Every year in the United States, there are six million work related injuries. Additionally, there are about three million injuries resulting from automobile accidents. Each year, surgeons perform about one-half million spine surgeries. The majority of these surgeries are needed as a result of either work injuries or auto accident cases. For almost 14 years, Mr. Prisbrey has handled hundreds of spine surgery cases. It is Mr. Prisbrey’s experience that the most common injury that occurs from automobile accidents is neck injury. Conversely, the spine injuries which occur on the job tend to be low back injuries from lifting heavy objects. When a request for a spine surgery is presented to an automobile insurance or worker’s compensation carrier, it is typically denied.
It is no secret that automobile insurance and worker’s compensation carriers dislike spine surgeries. Typically, the insurance carrier will argue that the need for such asurgery relates to some type of preexisting condition, certainly not to an automobile accident or a work related injury. However, it appears that these denials may well be based more upon economics than reality. Spine surgeries cost tens of thousands of dollars. Indeed, complex fusions involving multiple levels of the spine can easily cost six figures. When presented with denial on a surgical spine case, it is essential that you have an experienced attorney who is familiar with this system of denial and how to approach it.
As we age, we all undergo degenerative changes in our body. These changes take place outwardly through wrinkles, loss of hair or an inability to perform physical acts to the same degree as in our youth. The same processes take place inside our body. Arthritis may start to set in, our bones become somewhat more brittle and our joints begin to wear.
On many occasions, even those of us who have never had spine problems, may have hidden degenerative processes of which we are not aware. Most of us have experienced an appointment with our doctor when we are told of a problem we did not even know we had. It is this information the insurance company will typically rely on in denying a spine surgery.
However, the experienced personal injury attorney recognizes that preexisting problems, or occult spine problems, may have little or no bearing on your claim. For example, if you have sustained injury to your spine in an automobile accident and diagnostic studies, such as an MRI, show that you had a previous asymptomatic condition, such as degenerative arthritis, your case would still be compensable under Utah law. However, such a result may be different in a worker’s comp case. The fact that your condition was asymptomatic, in a worker’s comp case, is irrelevant to the defense of the claim.
The complexities which arise in a personal injury claims involving preexisting conditions are quite complex. This is not an area of the law that is easily understood, and you do need to hire an attorney who is experienced in personal injury law and specifically in claims dealing with back and spine surgeries.
We have developed strategies and procedures to ensure the best resolution possible in your spinal injury case, whether it relate to worker’s compensation, automobile or the negligence of someone else. We work with you, your physicians and the insurance company to obtain the most appropriate settlement possible in your case. If such a settlement is not offered by the insurance company, we will prepare your case in the most expeditious fashion to present your case to a trial.