Page 17 - Phoenix Vol 11 No 5

BILL GALLAGHER, DC, CMVI | Chiropractor Whiplash et al.
For any doctor or attorney in- volved in personal-injury cases getting a solid whiplash case is
always a blessing. e problem, how- ever, is that injuries in a motor vehicle collision usually far exceed a simple cervical whiplash.
Statistics from the Arizona Depart- ment of Transportation for 2017 show that 44.5% of motor vehicle collisions in the state are rear end collisions. ree things stand out with this.
First, with almost 100% of those rear-end collisions there is also a front-end collision. ( ere are rear- end to rear-end collisions.) While it is generally accepted, that a driver is re- sponsible for what happens in front of them there are plenty of cases with a striking vehicle is not at fault.
Second, there is no ICD – 10 diag- nosis code for whiplash. All too of- ten medical doctors will go with the safe, generalized diagnosis of cervi- cal strain. By de nition, this is a mus- cular injury. e healing process for muscle strain, which has an abundant blood supply and the nutrients need- ed for repair, is a relatively short one. IME doctors will o en revert to this diagnosis ignoring radiographic nd- ings of more severe injuries so that they can claim the patient should have had their symptoms resolved within 6 to 8 weeks a er the collision.
Chiropractors who are far better educated in neuro-musculo-skeletal issues will more commonly diagnose this as a cervical sprain. e di er- ence is that sprain refers to ligament injuries and ligaments lacking an abundant blood supply, coupled with the nature of their structure tend not to heal quickly.
e weakness here is that even for
those who have made the diagnosis of a sprain they rarely take the time to quantify the degree of that injury. Failure to do so allows insurance car- riers to reduce that to the simplest lev- el of sprain rather than a more com- plex injury.
ird, if cervical injury is the only injury considered, and this is o en the case with emergency departments and medical doctors, then there are a multitude of injuries that are probably overlooked. Injuries that are not diag- nosed also tend to be injuries that do not receive proper treatment. From the attorney’s perspective these are injuries for which you cannot claim damages or compensation
It is essential to diagnose all the in- juries in a motor vehicle collision. Unfortunately, most doctors lack the training to understand the mecha- nism of injury and with that lack an understanding of which injuries to look for.
Doctors who have taken the cer- ti cate program with the American Academy of Motor Vehicle Injuries have learned about the mechanism of injury relative to each direction of im- pact. As such, they are in a better po- sition to know what to look for. As I teach in diagnosis classes if you don’t know what to look for you will have a hard time nding it.
It is essential to understand that a patient who was rear-ended will suf- fer a di erent set of stressors and in- juries than someone who rear-ended them. Likewise, when the force is in- troduced straight on from either side a di erent set of injuries needs to be considered.
Finally, when assessing spinal in- juries understanding the additional
forces introduced with any rotational motion can make all the di erence in patient care and your ability to garner a just settlement.
Usually in an emergency depart- ment and with follow-ups by prima- ry care physicians, the diagnosis will be limited to the patient’s chief com- plaint and will likely be the most gen- eralized of the possible options. is mindset as we have already seen re- duces the possibility of diagnosing all of the spinal injuries.
Of equal importance is understand- ing how an individual’s arms and legs and head and face can be traumatized in a motor vehicle collision. Here too, understanding the forces introduced at di erent directions allows a trained diagnostician to include in their care plan a wide assortment of injuries to the arms, shoulders, legs, hips, or head and face.
Bottom line, whiplash is a mech- anism of injury not the injury. e whiplash associated injuries a ect- ing and individual’s spinal column are important to be diagnosed for all their components. It is equally important to know that there are far more in- juries that are commonly overlooked that need to be identi ed, tested, and managed.
is is not only important from the healthcare provider perspective as far as ensuring that the patient gets the care, they need but
it is just as impor- tant from the legal side to ensure that they get the com- pensation they de- serve.
Scottsdale chiropractor, Bill Gallagher has taught personal injury seminars across the US and Europe through the American Academy of Motor Vehicle Injuries. He also offers support to attorneys with Phoenix Medical Legal Ser- vices and the Concussion Recovery Center. He can be reached at [email protected] or 480-664-6644.
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