Mahmood v Vicks, 2011 NY Slip Op 00653 (2d Dept. 2011)
Call this one: why an MRI performed more than 6 weeks after the MVA is actually advantageous to the personal injury plaintiff. As anyone who reads this blog knows, an MRI of the spine performed within 4-6 weeks of the initial examination when the allegation in a “soft-tissue” injury case will usually be grounds to prima facie uphold the lack of medical necessity of the service. Of course, this requires the testimony of a physician or chiropractor who cites to the 3 or 4 journal articles that correctly stand for this proposition. Thus, an MRI performed later in the patient’s treatment will usually fare better at trial.
But this case demonstrates another reason why it might be in the patient/plaintiff’s best interest to wait at least two months post evaluation to perform these tests:
“Dr. Tsatskis’s range-of-motion and other tests revealed more than minor limitations in the cervical, thoracic, and lumbar regions of the plaintiff’s spine, as well as in the plaintiff’s right shoulder and left knee. The MRI study of the lumbar region of the plaintiff’s spine, performed about four months after the subject accident, revealed, inter alia, muscle spasm and a bulging disc. The MRI study of the cervical [*2]region of his spine, performed almost a year after the subject accident, revealed muscle spasm and a central disc herniation. This evidence of the extent and duration of the plaintiff’s claimed injuries was sufficient to raise a triable issue of fact under the significant limitation of use category of Insurance Law § 5102(d)”
Now, there are certain attorneys who preach that they are better than other attorneys because they know the medicine better than anyone else. While that is great, it is even more important to know how the law effects the timing, duration and scope of the medicine.
6 Responses
An early MRI that shows disc dessication (Sp?) is demonstrative, as in supportive, of the argument that the bulge/herniation was pre-existing.
I saw Crouching Tiger/Hidden Dragon. When I got home I started jumping on things to emulate what the martial arts experts did in the movie — jumped from branch to branch. Well I jumped real high onto a fence and fell back injuring the knee. It swelled like crazy.
The next day I say the ortho that had been in our family for 30 years. He examined the knee for breaks. He drained a ton of green fluid out of my knee. And sent me right for an MRI.
In that case it was clearly called for.
The MRI came out positive for a torn meniscus. He said surgery is easy here. My sister the doctor said pathology begats pathology — even arthroscopic surgery. No surgery.
Strengthed the hams. I squatted 450 over the summer and deadlifted 495. I can’t remember which knee.
Lesson: avoid surgery and utilize physical therapy involving the strengthening of the right muscle groups. With knees its often the quads overpowering the hamstrings that cause knee problems.
A Tip from The Zuppa.
The world according to Raymond J. Zuppa, Esq., with convenient offices located in an underground bunker, somewhere on Herbert Street, in sunny Brooklyn.
Ray, are you one of those attorneys that “understands the medicine”?
Why yes Jason I understand the medicine from my new office in Harlem. I received my training at the best place ever. The Office of the Corporation Counsel City of New York.
One of the best lessons I learned as a defense attorney was not to use an expert unless there was a serious injury. When the injury is B.S. you can kill the whore doctor on cross and base your whole case on “this is all for the money”; well then it looks awful bad when you put on your own Miscreant.
Here’s how to spend the money wisely. A good P.I. and plenty of surveillance early enough so they do not suspect it. I nailed plaintiffs with surveillance during trial and killed them with it.
But how much do you bench?
Kidding.
They asked Sylvester Stallone that in a recent interview. Of course he’s on tons of human growth hormone. But when he answered he seemed to be speaking of all the aging action heroes. He said: “We don’t bench anymore. Our shoulders can’t take it.”
They do light flies and the push up is making a big comeback.
That being said my bench is way down to about 330. Anytime I make a run to go higher the shoulders go and it drops down to less then 300.
Shoulders are usually first to go.
But D.G. the Clean and Jerk is at 250 pounds. That’s the lift that the NFL uses right now to gauge explosiveness. That’s in one basic motion taking the barbell from the floor — hoisting it to a standup press position — and then using your legs, shoulders and arms to press it to a lock out over the head.
After my son’s basketball game today I jammed a basketball on a regulation height hoop.
I should give you all my work out.