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MILD TRAUMATIC BRAIN INJURIES – A SILENT EPIDEMIC

We hear more about brain injuries than ever before.  After his tour bus was struck by a Walmart tractor-trailer in 2014, actor and comedian Tracy Morgan underwent daily speech, cognitive, occupational and physical therapy for his traumatic brain injury.  In an interview a year later, Morgan said, “I have my good days and my bad […]

We hear more about brain injuries than ever before.  After his tour bus was struck by a Walmart tractor-trailer in 2014, actor and comedian Tracy Morgan underwent daily speech, cognitive, occupational and physical therapy for his traumatic brain injury.  In an interview a year later, Morgan said, “I have my good days and my bad days, or I forget things,” as he also described recurring headaches.  And in sports, with the beginning of the 2013-14 NFL season, an independent neurological consultant stays on the sideline of each team for every game as part of the NFL’s concussion protocol.

About 85% of the time, symptoms from a concussion or minor head trauma (other names for mild TBI) resolve within a short time.  More than 50% of these cases result from falls or motor vehicle crashes.  Unfortunately, about 15% of those injured have more persistent effects, some permanent.

More Common Effects of Mild Traumatic Brain Injury

Mild TBI has been referred to as a “silent epidemic” because the signs and symptoms are often subtle.  Someone feels fine a few weeks after an accident, only to find out from a loved one, co-worker or friend that all is not the same.  Many people experience the most common signs of mild TBI, including nausea, persistent headaches, double vision, or dizziness.  Problems with concentration and recurrent headaches are common and are viewed by some as the brain “working overtime” to heal completely.

Within months, many generally feel better, but upon returning to the workplace or to school, some are overwhelmed.  Unable to remember the name of a co-worker or a simple chemical formula, they have problems with basic cognitive skills.  It becomes challenging to learn new material, to concentrate or to pay attention.  The injured person has a low threshold for confusion and thinks more slowly.  When using a computer screen, headaches return, often accompanied by problems with double vision or blurriness.  Complaints of disbelief range from, “I’ve forgotten my bank account PIN number,” to “I can no longer parallel park.”

Psychological Disruption

Not expecting what may have been a relatively mild car crash to cause long-term issues, the mild TBI patient often minimizes the deficits or tries to compensate.   In leaving notes all over the house or carrying an index card with the names of co-workers, there is an effort to both dismiss and to compensate.  If recall and concentration abilities continue to fail, then frustration and depression can set in.  The TBI patient feels socially isolated, not wanting the “secret” to be disclosed.  However, the deficits are often apparent to others, and they may encourage the injured to seek further medical evaluation and care.

The Clinical Setting

Because mild TBI can be difficult to identify objectively, medical providers look at the entire clinical picture, including the severity of the original blow to the head, whether there was a loss of consciousness, how the patient scores on basic tests of recalling numbers and words, and, upon reviewing test results, whether more subtle neuro-psychological symptoms emerge.  Vision disturbances, including subtle but rapid movement of the eyeball, may provide clues.  Even more recent developments in MRI imaging of the white matter of the brain can help the radiologist determine whether the axons (the connectors between the brain cells) have been torn.

Treatment and Support

When all of these tests, evaluations, and scans are considered together by a treatment team, then truly effective treatment can begin.  Eyeglasses with subtle prisms can help restore peripheral vision and re-train the brain to see.  Social workers, psychologists and concussion specialists are more in tune with the cognitive and emotional effects.  A mild TBI patient’s sense of mental wellness can be improved with acceptance and rehabilitation of the brain through mental and visual exercises.  Targeted medication can alleviate mood impairment.  Family, co-workers and friends can be educated to understand that a person with TBI may be irritable, experience mood swings or may simply zone out, but these are not intentional, and over time they can be better controlled.

Summary

The impact of a traumatic brain injury may not become apparent until long after the cuts and bruises have healed following an accident and blow to the head.  The feelings of isolation, depression, and frustration can only be lessened through an inter-disciplinary approach with the patient, the family, and health care professionals.   

While this collective effort can never lessen the blow to the head, it can make the

“new normal” easier to bear for the patient, as well as the injured’s friends, co-workers, and family.

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Self-Driving Vehicles

The Good, the Bad, and the Inevitable As personal injury lawyers, we see the devastating impact of auto accidents upon individuals’ lives each day.  The arrival of self-driving technology brings with it the promise of safer roadways and fewer accidents, but it also presents challenges to numerous U.S. industries — including auto insurance, commercial transport, […]

The Good, the Bad, and the Inevitable

As personal injury lawyers, we see the devastating impact of auto accidents upon individuals’ lives each day.  The arrival of self-driving technology brings with it the promise of safer roadways and fewer accidents, but it also presents challenges to numerous U.S. industries — including auto insurance, commercial transport, and personal injury litigation.  So, besides safety, what other benefits do self-driving cars offer?  How badly will they affect jobs in the United States?  And when will they actually be here to use?  This article aims to answer those frequently asked questions.

What is the Benefit of Self-Driving Technology?

With the world seeming to progress at lightning speed in technological advancement, it bears asking – is this new technology helpful, or are we creating merely to create?  While self-driving technology presents challenges, the benefits it offers to society are undeniable.

Safety

There are about 30,000 fatal accidents in the United States every year.  When one considers alcohol, texting, or road rage, it is no surprise that 95% of fatal accidents are the result of human error.  Experts predict that self-driving vehicles will nearly eliminate those fatalities and dramatically reduce the number of non-fatal accidents.

Inclusive Transportation

With self-driving comes ride-sharing.  Gone will be the days of individual vehicle ownership.  Instead, consumers will summon a self-driving car whenever needed – much like Uber and Lyft, except no humans required.  Widespread ride-sharing will allow seniors to retain independence and provide accessible transportation for the disabled and other individuals who could not otherwise drive (including your kids who need to get to soccer practice while you are stuck at work).

Productivity

Ask any regular train commuter, and she will tell you why she prefers public transit to driving — “I can get work done.”  Self-driving cars will allow individuals to use their full commute time to finish a presentation, respond to emails, or simply fit in a much-needed power nap.  Added benefit: decreased stress and less road rage.

Will Self-Driving Cars Take Away Jobs?

Automated technology poses a threat to human jobs, and self-driving cars are no exception.  Some of the more obvious jobs threatened by self-driving technology include truck drivers, taxi drivers, bus drivers, and body shop mechanics.  Perhaps not so obvious, however, is the impact self-driving technology will have on other commercial industries, including auto insurance and personal injury litigation.  Those professions depend on the existence of auto accidents and resulting injuries.  As the motor vehicle accident rate approaches 0%, and fewer individuals own their own vehicle, consumers will find it difficult to justify spending hundreds of dollars per year on auto insurance premiums.  Indeed, some experts predict that the entire model of auto insurance will soon become archaic.

When Will Self-Driving Cars Become Universal?

The short answer: sooner than you think.  The long answer requires understanding each self-driving technology “phase,” of which there are four.  Phase 1 of self-driving technology refers to “passive autonomy, ” and it already exists throughout the consumer market.  Examples include blind spot warnings, automatic wipers, backup warnings, and driver-initiated cruise control.  Phase 2 refers to “limited driving substitution.”  Examples include assistive parallel parking and self-braking.  Many Phase 2 features have already become standard in today’s vehicles.

Phase 3 refers to “complete autonomous capability” – meaning the vehicle can completely drive itself, but a human must sit behind the steering wheel to intervene if necessary.  While Phase 3 vehicles have yet to reach the mass consumer market, several technology companies, including Google and Uber, have developed and are currently operating Phase 3 vehicles throughout the country.  Finally, Phase 4 refers to “100% autonomous penetration.”  Phase 4 requires no human interaction and is fully sensor driven.  Phase 4 vehicles will have no steering wheel, pedals, or mirrors.  All of the driving will be controlled by a computer, utilizing a combination of sensors, the internet, and GPS technology.  Many experts predict that Phase 3 vehicles will become fairly universal within the next 10-15 years, with Phase 4 autonomy following soon after that.  Of course, that timing depends on legislative regulation and consumer acceptance.

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Legal for Less

An Insurance Tragedy Not one person injured in a car accident wake up that morning thinking, “I bet today is the day a careless driver will put me in the hospital.”  But have you ever seen how many drivers are texting while driving on Route 22?  And have you noticed that there are more trucks?  […]

An Insurance Tragedy

Not one person injured in a car accident wake up that morning thinking, “I bet today is the day a careless driver will put me in the hospital.”  But have you ever seen how many drivers are texting while driving on Route 22?  And have you noticed that there are more trucks?  The number of tractor-trailers in the Lehigh Valley corridors will double by 2019.

Yet, we never wonder how much insurance a negligent driver will have if he hit us.  To be “legal” in Pennsylvania, a driver must carry a mere $15,000.00 of liability insurance.  If that driver veers into your lane of travel, will that $15,000.00 cover six months of your disability, your absence from your work during physical therapy and rehabilitation?  And what if that driver is instead one of the many uninsured drivers passing through the Lehigh Valley?

Now, instead of $15,000.00 to protect you, there are zero dollars to cover your losses.  If you are a self-employed professional, can you survive being away from your business for six months?  You can’t control how much insurance another driver carries to protect you.  And yet, that driver can injure you, causing financial ruin.  So, what can you do?

Fortunately, this article provides that answer.

While you can’t control other drivers on the road or the amount of their coverage, you do have an inexpensive option in selecting automobile insurance that includes a provision for UNINSURED/ UNDERINSURED MOTORIST BENEFITS, or “UM/UIM” for short.  Here’s how UM/UIM works: A 32 year old financial advisor in the Lehigh Valley spent three months in the hospital following a head-on collision in which she sustained a severe concussion and a broken pelvis followed by two months at a rehabilitation facility.  She then returned to work three hours a day, while still receiving cognitive therapy.  She was making slow progress and continued to require narcotic pain medication to get through the day.  She was finding she could no longer retain information as she did before the impact.  A medical and vocational economist might show the value of her case to be $3.8 million when her future lost earning capacity was considered through the age of retirement.

If the driver who caused the collision carried $15,000.00 of liability insurance, that would typically be paid immediately. Without UM/UIM coverage, this professional might lose her home, and be unable to get the best therapy in the future. However, for a relatively low premium payment, she could have added UM/UIM coverage to her own automobile policy.  As soon as it was determined that the responsible driver lacked insurance or sufficient insurance (in other words, he is either uninsured or underinsured), the UM/UIM coverage would be available.

This coverage is critically important, especially to any self-insured professional.  It covers all damage to a person’s earning capacity, unpaid medical expenses and pain.  Amazingly, your rates should not increase, and your coverage will not be impacted if a  UM/UIM claim is made.  And, by directing your agent to “stack” your UM/UIM coverage on each vehicle, the coverage becomes a multiple of the number of vehicles that you own.  For example, someone owning three cars with $100,000.00 of stacked UM/UIM coverage would actually have $300,000.00 of this safety net insurance for any one accident.

As a lawyer representing people who have already been injured, I can only tell my clients that I wish they had protected themselves with strong UM/UIM coverage.  Once they are injured, it is, of course, too late.  Such coverage can’t restore a person’s health but it can keep him or her financially solvent and independent, and that is sometimes as close to justice as we can get.

I urge you to write yourself a note to check with your insurance agent that you have as much UM/UIM coverage as you can reasonably afford.

I’m always interested in what my doctor takes as her cholesterol-reducing drug, what my architect friends use as siding on their own homes and where my own investment counselor invests his own money.  Feel free to contact me, as I would be glad to share with you my levels of coverage and the premiums I pay after spending more than 25 years representing injured victims in the Lehigh Valley.  Adding UM/UIM coverage may be the single best insurance decision you will ever make.

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