1. Introduction To This Page
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 Biodynamics Research Corporation (BRC). Interested parties not Arizona chiropractors wishing provisional access should contact ACS at (602) 368-9496 or ACS@AZChiropractors.org.
2. Dr. Immerman Offers Expert Witness Services
Dr. Immerman is one of the most experienced expert witnesses in the country having testified in 63 trials in the past 12 years (click here for list of trials with CV numbers and case names and dates) and having had his deposition taken 43 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 63 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 aimmerman1@cox.net. 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 aimmerman1@cox.net 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.
4. Can Delta V Predict Injury Likelihood or Severity
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 is available at the ACS Store.
5. Threshold of Injury for Any Single Individual or Entire Population Not Known
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 1,500 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 at the ACS Store.
6. Common Flaws in Delta V Calculations by Defense Accident Reconstructionists
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 at the ACS Store.
7. Exemplar Rebuttal Reports to MD IME Orthopedic Surgeons in Personal Injury Cases
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 1,500 rebuttal reports, testifying more than 60 times in court, and being deposed 40 times in the past ten 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 at the ACS Store.
8. Exemplar Rebuttal Reports to Chiropractic IME Defense Doctors in Personal Injury Cases
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 at the ACS Store.
9. Exemplar Rebuttal Reports to Defense Biomechanical Engineers
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 1,500 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 63 trials and 43 depositions, Dr. Immerman knows what it takes to win in the courtroom. This PDF document is available at the ACS Store.
10. Personal Injury Practice Tools and Documents
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:
Assignment of Benefits and Payment Agreement Form
Automobile Accident Report Form
Outcome Assessment Tools for Neuromusculoskeletal Conditions
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.
12. Are Spinal Range of Motion and Muscle Spasm Exams Subjective or Objective?
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 Stardards 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 epidemiologic 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 epidemiologic 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.
14. Methonds for Attacking the Defense Biomechanist by Attorney Nicholas E. Vakula, Esq. of Phoenix
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.
15. Key Resources in Personal Injury Matters with Emphasis on Low Speed Impact Cases
In the case of Hallmark v. Eldridge, July 24, 2008 Nevada Supreme Court (2), the Neveda 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.
16. Litigation Questions for a Typical Biomechanical Engineer
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.
17. U.S. Court Cases Where Defense Biomechanical Engineers have been Excluded and the Theories Used
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.
18. Summary of Specific Human Subject Crash Papers
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.
19. Eighteen Studies Frequently Cited by Defense Engineers
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.
20. Questions about Comparable Activities and Bumper Car Rides
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 arguements 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.
21. These Newsletters are Reviews of the Scientific Literature by Dr. Immerman
Mechanisms of injury following rear-end collisions are well understood
The best peer-reviewed medical journal whiplash review article ever, January, 2007
The best medical journal low speed impact studies ever, December, 2006
Factors predicting outcome after whiplash injury in subjects pursuing litigation, September, 2006
Summary of recent medical journal studies regarding low speed impacts and injuries, April, 2006
"You can't predict the past" -- a low speed impact automobile accident commentary, March, 2006
New low speed impact article published in peer-reviewed medical literature, January, 2006
Is cervical spinal manipulation contraindicated due to risk of stroke? August, 2005
Major flaw found in defense engineers' analyses, May, 2005
New research ends the debate on low speed impacts, April, 2005
Breakthrough low speed impact article published in The Spine Journal, March, 2005
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 aimmerman1@cox.net for the most recent literature and advice.
22. Health Care Provider Liens
Arizona Revised Statutes 33-932. Perfecting lien; statement of claim; recording; effect
Arizona Revised Statutes 33-933. Recording and indexing lien claim
Arizona Revised Statutes 33-935. Workers' compensation cases exempted
Arizona Revised Statutes 33-936. Release of hospital lien; liability
HISTORY
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.
24. How Every Chiropractor Can Qualify as an Expert Witness in Clinical Biomechanics
ACS has developed a document that throughly 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 qualifed 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.