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Information about Personal Injury in Washington State

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Monthly Archives: July 2013

Department of Health raises ceiling on copy fees for patient records

Categories: Personal Injury Resources

By Jacob W. Gent. Posted on .

Medical recordUnder the Uniform Health Care Information Act (HCIA), health care providers are allowed to charge certain fees to produce copies of a patient’s medical records.  The Act states copy charges may be adjusted every 2 years for inflation based on the consumer price index.  Recently, the Washington State Secretary of Health updated the maximum charges providers are permitted to charge for records copies.

Effective July 1, 2013, reasonable fees for duplicating health care records are as follows:

  • A maximum $24.00 flat fee for clerical searching and handling, up from $23.00 over the last two years;
  • A maximum $1.09 per page for the first 30 pages of records, up from $1.04; and
  • A maximum .82¢ per page after the 30th page, up from $.79.

Rates are based on the Seattle-Tacoma consumer price index and are reviewed every two years. These rates will remain in effect until July 2015.

Mobile Hand-Held Devices Can Increase Musculoskeletal Symptoms

Categories: Personal Injury Resources, Practical Tips You Can Use, Spine Injury

By Steven J. Angles. Posted on .

Did you know that the average human head weighs 10 pounds in a “neutral position” – where the ears are aligned over the shoulders?  Did you know that for every inch you tilt your head forward, the pressure on your spine doubles? In other words, if you are reading this blog with your head leaning down, or slouched over in a chair, you are asking your neck to support 20-30 pounds of weight.[1]   Now ask yourself – how many hours per day do you spend hunched over your smart phone, tablet, or some sort of mobile electronic device?  Your musculoskeletal system, particularly your neck and arms, may be paying the price for the convenience of having instant and portable access to all that information.

Mobile DeviceIn 2011, Canadian researchers Berolo, Wells and Amick conducted the first epidemiological study to investigate the frequency of upper body musculoskeletal pain of in mobile device users. [2] This was the first study of this fast-growing health concern to provide empirical evidence of relationships between mobile device use and symptoms of the upper extremity and neck. Participants in the study reported their daily use of mobile devices and self-reported pain symptoms through an internet based questionnaire. 104 students and 32 staff or faculty members participated in the study (80 females, 60 males). 94% were right hand dominant, and 26% use both thumbs to type (vs. one thumb typing)).  The study revealed:

  • 98% of the study participants used a hand-held mobile device for emailing, scheduling, browsing the internet, making phone calls, watching videos, taking pictures, or gaming.
  • Participants used such devices for a mean time of 4.65 hrs/day
  • 84% reported at least some pain in at least one body part
  • Pain of any severity was reported as follows:
    • 68% in the neck
    • 62% in the upper back
    • 32% in the right elbow and lower arm
    • 52% in the right shoulder
    • 46% in the left shoulder
    • 27% in the left elbow and lower arm
  • Statistically significant associations were observed between total time spent using a mobile device and pain in the left shoulder, the right shoulder, and the neck

The study also indicated that musculoskeletal symptoms can also develop in the extremities with activities such as typing, as pain in the hands was a common complaint, particularly at the base of the thumbs.[3]  This would be consistent with case reports suggesting a link between device use and both tenosynovitis and osteoarthritis [4] at the base of the thumb (carpometacarpal joint), as well laboratory studies showing that smaller keyboards (as compared to desktop or laptop computers) may increase “static strain” on the hand and arm muscles.

While mobile electronic devices have become an indispensable part of life for many people, the Berolo Study underscores the importance of taking simple steps to limit the amount of time we place our bodies in an abnormal position that can increase stress on the muscles, cause fatigue, muscle spasms and even stress headaches.  These include improving posture, raising electronic devices towards the head (not vice-versa), taking breaks to break up static body positions, and using speech-to-text functions rather than typing.

Individuals already suffering from musculoskeletal injury due to trauma may be at a higher risk for complications arising from the over-use of personal electronics.  Postural strain, overuse, or prolonged immobilization in these patients can result in additional changes in posture or body mechanics that may bring about spinal alignment problems and muscle shortening.  As such, patients recovering from traumatic injury to neck, back, arms, or hands should be particularly aware of their habits while texting or surfing the web on their electronic tablets to prevent additional injury or a prolonged recovery.





[3] Id.


Pedestrians at Higher Risk During Left Turns

Categories: Auto Accidents

By Steven J. Angles. Posted on .

A 2013 study released by Oregon State University reveals that about 4 – 9% of the time, drivers making a “permitted” left turn do not look to see whether there are any pedestrians in their path of travel. [1] (A “permitted” left turn is defined as one in which a left turn is allowed by a circular green light, a flashing circular yellow light, a flashing circular red light, or a flashing yellow arrow, as opposed to a “protected” left turn in which in which a solid green arrow gives a driver the complete right of way in a left-turn lane).

ped crossingThis estimate is much higher than previously thought.  The engineers conducting the research found that approximately one time in 10 or 20, a driver attempting a left turn did not even look to see whether there was a pedestrian ahead before initiating the turn.  As part of the study, the researchers used a full-scale driving simulator that monitored eye movements. The heavier the traffic, the less attention research subjects paid to the possible presence of pedestrians.  In essence, the study found that many drivers were simply faced with too many distractions while attempting a left turn on a traffic signal other than a basic left green turn arrow. These distractions ranged from focusing on narrow windows in which to complete a turn relative to oncoming traffic, to focusing on the traffic signal rather than the intended path of the vehicle.

Interestingly, the researchers concluded that permitted left turns are now sufficiently dangerous to pedestrians that states should consider prohibiting them. In fact, in Washington County, Oregon, traffic managers recently implemented this step after a high numbers of pedestrian-vehicle collisions.

Also of interest is the preliminary evidence to suggest that the currently-mandated type of signal in many states, which uses four heads instead of three, can still be sufficiently dangerous as to cause an immediate hazard to pedestrians in a crosswalk. However, the cost to implement a four-head signal is about $800 more than retrofitting the three-head version, which is widely used around the nation, prompting the question of whether many millions of dollars might be saved nationally by using the simpler signal.

As the amount of foot traffic increases in cities around Washington State, it is crucial for both drivers and pedestrians to take the utmost care in these situations to avoid the potential for serious personal injuries.

[1] Oregon State University (2013, April 2). Pedestrians at serious risk when drivers are ‘permitted’ to turn left. ScienceDaily. Retrieved

CURVEBALLS AND KIDS: How Can Parents Protect Their Young Pitching Athletes From Serious Arm Injuries?

Categories: Other Physical Injuries

By Melissa D. Carter. Posted on .

With the first day of summer on our heels, most little league championships have concluded and young baseball players are done for the season.  Unless you, like I, have a TOK (totally obsessed kid) that plays post little league pitcherseason Allstars, followed by summer ball league, sprinkled with summer baseball parties and topped with pitching sessions with dad in the yard.  We are All-Baseball, All-The-Time.

At one particular little league championship this spring, an 11-year old pitching dynamite on the mound was destroying our team.  He was throwing curve ball after curve ball, striking out one batter after the next.  He was fierce.  He was feared.  The championship was on the line, and he was a Hero.  That is, until his 11-year old arm gave out on him and he collapsed on the mound, grabbing his ravaged elbow, screaming in pain.

According to the Division of Sports Medicine at Children’s Hospital Boston, the “Little League elbow” is on the up-tick, and they are seeing 12-14 year olds in droves with injuries caused by throwing curve balls.

Sports medicine physicians seem to agree that pitchers under the age of 13 are simply not physically capable of absorbing the torque and strain on the elbow caused by throwing a curveball.  The ulnar collateral ligaments that connect the lower and upper part of the arm are too underdeveloped to survive the strain.   The American Sports Medicine Institute says, “don’t throw curve balls until you can shave.”[1] ASMI Executive Director Lanier Johnson added, “The kid who throws all those curve balls in the Little League World Series is a hero. But does he ever get a change to earn a college scholarship or sign a major league contract? Do you want to take a chance on your son or daughter to get a college scholarship? Do you want to be a hero at 13 or 14 but never much else after that?”[2]

Dr. Lyle Micheli, director of the Division of Sports Medicine at Children’s Hospital Boston, believes the curveball is best not thrown until a pitcher is at least 14. He also said kids shouldn’t attempt to throw a slider, a pitch that puts even more stress on the elbow, until 16.[3]

Little League International and Little League Baseballs have tried to minimize the risk to young pitchers by mandating a pitching count limit and innings’ pitched limit per game.  They have not, to date, mandated an age requirement or restriction on curve balls.  “It doesn’t mean we’re advocating throwing breaking balls,’’ Stephen D. Keener, president and chief executive of Little League International.  “We don’t promote it. We just think it’s very difficult to regulate it out of the game, and there is no data to show that throwing breaking balls is at the root of arm injuries.’’[4]

Timothy Kremchek, an Ohio orthopedic surgeon and the Cincinnati Reds team physician, disagrees.  “They have an obligation to protect these 12-year-old kids and instead, they’re saying, ‘There’s no scientific evidence curveballs cause damage, so go ahead, kids, just keep throwing them.’’’[5]

While there is no Little League rule banning the destructive pitch, parents should remain vigilant to protect their children from serious injury, and heed the warnings by the medical profession concerning this growing trend among young pitchers.  Without Little League oversight, parental knowledge is instrumental in protecting young athletes. These injuries are totally preventable, and awareness is key.

Dr. Kremcheck offered the following tips to parents and their eager, baseball loving children, on appropriate measures to minimize serious injury to pitchers:

  1. No curveballs until aged 14-16;
  2. No more than 300 pitches per week, be it games or practices; and
  3. Good coaching: ensure your child has a knowledgeable, experienced pitching coach teaching proper techniques.

If you are someone you know has suffered a traumatic, preventable, injury while participating in a sporting event, we have trained, knowledgeable and experienced attorneys in the area of sports injury law that are able to consult with you.






[5] Id.