a vehicle with the same make and model needs to emit the same sound or set of sounds.

The NHTSA's proposal

The NHTSA has already sent the proposal to the Federal Register, for finalization. After that, this measure will then be publicized where the public will be given 60 days to comment on the action by the agency. If there wouldn't be any more problems, this measure will then be implemented to upcoming models that are going to be tested by the NHTSA. These vehicles will then be required by the agency to be equipped with the above mentioned safety system. With this new measure in place, the agency estimates that there would be around 2,800 lesser pedestrian and cyclist injuries.

Soon people with disabilities, bicyclists, and the general public will reap the benefits of this newest move by the NHTSA. This way, you won't need the assistance of a car accident lawyer to help you seek for damages since you won't get into an accident anyway because you'd be able to avoid it now.

ABOUT THE AUTHOR:

Anne Roberts is a web content writer for the Mesriani Law Group, a professional law corporation with its main office in Los Angeles, California and satellite offices in nearby counties in Southern California. She excels in writing blog posts, how-to's, and other related web copies.

There are many reasons why it is important to have a lawyer when dealing with a car accident injury claim or lawsuit. The many reasons are discussed here. Additionally, you need a lawyer to navigate through the many liens or claims that may be asserted by companies against your settlement or judgment money. The following are common claims by 3rd parties wanting money from your settlement:

1. Hospital and Doctor Bills not Submitted through Health Insurance
2. Health Insurance Companies wanting to be paid back
3. Medical Payments Coverage from an Auto Insurance Policy
4. Medicare or Medicaid
5. Workers' Compensation Liens

1. Hospital and Doctor Bills not Submitted through Health Insurance:

If a hospital or doctor refused to submit their bill through your health insurance there is probably a "claimed lien" on your recovery by the hospital or doctor wanting to be paid back in full for their bill. We advise all of our clients to demand the hospital or doctor submit the bills through their health insurance coverage and to go to a different provider if they refuse to do so. Hospitals do this because they want a higher reimbursement rate at the expense of your settlement share. So you must insist that bills are submitted through health insurance and do not agree or sign anything to the contrary. However, if you do not have health insurance you have no choice but to be treated with a lien against your recovery or pay out of pocket costs.

In both Missouri and Illinois there are limits to the amount of the lien the healthcare provider can claim. For a discussion on the Missouri law see, "Can Your Health Insurer Demand Payback for Medical Expenses?"

In Illinois the law is called the "Healthcare Services Lien Act" as essentially states that the total amount of liens from doctors and hospitals cannot eat up more than 40% of your recovery, after attorney fees and costs. EXAMPLE: Case settles for $100,000 but you have medical liens for $50,000. After attorney fees of 1/3 and costs of a few thousand dollars, let's say your recovery is $65,000. the most the healthcare providers can take as part of their lien (assuming they have a valid lien in the first place) is 40% of the $65,000, or $26,000, leaving you with $49,000 in this hypothetical.

The above numbers are assuming a valid lien has been made and the bills are reasonable and necessary. There are many other ways to deal with the liens, however, under Illinois law the above is the maximum amount they can take. Experienced car accident lawyers know how to get the liens often reduced even more through other means. Another example on why having a lawyer maximizes your recovery after a car accident.

2. Health Insurance Companies wanting to be paid back:

Your health insurance paid for all your treatment, so you have to pay them back from your settlement? That depends, do you have coverage through work? if so it is likely an ERISA protected plan. See "Dealing with ERISA Liens When Settling Personal Injury Cases". For ERISA plan treatment in Illinois injury cases see: "Illinois ERISA Plan's Right of Recovery from Your Personal Injury Settlement".

If you have individual coverage, then in Missouri they cannot take any of your settlement money. It would be called "subrogation", and in Missouri that is not enforceable in car accident cases.

In Illinois, however, subrogation by a health insurance company is allowed. Their amount recoverable from your settlement is reduced by the proportionate share of attorney fees. Therefore, if the subrogation claim is for $10,000 and your paid 25% in attorney fees, the subrogation claim is also reduced by 25%, this is referred to as the "Common Fund Doctrine". Additionally, if you are held partially at fault for the accident, lets say 25% at fault, then the subrogation amount is also reduced by that amount as well.

3. Medical Payments Coverage from an Auto Insurance Policy:

Sometimes you may have "Med Pay" coverage under your auto policy which will pay for some of your medical bills, regardless if the accident was your fault or another driver's fault. Just like subrogation with individual health insurance discussed above, in Missouri the med pay insurance company has no right to med pay reimbursement, but in Illinois they do.

4. Medicare or Medicaid:

If you are a Medicare or Medicaid beneficiary and they paid for medical treatment related to a car accident, then the government has a "super-lien" against your recovery. A super-lien is an automatic lien, they do not have to notify you, your attorney, or the insurance company. Therefore, if the insurance company settles and writes you a settlement check without making sure there is not a Medicare or Medicaid lien on the case then they are responsible for the lien amount. Most auto insurance companies will not write any injury settlement check until we get written confirmation from both Medicare and Medicaid that there is not a potential lien on the recovery.

Again, a very critical reason to have a good injury lawyer handle your car accident case. For more details on Medicare and Medicaid liens see: "Medicare recovery against Personal Injury Awards".

5. Workers' Compensation Lien:

If you were hurt in a car accident while on the job then you probably had a work comp claim and a 3rd party claim against the at fault driver. The workers' compensation coverage will pay out faster, cover medical bills, and a percentage of lost wages. These work comp payments are typically made early on and help avoid financial distress.

When the case against the at-fault driver is resolved, you have to pay back the work comp insurer for benefits paid. In the long run the victim still come out ahead and the payment is reduced by what is known as the " The Ruediger Formula" because the lien reduction formula was laid out in the case of Ruediger v. Kallmeyer Brothers Services, 501 SW2d 56 (Mo. 1973).

The Ruediger Formula applied with an example of $300,000 settlements and $90,000 in work comp benefits paid.

So $90,000 / $300,000 equals a ratio of 0.3 meaning that the work comp insurer can recover up to 30% of your recovery AFTER deduction for attorney fees and costs.

So if the 3rd party case attorney fees and costs totaled $110,000 then the work comp carrier and recover up to 0.3 of $290,000, or $87,000.00

Preventable Medical Errors are one of the leading causes of death in the United States. Medical malpractice lawyers have been sounding this alarm for years and been fighting this safety risk through the civil justice system. The fact that medical errors are so rampant has not been claimed by just injury lawyers, but also by the Institute of Medicine, which is the health division of the National Academy of Sciences. The Institute of Medicine has found that since 1999, "Preventable Medical Errors" are a leading cause of death in America, more people die from "preventable medical errors" than from breast cancer, traffic accidents, and AIDs, all combined. See: Missouri University School of Medicine Article:

"More than a decade ago, an Institute of Medicine study revealed that preventable medical errors were a leading cause of death, accounting for more fatalities than breast cancer, traffic accidents or AIDS in the United States. Today, the problem of medical errors remains and might even have escalated."

One of the most common preventable medical errors are patient falls in hospitals, typically due to inadequate fall risk assessment and fall prevention practices. Additionally, many surgical mistakes and emergency room mistakes and injuries are the result of bad communication and teamwork between the doctors, nurses, and other staff present in the operating room.

As a St Louis medical malpractice attorney, I hear stories almost daily from clients and patients about negligent care in the hospital. Admittedly, some people are just upset about bad bedside manner and not actual negligence, however, many people have been neglected and errors routinely occur. Many times the errors are from the doctors or nurses simply choosing not to pay close enough attention to what they are doing, or rushing through their jobs at the expense of patient safety.

Another typical cause of preventable mistakes, are doctors doing surgeries they have not been adequately trained to do or simply do not have the pedigree to perform. Such as lap-choli malpractice cases, unqualified surgeons get away with substandard surgical techniques for a while, but as soon as a minor complication comes along, such as atypical but known anatomy differences, they end up cutting the wrong duct or artery and cause real harm or even death.

To help curb preventable errors, some medical schools are finally putting a heavy focus on Quality and Safety through actual safety curriculum and classes that address the underlying issues for medical errors and help teach the techniques to prevent these medical errors.

"Our findings from this study and others indicate that every academic health system should have a critical mass of physicians who can perform and teach others about how to improve quality and safety," said Headrick, who leads the Association of American Medical Colleges' Teaching for Quality initiative. "Ultimately, our efforts should focus on ensuring that physicians become proficient in quality improvement to advance on their career paths."

Unfortunately, contrary to many new sources, the vast majority of medical malpractice cases that go to trial are lost because the jurors feel sympathy towards a doctor or make the decision based on political arguments often heard, such as, rising insurance rates, running doctors out of the state, etc .. all of which are untrue. See Medical Malpractice Myth Debunked by Harvard. Healthcare providers are no different than other people, some are good, some are bad, some chose to cut corners, some have days where they don't pay attention and days when they do very well. Just like many people driving cars on the road do not mean to get into accidents or hurt anyone, yet juries hold them responsible because they chose to text while driving, they chose to try to beat the light, or other things that lead to car crashes. The defense of "known complication" does not work because we all know it is a "known complication" of driving that we could be involved in an accident, just because it is a known risk should not let a negligent driver (or healthcare provider) off the hook. The civil justice system and holding healthcare providers accountable for their mistakes will force them to do better and reduce the number of errors, thus improving patient safety for everyone.

Oxygen Breaths New Life into Neurons!

Traumatic brain injury suffered as the result of a car accident can have devastating effects on the brain. For many brain injuries there is no available treatment for the genesis of the injury itself, just treatment of the symptoms. Just like the common cold, medical science does not have a cure, only treatment of the symptoms through medication.

Head injuries effect the neurons in the brain, sometimes the neurons are affected by metabolic dysfunction, meaning they have the energy to stay alive but not enough energy to function by generating the electric signals that the brain uses to work. Neurologists know that the brain uses about 20% of the bodies oxygen, however this is not enough oxygen to support all neurons at one time, only about 10% of the brains neurons are working at any one time. Brain cell regeneration requires much more oxygen to stimulate the healing of a brain injury. Therefore, HBOT (Hyperbaric Oxygen Therapy) forces more oxygen into the brain by ten times the normal amount which assists in brain cell regeneration and giving the brain cells energy to fire off electric signals needed for normal brain function.

"Analysis of brain imaging showed significantly increased neuronal activity after a two-month period of HBOT treatment compared to control periods of non-treatment, reported Dr. Efrati in PLoS ONE. Patients experienced improvements such as a reversal of paralysis, increased sensation, and renewed use of language. These changes can make a world of difference in daily life, helping patients recover their independence and complete tasks such as bathing, cooking, climbing stairs, or reading a book." Oxygen chamber can boost brain repair years after stroke or trauma from American Friends of Tel Aviv University, January 23, 2013.

For many years the only healing of brain injuries was time. Medical science could offer treatment of the symptoms but not the underlying physical injury to the brain cells. Oxygen therapy is very exciting for traumatic brain injury victims as it appears to jump-start the healing process, even many years after the original head injury.

May of our clients who have suffered brain injuries form car accidents suffer symptoms for more than a year, and typically, if a head injury symptom last more than one year it is probably permanent and not going to be healed by time. In the past the headaches, dizziness, and other long term symptoms of post-concussion syndrome have only been treatable through prescriptions which do not heal the injury itself. HBOT oxygen therapy is new and probably a few years off from availability to most traumatic brain injury victims. Like all new medical treatment and technology, it will eventually become more available and hopefully help some victims of head injury.

Brain injury law is a very specialized area that requires an injury attorney to have a good understanding of the ins and outs of traumatic brain injuries and the long term effects of these injuries on their clients. It is important for a lawyer to know how to explain to a jury through doctors and medical literature the effects of these injuries. It is so important in these cases because most people with brain injuries "look normal". A jury will see you during trial for several days or even weeks, you will "look normal" to them and they may think, "he looks fine, he can't be hurt that bad." Proving a broken bone is court is easy, the x-ray shows it; but brain injuries usually do not have evidence that can be seen on a x-ray, MRI, or CT image.

Hurt in a accident and need a brain injury lawyer? Call us today at (314) 863-0500 or contact us online to set up a free consultation at our office or a location more convenient for you. Also see our client reviews - 5 of 5 stars!

Many of us have heard of someone that walks away from a severe car crash without a scratch, and as a car accident attorney, I also know many people that are in accidents that are not so severe yet end up with persistent pain and significant injuries.

Why is it that some people are hurt worse than others in similar impacts? That is a complex question with many answers. Much of it has to do with the mechanics of the impact, angle, speed, weight of the cars, height of the different cars, shock absorption of the car's frame, etc. Additionally, some people are more susceptible to injury than others. In my experience when someone under the age of 18 is involved in a car wreck, the vast majority of the time they suffer little in the way of injury and recovery very quickly. however, their parent or an older adult in the same car suffers significant injury, such as a slipped disc in their neck or back.

There are many factors that determine the amount of injury suffered from a car crash, but a new study shows one factor may be hereditary. "[P]ain after an MVC is not solely due to tissue damage at the time of trauma, but rather may also be strongly influenced by physiologic systems involved in the body's response to the collision. These physiologic systems influence the function of nerve cells that process pain in the brain, spinal cord and body tissues." Is immediate and long-term pain after a motor vehicle collision hereditary? from the Journal of the American Society of Anesthesiologists (ASA), October 16, 2012.

The study involved more than 900 patients and included data about the severity of pain complained of at the emergency room, pain reported six weeks after the car collision, and based on the blood work taken from each patient. The study focused on dopamine receptors in the brain, particularly dopamine receptor 2 which has been shown to play a very important role in the transmission of pain. "The findings suggest dopamine pathways involving the dopamine receptor 2 contribute to the intensity of pain experienced immediately after an MVC,"

The study has identified genetic factors that put some individuals at a higher risk for persistent pain after a car accident and has concluded that persistent pain after a car crash has a biological basis.

Legal Analysis:

What does this mean to your car accident case? It can help explain why some individuals experience more pain than others from injuries. The defense in injury cases is sometimes the "malingering defense", basically that the victim is faking their injury or pain just to get money. Defense lawyers sometimes try to argue that the accident was minor so it is unlikely the pain is real. There are many ways to deal with these bogus defenses, but now genetic evidence of experiencing more pain than others may be one of them in the coming years.

As genetic testing becomes more prevalent maybe this test will be done by primary care doctors or specialist that treat clients for injuries after a car accident. I can imagine that eventually pain management specialists will have access to this genetic testing and use it to help determine why the patient is experiencing the level of pain that they are, in conjunction with their actual physical injury as well.

On personal note, I have high cholesterol and have been on medication to control it for years. Recently, at my annual physical, my doctor offered me "cardio genetic testing", I was amazed to find out they can now isolate the genes that affect cardiac disease factors and then tailor more specific treatment of my high cholesterol. I have not gotten to results yet, however, it may point my doctor and I in a diffident direction for medication and other treatment.

With genetic science becoming more and more available and affordable, I can foresee genetic testing becoming an issue in some injury cases in the future. Most likely testing to support doctor opinions about the injury, how it was caused, and the likely continuing effects of that injury on the victim.

Continue reading "Pain From a Car Accident is More Severe Based on Genetic Factors " »

This is a guest author post that has been reviewed by our staff and approved since it is relevant and beneficial to safe bicycling. As a law office that handles many bike accident injury cases in Missouri and Illinois, we see bike safety as a very important issue. The guest post begins below:

People ride bicycle for many reasons, some use it for travel, some for sports, some for hobby, and there are even some who utilize this amazing two-wheel drive for business. Bicycles existence have lasted for centuries, but its popularity never ceased. It can be primarily due to its usefulness and practicality that sometimes cannot be equaled by other modern vehicles. Moreover, its basic and simple design compared to other transportation mean, has never been a hindrance for bicycles to thrive and stay as they are no matter how plenty of innovations in vehicles have evolved.

Riding bicycles come with plenty of advantages; it does not let out polluting smoke that place the environment in danger, it saves the economy from fuel dependence, it is a cost-efficient drive that can make the biker save transportation budget, and lastly, it benefits the health.

Nowadays, many Americans are supporting creation of communities that promote safety for people who choose to walk or ride their bikes. However, like any other vehicle, bicycles are also subject to laws--laws which are created to protect the pedestrians' interest as well as to let bikers be responsible in their riding. The way bicyclist manipulate their bikes, may it be motorized or not, can make a big difference in the way they ensure the safety of people around a town.

For self-help reasons, below are simplified explanation of "Missouri State Statutes Regarding Bicyclists" so that bikers can follow the law for a responsible and safe bicycling.

• Every person who will ride a bicycle will be given all the right to use the road. The granting of the rights allow bicyclists to be subject to the duties applicable to other vehicle drivers. (307.188)
• Rider of bicycles and motorized bicycles are required to ride at the right side of the roadway to practice safe distance from other motorists. Squeezing past other vehicles is relatively unsafe, no matter what kind of vehicle have you tried to pass with. (307.190)
• Riding a bike in sidewalks within a business district is not allowed. (300.347)
• When a biker is riding on a sidewalk, he or she must yield the right of way to the pedestrian. When overtaking or passing a pedestrian, the biker must give an audible signal before doing so. (300.347)
• Riding a bicycle in the sidewalk while it is attached to another vehicle is prohibited. (300.347)
• Every bicycle or motorized bicycle must be equipped with brake or brakes in working order that will allow the rider to stop the bike within a safe distance of twenty-five feet at a speed of 10 miles/hour on a dry, level, and clean pavement. (307.183)
• Bicyclist who are using the roadways ½ hour before both sunset and sunrise should be equipped with lights and reflectors. This include, front lights, a rear-facing red reflector or a rear-facing red lamp, and night-vision reflective gears that can be incorporated in the riders shoes, lower leg, or crank arms. (307.185). This will ensure that the rider will remain visible under normal night riding condition.

Any person with the age of 17 years or older can receive lawful punishment from violating the Missouri statutes for biking laws. The offender may pay for a fine of five dollars or more than twenty-five dollars upon conviction. If a person under the age of 17 will violate the mandated biking laws, traffic officers may impound the bicycle/motorized bicycle for a period of no longer than five days upon issuance of the violation receipt to the minor riding the bike or to the owner.

About The Author

Jafrum International is one of the fastest growing biking apparels and motorcycle gears outlet in the US would offer quality gears for riders to be used for competitions. Racing and bicycling requires a lot of security and determination. If a racer or a biker wants to avoid injuries, the best way to do is wear safer gears to secure protection. Ride safe!

Anyone I have represented in a bicycle or motorcycle accident has significantly less injury if they were wearing a helmet. Most states require helmet use, however, some so not require it at all or only on certain age groups. See map regarding the current state of the law. In Missouri helmet use is mandatory; however, in two of its neighboring states, Iowa and Illinois, there is no helmet law in effect.

A recent study has found that education on the severity of brain injuries from post-concussion syndrome to "TBI" Traumatic Brain Injury increases bike helmet use. After many years as a bicycle accident lawyer I have seen first-hand the increased injury to a cyclists head and brain when helmet is not worn. Many people do not understand the severity and life altering effects of a brain injury; once they do, wearing a helmet is an obvious choice.

The study was conducted on children ages 5 to 18, the researchers provided bicycle helmet safety and brain injury prevention information to over 100 children patients; helmet usage went up 72.5% in the children. A local St Louis City Charity, Helmets First, advocates helmet use by children and education on the effects of head injuries. See Helmet Hustle - St Louis Bike Safety for Children All parents must provide some safety education to their children at a young age to instill helmet use. Our law firm supports the helmet hustle every year as the safety of our children is of the utmost importance. Many kids grow up in families that simply just do not understand the debilitating effects of head injuries, injuries that can occur even in low speed bike accidents and not involving a car.

Helmet education is so important as the "CDC" Centers for Disease Control, report that about 25% of children ages 5-15 wear a helmet when riding a bike, and the teenage helmet rate is near zero. As a result, about 153,000 children are treated in emergency rooms each year for head injuries suffered from bicycle accidents. If the increase in helmet use reported by the researchers is true, than the above number of children admitted to emergency rooms with significant brain injuries every year should be drastically reduced.

Experts say that helmet use reduces the risk of a brain injury by 88%. Part of the education to encourage helmet use is a great analogy of the brain and head to an egg, which is explained as follows:

The egg is the head;
The egg shell is the skull;
The egg white is the fluid surrounding your brain;
The egg yolk is your brain;
Drop and unprotected egg - that is what a brain injury is like.

Additionally, the researchers used a gelatin brain mold to show children just how soft and pliable the brain really is. Many people think the skull is thick and very protective of the brain underneath, however, brain injuries can occur in low speed accidents. In fact, brain injuries are even known to occur through centrifugal force, such as in car accidents that create a whiplash motion and injury. The flying back and forth of the brain inside the skull not only causes impact with the inside of the skull, but can also cause neuronal shearing from the force of motion created. See Concussion Lawsuits Bring Head Injury Awareness Mainstream.

Continue reading "Brain Injury Education Increases Bike Helmet Use by 72.5% " »

One of the first concerns after a car accident is deciding whether or not to go to the hospital or a doctor right away. Usually, the responding police will ask if you are injured or need medical treatment, if you are hurt tell them, even if you do not want to go to the emergency room right away. My advice, as an experienced car accident lawyer, is to get medical treatment sooner rather than later.

Should I go straight to the ER from the scene of the accident?

Obviously, if you have severe injuries you should go to the emergency room by ambulance as soon as possible. Maybe you do not want to go to the emergency room straight from the scene of the accident, usually that is ok. Many people do not go to the ER by ambulance right away because they want to make sure their car is taken care of by being towed away properly or they drive it home and then decide later or the next day if they need to go to the ER or a doctor.

Make a Doctor Appointment As Soon as Possible:

Regardless if you go to the emergency room or not, make an appointment with a family doctor after the accident or for an emergency room follow up. Most emergency room doctors will advise you to do this. If you do not have a family doctor to go see, call us, we will send you to a doctor that will take care of you either through your health insurance or agree to get paid after the case settles.

I Do Not Have Health Insurance, What Should I Do?

Go to the doctor! If you have been hurt in a car accident you must get medical treatment or risk permanent damage to your health. If you do not have health insurance we have doctors that will agree to treat you without health insurance. We have a network of Missouri doctors that trust us when we send them clients and assure them they will eventually get paid from a car accident settlement. Additionally, many of these doctors will agree that if you lose your case (which we never have!) that you then do not have to pay the medical bill.

How Long Should I go to the Doctor, Physical Therapy, Etc ... ?

For the sake of your physical and mental well-being you should go until you reach "MMI" - Maximum Medical Improvement. MMI is the point where you are 100% better or as close to 100% as you are expected to get. Not only is this crucial for your recovery, but if you settle your case and then realize several months later your injury is worse than you thought, you can't reopen the case. Therefore, it is very important that your injuries have completely resolved or reached MMI before settling a case.

I Missed an Appointment, is that OK?

Missing appointments on rare occasions is to be expected with today's busy lifestyles; however, do not make a habit out of it. Multiple missed appointments can look bad, auto insurance companies and their lawyers will argue that you were not very hurt, especially since you did not make it a priority to get better when you missed several appointments.

What Should I tell the Doctor or other Healthcare Provider When I see Them?
Tell them about everything that is bothering you. Just today I met with a new client that was hurt when her car was t-boned at an intersection. She told me she has had bad headaches since the accident and has been taking aspirin for relief. I asked her if her doctor recommended anything and she advised me she did not tell her doctor, because she knew aspirin or Tylenol was really the only thing you could do.

Do not do this! Tell the doctor everything that is bothering you from the car accident, even if you do not think the doctor cannot do anything about it. Take the headache example from above, imaging that if 6 months after the accident the persistent headaches are still there, you then tell the doctor, and then lets say he diagnoses you with post -concussion syndrome. When we make the head injury claim to the insurance company or a jury, the defense can argue that the victim said nothing about the headaches to any doctors for 6 months after the accident, therefore, the claim of headaches is vulnerable to a credibility attack. They will then argue that something else later on caused the headaches and that they were not caused by the car accident because they were not disclosed to the doctor.

If you are hurt in a car accident the most important things to do are:

1. Call the police;
2. Seek medical treatment;
3. Call a car accident lawyer.