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I Don't Have PIP or UM Coverage, or Do I?

2/18/2015

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by Ryan Pauley of The Pauley Law Group

Many people don’t know what type of insurance benefits they have under their automobile policy until an accident occurs.  Two of the most important benefits under any automobile policy are Personal Injury Protection (commonly referred to as “PIP”) and Underinsured Motorist Insurance (commonly referred to as “UM”).

PIP coverage pays for any of the costs associated with medical treatment that is related to the auto accident that you were involved in.  PIP can also cover lost wages and any other expenses incurred because of the crash, but these amounts are usually limited to a weekly dollar amount.  The two most common PIP coverage amounts in Washington State are $10,000.00 and $35,000.00.

UM coverage provides benefits to the victim in the car crash, when the person responsible for the accident has little or no insurance to pay for the costs and damages that resulted from the crash.  The minimum UM benefit coverage that a person can purchase in Washington is $25,000.00. This amount can be as high as $100,000,000 (one hundred million?) and of course like all insurance the more benefits you get the higher is the cost.

When a person in Washington State purchases automobile insurance, the Company providing the policy has a duty under state law to offer both PIP and UM insurance to the purchaser.  If the purchaser declines PIP and/or UM coverage, the insurance company must obtain a written waiver form the purchaser in writing which declines the purchase of these benefits.  If the insurance company fails to obtain this written waiver, then it is required to provide the purchaser with the state minimum benefits at the insurance company’s cost.

For example, assume I purchase an automobile policy in Washington State and decline both PIP and UM benefits to keep the premium low.  The insurer then fails to obtain a written waiver from me stating that I am declining PIP and UM coverage.  I then purchase the policy.  The next day I am involved in an automobile crash and the person causing the crash has no insurance.  Under Washington law, the insurance company who sold me the policy must provide me with $10,000.00 in PIP benefits and $25,000.00 in UM benefits at its own cost.

If you can afford it always purchase PIP and UM benefits.  With the costs of medical treatment and the number of people who drive without insurance these days, it is too much of a risk to not have these benefits.  If for some reason you didn’t purchase these benefits, and you are involved in a crash, make sure your attorney checks to see if you signed a written waiver for your insurance company that waives PIP and/or UM coverage.  If your insurance company cannot produce this waiver, demand that they pay benefits.

To learn more about Ryan Pauley and The Pauley Law Group visit http://www.pauleylawgroup.com/blog/i-don%E2%80%99t-have-pip-or-um-coverage-or-do-i

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"I Can't Turn My Head After My Car Accident. What Do I Do?"

2/8/2015

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Have you ever known anyone that has gotten GREAT results with a chiropractor in respect to how much better they can move their neck or back after they were in a car accident? Why is this? One of the reasons is the fact that chiropractors are "doctors of the nervous system" and we affect the body, not only on a mechanical aspect (bones, joints, muscles), but on a neurological level.

In the text book "Principles of Neural Science" by Kandel and Schwartz, which is a 1400 page text that I used in my postgraduate work in chiropractic neurology, it shows us perfectly how your "range of motion" is improved after seeing the chiropractor for your whiplash injuries.

The chiropractic "adjustment" puts a fast stretch (just what it sounds like) on the muscle spindles and the golgi tendon organ in the muscle, which in turn creates a reflex relaxation response and activates the 1B fibers of the golgi tendon organ which creates relaxation with the muscle. This whole crazy reaction then allows you to turn your head normally, or bend forward at the waist in a normal way. Sound complex? It really is, but this is how chiropractors get such great results is that this effect to the nervous system so profoundly!

If you are having any problems in your range of motion in the neck and/or low back following a car accident, this can be a warning sign of serious health problems. Especially if you are having any type of pain with your decreased ability to move, you need to seek help. A chiropractor will be able to diagnose if your range of motion problem can be fixed and set out to help your problem.

This is a revised article that I originally wrote for ezinearticles.com 5 years ago.
Article Source: http://EzineArticles.com/4879901
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"Why Do I Still Have Pain Years After My Car Accident?"

2/5/2015

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You may or you may not know this, but our human bodies are absolutely amazing! This last week I had the opportunity to discuss with one of my patients just how adaptable the human body is to stress. I tell all of my patients, this is a good thing cause if we didn't adapt to stress we would probably be dead! In neurology we call this process of adaptability "plasticity". This is your body's ability to change, for the good and the bad. This is why, when you sit at the computer all day, you have a stiff neck at night. Your body literally changes, like a piece of plastic, to the position that you are sitting in.

One thing we have to remember is that these changes do not happen over night. Some take years and years to happen, but I can assure you, if the bones of the spine loose their normal alignment or mobility this will cause problems. Headaches, stiff and painful neck, sinus pain, jaw pain, etc... can all be the result of plasticity. The good news is that the ability of the body to change can be a good thing too! I work with plasticity of the human body every single day with every single patient that I see. As I am helping my patients regain the normal alignment of their spines, we are making changes in a positive direction.

Has the process of plasticity taken place in your body? Odds are, if you work in Bellevue at a computer you have developed what I call Bellevue Neck. If you have headaches, neck pain or stiffness by the end of the day, then you most likely have developed plasticity in your system and need to find a Bellevue chiropractor. As a chiropractor I can help you to reverse the changes that has taken place in your body and help you regain the normal alignment and motion of your body.

The other sure indicator that this process had occurred is if you have ever been in an automobile accident. Car accidents stretch the structures of the body too far making them more susceptible to this happening. Again if you have ever been in a car accident call me today and we can set up a consultation to assess if you are a candidate for care.

Do not let the process of plasticity create disease in your body. Call me today to reverse the changes that have taken place and find ways to prevent it in the future.


Article Source: http://EzineArticles.com/5009716
Below is an article I wrote 5 years ago for ezinearticles.com. Thought I would pull it out of the archives and share. Enjoy...
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A Sampling of Medical and Chiropractic Support of Video Fluoroscopic Studies:

2/5/2015

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Recent medical literature, including several citations in journals such as SPINE and the Journal of Spinal Disorders, support the importance of dynamic motion x-ray for the evaluation of the cervical spine.

American Academy of Pain Management Practical Guide to Clinicians, Fifth Edition states, "...digital motion radiography is currently a valuable diagnostic method in evaluating painful hyper-mobility and instability of capsular and axial ligaments in the cervical spine."

The American Medical Association, Guides to the Evaluation of Permanent Impairment Fifth Edition states, "Alteration of motion segment integrity is defined from flexion and extension radiographs as a least 3.5 mm of translation of one vertebra on another, or angular motion of more than 11 degrees greater than each adjacent level..." as a criteria to determine the "Impairment of the Whole Person".

The Occupational Medicine Practice Guidelines, Second Edition 2004 (American College of Occupational and Environmental Medicine) states, "If probable ligamentous injury with persistent pain, consider fluoroscopically directed flexion study."

Donald Resinck: Professor of Radiology, University of California, San Diego. Diagnosis of Bone/Joint Disorders: 1988, chapter 3. "Videofluoroscopy is useful in the evaluation of joint movement. Used during R.O.M., (range of motion) it identifies the level of Instability secondary to ligamentous damage."

The Cervical Spine: the Cervical Spine Research Society: 1989, page 260. "Video fluoroscopy is a dynamic technique that allows precise positioning during R.O.M. studies. Anterior gapping of a disc space sudden translation of a vertebral body on another may indicate intersegmental instability."

Buonocare, Edward, MD et.at.k Cineradiograms of Cervical Spine in Diagnosis of Soft-tissue Injuries, Journal American Medical Association. The author concludes that cineradiography adds another diagnostic method of evaluating suspected soft-tissue injuries of the cervical spine by demonstrating its motion during exercise. Furthermore, the cineradiographic study will have its greatest value if it can detect abnormal motion in patients who show normal spines on standard roentgenograms and before degenerative changes have occurred.

John Bland: Disorders of the Cervical Spine: 1987, page 144.
"Video fluoroscopy is the most valuable technique in analyzing cervical spine motion."

Jones, Malcomb, D., MD, Cervical Spine Cineradiography After Traffic Accidents, Archives of Surgery. Cineradiographic studies demonstrated 1 or more abnormalities in 43 of 50 patients involved in rear-end vehicle collisions."

John Bland: Professor of Medicine, University of Vermont. Disorders of the Cervical Spine: 1987, page 134. "The Stability of the cervical spine depends on bony structures only to a minor degree; stability depends to a major degree on the ligamentous structures."  Such injury is not always detected on static plain film x-rays (standard roentgenograms). The next best medically reasonable diagnostic tool for determining ligamentous injury (a biomechanical source of pain) is the fluoroscopic exam.

Ruth Jackson: instructor of Orthopedic Surgery; Baylor University, the Cervical Syndrome: 1977 "Video fluoroscopy shows areas of limited or unstable motion resulting from ligamentous and capsular injuries."

Robert Baily: Professor of Orthopedic Surgery, University of Michigan, Ann Arbor. The Cervical Spine 1974, chapter 3. Dynamic Anatomy and Cineradiography of the Cervical Spine. "Video fluoroscopy shows abnormal secondary to soft tissue (ligamentous) damage. Stability is dependent on ligaments."

Jones, Malcomb, D., MD, Cineradiographic Studies of Abnormalities of the High Cervical Spine, Archives of Surgery. The author begins by noting cineradiography is becoming widely available and reports of its use in orthopedic problems, particular those of the cervical spine. Cineradiography, it was concluded that the use of cineradiography has elucidated abnormalities seen on plain roentgenograms of the cervical spine.

Woesner, Merlin, E., MD, and Mitts, The Evaluation of Cervical Spine motion below C2: A comparison of Cineroentgenographic and Conventional Roentgenographic Methods. A Comparison study of 40 randomly selected patients who had roentgenographic investigation of the cervical spine by both cineradiography and conventional lateral roentgenograms in flexion, neutral position, and extension was made for the analysis of motion. In 14 of the 40 patients, abnormal motion was detected in the spine that was not seen on the plain roentgenograms.

It is further appropriate to determine the level of this individual's long-term prognosis related to injury. Ligamentous instability is recognized as "whole person" impairment by the American Medical Association (AMA). Any translation of one vertebral body on another in the Cervical Spine is abnormal, and as little as 3.5mm is considered grounds for 25% whole person impairment. It should be noted that the ACCR and Committee on Scientific Affairs has determined that the utilization of Fluoroscopy is useful imaging modality for the demonstration of spinal intersegmental joint dysfunction.

Spinal Impairment Categories: AMA Guides (Diagnosis Imaging of the American Chiropractic Association/Position Statement of 6/13/91). "With the publication of these guidelines...the American Council of Chiropractic Radiology no longer considers Spinal Video fluoroscopy as investigational within the chiropractic profession."

Fluoroscopy is supported by the ACOEM (American College of Occupational and Environmental Medicine) Guidelines.

Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, second Edition. "If probable ligamentous injury with persistent pain, consider fluoroscopically directed flexion study."

Also in this regard, the 1993 Mercy Center consensus Conference rated Video fluoroscopy as Promising, with evidentiary ratings of Class II and III and a consensus rating of #1 (the highest level).

Excerpt from the proceedings of the Mercy Center Consensus/Section on Video fluoroscopy procedures. 1993. Scott Haldeman D.C., M.D., PhD. Commission Chairman. These Video fluoroscopy procedures are effective for evaluation for the quality of spinal motion. It is unique in this respect since, unlike stress vies, it not only provides a view of total excursion, but also how the segments arrived there.

The Centers for Medicare and Medicaid Services further support the appropriateness of fluoroscopy as an examination technique utilized to determine biomechanical abnormalities (subluxation). Medicare coverage database; LCD for Chiropractic Service (manual spinal manipulations) ( L15759).
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"Should I Get A Motion X-ray After I Have Been In A Car Accident?"

2/5/2015

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One of the many things that differentiate Bellevue Whiplash Center at Back in Action Chiropractic is our use of video motion x-ray. Video motion x-ray is much what it sounds like... a moving, real time x-ray of your bones. When a patient comes to see us that has been in a car accident we do a thorough history, exam, and x-rays and if indicated we also do motion x-ray. Below is a short list of some of the reasons we may take a motion x-ray to further assess our patients injury's.

  1. Suspected Persistent Intersegmental Joint Dysfunction
  2. Inconclusive Intersegmental Joint Dysfunction via X-ray / CT / MRI
  3. Headache, Dizziness or Blurred Vision
  4. Pain increased with Movement
  5. Increased pain and clicking on opening and closing of the jaw.
  6. Confirm Ligamentous Instability in the upper 30% of the cervical spine, which is supported by ligaments only and contains no discs. (Alar-Accessory-Transverse Ligaments)
  7. Confirm Ligamentous Instability to the complete cervical spine in flexion-extension views.  (Anterior Longitudinal Ligament, Posterior Longitudinal Ligament, Inter-spinous Ligament, and Compression Fractures)
  8. Confirm ligamentous instability at facet joints in flexion-extension oblique views.  (Capsular Ligaments)
  9. Confirm referred pain syndrome from capsular ligamentous injury.  (Scleratomal Pain)
  10. Confirm Swallowing difficulty or complaint of swelling in the throat.

Doing a motion x-ray will allow us to discover hidden injury's and give our patients the most complete picture of their injury's, which most importantly, gives us the best understanding of the appropriate care plan to help them get better.
photo credit: Neck x-ray via photopin (license)
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What To Look For In A Chiropractor Following A Whiplash Injury

2/5/2015

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Every Chiropractor is very different in their approach to treating car accident injuries. This is a good thing because not every injury is exactly same and every ones body differs in how they respond to care. The following are things that I tell my friends, family, and out of state patients to look for when looking for a chiropractor out of state and what you should be looking for following a car accident.

1. Do they have a technique (how they treat you) that is best for your body and your specific injuries? Again, remember what I stated above. Not all chiropractors do things the same way and not all ways will work for your individual body or your individual injuries. So how do you know? First off if you are queasy AT ALL about the "snap, crackle, pop" that comes from a hands on treatment, then that is not right for you, and you need a more gentle treatment like the Proadjuster or the activator. Next, if you have ever received a "deep tissue" massage and been worse afterwards then a heavier chiropractic treatment is not for you.

2. Do they have a way of analyzing your ENTIRE body and all of the injuries that you had while in your car accident? Yes, from the tips of your toes to the top of your head. It is important to assess you as a whole, because we are one big connected chain. Something that I see quite often when I am examining a patient who has been in a car accident is that the foot that they had on the brake pedal was affected. Its important that this is found and addressed. Something in your shoulders because of the seat belt could give you head aches. So, ask if they have a way to assess your feet such as digital scans of the foot, do they have ways to look at your arms and shoulders? Now it may not be necessary to do all of these tests on every person, but it is important that they have the ability to.

3. Does the chiropractor continue his education above and beyond the "required" hours to renew their license? The health care field is changing on a daily basis. New research is coming out all the time, and if every chiropractor does not stay up to date on what is new in the field of automobile injuries then they are not giving their patients the best care available. Every chiropractor in the United States has to have a certain number of continuing education each year. What I have found is that this amount is far less than what is necessary to keep up to date.

4. Do they do rehabilitation or prescribe exercises? This is a vital component to getting better following a car accident. I tell my patients all the time "I can put you back together all day long, but until your muscles can hold you there you are going to have ongoing problems". This does not have to be complex, but it does have to be a part of getting you better.
Make sure that when you are searching for a physician following your car accident that you ask these questions.


Article Source: http://EzineArticles.com/4809037
photo credit: neck check via photopin (license)
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"Will My Car Accident Injuries Heal To 100%"

2/4/2015

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I recently had a patient come to see me after an auto accident they were involved in who was in quite a bit of pain. As we got to talking though, it became obvious that it was not the pain that they were currently in that concerned them the most, it was if they would be able to run in marathons again following this significant injury. "Will my injuries heal to 100% and allow me to partake in running again like I was able to do before?" The good news is that with appropriate treatment, motor vehicle injuries can heal without leaving you with residual problems. The bad news is that a large percentage of traumatic injuries will have residual problems.

        In one study published in the Journal of Bone and Joint Surgery, the authors
        followed up on patients involved in motor vehicle collisions approximately fi-
        fteen years earlier. The authors wanted to know whether patients, fifteen ye-
        ars after cervical injury, had improved or worsened symptoms, and whether
        psychological variables played a role in the patient's condition. A group of six-
        ty one patients was studied. All had presented to the same emergency depar-
        tment in England after car collision-related soft tissue injury to the neck. Forty
        were available for the follow-up. Ninety percent of this group had been involv-
        ed in rear-end motor vehicle collisions. (From Injury to Action: Navigating Your
        Personal Injury Claim, Richard H. Adler, Chapter 31, Page 130)


What the study found was quite surprising. They found that 70% of the patients were still experiencing some sort of symptoms. Of that 70%, 42% of the injured had moderate to severe symptoms. Of the 61 patients 28% of them had actually gotten worse over the years. It was found that the patients who had radiating pain at the time of the injury typically had the worst outcomes. The researchers also found that there was definitely a correlation between the patients pain and depression symptoms.

In my opinion the thing that gives an injured person the best chance for a positive outcome to their injuries is two fold: 1. Know the extent of your injuries via in-depth and thorough diagnostics, including video flouroscopy if involved in a whiplash type injury. 2. Receive the appropriate treatment for your injuries to its completion.


photo credit: Andrew's totaled Car via photopin (license)
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Tips For Driving in the Bellevue Rain

2/3/2015

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If you live and drive in Washington, you live and drive in the rain. Driving in rainy conditions can at times be a treacherous feat, so here are a few tips for safely driving on our wet roads.
1. Reduce your speed. There is no place you need to be so bad that you drive too fast for the conditions.
2. Turn on your headlights. Make sure you can see the people driving around you and that they can see you.
3. Increase your driving distance. Make sure you have plenty of room to stop when there are slippery conditions.
4. Be more alert. Put down the phone, set the  radio before you start driving, put down the Big Mac, and please stop doing your make up.
5. Make certain that your wipers and defroster and in good working order
6. Be very careful around big trucks. Semi's prevent you from seeing the road fully, and can kick up standing water blocking your visibility for a moment (that's all it takes for a car accident to happen)
photo credit: where are you summer? via photopin (license)
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Chiropractors and Auto Accidents

2/2/2015

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Seeing a chiropractor following a motor vehicle collision can be a very good idea for quite a few reasons. One is that we see a lot of accident victims and are experts at diagnosing and finding the root cause of your pain and discomfort. We are well trained at treating a variety of accident injuries. We are also one of the only physicians and providers that take a car accident case on a lien. One of my fellow chiropractors Troy Davis wrote a fantastic article detailing why seeing a chiropractor following a car accident is a great idea. Check it out here http://accidentdoctor.org/accident-chiropractor/
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photo credit: October 22, 2013 via photopin (license)
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    Dr. Michael Weir is the clinic director at Bellevue Whiplash Center at Back in Action Chiropractic. We will also be hosting a variety of relevant guest bloggers to help you understand your injuries better.

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