Monday, August 22, 2016

Digital Motion X-Ray (DMX) - Identifying Ligamentous Injury

What is a Digital Motion X-Ray?

Your client was rear-ended five months ago at moderate speed.  She has been seen in the Emergency Room, by her PCP, by her chiropractor, by a physical therapist, and by a neurologist.  Plain films and a cervical MRI revealed only minor information about her status, and she is telling you that in addition to frequent headaches and neck pain, her head still “doesn’t feel right,” and it’s affecting all aspects of her life.  She’s been given a different story about her case at every step along the way, and she keeps saying, “I just wish I knew what’s wrong with me.”

Contrary to popular opinion, the ability of a spinal MRI to identify the degree of ligament damage in the neck is fairly limited.  Fortunately, there is a diagnostic study available which can provide objective proof of permanent ligament injury in the spine.  It’s called digital motion x-ray (DMX); a sample image from a DMX video is shown to the left.

For decades now, we have known what happens at each joint, including the spinal joints, when a person moves.  It’s pretty simple: Joints are formed when two bones come together.  The bones are held in place by strong, non-elastic connective tissue structures called ligaments.  When your clients are involved in car crashes, strong forces travel through their bodies and up the spine to the neck and head.  The ligaments in the upper cervical spine are the most brittle ligaments in the body, and they were never meant to withstand these forces.  As a result, they are abruptly stretched, and when they are stretched, they never regain their original length, so there is slack in the ligament, and now the joint is unstable.  These are not “self-limiting injuries.”  Because of the close proximity of the central nervous system--the brain stem and the spinal cord--this is absolutely critical to the health of the rest of the body.  When bone bangs into spinal cord, bad things happen.

How Does a DMX Work?

A DMX study records the motion of the spine as it moves in all directions, and what the interpreter looks for is unusual and excessive gapping between the bones, which indicates that the ligaments have been stretched out and injured.  There are 22 major ligaments in the neck, and all of them can be visualized in this way.  The medical literature is full of reference articles which address the abnormalities which can be found in ligaments.  Ligaments have fairly specific pain referral patterns, and when a torn ligament is found which matches up with pain in a specific area, then a definite cause-and-effect relationship can be established.

While the DMX study is very good for identifying ligament injuries, it is useless for detecting injuries to the intervertebral disc.  If damage to most of the ligaments at one level can be identified, then medical necessity for a cervical MRI can be established.  It’s hard to believe that if serious trauma damages most of the ligaments at one spinal level, that the disc got away unscathed, because, after all, it’s actually just a highly specialized ligament.  By the same token, the MRI is not capable of doing a credible job in detecting ligament injury.  So the two diagnostic studies are not contradictory, but complementary.

Using Digital Motion X-Ray Studies in Personal Injury Cases

Identifying ligamentous injury is not only essential in formulating a patient’s correct diagnosis so that they can get proper treatment, it has the effect of increasing the cash value of a personal injury case.  The computer programs used by the insurance industry (Colossus and its knock-offs) place a higher value on the diagnosis codes which describe ligament injury than they do for disc injury, and so does the universally accepted medicolegal textbook, the AMA Guide to Evaluation of Permanent Impairment, 6th Ed., in terms of impairment rating and resultant disability.  This is not artificially inflating the case by manipulating the codes; rather, it is just a case of accurately presenting the truth concerning the severity of a person’s injuries.  It is fair to say that before DMX studies were available, whiplash victims have been grossly under-diagnosed.  About 1 million people get whiplashed each year in car crashes, and the most conservative estimates tells us that about 33% of them end up with chronic pain, despite their doctor’s best efforts.  Most studies indicate that the percentage is a lot higher than that.  And these people are your clients.

How do you get a study done?  Dr. Winberry is in Tucson, and if your clients don’t live there, remember, they only have to go to his office one time.   The study is performed in 30 minutes, the report is written in three to four hours, and then sent to EliteRad for medical validation.  The films are over-read by Avery Knapp, MD (licensed in Arizona), who focuses on reading trauma films, including not only DMX, but also plain films, MRI, CT, etc.  Dr. Winberry can be reached at 520-241-1995 for more information about referrals for the DMX study, and for more information about EliteRad.

Source: “What’s Wrong with Me?”  Winberry, Michael. 2016.  Reprinted with permission.

Sunday, August 14, 2016

Lady Killed in Marana Pedestrian Accident

Fatal pedestrian crash in Marana, Arizona

June 23, 2016 - The victim of a fatal bicycle accident in Marana Arizona was identified. She was Clarissa Marie Ballesteros, and she was 22 years old, at the time of the collision.  The accident occurred while Clarissa was using a pedestrian cross walk on Ina Road near Meredith Avenue.

Manner of Collision

The vehicle turned left and failed to yield to the bicyclist and struck her with the center of his vehicle. The driver seems to be at fault for causing this collision. Clarissa was transported to Banner University Medical Center, but the doctors could not save her life.

The investigation into the fatal accident is ongoing.  

Saturday, August 13, 2016

2 Killed in Golf Links Road Accident

Two Green Valley Residents were killed in rollover accident

August 11, 2016 - A drunk driver lost control of his vehicle and crossed the median on Golf Links Road and collided with a couple from Green Valley. The head-on collision caused the death of the married couple.  The accident is very saddening since the driver was heavily intoxicated during the sunny hours of the day.

Drunk driver charged with second-degree murder

The collision involved three vehicles and only the couple from Green Valley lost their lives.  The intoxicated driver was taken into custody and was charged with a crime.  The drunk driver, Alexander Bondy, is 21 years old and he was charged with tow counts of second-degree murder.  The victims are Joel W. Cohen and his wife, Mary Jane Cohen.  The intoxicated driver was driving at a high rate of speed eastbound on Golf Links Road when he caused the collision.

The married couple lost their lives before they could be taken to the hospital.

Friday, June 24, 2016

Tucson Loses Ann Day After a Drunk Driver Accident

Drunk driver kills Ann Day while operating his vehicle under the influence of marijuana

May 7, 2016 will be remembered as another day when an impaired driver took the life of an innocent victim.  This time it was the life of a very well known member of our community who dedicated her life to public service and teaching.  Ann Day was hit head-on by another vehicle while she traveled on Ina Road in Tucson, Arizona.  The collision caused the loss of her life, and the other driver, Jarrad Barnes, was arrested and charged with manslaughter, DUI, and other criminal offenses.

Ann Day: Politician, Teacher, and Counselor

Ms. Day was a politician, a teacher, and a counselor in Arizona.  She graduated from an Arizona college and served in the Arizona Senate.  She is also the granddaughter of H.C. Day (chairman of the Graham County Board of Supervisors and founder of the Lazy B Ranch) and sister of Sandra Day O’Connor (the first female U.S. Supreme Court Justice). 

Ms. Day’s funeral was attended by hundreds of members of the community and politicians who remembered her as an honorable and hard-working member of our community.  

Avoid Driving While Impaired

For those who read this post, please counsel others to avoid driving while impaired at all costs.  Free taxi rides can be requested from some local vendors.  It is always easier to avoid thousands of dollars in DUI costs by using a taxi, or by riding as a passenger on a friend's car.  Ms. Day's loss and hundreds of other victims lose their lives after senseless decisions of impaired drivers who take to the streets.  Ms. Day's loss is especially heartbreaking since she dedicated her life to public service and she lost her life during a sunny Tucson day to an impaired driver who could have easily avoided the accident.  

Wednesday, May 18, 2016

Bicycle Accidents in Tucson

Tucson Bicycle Accidents Attorney

In the United States, approximately one million children receive injuries due to bicycle-related accidents each year. The Tucson personal injury attorneys at the Lara Law Firm, PLLC have handled thousands of motorcycle and bicycle crash cases. Our Tucson lawyers have the knowledge and experience to represent even the most serious cases.

Causes of Bike Crashes

Every six hours a bicyclist is fatally injured in America. Head injuries account for seventy-five percent of all serious injuries and deaths from bicycle accidents. Negligent drivers are a major factor in bicycle accidents. If a driver makes a turn, pulls out of a driveway or alley, or opens a car door without being observant they are putting bicyclists in danger.

Injuries sustained to bicyclists may be fatal because of the lack of protection that a bicycle provides. There is no competition between a bicycle and a vehicle that weighs thousands of pounds. Drivers must be held accountable for the injuries that they cause.

Types of Injuries

A bike collision can be very frightening and the injuries involved may be extremely painful. There are many different injuries that a person may suffer due to a bicycle accident, including:

•Head injury
•Fractured bones
•Spine injury

Compensation for Your Injuries

If you file a claim you may be able to receive monetary compensation for your injuries. Our bicycle accident lawyers will investigate all aspects of your injuries to find out who is at fault. Our investigators will take photos, speak to witnesses, and perform other investigative endeavors to learn the facts regarding your accident. 

The quality legal representation and advice that you will receive from the attorneys at the Lara Law Firm, PLLC will make the legal process easy and fast.

When carelessness or negligence by another driver causes an accident and leads to injury, they must be held responsible.  With the help of a Tucson personal injury lawyer, you can seek the monetary damages you need to cover medical bills, lost wages, pain and suffering after being hurt in a bicycle accident.

Tuesday, May 10, 2016

Injuries before and after your traffic accident

Other injuries before or after your car accident

As luck may have it you may be injured after your car accident in another work injury or another car accident. Knee injuries could also be pre-existing before the car accident. Thus, it is important to distinguish the injuries incurred from those other incidents to those incurred as a result of the motor vehicle accident. 

Your attorney can gather all of the medical records for all of these accidents and better explain to a jury how these injuries differ from each other. 

If the accident aggravated a prior injury then you can read that the additional injuries or the aggravation of those injuries has caused a loss of enjoyment of life or you can explain how it has diminished your abilities to work or enjoy other personal activities.

Monday, May 9, 2016

Tucson Drunk Driving Accident

Drunk Drivers Cause Many Deaths on Roads

Every year over 17,000 people are killed in alcohol related crashes. These are senseless acts of violence that should not be happening. The drunk drivers who are responsible for the injuries and deaths of innocent people need to receive severe consequences for their actions. If you or a loved one has been injured or suffered a wrongful death due to a drunk driver please contact the Tucson auto accident attorneys at the Lara Law Firm, PLLC.

Driving Drunk While Operating A Motor Vehicle 

Being injured or losing a loved one is a terrible experience to have to go through. But when it is because someone was driving drunk, it is much worse and can include an almost unthinkable rage and regret. If you or a family member has been a victim in a drunk driving accident, get in touch with a Tucson Personal Injury Attorney right away.

Money will not reverse the past, but it can bring relief for high medical costs, loss of income that the victim had been making, and loss of lifestyle. Drunk Driving Accident Attorney in Tucson Accidents caused by someone under the influence of drugs or alcohol (DUI) can be some of the most devastating crashes. This is because a drunk driver is not likely to be alert to their immediate surroundings and thus they don’t usually try to slow down or avoid collision like a sober person would.

Tremendous property damage, injury and even loss of life results from these accidents. Anyone driving in Arizona with a blood alcohol level of .08% or higher is legally driving under the influence of alcohol. It is also illegal for anyone under the age of 21 to have any alcohol percent in their blood while on the road. Whether you were hurt or someone in your family was an injured party, you owe it to yourself to get in touch with the attorneys and professional legal staff at the Lara Law Firm for our experienced legal help.

Sunday, May 8, 2016

Liens After An Accident

Liens filed after your accident

Hospitals and other medical providers may file a lien on your case after your treatment for your accident. Many times the provider's fee payment through the third party who caused the accident. These things can be negotiated and reduced through several means. 

First, your health insurance can be used to pay a portion if not all of the medical bills associated with your accident. Second, you can use the net pay in your auto policy to pay any remaining balance. If there are any outstanding bills after these resources are used, the third parties insurance company can be used to pay such balance. The third party was not insured you can use your uninsured motorist coverage. Or, you can use your under-insured motorist coverage if the defendant had too little coverage on their policy. 

Attorney for Liens Placed on an Insurance Settlement

It is important to pick an attorney who has handled lean issues in the past. Sometimes the most difficult portion of your personal injury case will not be the liability or the payment that should be made by the third party but the liens and how they should be paid after your case has settled. 

You may contact our office if you have any questions regarding Medicare liens taxes liens Medicare liens Medicare Advantage leads or any balance billing issues in the state of Arizona.  You may contact our law office if you have any questions regarding any type of lien in the State of Arizona.

Thursday, May 5, 2016

Fatal Wrong-Way Collision

Wrong-way collision turns deadly

It is unknown whether the driver who was driving the wrong way was impaired.  This collision caused the death of the two occupants of the other vehicle.


Other vehicles later collided with the first two vehicles.  The police investigation has not been concluded.  This accident was very tragic, but it could have been prevented.

Read more about fatal accidents on our page.

Litigation in a Wrongful Death Case

It is difficult understand the legal process and the many obstacles that it places for plaintiffs during a legal claim. We understand the legal process and why it is important to file a lawsuit immediately. We also know how difficult it can be to lose a loved one as a result of another person’s negligence. Claims for loss of consortium, the deceased’s medical bills, funeral costs, and future support of his or her children or spouse can be made.

The ability to provide for the deceased’s children or spouse is often the greatest claim that can be made.

High Auto Accident Death Toll in Arizona

Auto Accident Deaths in Arizona Roads

Arizona has one of the highest per capita automobile related death tolls in the country.  In a wrongful death case, compensation may be awarded which is intended to aid the family of the victim.  The reparation for which you may be entitled is for the compensation for:

  • Costs related to medical and funeral services 
  • Lost benefits Lost financial support 
  • Lost love, companionship and advice

Claims After The Accident

In some cases punitive damages can be awarded.  You may also be able to receive maximum compensation for these expenses along with the compensation of your loved ones lost wages and the loss of your loved one’s companionship.

These cases are common in Arizona, especially deaths of pedestrians and victims hit by drunk drivers.  According to the the Arizona Department of Transportation there were 103,423 car accidents in Arizona last year, and 754 of those caused the death of at least one of the occupants of the vehicle. Forty three percent of those fatalities were alcohol related.

These facts are very alarming because the number of car accident fatalities in Arizona has increased in the last few years.

Sunday, July 19, 2015

Personal Injury Attorney Tucson AZ

At the Lara Law Firm we thoroughly investigate every truck accident case that comes through our office. The truck, or the components of the truck, not just the truck driver may have caused the accident. Further, the commercial truck driver may have been negligent in driving over the speed limit, over the hours of time allowed under the law, or may have simply been tired and inattentive at the time of the accident.

Trucking companies have high exposure limits when involved in an accident, so they have highly trained insurance adjusters and lawyers who investigate their losses. Thus, when you are injured in a truck accident, it is vital to have someone with the resources that the Lara Law Firm can provide you with.

The Electronic Control Module, or ECM, monitors the operation of the vehicle and its data can tell the attorneys and litigants what happened before and during the accident.  Such information should be retained before trial.

Friday, February 28, 2014

Drunk Driver Accidents in Tucson


Legal Representation for Victims of Accidents Associated With Drunk Drivers

Arizona has enacted tough DUI laws that severely punish anyone who is driving under the influence.  Drivers may lose their licenses for at least 90 days, and they may also face criminal prosecution, incarceration, and hefty fines.  In Arizona, statistics have shown that someone is injured or killed in a car accident at one time per hour. 

Despite the severe consequences of a DUI, many drivers continue to drive under the influence of alcohol and other drugs and cause accidents.  Injury victims typically require hospital care and follow up treatment.  A driver who causes an accident while driving under the influence is said to be grossly negligent and is responsible for punitive damages.  The Lara Law Firm can help you pursue damages against the responsible party to fully compensate you for your losses.

Arizona DUI Laws

Driving under the influence of alcohol or drugs cannot be tolerated because the loss of life and property is too great.  Under Arizona law, the legal limit for which a person can be considered intoxicated is 0.08% blood alcohol concentration (BAC).  Any amount of any other drugs (such as marijuana) can also subject a driver to DUI charges.  For commercial truck drivers, the BAC is lower--a 0.04% BAC limit.  A DUI conviction can be used as former proof by another court (res judicata) that the opposing driver was impaired and negligent at the time of the accident.

Litigation in Drunk Driving Accident Cases

A civil lawsuit can be commenced even after the drunk driver has been convicted of a DUI in a criminal court.  The witnesses in the criminal case may be brought to testify at a trial in a civil case, or at a deposition in preparation for trial.  Accident victims can request damages such as lost wages, pain and suffering, reimbursement of medical expenses, and punitive damages.  Our Tucsonaccident attorneys can help you recover damages in this type of case.  Wrongful death may also be a cause of action, or dram shop liability if the driver was over served at a bar or any other facility with a liquor license.

Please call The Lara Law Firm at 520-577-0707 if you have any questions regarding your accident case.