Chronic Regional Pain Syndrome - A Devastating Condition Explained

Through the years, I've worked with many clients who suffer what is often termed chronic regional pain syndrome (CRPS) following a personal injury.  This condition is usually devastating to the person suffering.  Not only does the person suffer pain that can leave them disabled, they often cannot get good medical treatment or even straight answers from their physician.  These patients don't just hurt.  They usually become depressed from the pain and frustrated by a medical system that does not help.  Their families also suffer tremendously as well.

The medical issues with chronic pain are complex.  I have deposed many doctors and have found that even the medical professionals often do not understand (or cannot explain) these issues unless they specialize in this area of care.  This evening I came across a blog entry from another attorney that referenced a video explaining the condition.  After watching the video, I decided to post it.  It is a great discussion of chronic pain and its cause. 

 

 

 

A Reminder of the Danger Posed by Fire Ants in Nursing Homes

Recently, I was reading a copy of The Safety Report when I found an article written by attorney Billy Cunningham.  Billy is an excellent attorney with the firm Burns, Cunningham & Mackey in Mobile, Alabama.  In past years, I have had several opportunities to discuss cases with the attorneys in this firm.  They approach every case with a great degree of preparation and skill.

The article was entitled The Danger of Fire Ants.  It provides some interesting history on the spread of fire ants throughout the southern United States.

Fire ants pose a danger to anyone working outdoors.  If you have ever seen fire ants swarm, then you know how quickly this danger can become a real injury.  While fire ants are generally found outside, they can come indoors foraging for food.  This is what presents a special danger to elderly patients in nursing homes.

In recent years, there have been several instances of elderly people being attacked by fire ants.  These vicious attacks have led to severe personal injuries and even deaths.  Several years ago, our firm represented an elderly lady who was viciously attacked by fire ants in her nursing home over the course of two nights.  Early in the morning following the second night of attacks, our client's daughter came for a visit.  What she first saw was a horrible scene of thousands of ants swarming her mother's bed.  She then heard screams and found her elderly mother in the bathroom with one of the facility's attendants desperately trying to clean the stinging ants off of her.  Her injuries were devastating.  However, the attacks could have easily been prevented by the nursing home.

Billy gives some great advice in his article.  Hopefully, he won't mind if I copy it here:

Nursing homes, hospitals and day cares – those places where the vulnerable are located- need to recognize this risk and take appropriate actions to assure the safety of their patients and wards. With appropriate interventions fire ants can be controlled. Consumers need to be aware and look for signs in their loved ones’ rooms or areas. Ask the facility if they are looking out for ants and other animals that could cause injury and who the pest control company is. There is no reason such attacks should occur if proper precautions are made in these areas where persons not able to protect themselves.

I would highly recommend reading Billy's article.

A Reminder From Our Supreme Court Concerning the Procedure Necessary to Make a Claim for Underinsured Motorist Coverage

I have written previously about the problems caused by Alabama drivers who don't have liability insurance.  Because of this issue, several legislators have worked to develop a system of instant verification.  While important in keeping totally uninsured drivers off our roadways, instant verification does not completely resolve the problem.  That system does nothing to resolve the problem created when a driver with insurance, but not enough insurance, causes an accident.

What if you suffered a disabling injury in a car accident caused by another driver?  Suddenly, you cannot work and you are faced with huge medical bills.  Then, on top of that, you discover that the other driver had only $50,000 in insurance coverage.  That coverage is certainly not enough to compensate you for a disability that causes you to be unable to work for the rest of your life.  In fact, it is not even enough to cover the bills you might incur by a significant course of medical care.  What do you do?

If you have uninsured / underinsured coverage (often referred to as "UIM"), then you can receive compensation for your damages from your own insurance policy where the at-fault driver has no liability insurance or insufficient liability insurance.  When the at-fault driver is totally uninsured, you can simply make a claim directly against your own carrier for this coverage.  However, when the at-fault driver has some coverage, but not enough, the procedures are a little different.  And, if you don't follow the correct procedure, you will lose any right to receive this additional coverage.  The Alabama Supreme Court recently issued a harsh reminder to anyone seeking benefits for injuries caused by an underinsured driver that the procedures must be followed.

So, what must you do to make a claim for UIM benefits when the at-fault driver does not carry enough insurance to cover your damages?  Basically, before agreeing to any settlement with the at-fault driver (or his carrier), you must follow several procedures designed to notify your own UIM carrier and allow it time to both investigate the claim and determine how to proceed.  Here is the exact question and answer from The Alabama Supreme Court:

Under Alabama law does the failure of an insured to give prior notice to his or her insurer of a proposed settlement and release of an alleged tortfeasor cause the insured to forfeit underinsured motorist coverage regardless of the insured's actual knowledge of said coverage and regardless of prejudice to the insurer if the insured has possession of the policy which provides the coverage?

We answer this question in the affirmative.

Downey v. Travelers Property Casualty Insurance Company.  Not only did The Alabama Supreme Court remind us of the procedure that must be followed, the Court also basically said there would be no exceptions or excuses allowed.  This is an area where you can easily lose your right to additional insurance coverage.  That is why it is very important to seek advice from someone who understands the issues involved in automobile collisions and insurance.

 

 

Update - Alabama's Mandatory Automobile Insurance Requirement Needs Instant Verification

Back in February, I wrote about Alabama's mandatory automobile insurance requirement and the need for instant verification.  Too often, people on Alabama's roads suffer devastating injuries due to the negligence of uninsured drivers.  A system of instant verification could reduce the number of uninsured drivers endangering the lives of others on our highways.

This afternoon, WSFA News ran a story highlighting the problem and this potential solution.  It is well worth a few moments of time to read the WSFA story.  According to the story, the bill introduced by Sen. Arthur Orr has passed our state senate but is still pending in the state house.

Here is an interview of Sen. Arthur Orr where he also discusses this proposed legislation:

 

 

Challenging False Claims of Malingering by the Defense

I recently read a post by Edwin Lamberth titled "Beating the Malingering Defense" on his firm's blog. Edwin is an excellent attorney practicing in Mobile, Alabama.  I have had several occasions to discuss cases with him in the past.  His post raises an issue that we must handle in many of our cases.  Edwin offers some valuable advice when dealing with such allegations by defendants and their legal counsel in personal injury litigation.  I agree with Edwin that it is very important to identify people who live and work around your client. These witnesses can provide valuable and credible testimony concerning the very real impact of a serious injury on your client.

In his post, Edwin also points out that defense counsel will rarely come right out and say your client is exaggerating or faking his injuries.  Instead, the defense will try to imply these bad motives to prejudice the treating doctors, judges, and juries against your client. What the defense knows is that an outright accusation of malingering could easily be defeated.  The implication of a bad motive casts a shadow of doubt that is much more difficult to defeat.

The medical experts for the defense will often use official sounding tests to claim that they suspect exaggeration by the plaintiff or cannot reach a diagnosis because of questionable results. In order to effectively represent an injured client, an attorney must understand the terminology and "tests" cited by a defense medical expert.  Deceptive defense medical experts use a variety of questionable tests to imply malingering.  I hope to discuss several of these questionable tests in the future.

Today, I want to talk about just one supposed "test" that defense medical experts mis-use to claim malingering.  In the last month, I have deposed two different physicians where this test was cited as an implication of bad motive by my client.  This test is called "Waddell's Signs."

When do you typically see a defense expert cite Waddell's Signs?  The defense medical expert will most often utilize this "test" in cases where the plaintiff has had a severe injury that results in chronic pain.  Why do defense experts cite Waddell's Signs?  The expert will cite this "test" to imply that the injured person is exaggerating their pain.  The defense expert will often use this implication to say that they cannot accurately state the injured person's limitations or true functional problems because of the positive signs.  Again, what makes this accusation so difficult is that the defense expert typically will not outright accuse the injured person of malingering, but rather, will say the positive Waddell's Signs lead to questionable claims.  This is the shadow of doubt that the defense will want to present to a jury.

So, what are "Waddell's Signs" and what do they really show?  Basically, the "signs" consist of the doctor performing certain physical maneuvers on the patient and asking if they result in pain.  They were developed by Gordon Waddell.  The idea behind these maneuvers is that the specific maneuvers should not physically produce such pain.  The first problem with them is that the physician may not have even performed the maneuvers correctly.  Most physicians I have questioned about this test really do not even fully understand the maneuvers they are supposed to perform.  However, even if performed correctly, positive results do NOT mean the injured person is malingering.  The creator of the signs, Gordon Waddell, clearly stated in his research that they were NOT intended to identify malingerers. In fact, positive results can mean several things, some of which are related to patients experiencing severe chronic pain from an injury.  Subsequent research has also suggested that Waddell's Signs have little or no correlation to the issue of malingering.  In my own practice, I have seen several past cases where the defense medical expert cited positive Waddell's signs to imply my client was malingering, only to have a surgeon months later find and operate on a very real and painful injury to the person's spine.

Keep in mind that Waddell's Signs are just one of several suspect "tests" used by defense experts to cast doubt on a legitimate claim.  As Edwin noted in his blog post, it is very important to identify the people who live and work with the injured person.  These witnesses can provide important testimony concerning the very real impact of the person's chronic pain.  It is also important to not allow the defense medical expert's unsubstantiated and vague implication of malingering go without challenge.  The attorney who regularly represents injured people must understand these medical issues and directly challenge unfounded allegations.

Alabama's Mandatory Automobile Insurance Requirement Needs Instant Verification

Imagine that you are injured by a negligent driver on an Alabama roadway.  Alabama law requires the other driver to carry liability insurance coverage.  The accident report even lists the other driver's insurance carrier.  At least there is insurance coverage for your injuries.  Or, so you think. Unfortunately, things are not always what they seem.

Despite a law requiring drivers to carry liability insurance coverage, it is estimated that 25% of the drivers on Alabama roads do not currently have insurance.  How is this possible?  It is possible because many people purchase the required coverage, receive their insurance card, and then promptly cancel for a refund.  Although the driver does not possess current coverage, they do possess an insurance card which indicates that they possess coverage.  That card is all the person needs when insurance information is requested by law enforcement.

What can you do to protect yourself from a driver who fails to carry valid or sufficient liability coverage?  The most important thing you can do is to make sure you have adequate uninsured motorist coverage on your policy.  This coverage is fairly inexpensive and it provides coverage for injuries caused to you by a negligent driver who does not possess sufficient liability coverage.

What can the State of Alabama do to help with the problem of uninsured drivers?  The State can create a system of instant verification.  It would be simple to create this system.  Law enforcement can already immediately verify the status of your license with its database.  Simply require insurance carriers to report the issuance or cancellation of coverage so that this information can also be part of the database. That way, insurance coverage could be immediately verified by law enforcement as well.  One member of Alabama's legislature, Senator Arthur Orr of Decatur, is proposing the creation of such a system.  

Uninsured drivers cost the rest of us greatly.  Instant verification is a great proposal to help law enforcement protect us from uninsured drivers on our roadways.

Alabama Physicians Earn Millions from Drug Companies

I recently spoke at a seminar where we had a great discussion about ongoing medical device and pharmaceutical litigation.  No, the companies that we discussed did not pay me to mention their products.  No, none of these large corporations agreed to host the seminar at a sunny beach location or at a ski resort.  Then, again, their executives probably would not have paid for the kind of honest discussion we had about the damage caused by some of their products.

However, these same companies have provided millions upon millions of dollars to various physicians and medical groups.  This includes money directly to physicians.  It also includes trips to the fun places I mentioned earlier.  This infusion of cash to the various physicians who are supposed to be unbiased in their assessment and research raises serious questions.  I have written about these issues previously.

According to the Birmingham Business Journal, we now learn that drug companies paid Alabama doctors $4.6 Million in 2009-2010.  A recently released document shows that one local physician, an internist in Decatur, even received over $200,000.00 in payments from GlaxoSmithKline, alone.  If you are taking notes, that is the same company that made billions marketing Avandia before the public became aware of its dangers.  The same company that apparently hid negative test results concerning Avandia.  The same company that may have paid one member of the FDA advisory panel.  I don't mean to single out Glaxo.  The same Decatur physician also received significant money during this short period of time from another pharmaceutical giant as well.

In fairness, I do not know the relationship between the local physician I mentioned and his patients.  I do believe, however, the process of approving and marketing drugs and medical devices to patients is tainted by the flow of money to physicians and those involved with the regulatory process.  If we ever want the process to focus on what should be the most important goals, patient health and safety, then we must insist on a regulatory process that requires full disclosure by both the companies and the decision makers.  We must also insist that patients have full disclosure of the relationships between their medical providers and the companies whose products the are providing.  I would certainly want to know if my doctor had received a significant amount of money from the drug company whose product he was now prescribing to me.

A Tragic Bus Accident and an Alabama Supreme Court Decision Addressing Time Limitations on Claims

On Monday morning, November 21, 2006, a local school bus crashed over the railing of a Huntsville overpass and plunged to the ground below.  That morning several students lost their lives.  Many others suffered severe injuries.  When I learned of the tragic crash that morning, I quickly turned on the television and saw images of the mangled bus.  Seeing the bus and the distance it fell, it is amazing that so many students did survive.  This crash was one of those tragedies that impacts an entire community.

Following the accident, both Federal and Alabama agencies conducted extensive investigations.  The crash has resulted in a continuing discussion in Alabama concerning the safety of our children on school buses.  Hopefully, these studies and discussions will eventually lead to positive safety changes.

As individuals, many of the students or their families pursued damage claims.  I understand that the claims against the bus company and involved drivers have been settled.  Along with those claims, some of the injured students also initially filed, and continue to pursue, specific claims against the bus manufacturer alleging that the bus itself was defective.  Another group of injured students did not initially pursue product liability claims against the bus manufacturer.  These other students only attempted to allege product liability claims after first resolving their claims against the bus company and involved drivers.  Because this second group of students first alleged their product liability claims long after the tragic crash, the trial court ruled these additional claims had not been filed within the applicable statute of limitations and were barred.

The students appealed.  This provided the Alabama Supreme Court an opportunity to discuss Alabama law concerning the time in which a personal injury claim involving a child must be filed.  This post is certainly not a complete discussion concerning the limitations periods applicable to claims in Alabama.  Many factors affect the specific limitations period available to file a given claim.  As a result, an injured party should discuss their specific claim with an attorney as soon as possible.  However, the opinion released by The Alabama Supreme Court on December 3 does provide a good discussion of claims involving an injury to a child and how different rules apply to them.

If a person is a child when their right to pursue a claim arises, then the statute of limitations generally does not begin to run until the age of majority (adulthood), which is 19 in Alabama.  Again, this general rule is subject to certain other factors.  However, because the students injured in the bus crash were under the age of 19 when it occurred, the Alabama Supreme Court ruled they had additional time to pursue their claimsThis is an important reminder that if you suffered significant personal injury as a child and are now reaching adulthood, it may not be too late to pursue your claims.

 

Upcoming Seminar Offers Some Great Discussion Involving Issues Related to Personal Injury Litigation in Alabama

I have now been involved in several prior legal seminars that were planned and hosted by the National Business Institute (NBI).  NBI offers continuing legal education courses in numerous states, including Alabama.

On one earlier occasion, NBI planned a seminar that brought together a number of distinguished Judges in North Alabama to provide practical advice.  Due to a conflict, the attorney scheduled to host the question and answer session had to cancel.  I offered to fill-in for him as host and greatly enjoyed the opportunity to interact with both the Judges and audience of attorneys attending the event.  Last year, I attended an environmental law seminar sponsored by NBI.  Again, I was thoroughly impressed with the speakers and their presentations.

On November 17, NBI is sponsoring a seminar in Huntsville titled "Personal Injury 101."  When NBI approached me about being one of the presenters at the seminar, I was hesitant to commit.  I initially thought the topic was a little too broad to provide any meaningful information.  However, when the event planner at NBI explained the actual topics for discussion and the attorneys committed to presenting them, I quickly changed my mind.

This upcoming seminar is going to provide a wealth of information.  I am going to speak about some interesting Alabama appellate decisions in 2010 as well as current product recalls that impact the safety of our citizens.  My good friend and fellow attorney, Tony Graffeo, is going to speak about several issues, including expert witnesses.  Tony and I have worked together on several cases, including, recently, a complex business and environmental case against a large chemical company.  He understands well the issues and challenges involving expert witnesses.  Another good friend and excellent attorney, Eric Artrip, is also going to address several topics, including insurance liens and subrogation.  This is a topic that presents a daily challenge to attorneys handling personal injury cases.  I think this seminar will be excellent.  Thankfully, I get to present first so I can sit back and enjoy the rest of the presentations.  If you are an attorney in North Alabama, think about attending this event.

 

A Federal Court Limits Medicare's Reimbursement Rights

In at least two prior posts, I have discussed issues surrounding Medicare's rights to be reimbursed for medical payments from settlements or judgments in personal injury claims.  As I stated in the past, dealing with Medicare can be an extremely frustrating experience.  So, I am happy to report a recent court decision that, to some degree, requires Medicare to play by rules that apply to the rest of us.

On September 29, the United States Court of Appeals for the 11th Circuit issued a decision in Bradley v. Sebelius.  The case involved reimbursement claims by Medicare arising out of a wrongful death settlement in Florida.  This case is a welcome decision for attorneys frustrated by the experience of dealing with Medicare.  On his blog, Tennessee attorney John Day wrote a great analysis of this decision.  I agree with John after reading the facts of the case that it involved some great lawyering on the part of plaintiffs' counsel to document and position the case in an effort to achieve this great result.

In the case, the Federal Court rejected Medicare's far-reaching argument that its own field manual was basically entitled to the force of law.  In rejecting those claims, the Federal Court actually stated:

The Secretary's ipse dixit contained in the field manual does not control the law.

If you want to understand the Latin phrase ipse dixit, here is one definition as to its meaning:

The term ipse dixit is the Latin equivalent of the Greek autos epha, referring to Pythagoras, as in, The master (Pythagoras) said it so it must be true and no proof is needed.

The master said it so it must be true!  That pretty much sums up Medicare's prior attitude in dealing with its beneficiaries.  Here, Medicare created its own manual and has attempted to enforce it against beneficiaries as if it were a validly enacted statute.

Additionally, according to this case, Medicare must account for underlying state law concerning substantive recovery rights.  Under Florida's wrongful death law, the claim of an estate is separate and distinct from the claims of the survivors.  Both the estate and survivors of a deceased can sue the party responsible for causing the death in Florida.  However, under Florida law, only the estate can claim medical expenses as part of its damages.  Thus, only the estate's share of any settlement is subject to Medicare reimbursement claims.

This decision is a welcome limitation upon Medicare's actions.  Now, if Congress would only pass legislation requiring Medicare to respond in a timely manner to efforts by private parties to reimburse medical payments.

Proposed Legislation Would Impact Medicare Reimbursement in Personal Injury Claims

As I have previously written, it is essential that an attorney handling personal injury claims have a sound knowledge of reimbursement and subrogation issues.  Otherwise, the attorney will be ill-equipped to protect his injured client and maximize any recovery for that client.  Many issues and facts impact the rules applicable to each specific case.  For instance, does the injured party have health coverage through a private plan?  Is that private plan provided through an employer?  If the injured party does not have private coverage, do they have coverage through Medicare or Medicaid?  Is the coverage through some other public source, such as the Veterans' Administration?  Each of these presents unique issues and rules.

I could write exhaustively concerning the various aspects of dealing with each type of coverage and its unique issues.  However, I truly believe that most attorneys who handle personal injury claims would agree that dealing with Medicare is the most frustrating of any of these.  Imagine a system that requires (with the full force of Federal law) the injured party and his legal counsel to reimburse it from a settlement or judgment, then will not communicate effectively or timely so that those parties can fulfill their legal obligations.  That is Medicare.  Attorneys for personal injury claimants often wait months (or longer) for Medicare to respond to efforts at repayment.  A reporter at The Miami-Herald did an excellent job documenting the frustrations of lawyers attempting to comply with Medicare laws on behalf of their injured clients.  At our office we have experienced that frustration first-hand.  In addition, just imagine how much money is actually available to our government in attorney trust accounts throughout our country.

Finally, those knowledgeable and involved in the Medicare reimbursement process are beginning to discuss methods that would force Medicare to act in a just and timely manner.  In March, legislation was introduced into the U.S. House of Representatives on this issue.  The proposed legislation has support from varied groups, including groups often at odds in personal injury claims.  Despite their differing opinions on many issues, these varied groups all seek changes in Medicare reimbursement procedures that would make the process quicker and more efficient.  What does the proposed legislation do?  The bill itself is fairly short.  It simply provides time limits for Medicare to respond when parties seek to reimburse prior payments for medical treatment.  That is a much needed change that should certainly be discussed and considered.  While I do have some initial concerns with the bill, including whether a potential defendant in a claim could use the provisions to its benefit in litigating that claim, it is a much needed start to resolving a frustrating issue for injured parties.  It is also my hope that Medicare will act to comply with any enacted time requirements so that health care costs are not unnecessarily shifted from private insurers to our government.

 

 

OSHA Proposes New Standards to Prevent Injuries From Falls

On May 24, 2010, the Occupational Health and Safety Administration (OSHA) announced proposed revisions to the rules governing fall protection standards.  Falls are one of the most common work-related hazards.  According to OSHA, falls are the most common cause of fatalities at construction sites and account for one of every three construction-related deaths.

I have seen first-hand the life-changing injuries that can be caused by easily preventable falls.  They include a worker who suffered a disabling brain injury when he was required by his company to climb on stacked materials that shifted, causing him to fall to the concrete floor.  They include two workers knocked from their elevated work platform by a moving crane.  They include a worker who was required to move a scissors lift while extended despite an uneven surface below, resulting in the entire lift toppling to the ground.  These disabling injuries (and many of the deaths and injuries from falls) could easily be prevented through either the provision of proper equipment or proper job planning.  Instead, the employers in each of these falls neglected to provide the proper equipment or to plan for potential hazards.  In fact, if employers would simply conduct an activity hazard analysis before performing a specific job for the first time, most hazards could easily be identified and prevented.

According to OSHA chief Dr. David Michaels:

This proposal addresses workplace hazards that are a leading cause of work related injuries and deaths.

I plan to review the new proposal carefully.  Hopefully, it will provide some of the clear and simple safeguards needed to protect workers from fall hazards in the workplace.

It's Time to Re-Think Alabama's Survival Statute

In Alabama, un-filed tort claims do not survive the death of the victim.  This is because of a special statute created by our legislature.

Why is this significant?  Consider the impact of this technicality on two different, hypothetical, tort victims.  Both victims suffer terrible injuries when struck head-on by an intoxicated driver.  Both are rushed to the hospital.  Both spend months receiving very expensive, specialized medical care.  Did I point out that months of hospital care would be very expensive!  Both lose wages.  The first victim files his case against the intoxicated driver who injured him.  Then, he dies.  The second victim dies before he can file his claim.  For the first victim (who actually filed his claim), his estate can still pursue the claims and seek to recover for the tremendous damages.  For the second victim, his estate must now pay huge expenses for medical care and other losses out of his assets, with no ability to recover these items from the person actually at fault.  Needless to say, these bills could easily consume an entire estate and leave the heirs with nothing.

Doesn't Alabama allow wrongful death claims?  Yes.  If the above victims died from their injuries (and not some separate cause), their heirs could pursue wrongful death claims.  However, under Alabama law, you cannot recover compensatory damages in a wrongful death claim.  Under Alabama's unique wrongful death procedure, only punitive damages are recoverable.  So, again, one estate can recover these huge expenses while the other cannot.

This unique aspect of Alabama law can lead to devastating consequences for families.  However, this injustice could be easily fixed by our legislature.  Alabama could adopt the Uniform Law Commissioners' Model Survival and Death Act or enact some other provision that fixes this problem.  In prior years, proposals have been introduced into our legislature.  It is certainly time for this issue to be seriously considered.

 

Settlement Mills And The Lost Art of Advocacy

After spending the last few days in trial, I found the recent entry of Philip Thomas on his blog concerning settlement mills very timely and interesting.  Philip provides a detailed discussion of a research article on this issue by Stanford Law Professor Nora Engstrom.  Before I add my comments to his entry, I should first compliment my law partner Jennifer McKown on a job well done at trial this week.  Typically, our firm carries 2 or more partners to each trial.  Since Jen primarily worked this case, I had the opportunity to do more watching than working.  So, I watched two excellent attorneys, both Jennifer and her opposing defense counsel, really show their great skills.

However, I probably should return to Philip's blog entry on settlement mills.  I would encourage anyone interested in law practices to read his entry as well as the research upon which it is based.  When I consider the phrase "settlement mill," I typically picture a law firm that advertises on television, takes a high volume of cases, does very little to develop or prepare their cases, and then settles as quickly as possible.  Clearly, these "settlement mill" firms are not serving the best interest of each individual client.  Clearly, these "settlement mill" firms are not serving the best interest of our justice system.

When I travel to larger cities, I am confronted with more settlement mill firms.  However, they are now present practically everywhere.  Here, in Alabama, you can see their advertisements on television.  They employ well known actors to make claims of great success or use a catchy jingle that sticks in your mind.  In one local advertisement, a well-known celebrity implies that "the firm" will get you maximum results.  However, with a little background work, you can discover that "the firm" is really one attorney working from an office many hours away.  You don't see the attorney in the actual commercial and I've never seen his name on an actual docket for trial.

On a more personal level, I frequently receive calls from injured individuals who hired one of these mills.  They often call right before the statute of limitations is set to expire, barring their claim.  In these cases, the settlement mill could not get their claim settled and simply did not want to go to court.  Other times, the caller settled their case below its value at the recommendation of the firm and now regrets that decision.  On other occasions, the caller hired the settlement mill firm and then could never speak with an actual attorney (or sometimes anyone at all who was familiar with their case).  Many times, the settlement mill firm has placed their client at such a disadvantage by not working the case that any actual trial becomes a very difficult task.

What should you look for in an attorney?  Look for an attorney who will actually go to trial.  Look for an attorney who will actually prepare the case.  A good attorney rarely needs paid celebrities or catchy jingles to market his professional services.  A true trial attorney is often very selective in screening what cases he or she accepts.  Then, once accepted, that attorney prepares the case as if it will go to trial.

 

Confidential Settlement Agreements Present a Host of Problems

I often read the entries on another blog titled Plaintiff Trial Lawyer Tips.  A recent entry on this blog titled Secrecy in Settlement Negotiations by Paul Luvera discusses a significant issue concerning the settlement of lawsuits.  The issue, confidential settlement agreements, is one our firm has long considered an area of concern.  In his entry, Paul writes clearly why he is against secret settlements.  I agree completely with Paul's reasons for not favoring secrecy.  Like Paul, I try to explain to my clients the issues surrounding confidentiality.  I discourage my clients from agreeing to these settlement arrangements but will honor their decision if they choose to do so.

Why are confidential settlements an issue?  Our tort system should work to provide accountability, to assess just compensation to victims, and to deter wrongful conduct.  A secret settlement defeats all these purposes.  By making a settlement confidential, a defendant is much less likely to actually change their dangerous conduct.  Others may also be injured because the problem has now been concealed from the public.  When injured, these other individuals will then not benefit from the information gained in the earlier claim that could assist them in seeking justice.  As a matter of public policy, these secret settlements harm society as a whole.

On a case-by-case level, entering into a confidential settlement can also expose both the injured party and their legal counsel to future liability.  When parties enter into a settlement agreement they expect the issues to be completely resolved.  Yet, any accidental disclosure of the deal in the future could result in both the injured party and their counsel being sued for a return of the confidential settlement proceeds or other damages.  Instead of resolving the initial litigation, a confidential settlement can create future litigation.  In his blog entry, Paul notes several actual instances when such agreements have resulted in future litigation.

To all of the issues expressed by Paul, I would add that confidential settlements can also create income tax problems for the injured person.  I am no tax attorney.  I certainly do not intend this post to provide specific advice concerning our ever-changing tax laws.  However, our tax laws exclude some types of damages from a person's income, such as those generally received solely for a physical injury.  That is, such damages may not be taxable as income.  However, other types of damages or compensation may be taxable as income.  By entering into a confidential settlement, the injured party risks the IRS claiming that he received money not as damages for his personal injury, but instead, as payment (and thus income) to stay silent.

Has the IRS ever made such a claim?  Yes, in the case of Amos v. Commissioner.  In January, 1997, Eugene Amos was operating a television camera during a professional basketball game.  During the game, Dennis Rodman jumped for a ball and landed in a group of photographers.  As he returned to the court, Rodman kicked Amos in the groin.  An ambulance took Amos to the hospital.  He later pursued a personal injury claim against Rodman which was settled with a confidentiality provision.  When he later filed his tax return, Amos excluded from his gross income the settlement proceeds as personal injury damages.  Unfortunately, the IRS saw the issue differently, concluding that the proceeds were not personal injury damages but paid in return for confidentiality.  Under the IRS conclusion, the money would be considered taxable income.  Amos and the IRS then litigated the issue in the U.S. Tax Court.  The Court eventually reached a conclusion that some of the proceeds were attributable to the confidentiality provision, and thus, taxable.

How do you avoid this potential problem in a settlement of a lawsuit?  The obvious and easiest way is simply to settle without a confidentiality clause.  However, if you do settle with such a clause, don't simply ignore the risk of tax problems.  Instead, carefully consider the settlement language to minimize the risk.  Although it is very important to carefully review the language contained in settlement papers for a number of reasons, I am constantly amazed at how often attorneys and their clients will simply sign a proposed agreement with little or no regard for its potential impact in the future.

We are not tax attorneys.  However, our office has considered a number of recommended approaches to address the tax risk in confidential settlement agreements.  Several of these approaches are also suggested in an article by the law firm of Mallor, Clendening, Grodner & Bohrer, LLP.  These suggestions include:

  1. Mingle the confidentiality terms throughout the agreement so that they do not appear as a significant or distinct section.
  2. Explicitly state in the agreement that all settlement funds are being paid only because of the personal injury.
  3. Negotiate a separate confidentiality agreement with other money paid for it (which would be taxable).  This is often accomplished by simply allocating a portion of the total settlement proceeds to the confidentiality agreement.
  4. Include language in the settlement agreement that the defendant will indemnify your client for any adverse tax consequences.

On the whole, I still consider confidentiality clauses in settlement agreements to be a bad idea for my clients.  When allowed by my client, I will simply reject them completely.  However, when they become necessary, you must then see that the agreement is written as carefully as possible to minimize any future risks.  This includes the risk of adverse tax consequences as well as other anticipated future risks.

 

Effective Counsel in Injury Litigation Requires a Sound Knowledge of the Law Related to Medical Reimbursement and Subrogation

This morning, the workers' compensation attorney Jon Gelman had an interesting note on his blog about a recent Medicare recovery case filed here in Alabama.  Essentially, the case involves the United States seeking to recover medical payments made by Medicare on behalf of several injured individuals.

The case raises an often misunderstood and complicated issue that we must handle on a daily basis.  Most often, our clients have some type of health coverage that pays their medical bills.  For many, this coverage is provided by private insurance such as Blue Cross.  For others, coverage may exist through some type of government program such as Medicare, Medicaid, or the Veterans' Administration.  Normally, when we seek medical care our particular coverage provides some level of payment.  Typically, this is the end of the story.  However, each of these plans or programs possesses unique rights to be reimbursed for their payments if an injured individual then recovers for their injuries from some third party, such as a personal injury lawsuit recovery.

Many personal injury attorneys seem to focus exclusively on the value of their case from the perspective of what amount of verdict or settlement can be obtained from the responsible defendant.  Personally, I believe that every case should be prepared for trial, rather than simply a settlement, from the beginning.  While this should be the most important focus of an injured person's legal counsel, it should not be the sole focus.  Too often, legal counsel ignores the complicated issues of medical reimbursement and subrogation.  Each particular type of coverage brings unique recovery rules and rights to the table.  These recovery rights are probably the greatest with Medicare.  In the case of Medicare, the government has far reaching rights to pursue claims against not only the injured party, but also, their legal counsel and the original personal injury defendant.  In the case of Medicare, as opposed to a typical private plan in Alabama, those rights even extend to future medical costs.

Effective legal representation in personal injury cases requires an attorney to understand the complex web of subrogation law and to deal effectively with the specific providers.  This is important to avoid a negative action by the coverage provider such as a lawsuit or a future refusal to provide benefits.  Also, if counsel clearly understands the various rules and how to use them, he can often work a resolution that minimizes any reimbursement, and thus, maximizes the recovery ultimately provided to the injured individual.