Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 1121
Lawyers and Medical 75 L

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"Auto Body Shop Scan, Carrier SIU and Testifying"

 

Dr Studin: Let me just give you the setup and what I found, and this is what's going on with contemporary carriers right now and it's really well-organized pattern or paradigm that they've created. And what they've done is they've certified auto body shops in car accidents and you got to get on the list for a carrier and then you're an approved auto body shop and once you become like a gold ribbon or blue ribbon or a silver star shop, it means the carriers have recognize you for being a shop of excellence. What that really means from what my investigation has found out, it really means you’re playing with the carrier and giving estimates that are not really complete. And most people and it's not that the autobody shop won't do the entire work, it's just that they give an estimate and then what happens is all the attorneys work off of that estimates and they make estimates based upon what they see and the auto body shop is happy because the carrier pays really fast on those estimates but what they don't do is the polyurethane or the plastic skin of the bumpers for instance are meant to be elastic like a basketball but it doesn't show the damage of the understructure cause you can see it because it bounces back. A lot of clients will just take a check really quick to get their car fixed. They want their car back and the auto body shops are happy because the more they do this the more it moves them up the chain to get a lot more referrals from the carriers because the carriers direct care, they suggest where you should go. Now as a scheme, what happens is now you've got an auto body shop that repaired from an estimate and didn't really dig deeper and you have very low damage because they didn't look at the actual bumper itself, which is under the plastic and under polyurethane. They look at the weld joints into the chassis. They didn't look at the chassis, they didn't look at any of those things where there could be a consider amount of damage. Then they say it's low monetary damage. Then the person couldn't get hurt. But if the person's hurting, they're treating with the doctor. Now the doctor's committing and if there is a pattern of the doctor treating these types of patients, now the doctor can be under scrutiny because that's how you comes in and comes up with a statistic or an algorithm which they've created to determine that a doctor is treating all of these no damage crashes they possibly couldn't bear it. Now the doctors under scrutiny, they won’t pay the doctor. And now the plaintiff's attorneys are the trial lawyers’ cases gone because all of this is underreported not necessary simply because they use the recommended auto body shop and it slows down. Now, as this solution, you should go to independent or have your clients and patients go to independent auto body shops that are not supported by the carriers because there is no financial inducement. They get pushed up to the top of that referral list. But the other side to the coin is for the doctor to be able to through the appropriate credentials opine on the amount of force based upon the event data recorders, the skid marks, the all marks, all these things that we can determine if the doctors credential. I just gave you 500 things to talk about. What’s your gut?

Guest Doctor: First of all, I question the source of all the information, but I don't question the motivation of the insurance carriers to undervalue and undermine every which way they can. A legitimate injury case that a client may have, especially in low visible damage cases. Let me throw a couple of extra things at you. A lot of carriers now are coming up with this new method of valuation on your property damage. Take a picture and we'll send you an estimate and then they tell you to go to their body shop just like you said. And then the body shop, we'll either fix for the price or rebuild a carrier more money where some of the scams coming in is when they're not using legitimate factory made parts where they're getting the parts imported from China or wherever they're cheaper and they're not using the high quality parts specifically to the manufacturer's specs. That's one of the problems. The other thing is you're always better off dealing with a reputable body shop and somebody stops that are repeatable, have to make deals with these galleries to stay in business. If you go to the dealer where you bought the car, there's less probability that they're going to accept and put in poor quality parts. So you always want to check with the body shop and make sure they're putting in quality points. Now that being said, the premise of your point is they're undervaluing the damage. Body shops are accepting the lower value and because of that, the carriers are now standing into a special investigation unit that's a you and trying to imply fraud, therefore scaring doctors, lawyers and patients away from legitimate claims. I think that's the premise of what you're saying. Am I correct?

Dr Studin: That's part of, but a friend I spoke to maybe four or five years ago said, listen, this is the estimate that the carrier is going to pay from. They're not going to go for anymore and if I push it, they're going to throw me off their list and I can't afford that. I said that there's more damage on underneath.

Guest Doctor: That's fraud. If there's more damage underneath and body shops are not fixing it. The other thing you have to remember also is there's two ways they body shops get paid. One is from your own insurance company because you purchased the collision damage and you're going to pay a deductible, which you might get back later on if the accident's not your fault. And the other is, the one who's at fault is paying for the property damage. So, some people get estimates from a collision recommended carrier and then they're not going to use that carrier because they don't want to pay the deductible. Then finally the carrier for the person who fought finally gets the estimate done. Usually 30 days later and that's who they end up using because they don't have to pay a deductible. I say getting two estimates is always a good idea.

Dr Studin: The truth is probably, there's always the fraud that needs to be in jail and there's always the super sane. The truth is probably somewhere in the middle.

Guest Doctor: That could be, I mean it's an interesting that the body shop people are getting this pressure. They may want to report those insurance carriers to the regulators for the state and say, I'm getting undue pressure to undervalue claims here and this isn't right

Dr Studin: That is just like the IME doctor who's making $800/$900 million dollars a year. They're going to really report the carrier for that.

Guest Doctor: I've had that happen. I had an IME doctor, They usually won't come to me and tell me. But I actually had someone, and I offered to sue the carrier, not even charge a fee and put in a complaint, but he didn't want to be cut off from the business because he needed the business to survive. But he did follow my advice and he went to supervisors within that particular carriers so that the adjusters that were threatening him, he did report them, but he did it in a internal method. So, it wasn't done externally.

Dr Studin: That's like a, the Fox given the Fox, the keys to the hen house, but complaining to the fox’s sister the Fox is bad. Right?

Guest Doctor: Well that's the truth. But this is a very interesting concept. What we all really have to look at is how important is it for our doctors that are treating our patients to be properly credentialed, to look at the car's damage and to understand that in and of itself, the visibility of the damage is really not that relevant. There's case law in New Jersey that says, if you could have a lot of damage to a car and not necessarily have someone injured or are you going to have minimal visible damage to a car, but that doesn't mean they're not seriously injured and it really takes an accident reconstruction and a biomechanical engineer and people who are credential that can talk about the forces of impact and why it is that there are flection extension injuries when you're rear-ended or why side impact could cause a herniated disc even more frequently sometimes than a rear end impact because of the nature of what happens to the neck when it's moved sideways as opposed to having that head rest protects you moving back and forth.

Dr Studin: Would you be able to send me the citations for those two cases?

Guest Doctor: Yes, Redmond. I'll tell you right now, there's actually a jury instruction charge. There's a model jury instruction charge in the New Jersey rules and Brenneman is the leading case. It's a Supreme Court of New Jersey case that actually says that because they were having these battles of biomechanical engineers testifying in cases, oh to force of that impact couldn't possibly have caused this person's herniated disc and they had competing forces. And then the court finally said after someone blew up a picture of a scratch on the bumper basically and using that for the entire argument as to why the person couldn't have possibly had a permanent injury from that, the court got fed up and just said, well it could go either way and this is the instruction from now on. If anybody's using property damage photos and making an argument that someone either was hurt really bad or not hurt bad enough then this instruction goes into the case. And Brennan and I'll be happy to send you the copy of the case.

Dr Studin: If you could do that. And secondly, there is an accident engineering course that is taught by myself and a Patrick Sunday. And Pat is an accident investigator/Engineer. He is trained for Prince William County, Virginia, a police department. He taught at the police academy accident engineering and accident reconstruction. He is one of the professors, actually the main professor in this course. It's a 30-hour course and it's recognized or approved through Cleveland University, Kansas City chiropractic and health sciences it's proven through chiropractic academia formally for continuing education and we modeled that after every single other course because it's a master's level course. You don't get a masters, but you get graduate chiropractic education.

Guest Doctor: that's critical. To go and get that kind of education and treat your patients and then get the police report, look at the damage. And you not only have to look at the damage of one vehicle, you've got to look at the damage of all the vehicles to help determine the forces. And I'm sure that is taught in those courses.

Dr Studin: let me give you a little insight on that. It's called the spring factor. And what you want to do is you want to look at the crush zone of each vehicle, the depth, the width, and the vehicle type. And there are mathematical calculations that will tell you the amount of energy required for every millimeter of crush and then you can back into it to determine the speed of each vehicle when you're looking actually at causality and putting it together. And when you're looking to determine the amount of Gs that gets translated from the bullet card of the target car to the occupant, because that's the injury arbiter. For instance, if you look at a space shuttle going 23,000 miles an hour, the astronauts don’t get hurt. But if someone pulls a chair out from under you and you fall and go eight miles an hour and you hit your tailbone; you could break your tailbone. So, the injury arbiter is the amount of Gs, or force of the occupant, which really comes to how fast or how quick you come to a complete stuff, not how fast you're going. And those crushed zones actually will tell you from each vehicle how fast, how many Gs. There's a lot that could be ascertained. It's very technical and very precise from a mathematical perspective,

Guest Doctor: which is why as an example on highways, they'll have the crush zones or they'll set up the barrels of water or barrels of salt because instead of somebody coming to an incident home hitting that concrete wall, it slows them down at a greater amount of time, therefore lessening the tremendous forces on the occupants inside of the vehicle. So, all of that is so important for doctors to understand why patients get hurt in traumatic accidents and things. And as safe as vehicles are becoming with airbags, also that comes out to prevent the patient from being thrown in a cushiony way. Although those airbags are dangerous in and of themselves with the way they made them overseas. But these are all important facts that you got to take the course. I agree with you 100%

Dr Studin: yeah, it's really good stuff. I listen, I think we've covered this subject, and the other thing is is one of the things that we talk about extensively and the testifying part two course called forensic documentation is how to handle all of these things involve direct and cross examination and how to prepare your demonstrative evidence.

Guest Doctor: Oh There is no doubt. That's exactly what you and I did. We went through a practice wide on qualifications. We went through a fraud. The kinds of questions you're going to be asked not only on direct exam from your own lawyer that's representing the plaintiffs and presenting you as a testifying doctor, but the other side and the kind of way they trick you up on cross examination. That's all covered in our testifying to course. 

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