Welcome to the all new Personal Injury, Automobile Accident and Medical Legal Issues Page. Here you will find a wide range of resources as seen in the Table of Contents including all the information you will need to rebut defense low speed impact experts such as those from Biodynamic Research Corporation (BRC). Here's a complete directory to all resources that ACS has available in the area of personal injury. Interested parties not Arizona chiropractors wishing provisional access should contact ACS at (602) 368-9496 or ACS@AZChiropractors.org.
BREAKING NEWS 03/26/12: $70,000 Plaintiff's award in classic low speed impact case. Patient sues State Farm directly which retains Joseph Peles, PhD, top biomechanical engineer, who argued that the forces were too minor to cause anything more than a minor injury. Plaintiff's attorney Harold Hyams retained Alan M. Immerman, D.C. as a rebuttal witness. Jury reported they did not believe Dr. Peles after hearing from Dr. Immerman and concluded the plaintiff was injured and awarded $70,000.Click here to read the entire Court's Minute Entry.
Dr. Immerman is one of the most experienced expert witnesses in the country having testified in 71 trials in the past 15 years (click here for list of trials with CV numbers and case names and dates) and having had his deposition taken 50 times (click here for list of depositions with CV numbers and case names and dates).
Areas of expertise include the clinical biomechanics of whiplash injuries, a subject he now is approved to teach as a postgraduate instructor at the Parker College of Chiropractic. He is also an expert in detecting flaws in accident reconstruction analyses, and is frequently called to opine regarding whether the treatment rendered post-trauma was reasonable and necessary.
After qualifying as an expert witness in 73 trials, Dr. Immerman has become someone Arizona lawyers have come to rely upon in the areas of medical necessity of treatment, clinical biomechanics of injury and accident reconstruction. His case list is posted here. His CV is posted here. He is available to consult on cases and may be contacted at (602) 368-9496 or at email@example.com. References available on request. Dr. Immerman consults with attorneys across the country on personal injury matters.
3. Rebuttal Reports to Low Speed Impact Experts from Biodynamic Research Corporation (BRC) and Local Arizona Defense Experts
ACS now supplies expert reports to rebut defense low speed impact experts Joseph Peles, PhD, Robert Anderson and out of state experts from Biodynamic Research Corporation (BRC), San Antonio, TX (www.brconline.com) including Richard A. Allnutt, MD, Mph, MS, Karyn J. Ayers, MD, Mph, C.E. “Ted” Bain, B.Eng., MD, Robert D. Banks, B.Eng., MD, James V. Benedict, PhD, MD, Alfred P. Bowles Ii, MD, Joseph M. Cormier, PhD, PE, James R. Funk, PhD, PE, Richard M. Harding, BSc, Mb Bs, PhD, Thomas M. McNish, MD, Mph, Amy L. Mumbower, MD, James H. Raddin Jr., MD, Sm, William R. “Mike” Scott, PhD, Harry L. Smith, PhD, MD, Jeffrey Wirth, M.S., P.E. Call or email Dr. Immerman at firstname.lastname@example.org and (602) 368-9496 for more information.
BIODYNAMIC RESEARCH CORPORATION (BRC) ORIGINALLY WAS LARGELY FUNDED BY STATE FARM INSURANCE COMPANY INDICATING POTENTIAL CONFLICT OF INTEREST
State Farm Mutual Automobile Insurance Company paid Biodynamic Research Corporation (BRC) $7,676,000 for services from 1990-1995. This is based on Interrogatory Answers and Production of Documents disclosed 01/29/97 in Maricopa County Superior Court in CV 95-21280, 01/29/97. Click here to read and download the full set of legal documents revealing the payments. BRC did the original human volunteer testing later used by defense experts to argue in court that plaintiffs could not be injured in low speed impact collisions. BRC experts still travel throughout the country testifying on behalf of defendants and should be questioned about the inherent bias of BRC based on its funding source.
Can Delta V predict injury likelihood or severity? In a word, no.
Engineer Siegmund, an authority cited by most defense engineers, lists 13 factors that must be taken into account when predicting injury likelihood and severity, and Delta V is only one . . .
Another scientific peer-reviewed published journal article concluded that in order to predict injury likelihood and severity, one would need to know information about the individual’s tissue strength and elasticity and “any multitude of variables that evade accurate determination” along with the Delta V.” Read the details in this article.
Four key journal articles from the peer-reviewed scientific literature reflect the general consensus of the clinical biomechanical and accident reconstruction communities. The journal studies and their noted conclusions are supported by numerous references cited by the authors. The conclusions drawn by these multiple authors were approved by the independent peer-reviewers and have achieved general consensus in the scientific community. They prove that the modern peer-reviewed scientific literature supports the position that one cannot calculate Delta V and then predict injury likelihood or severity. Read summaries of the articles with complete references here.
In order to further understand why Delta V cannot be used alone to predict presence or absence of injury in an individual, it is important to understand the difference between predicting an injury outcome in the general population and in an individual. While it may be correct to state, for example, that a 5 mph Delta V rear impact collision will only result in a significant injury in 1 in 100 individuals, this low probability of injury is unrelated to the actual result of the crash in an individual, as they may very well be the one in 100 who was injured . . . The full argument is explained with references here.
Defense engineers generally place no weight on medical records, not surprising since engineers have no medical education and thus no ability to read and comprehend medical records. A case file might include records from multiple doctors documenting objective evidence of injury immediately following the subject trauma but all such records are dismissed as irrelevant by the engineer. This denial of medical reality has been legally banned in Arizona which requires “genuine reliance” on medical records in all biomechanical/accident reconstruction analyses . . . The legal citation is provided here.
This full PDF report complete with references by clicking here.
The defense engineer’s entire analysis is predicated on the assumption that scientists know how much Delta V is required to cause injury to all people and to each individual in particular. The truth is that insufficient testing has been performed to date on human volunteers to know how much force is required to cause injury to any particular individual. This renders the entire engiineer's analysis invalid. Dr. Immerman has rebutted engineers more than 400 times in litigated cases and included three of his responses to engineers on the threshold of injury issue in this report with references. This is essential rebuttal material for your cases. This full PDF report with forty nine references is available by clicking here.
There are a number of common flaws in the analyses conducted by defense accident reconstructionists when they calculate Delta V in automobile accidents. This usually leads to an underestimation of the Delta V. These same flaws are seen in reports across the country and are based on methodology originally developed by Biodynamic Research Corporation (BRC) of San Antonio, TX, an organization that received more than $7.6 million in funding for services during its formative years from 1990-1995. In this report, all of the common flaws will be thoroughly analyzed. These include reporting a Barrier Equivalent Velocity (BEV) as if it were a Delta V, minimizing or ignoring the medical records and practicing beyond engineering bounds, underestimating Delta V in vehicles with foam, honeycomb and deformable strut bumpers, relying solely on photographs and not performing a physical inspection or reviewing repair estimates, and many other tactics which result in an underestimation of the Delta V. This fact-filled, fully referenced PDF report is available by clicking here.
In every city and town there is a cadre of MD orthopedic surgeons called upon by the defense to opine that the treatment rendered after an automobile accident was excessive, and that no future care is necessary. They universally deny the existence of a chronic pain syndrome following whiplash injury and claim that all such problems are self-resolving in a few weeks post-trauma.
In these exemplar rebuttal reports, Dr. Immerman reveals the literature which proves that approximately 1/3rd of whiplash victims develop chronic pain, that soft tissues heal over the course of months and often never heal fully, that active treatment with manual therapy and exercise is proven effective, that non-treatment with advice only is proven harmful, and that NSAID and opiate drugs should be second options only. Dr. Immerman lists the professional guidelines that should be followed in managing whiplash cases.
After writing 700 rebuttal reports, testifying more than 70 times in court, and being deposed 50 times in the past fifteen years, Dr. Immerman knows the arguments which are relevant and which actually prevail in real cases. This is the report you want to read. This PDF document is available by contacting Dr. Immerman at (602) 368-9496 or email@example.com.
Chiropractic IME doctors usually work almost full time honing their skills to write reports which effectively undermine the documentation and medical necessity of much of the care rendered by the average chiropractor. These doctors have the time to stay current with the literature and usually "cherry-pick" those articles which support their view, thus giving their reports the appearance of great authority. The treating chiropractor is outgunned in most cases. These exemplar reports from Dr. Immerman will even the playing field with the key rebuttal arguments and references you will need in almost every case when you are attacked by a chiropractic defense IME doctor. This PDF document is available by contacting Dr. Immerman at (602) 368-9496 or firstname.lastname@example.org.
When the property damage in an automobile accident is less than $1,000, automobile insurers routinely ask for a report from a biomechanical engineer who calculates the amount of force and reports it as Delta V. The engineer then opines there was insufficient force to cause the injuries diagnosed and treated by the patient’s doctors. Dr. Immerman has written more than 700 rebuttal reports to defense biomechanical engineers and learned exactly what it takes to defeat their arguments which are often based on junk science. His reports are fully referenced to the modern scientific literature. After 73 trials and 50 depositions, Dr. Immerman knows what it takes to win in the courtroom. This PDF document is available by contacting Dr. Immerman at (602) 368-9496 or email@example.com.
30 – Ethics Opinion 98-06 which requires PI lawyers to pay your bill if they know it exists (constructive knowledge) even if there is no written agreement.
31 – Balance Billing in PI Cases: Why balance billing to a third party insurer is almost always allowed in PI cases including citations to legal authorities.
32 – PI Attorney’s Explanation of Healthcare Provider Liens: Detailed explanation of the law.
33 – Sample form for Notice and Claim of Medical Lien: Fill in the blanks with your office information.
34 – Sample form for Release of Medical Lien: Fill in the blanks with your office information.
35 – Arizona Department of Insurance Circular Letter 2000-02 mandating fair investigations of low speed impact automobile accidents. Use to combat insurance company fraud.
36 -- Forms:
Lien Acceptance Policies: A form which includes all of the policies of your office which your patient must accept for you to agree to work on a lien basis including having all medpay payments sent directly to your office.
11. ACS Endorses Management of Whiplash Disorders Guidelines Which Includes Croft Whiplash Guidelines
ACS has endorsed the Management of Whiplash Disorders Guidelines which include the Croft Whiplash Guidelines. These guidelines have been accepted by the prestigious National Guidelines Clearinghouse and can be accessed through their webpage by clicking here. Dr. Jerry Kennedy's webpage has the Croft Guidelines displayed in an extremely usable format at http://www.drjerrykennedy.com/lawyer-info/croft-guidelines-for-treatment/
The simplest of all exams are the most revealing and objective. See the peer-reviewed scientific literature supporting the validity of range of motion and muscle spasm evaluations to document your patient's condition. Click here to read this four page paper written by Dr. Immerman.
13. The Standards for Epidemiologic Determinations of Cause and Effect
“Any expert opinion that addresses the probability, risk, incidence, or prevalence of an event occurring or not occurring in an individual or a population is an opinion that must have a foundation in valid epidemiological concepts and data. Epidemiology is most simply defined as the scientific study or analysis of populations having similar disease or injury characteristics. The proper application of epidemiological concepts and data to forensic issues is the practice of Forensic Epidemiology.” (Freeman et al, 2008)
The standards for epidemiologic determinations of cause and effect comprise three basic elements . . . Read the full two page statement from Dr. Immerman's reports by clicking here. The reference to the journal article is provided.
The first Arizona attorney to challenge low speed impact defense experts in the late 1990's was Nicholas E. Vakula, Esq. of Phoenix. He has been perfecting his methods ever since and explains in detail his methods for attacking the defense biomechanist who argues there was not enough force to cause the injuries diagnosed by the patient's doctor(s). Click here to read his entire twelve page document. His work is unparalleled in the country in the field of low speed impacts. He can be contacted at Vakulalawfirm@aol.com.
In the case of Hallmark v. Eldridge, July 24, 2008 Nevada Supreme Court (2), the Nevada Supreme Court barred the testimony of a biomechanical expert. The arguments are priceless in forming your own. Read the entire ruling by clicking here.
The California Court of Appeals has excluded testimony by an insurance company expert who concluded there was not enough force in an automobile accident to cause the injuries diagnosed by the patient’s doctor after the trauma. This is a landmark case since it was decided in an appellate court, but was not published and so may not serve as a precedent in California. The case, posted here, is Harrison v. Smith, A114436, First Appellate District, Division Five, California Court of Appeals. Again, the arguments and research are priceless.
This is a six page document of questions and answers between a biomechanical engineer and a plaintiff's attorney. It was developed by Lawrence S. Nordhoff, Jr., D.C., a veteran expert witness in the fields of biomechanics, accident reconstruction and whiplash injury. He has written one of the best books on whiplash available today. His website is http://www.chiropracticofficeforms.com/index.html. To link to Dr. Nordhoff's six page list of questions and answers, click here.
The have been eight major U.S. court cases in which defense biomechanical engineers have been excluded. The rulings have been based on sixteen theories. Read summaries of the cases and the theories by clicking here. This material was developed by Lawrence S. Nordhoff, Jr., D.C., a veteran expert witness in the fields of biomechanics, accident reconstruction and whiplash injury. He has written one of the best books on whiplash available today. His website is http://www.chiropracticofficeforms.com/index.html. To link to Dr. Nordhoff's four page list of court cases and theories, click here.
This is a summary of the specific human subject crash studies usually relied upon by defense engineers to establish a threshold of injury in terms of Delta V for all people and for a particular plaintiff patient in a case. Review of these studies reveals how it is impossible to use these studies in this matter. This material was developed by Lawrence S. Nordhoff, Jr., D.C., a veteran expert witness in the fields of biomechanics, accident reconstruction and whiplash injury. He has written one of the best books on whiplash available today. His website is http://www.chiropracticofficeforms.com/index.html. To link to Dr. Nordhoff's six page list of studies and analyses, click here.
Most of these studies were published by the Society of Automotive Engineers (SAE) whose administrator has confirmed in an affidavit that the results of the human volunteer studies cannot be applied to the entire population or any particular individual. Some of the key studies were performed at Biodynamics Research Corporation in San Antonio, Texas and later legal filings proved that State Farm Insurance Company provided over $7 million in funding to BRC throughout the 1990's to develop its low speed impact defense strategy with in-house studies.
There are eighteen key studies that are frequently cited by defense engineers in support of their hypothesis that injury likelihood and severity can be predicted from Delta V. Analysis of these studies reveals this not to be the case. This material was developed by Lawrence S. Nordhoff, Jr., D.C., a veteran expert witness in the fields of biomechanics, accident reconstruction and whiplash injury. He has written one of the best books on whiplash available today. His website is http://www.chiropracticofficeforms.com/index.html. To link to Dr. Nordhoff's eight page list of studies and analyses, click here.
Many defense engineers claim the subject accident was no more severe than an amusement park bumper car ride collision or other comparable activities of daily living like stepping off a curb, sneezing, plopping into a chair, etc. This article comprehensively examines the literature underpinning these arguments and reveals why they rarely apply. This material was developed by Lawrence S. Nordhoff, Jr., D.C., a veteran expert witness in the fields of biomechanics, accident reconstruction and whiplash injury. He has written one of the best books on whiplash available today. His website is http://www.chiropracticofficeforms.com/index.html. To link to Dr. Nordhoff's seven page list of studies and analyses, click here.
Because of our ongoing involvement in personal lnjury litigation, we must stay current with all peer-reviewed literature relating to whiplash, low speed impacts, chiropractic, treatment of injuries, etc. Contact Alan M. Immerman, D.C. at 602-368-9496 or firstname.lastname@example.org for the most recent literature and advice.
In 1999, insurers found a loophole in the lien laws that allowed them to require doctors to file liens every 30 days on each patient. ACS brought this issue to the Legislature and asked for relief. HB 2090, Health Care Liens, was introduced by then-Rep. Tom Horne to solve the problem. An intern explained "the bill allows costs for continuing care incurred after the filing of a health care lien to be added to the lien. It further requires the health care services provider to include in the verified statement, concurrently recorded with the lien, information regarding the termination of continuation of the injured person's care and treatment." Mr. Horne is the newly elected Arizona Attorney General for 2011.
As a result of ACS' work to pass this bill, you now only need to file one lien for the entire course of care rather than one lien every 30 days. This change brought great relief to all Arizona chiropractors.
23. Affidavit from SAE Legal Administrator Steven Daum Regarding Lack of Statistical Analysis or Methodological Scrutiny of SAE Articles Prior to Publication
Certain experts rely largely or exclusively on articles published by the Society of Automotive Engineers (SAE). Click here to read an affidavit from Steven Daum, the legal administrator for SAE. Mr. Daum confirms that SAE articles are not subject statistical analysis or methodological scrutiny. In fact, SAE takes the position that any opinions or positions advanced by an author of a paper published by SAE are not necessarily statistically representative of the response of the general public. Therefore, one cannot apply the results of these studies to any single individual, nor can one in most cases rely upon these studies in the formation of an expert opinion.
ACS has developed a document that thoroughly explains how any chiropractor can successfully argue that he or she is a courtroom expert in clinical biomechanics. Click here to read the document, and click here and here for the supporting documents. Dr. Immerman has knowledge regarding this matter since he has qualified has an expert in clinical biomechanics in Arizona Superior Courts 63 times in the past 12 years. Click here for his testimony list and here for his CV.
This compendium of five journal studies from Pain Research and Management in 2010 reviews all the studies that have examined non-invasive and invasive interventions for whiplash. The conclusion is that mobilization, including manipulation, and exercise have the best evidence to support use for acute and chronic whiplash, and that steroid epidural injections and spinal surgeries have very little evidence to support effectiveness. The studies are available free full-text online and reproduced here for members:
- “Toward an evidence-based approach to whiplash injuries”
- “A research synthesis of therapeutic interventions for whiplash associated disorder -- Part 1 overview and summary”
- “A research synthesis of therapeutic interventions for whiplash associated disorder -- Part 2 interventions for acute WAD”
- “A research synthesis of therapeutic interventions for whiplash associated disorder -- Part 3 interventions for sub-acute WAD”
- “A research synthesis of therapeutic interventions for whiplash associated disorder -- Part 4 noninvasive interventions for chronic WAD”
- “A research synthesis of therapeutic interventions for whiplash associated disorder -- Part 5 surgical and injection based interventions for chronic WAD”
Many defense engineers guesstimate the amount of crush damage by eyeballing photographs. This is an unscientific method that cannot result in an accurate figure for the amount of crush damage. Physical measurements of the vehicle are necessary. Read this fully documented position paper for proof.
Charles Davis, D.C., a nationally renowned expert in the field of personal injury and low speed impacts, has joined Dr. Immerman at MedicoLegal Services, where he will help write reports and testify. Dr. Davis has extensive training in accident reconstruction having completed the 40 hour course at Texas A&M University plus 240 hours at Riverside County Sheriff’s Department & University of California, Riverside from where he is certified in Traffic Accident Reconstruction. He has also taken courses consisting of hundreds of hours in spinal biomechanics and trauma. Dr. Davis is widely published in this field with the following journal studies, books and guidelines to date:
- “Mechanisms of Chronic Pain from Whiplash Injury”: Journal of Forensic and Legal Medicine. 2013;20:74-85.
- “Chiropractic Treatment in Acute Whiplash Injuries”: Grades I & II. Journal of Vertebral Subluxation Research 2008, May 19, 2008 pp 1-3.
- “Chronic Pain/Dysfunction in Whiplash Associated Disorders”: Journal of Manipulative and Physiological Therapeutics 2001;24(1):44 51.
- “Injury Threshold: Whiplash Associated Disorders”: Journal of Manipulative and Physiological Therapeutics 2000;23(6):420 7.
- “Rear End Impacts: Vehicle and Occupant Response”: Journal of Manipulative and Physiological Therapeutics; 1998;21(9):629 629
- “Chronic Cervical Spine Pain Treated with Manipulation Under Anesthesia”: Journal of the Neuromusculoskeletal System. 1996; 4(3):102 115.
- “Manipulation of the Low Back Under General Anesthesia: Case Studies and Discussion”: Journal of the Neuromusculoskeletal System 1993;1(3):126 134.
- “Soft Tissue Index: Essential Medical & Crash Studies”: Thompson-West Publishing 2003 – 2011
- “Evidence Basis for Chiropractic Treatment. Chapter 21”: In Motor Vehicle Collision Injuries, second edition, 2005, Lawrence S. Nordhoff, Jr. editor. Jones & Bartlett, Sudbury Mass.
- Editor: Management of Whiplash Associated Disorders. International Chiropractors Association of California, 2009. Accepted for inclusion to the National Guideline Clearinghouse (NGC-7408)
- Practicing Chiropractors’ Committee for Radiology Protocols 2006-8. Accepted for inclusion to the National Guideline Clearinghouse (NGC:007250)
- International Chiropractors Association – Practice Guideline Committee 2004-current
Dr. Davis has taught the course “Biomechanics of Low Speed Impacts: Injury Mechanisms” for the University of California, Riverside seventeen times from 2003 to 2012. He has taught the course “Biomechanics of Low Speed Impacts: X-ray Diagnosis and Interpretation” for the International Chiropractors Association eleven times 2003 to 2007. He has taught the course “Biomechanics of Whiplash Injuries” for the International Chiropractors Association of California three times in 2008.
Dr. Davis is an instructor at the University of California, Riverside, Extension Services, Biomedical Sciences; the Palmer Institute for Professional Advancement, Palmer Chiropractic College; and Life West Chiropractic College, Post Graduate Division. He has multiple awards and certifications. All details can be seen in his Curriculum Vitae.
All reports from MedicoLegal Services will now come from both Dr. Immerman and Dr. Davis and either expert will be available for testimony. We are very excited about this new change and the great benefits that it will bring to you. The fee structure from the past will not change. Please feel free to contact us with any questions at 602-368-9496 or email@example.com.