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The first challenge a spinal cord injury lawyer faces is knowing and understanding the medical terms, physiology and long-term impacts of a spinal cord injury in order to teach this medical field to a jury.

Spinal injury occurs when vertebrae, the supporting boney structures of the back that that make up the spine, are fractured, dislocated or the disks between the vertebrae fail and the soft center of the disk compresses the spinal cord.  Commonly, dynamic loading of the head downward or severe forward bending, or flexion of the spine, is the cause.

In either case damage to motor and sensory nerves in the spinal cord occurs by the displacement of vertebrae or the collapsing of a disk, which strikes or compresses the spinal cord.  In some cases the displacement is so severe that the spinal cord is severed when the bone cut into the cord tissue and causes permanent spinal injury.

In a complete spinal cord injury, the cord is disabled from relaying messages to the brain and all muscle function below that level of injury is lost to paralysis.  Sensation is lost as well.  In an incomplete injury, there may be limited movement and sensation below the injury.  Unfortunately the most common sensation in the case of an incomplete spinal injury is pain.

Proving all the damage caused by a spinal cord injury in order to win a lifetime recovery requires a skilled and experienced spinal cord injury lawyer.  In addition to proving fault, the testimony of family, friends and a host of experts, in addition to treating neurosurgeons, who are skilled in explaining their contributions are critical.  Here are some of the key players at trial.

A physiatrist is a medical doctor trained in rehabilitation medicine with a special emphasis on the neurological and orthopedic needs of patients who have suffered life-altering trauma.  The physiatrist leads the recovery team along with the following specialists.

An occupational therapist evaluates the ability and level of functioning in home, at work, and while engaging in leisure activities and hobbies and provides rehabilitation skills to help spinal cord injury patient perform gross and fine motor skills, as well as the key activities of daily living: bathing, dressing, toileting, transferring [moving from bed to wheel chair and to car], continence [voluntary bowel and bladder functions], and feeding.  Another important task is to determine the types of assistive devices that will help a person become more independent with daily living skills.

Physical therapists focus on restoring motor function, strengthening muscles, improving coordination, balance, endurance and joint movement.  Stretching muscles is an important daily task after a spinal injury and teaching how to stretch is key.  The testimony of a physical therapist explaining the important of the long stretching exercises seen in a  “day in the life” video is valuable for the jury to understand how much time must be devoted to stretching every day.

Vocational rehabilitation specialists are called to testify to explain they identify skills, and abilities that will help the spinal cord injury patient return to work. The process includes evaluating the ability to follow instructions and social skills. Testing helps determine the ability to learn, to make judgments, how to deal with the frustration of getting a new job and making sure the injured person has realistic expectations.  The reality is that the unemployment rate for men and women with spinal cord injuries is well above 50 percent, no matter what defense experts offer to the jury.  Defense claims that there will be minimal long-term income losses are not supported by real-life experience.

In the rehab process, social workers are called upon to provide the connection between the survivor, doctors, rehabilitation professionals, family, school, and work and often the insurance carrier funding the rehabilitation. The social worker studies the patient’s personality before suffering a spinal injury, lifestyle, emotional and financial resources, education, work experience, hobbies and special interests.  The social worker’s background study is one of the most significant documents in the rehabilitation chart and that makes the social worker an important witness at trial in many cases.

A rehabilitation case manager or rehabilitation specialist coordinates the goals of the patient, family and rehabilitation staff as an advocate for the patient and oversees the overall treatment of the person coping with a spinal cord injury. The case manager administers the funding of the recovery program through lawyers, insurance providers and the trustee of a special needs trust.

The information from this medical team is provided to a life care planner whose job is to identify all services and products that will be required over the lifetime of a permanent spinal injury, the frequency of services and the replacement life for wheel chairs, vans with lift gates and necessary household equipment.

Because the cost of future care is calculated in today’s dollars, the detailed report of the life care planner must be evaluated by an economist trained in explaining to juries how to calculate the future cost of care in today’s dollars.  That is a necessary calculation especially since the cost of health care during the last 20 years had continued to increase at a rate far greater than other sector of the economy.

Family members and friends play a major roll in the spinal cord injury rehabilitation by being active participants in recovery and encouraging the survivor to achieve and maintain the highest level of independence as possible. Their contribution is significant since it helps in planning rehabilitation, and integrating into the community.  They are critical witnesses at trial.

By bringing together this team to prove all the harm caused by a spinal injury, my track record as a spinal cord injury lawyer is excellent and my clients have secured a future with less financial turmoil.

Please watch the video by George Liu, who suffered an L-1 paraplegia to learn what we do and how we did it in George’s lawsuit.


Richard Alexander