By John M. Phillips
So, you have had an accident. You went to the hospital. Your doctor ordered a CT scan of your brain or back, because these are fairly quick and easy procedures to determine obvious injury. You are relieved that these radiological studies are negative for signs of injury. But you still hurt. You still want answers. Little do you know somewhere there is an insurance adjuster who will probably downplay why you should have ever gone to the hospital in the first place since the “CT was negative.”
This blog will examine the crucial differences between a CT and MRI, the difference between lawyers who practice personal injury and lawyers who know it and the unfortunate trend of insurance companies to turn ignorance into denial.
All too often, Florida insurance companies want to fight whether you had a permanent injury. The entire PIP (Personal Injury Protection) insurance industry is contingent on using these negative findings against you. These insurance companies save money by wrongfully turning the lack of findings on a particular report or doctor’s snap decision on a medical record into an opinion that nothing (or very little) is wrong with you. This used to be the exception to the rule. Now, it is the beginning of their negotiation process- low ball.
I recently had an argument with an insurance adjuster -who had no medical training- about just what a CT was. He insisted it was just like or synonymous with a MRI. He insisted they were harmless procedures. He insisted they were foolproof. He was wrong on all three accounts.
CT’s are increasingly common in hospitals because they are cheap, simple and great profit centers. They sometimes protect doctors from the malpractice of a missed diagnosis. They are often negative of any findings of new injury, meaning no injury was seen. We often see ignorant adjusters and insurance lawyers waive these “negative” results around as if injury never happened. We often see lawyers who wouldn’t know the first thing about neurology argue they handle personal injury cases and take “no” for an answer. It’s unfortunate. With this article you may know more than many adjusters and some self-proclaimed “personal injury” lawyers on either side of the aisle.
CT, or computerized tomography, use a series of X-rays taken from many angles to provide cross-sectional images of the inside of the body. Over 60 million CT scans are performed in the USA each year, about 10% of them in children, according to the American College of Radiology. They are linked to greater life expectancy, lower mortality rates and reduced hospitalizations, particularly when findings are “positive.” They are fairly commonly used to rule out or rule in head injuries, as they can provide stunningly detailed images from inside of a brain.
But they aren’t without risk. CT scans typically deliver about 70 times the radiation of normal X-rays. CT scans deliver ionizing radiation to the area being scanned and to nearby tissues, potentially damaging DNA. Doctors predict these tests therefore can cause cancer later in life, particularly in children. Yet, insurance adjusters will argue that these are “harmless.”
In fact, by you even going to the hospital and exposing yourself to a CT to rule out injury, you are therefore subjecting yourself to cancer causing agents I am sure that adjuster would object to if apart of his or her job. I can’t blame adjusters that much though, as even doctors fail to point this out. A recent study showed that only 35% of 271 patients surveyed at the Denver Veterans Affairs Medical Center had discussed the potential risks of a CT scan with their doctor before having the test. Yet, we commonly let jurors know- this was a risk, an inconvenience our clients endured, which the Defendants wants to downplay.
And they aren’t without limitation. Most injuries in car wrecks involve injury to the discs, ligaments and other “soft tissues” of the body. Soft-tissue details in areas such as the brain, internal pelvic organs, and joints (such as knees and shoulders) can often be better evaluated with MRI. When it comes to brains, it really depends on the information the doctor seeks. For the most part, CT’s are done to quickly determine if something is obviously wrong, while an MRI will use more precision (at a greater cost of time and money). As such, CT’s are hardly “foolproof,” often inconclusive and simply determine information quickly.
I rarely order or seek CT scans from clients unless it is a case I need that specific technology. I frequently use and have even learned to interpret MRI’s. As I sometimes joke with my clients, “I am not a doctor, but I may pretend to be one in my conference room.” My conference room, without question, has more anatomical models than most lawyers in the United States. It helps my clients understand what is wrong with them and why the insurance company might be misinformed. Can you guess which is which? The MRI is on the left.
Compared to the CT, MRIs give you similar, but more detailed information. They cost more, take longer, and there are restrictions (such as metal in the body) that makes MRI’s impractical or impossible. Most importantly, MRI stands for magnetic resonance imaging, which doesn’t use radiation but instead uses a magnetic field and pulses of radio waves to make pictures of organs, bones and blood vessels.
The point is- I have spent almost a decade working for these insurance companies and 5 years working for injury victims. You need a lawyer dedicated to personal injury and the understanding of bio-mechanical and biomedical forces. You need an advocate who is perfectly happy explaining to an insurance adjuster why they are wrong and why we will “show our math” is far more advanced than they understand.