Personal Injury Updates

Information about Personal Injury in Washington State

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Is Health Insurance More Trouble Than It’s Worth?

Categories: Practical Tips You Can Use

By Steven J. Angles. Posted on .

I recently came across a couple of studies about health insurance that I found truly troubling because of the messages they convey.  One study concluded that having no health insurance while hospitalized can lead to less effective care.  The other indicated that having health insurance while hospitalized can lead to less effective care.  See the problem?

A January 2014 study at the University of Pittsburgh Schools of the Health Sciences found that uninsured patients with a range of medical diagnoses are significantly less likely to be transferred between hospitals for treatment. [1] This was contrary to the study’s original presumption that uninsured patients would be transferred between hospitals on a more frequent basis because they were “unprofitable.”  The projected result?  Uninsured patients face reduced access to health care, and are not necessarily being transferred when they should be.

On the other hand, a February 2014 study published in JAMA Surgery by researchers at Stanford University Medical Center concluded that emergency rooms are less likely to transfer injured patients to trauma centers if they have health insurance because these patients are profitable.[2]  Thus, patients without insurance can be at less risk for receiving sub-optimal trauma care than those with insurance.

As attorneys representing individuals who are seriously injured, we often see clients with and without health insurance.  Despite the conflicting messages of the studies above, it is always our recommendation that those who have access to health insurance carry it, and not simply because it is now the law.  It’s impossible to predict how serious an injury will be, or how much care it will ultimately require.  Having health insurance will afford greater access to care and a greater chance for a speedy recovery. 

[1] Janel Hanmer, Xin Lu, Gary E. Rosenthal, Peter Cram. Insurance Status and the Transfer of Hospitalized Patients. Annals of Internal Medicine, 2014; 160 (2): 81-90 DOI: 10.7326/M12-1977


[2] M. Kit Delgado, Michael A. Yokell, Kristan L. Staudenmayer, David A. Spain, Tina Hernandez-Boussard, N. Ewen Wang. Factors Associated With the Disposition of Severely Injured Patients Initially Seen at Non–Trauma Center Emergency Departments. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2013.4398


Traumatic Spinal Cord Injuries Increasing in the U.S.

Categories: Other Physical Injuries

By Steven J. Angles. Posted on .

I very recently received news from a family member across the country that she had been injured as a result of a fall.  While performing some online research to try and determine the best possible resources in her area to help her cope with this difficult time in her life, I came across an interesting news item that was released by the Johns Hopkins University School of Medicine on January 27, 2014.  According to a study published in the Journal of Neurotrauma and conducted by Shalini Selvarajah, M.D., postdoctoral research fellow at Johns Hopkins, the single largest cause for the rise in traumatic spinal cord injuries in the United States is no longer the motor vehicle crash.[1]  Instead, the blame rests with the increasing number of falls that occur yearly, and in particular, among the elderly.

The study tracked 43,137 adults treated in hospital emergency rooms for spinal cord injuries between 2007 and 2009.   Over the course of the three-year study, falls accounted for 41.5% of traumatic spinal cord injuries, followed by motor vehicle collisions at 35.5%.  The average age of a patient with a traumatic spinal cord injury increased from 41 years old (during a 2000-2005 study), to 51 years old. 

The big question for me was: “Why the sudden large-scale shift from car crashes to falls?”  While the study did not provide a specific response, the researchers noted that we as Americans are living longer, more active lives, leading to more opportunities to be subject to injuries of this type.  In addition, advances in vehicle safety are making it increasingly possible to reduce serious injury in motor vehicle collisions, while individuals injured during a fall have little to no way of protecting themselves from some degree of injury. 

In the end, this study makes me recall the words of my snowboarding instructor, who always taught me to “hug myself” if I ever felt like I would fall (instead of instinctively bracing myself with my hands). Unfortunately, as in cases where someone unexpectedly falls due to the negligence of another, it is never quite that simple.




Cars & Bicycles in Close Proximity

Categories: Bicycle Injury

By Steven J. Angles. Posted on .

According to the US Department of Transportation, 677 cyclists were killed in motor vehicle accidents in 2011, and another 48,000 injured. [1] In fact, here in Washington, the State Department of Transportation has a web page devoted to keeping track of reported bicycle collision statistics, which can be found here.

Are bicyclists who wear highly reflective or colorful clothing less likely to be struck by a passing car?  Researchers in the United Kingdom sought to test whether bicyclists who wore high visibility clothing stood a better chance of avoiding injury caused by a passing motor vehicle collision than those that dressed less visibly.[2]

The chief researcher attached an ultrasonic distance sensor to his bicycle for several months while he commuted to work. He would wear different outfits on different days with varying degrees of eye-catching color or wording on it. He sometimes wore a highly visible vest with the words “Novice Cyclist” prominently displayed on the back. On other occasions, he would wear clothing with wording indicating he was video recording his trip.

Image Courtesy of Graur Codrin /

Image Courtesy of Graur Codrin /

After 5,690 vehicles passed the bicycle, researchers concluded that choice of clothing had little bearing on how much distance motorists gave when they passed most of the time. In fact, the bike sensor indicated that motorists passed dangerously close at times, sometimes as close as 50 centimeters (1 feet, 7 inches). Interestingly, the only outfit that offered a bit more distance from passing cars was the one that indicated the rider was video recording his journey.

If the worst should happen and you or someone you know has been injured as a result of being struck by a motor vehicle while cycling, feel free to contact our office for a free consultation concerning your rights.


[2] The influence of a bicycle commuter’s appearance on drivers’ overtaking proximities: An on-road test of bicyclist stereotypes, high-visibility clothing and safety aids in the United Kingdom, Ian Walker, Ian Garrard, Felicity Jowitt, published in the journal Accident Analysis and Prevention, 22 November 2013.

Cyclists cannot stop drivers overtaking dangerously, research suggests, news release from the University of Bath, accessed 27 November 2013.

Ride Safely Out There

Categories: Other Physical Injuries, Practical Tips You Can Use

By Steven J. Angles. Posted on .

Living in the Pacific Northwest means being surrounded by miles of natural beauty that can sometimes be best experienced on the back of a motorcycle or scooter.   However, it’s also no secret that a motorcyclist’s (or scooter operator’s) best defense against sustaining traumatic injury is proper training, constant awareness, reliable equipment, and taking appropriate safety precautions.  For those who prefer this two-wheeled mode of transportation, or are thinking about the transition from driving to riding, here is a quick safety review of Washington State’s “on-road” motorcycle laws:

Are safety helmets required by law?

A: Yes, as of January 1, 2007.  Following the letter of the law also means that your helmet must be certified by the manufacturer as meeting the United States Department of Transportation (DOT) standards listed under 49 CFR 571.218.  The Washington law itself can be found at RCW.37.530

Is eye protection required by law?

A: Yes.  Unless your motorcycle is equipped with a windshield, you are required to wear glasses, goggles, or a helmet with a face shield. RCW.37.530

Does Washington require the daytime use of a headlight?

A: Yes, pursuant to RCW 46.37.522.  As an extra safety precaution, the Code of Federal Regulations, Title 49, 571.108, permits modulating headlights (which flicker quickly between high and low beams in order to make an approaching motorcycle more visible).

How loud can your motorcycle be?

A: This is a tricky one since plenty of riders believe that a louder exhaust note means higher visibility, and therefore, increased awareness from those around them.  However, the letter of the law can be found at section 173-62-030 of the Washington Administrative Code.  It specifies that exhaust systems or mufflers causing “excessive or unusual noise” are prohibited.  The code section also specifies the decibel levels that are legally acceptable when measured at a distance of 50 feet.

Is lane –splitting allowed in Washington?

A: Unlike states such as California, Washington does not allow lane-splitting (riding between lanes of stopped or slower moving traffic, or moving between lanes to the front of the traffic stopped at a traffic light). RCW 46.61.608

What are the Washington State insurance requirements for motorcycles, scooters, or mopeds?

A: Believe it or not, Washington State does not require motorcycles, scooters, or mopeds to be insured under a motor vehicle liability policy, according to RCW 46.30.020.  All other forms of insurance, including “first-party” coverage (i.e. PIP or MedPay), uninsured motorist coverage (UM), or underinsured motorist coverage (UIM) are similarly “optional.”

However, it is always advisable to insure your motorcycle or other 2-wheeled vehicle to the extent possible.  Most attorneys or medical providers that handle personal injury situations will tell you that at some point, they have come across a situation where a motorcyclist has caused serious injury to another person, possibly a pedestrian, or a passenger.  These same attorneys and providers can also share stories of terrible situations where even a fully helmeted and armored motorcyclist or scooter operator has sustained life-altering traumatic injuries, only later to discover that the vehicle causing the collision was uninsured, or woefully underinsured.   Other situations are simply a matter of gravel in the wrong curve causing a motorcyclist to lay down their bike.  When you consider the fact that motorcycle insurance policies in Washington can be less expensive than similar policies for cars, and can offer very similar coverage amounts, it becomes clear why it’s important to invest in coverage regardless of the legal requirements, especially when you’re not protected by the “cage” of your automobile.

Pop Quiz: How Much Do You Know About Your Health Insurance?

Categories: Practical Tips You Can Use

By Steven J. Angles. Posted on .

With open enrollment for the Patient Protection and Affordable Care Act, also called “Obamacare,” beginning on October 1st, 2013, now is an excellent time to ask yourself how much you know about your own health insurance.  If you plan on shopping for health care insurance in the Washington State marketplace, are you familiar enough with the terms used by insurance companies to make the most informed decision for yourself and your family?  For example, do you think that a “premium” is an expense at the time of receiving medical service or a prescription? Do you think a “copay” is the cost of obtaining insurance?

According to poll results released in August 2013 by the American Institute of CPAs, more than half of Americans are not equipped with the basic knowledge of health insurance concepts and definitions to understand the basics of health insurance plans.[1]  According to the poll, 51 percent of adults surveyed could not accurately identify at least one of the three most common health insurance terms present in insurance contracts: premium, deductible, or copay.  (Incidentally, the poll also found that 41 percent of those surveyed were not knowledgeable about the Patient Protection and Affordable Care Act, with 48 percent of young adults ages 18 to 34 having no knowledge of this change in health care laws.)  This is especially troubling given that the Affordable Care Act requires all Americans to buy health insurance or pay a penalty beginning in 2014.

If you have suffered a traumatic personal injury and are lost in a sea of unfamiliar insurance terms, understanding the basics of health insurance is important to help you make more informed decisions about your medical needs and expenses, and how they affect your household finances.  However, knowing what your medical provider’s billing department is referring to when you speak with them during an appointment, or how to read the constant stream of statements you receive in the mail will also reduce the stress already there when you are living with and treating for injuries caused by another person’s negligence.

In addition to the many ways available on various web sites to help you increase your Insurance 101 I.Q., we have additional resources on our web site.


BUI Laws Toughened Up as of 2013 Boating Season

Categories: Personal Injury Resources, Practical Tips You Can Use

By Steven J. Angles. Posted on .

Summer on the waters of Washington State means getting boats out of dry dock, picturesque  white sails dotting the horizon, and flotillas of vessels grouped together to celebrate our  spectacular weather.  However, as of July 28, 2013, the Washington State Legislature has empowered law enforcement to crack down even more on boaters that operate their vessels under the influence.

According to Washington State Park data, alcohol is a factor in 30 percent of boating fatalities.[1] Senate Bill 5437, signed by Governor Inslee on May 16, 2013, creates stiffer penalties for boating under the influence (“BUI”) and expands prior BUI laws to include offenses for operating while under the influence of marijuana.  Boaters should be aware of the following new changes[2]:boating

  1. Per the revisions to RCW 79A.60.040, the penalty for BUI is no longer a misdemeanor (which carries a maximum of 90 days in jail and a fine of no more than $1,000.00.)  Boaters will now face gross misdemeanor charges for BUI, which means a maximum sentence of 364 days in jail and a fine of up to $5,000.00.
  2. Boat operators are deemed to have given implied consent to have their breath or blood tested for the concentration of alcohol, marijuana, or other drugs in their system, subject to RCW 46.61.506.  If the operator refuses to take the test, they will be issued a class 1 civil infraction under RCW 7.80.120 that carries a penalty of $1,000.00.
  3. Law enforcement officers are authorized to issue citations when investigating boating accidents, or, perform an arrest for violations of any criminal statutes.
  4. Operating a vessel without the proper safety equipment may result in citations for both the owner and operator of the vessel

In essence, the new laws allow law enforcement on the water more of the authority already permitted when investigating DUI cases on land.  The laws are also clearly anticipating the potential rise in BUI incidences due to the legalization of marijuana in Washington State.

Injuries caused by collisions on the water present special challenges for the injured parties, law enforcement, and emergency medical personnel.  An injured person may have to wait much longer to be evaluated at the scene for injuries due to the distances involved and the generally slower nature of boat travel.   Often times, there are few independent witnesses to what actually happened to cause the collision, making it difficult for law enforcement to perform a complete investigation.  In addition, there is the ever-present danger that an injured party may fall overboard and injure themselves more severely.

The attorneys at the law firm of Adler Giersch PS are experienced in cases of injuries from vessel collisions, and are available for a free consultation.



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

Lights, Camera, Action – Use of Dash Cameras On the Rise

Categories: Auto Accidents, Practical Tips You Can Use

By Steven J. Angles. Posted on .

Did you happen to see footage of the meteorite that entered Earth’s atmosphere several months ago? Did you ever wonder why most of the video footage of the event originated from ordinary citizens in the Russian city of Chelyabinsk? The answer has to do with one of the most important after-market components that Russian motorists add to their vehicles before they ever consider radar detectors or satellite radios – dashboard cameras. Unfortunately, drivers in Russia have a significant likelihood of being involved in a severe collision. In fact, in a 2007 study, Russian motorists averaged 25.2 traffic fatalities per 100,000 people. By comparison, motorists in the United States had 13.9 road deaths per 100,000 people in the same year, despite having six times more cars.[1]  Many Russian drivers opt to purchase cameras for their vehicles in order to maintain their rights and memorialize the facts.[2] The same principle applies in the U.S.

Most people involved in a motor vehicle collision quickly realize that a picture can truly be worth a thousand words. If that is the case, what is the value of a motion picture? The answer, often times, is priceless.  Regardless of whether the questions are coming from an insurance company, another driver, law enforcement, or an attorney, there is simply no substitute for being able to show first-hand what happened during a car crash.  This is largely why the idea of having a video camera mounted on the dashboard of a vehicle, or on top of the helmet of a motorcycle rider, is becoming increasingly common.  Video footage is the eyewitness whose memory does not decay with time, and whose bias or credibility cannot be questioned.

Personal injury attorneys can hire a number of experts to recreate what happened during a collision using calculations of time, speed, and distance. However, most of these experts would still agree that having first hand video footage of the event would be a tremendous advantage in reaching their conclusions.dash cam

While this technology became available to consumers about 10 years ago, there has been a spike in the number of cameras sold to motorists in recent years. The reason? Price. These days, it is easy to obtain a dash mounted video camera for your car for under $100. For an additional $100 you can obtain upgraded models that can record high definition video in total darkness, record what is happening behind and inside of a vehicle, pinpoint location by GPS, and can save recorded information automatically in the event of a collision.

These cameras can also help keep loved ones safe when they are borrowing your vehicle.  Are you worried about the driving habits of your teenager? Do you want to know whether your teen is texting while driving? Dash cam footage provides irrefutable answers and can help keep your children driving safely.

Ultimately, a video camera can help an injured motorist explain what happened before, during, and after a crash despite the toll that a physical or psychological trauma can have on that person’s recollection.


Does An Upright MRI Make Sense For You?

Categories: Spine Injury

By Steven J. Angles. Posted on .

If you suffer an injury, your treating doctors may refer you for an MRI (“Magnetic Resonance Imaging”) to see whether there is any damage to your organs, spinal discs, or soft tissues that may not be visible on X-ray films.  So what can you expect? Before the scan can begin, you will be asked to remove all metal, jewelry, watches, hair clips, or similar items prior to the scan. Your technician will ask about any prior surgeries or metal implants you have had undergone previously.  When the testing begins, you will be asked to lay flat on a patient table which will slide some or all of your body into the tube-like cylinder of the MRI scanner.  Once the scan begins, super cooled electric coils will generate a powerful magnetic field which, combined with radio waves, will show the location and appearance of your soft tissue and fluids.

For its many benefits, having an MRI scan can be uncomfortable to one degree or another.  You might feel claustrophobia while lying inside the machine.  Your body type may not allow you to lie comfortably and still inside the scanner for the duration of the scan.  You might find the knocking sound inside the scanner tube unpleasant (even if you have headphones with music playing).  More importantly, in the case of spinal injuries, the “traditional” MRI may not accurately show imaging in the position in which you actually feel pain.   For these reasons, you may benefit from an open upright MRI. Upright MRI

First developed in 1996[1], the open upright MRI (a.k.a. “Stand-Up” MRI) can effectively solve many of the concerns that patients experience in these procedures.  In an open upright MRI, a patient walks between two large magnetic imaging devices and either stands, or they can sit in a chair that raises or lowers their body into the proper position.  The front and top of the machine are open.   The scan typically takes less time than a traditional MRI, and patients might even be able to watch T.V. during the procedure.   In many instances, the scans are less expensive than traditional MRIs.   But the greatest benefit it offers is the opportunity to recreate the body positions that patients might feel pain, revealing causes of injury that might be undetected on recumbent MRI scanners.   For example, if you typically experience neck or back pain while sitting or standing, your scan will take place while your spine has the same weight and gravity it would normally have when you most feel your symptoms.  As a result, the scans may show where your spinal discs are compressed or injured in a way that a horizontal MRI might not show as well.

Of course, you will need to consult with your medical provider before deciding on an upright MRI, as there can be drawbacks specific to your situation.  Typically, traditional recumbent MRIs have a higher “field strength” or power to their magnets, resulting in clearer MRI results that show greater detail.  You definitely want your doctor to have the best quality scans possible in order to provide the best evidence of your injuries.  Some insurance plans do not cover upright MRIs.  Upright MRI machines are not yet as common as traditional scanners, so it may harder for you to locate one that fits your needs.   Lastly, your particular symptoms might be best represented while lying down for a scan, particularly if your pain is greatest in that position (i.e. while sleeping).