“Red Flags” in Medical Records in a Personal Injury Case

medical records in a personal injury caseIn a personal injury case, the NH injury attorneys at the Law Office of Manning & Zimmerman, PLLC submits copies of an injured victim’s medical records and bills to an insurance company adjuster for evaluation. Insurance adjusters will review these documents and make a determination about whether to make an initial settlement offer on the case – and, if so, the amount of such an offer. Although these initial settlement offers are often low, it is still important for the injured victim to be aware of certain all-too-common “red flags” that insurance adjusters look for in medical records and the affects they can have on a personal injury case.

Degenerative Changes

Degenerative changes usually appear on imaging studies, such as MRIs and x-rays, and are normally the result of aging. Degenerative changes are commonplace when the injured victim is middle-aged or elderly, but medical studies show that degenerative changes may begin to manifest themselves as early as a person’s twenties. Thus, imaging studies would likely show some degenerative changes on almost everyone.

When injured victims in a personal injury case undergo x-rays and MRI’s over the course of their treatment, insurance adjusters like to point to these imaging studies and attempt to show that the injuries – particularly soft tissue injuries – are simply the result of degenerative changes, rather than the car crash. This is particularly true when other medical records may demonstrate few, if any, objective findings for the symptoms the injured person  is experiencing following an automobile accident.

Whenever an injured victim’s imaging studies show degenerative changes, the Manchester, NH car accident lawyers at the Law Office of Manning & Zimmerman, PLLC may need to retain an expert who will testify that, despite the presence of pre-existing degenerative changes, those conditions were likely aggravated by the injury or injuries sustained in the collision, thereby bringing about the increased pain and symptoms.

Moreover, the injured person and/or the healthcare provider may testify that, despite the presence of degenerative changes on an imaging study, the injured victim was not experiencing any significant problems with the subject body part at any point immediately prior to the accident. Therefore, the subject injuries were caused by the accident and not by degenerative changes.

Prior Accidents and Pre-Existing Injuries

By the same token, when an injured plaintiff has sustained prior injuries to the same body part, such as in a prior slip-and-fall accident or motor vehicle accident, the adjuster will try to connect the injuries, pain, and symptoms from the current accident to the prior accident or injury. Again, however, testimony from a healthcare provider, as well as from the injured victim, will be necessary to show that, despite these prior accidents and injuries, the current accident aggravated or worsened those injuries, thereby establishing causation and increasing the prospect of high damages in the current personal injury case.

Gaps in Treatment

Gaps in an injured plaintiff’s treatment are a red flag for insurance adjusters when reviewing medical records and bills. Significant gaps in treatment can be detrimental to an injured person’s case although, as all know people who try to tough through pain, hoping the problem will resolve without the need to ongoing treatment, insurance companies and the attorneys they hire to represent their insureds at trial will try to use gaps in treatment to confuse a jury into thinking that the victim was not really hurt.

Knowing an insurance company will be picking apart every medical record in an effort to confuse juries and make them think victims are no being honest, is absolutely essential that injured victims comply with all of their healthcare providers’ treatment recommendations, that they show up for all medical and physical therapy appointments on time, stay for the entire appointment, and complete all prescribed home exercise regimens.

Frequent late arrivals or appointment no-shows may negatively impact a personal injury case and will likely result in an insurance adjuster placing less settlement money on the case than if the injured person had complied fully with their treatment protocols.

Speaking with Healthcare Providers About Your Symptoms

It is also important that injured victims are mindful of what they say to their healthcare providers, including emergency management technicians (EMTs) and emergency room personnel, about their symptoms, pain levels, and injuries following a collision.

While being treated in an emergency room following an accident, an injured victim should be very clear about what their symptoms are and what body parts are bothering them at that time. All too often, injured persons focus only on the most significant problem. For example, if you go to the emergency room by ambulance for a broken arm, it often seems silly to be complaining about some stiffness in your knee and a bruise on you lower back. However, as the arm heals and the knee and back problems linger on, the insurance company will look back at that initial emergency room visit and question why those complaints were not made.

It is very important to be clear, concise, and accurate about injuries, pain levels, and symptoms when communicating with healthcare providers at every stage of treatment. Despite this, not every record is going to reflect every complaint, even if you tell your doctor.

Often, if someone is seeing an orthopedic doctor for a follow-up to a broken arm, the arm is the only focus of this visit. Some doctors will even tell you that you need separate appointments for separate issues – this often has to do with their billing procedures. Although injury victims cannot control how accurate or complete their medical records are, they can make sure they are thorough and accurate when speaking with their doctors, increasing the chances that the records will reflect all their complaints.

Medical Records in a Personal Injury Case Are Important

Medical records and their contents are important – especially upon initial review by an insurance adjuster at the beginning of a personal injury case. We know that people with pre-existing conditions are easier to hurt and harder to fix. This does not change in any way that the person who hurt them should be fully responsible for fully and completely compensating them for their injuries. But being mindful of the way that insurance companies will twist this information and try to use it against victims is important for anyone with an injury claim to understand.

Contact Experienced NH Car Crash Attorneys

If you or a loved one have been injured through no fault of your own, contact the New Hampshire car crash attorneys at the Law Office of Manning and Zimmerman, PLLC. There are no up-front costs for our services. All personal injury and workers’ compensation cases are handled on a contingency basis, meaning that we are only paid for our services if we successfully recover damages from the responsible party. For a free consultation, call (603) 624-7200.

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New Hampshire Lawyers Present Top 2016 Stories

New Hampshire Lawyers: Top Safety and Justice Stories of 2016

Are you making all those lists and checking them twice? Gifts? Holiday cards? Party invitations? New Year’s resolutions? From the New Hampshire lawyers at the Law Office of Manning & Zimmerman, here’s one more for you courtesy of the American civil justice system: safer products and services.

This past year we have been following several stories of dangerous products or unfair practices that threaten the health, safety and legal rights of all Americans. Think exploding batteries, lead-laced drinking water, forced arbitration or faulty medical devices, for example.

But thanks to the courage of citizens like you and the power of the civil justice system, New Hampshire lawyers are holding accountable many of those who put profit over public well-being. And that’s a list we can all be proud of, as these stories so richly illustrate.

Read More >>>


According to a recent study by the U.S. Food and Drug   Administration, medical device recalls doubled from 2003 to 2012. [Download report]
Nearly 27,000 children were exposed to lead poisoning from the contaminated water supply in Flint, Michigan.
After years of denying any link between repeated concussions and brain injury, the NFL settled a lawsuit that sets aside almost $1 billion for players suffering from chronic traumatic encephalopathy.



400,000 Heart Defibrillators Subject of Recall

St. Jude Medical issued a recall for some of its 400,000 heart defibrillators after two people died when the batteries failed prematurely.   View video.

Inside Flint’s Lead Poisoning Disaster

Dr. Sanjay Gupta and CNN investigate the aftermath of massive lead poisoning in Flint, Michigan, which was initially denied by government officials. View video.

Five Facts – Samsung Galaxy Note 7 Recall

More than 1 million Samsung Galaxy Note 7s were recalled when users reported that the popular smartphone overheated or, in some cases, even exploded. Here are five vital facts about the recall.  View video.


What Concerns You the Most?

Browse the 2016 top safety and justice issues, and then tell us which one keeps you up at night. You could win an iPod shuffle for participating.

Add your thoughts here

Forced Arbitration: The Threat Continues

Forced arbitration continues to threaten the safety and legal rights of all Americans. Tia shares her story of sexual harassment and Circuit City.

Listen now



NH Car Crash Attorneys Share Winter Driving Tips

NH Car Crash Attorneys Share Winter Driving Tips

Reduce Speed

* When it snows, the NH car crash attorneys at Manning & Zimmerman Law urge you to use your head – not your feet. Slow down for wet, snowy, or icy conditions; when visibility is poor; or when conditions are changing or unpredictable. Stay alert!

* Slow down when approaching intersections, off-ramps, bridges or shady spots. These are all candidates for developing black ice – a thin coating of clear ice can form on pavement surfaces that may be nh car crash attorneys, nh injury lawyers, nh car crash lawyers, nh accident lawyerdifficult to see.

* Drivers should allow additional room between their vehicles and others. Winter road conditions often result in longer stopping distances.

* Don’t take chances when pulling out in front of approaching vehicles. Remember, they may not be able to slow down, and you may not be able to accelerate as quickly as on dry pavement.

* Avoid using cruise control in winter driving conditions. You need to be in control of when your vehicle accelerates based on road conditions – don’t let cruise control make a bad decision for you.

Driving Maneuvers

* Stopping on snow and ice without skidding requires extra time and distance. If you have anti-lock brakes, press the pedal down firmly and hold it. If you don’t have anti-lock brakes, gently pump the pedal. Either way, NH car crash attorneys urge you to give yourself plenty of room to stop.

* On snow and ice, go slowly, no matter what type of vehicle you drive. Even if you drive an SUV with four-wheel drive, you may not be able to stop any faster, or maintain control any better, once you lose traction. Four-wheel drive may get you going faster, but it won’t help you stop sooner.

* When you’re driving on snow, accelerate gradually. Avoid abrupt steering maneuvers.

* When you’re driving on snow, ice or wet roads, merge slowly, since sudden movements can cause your vehicle to slide.

* It takes more time and distance to stop your vehicle in adverse weather conditions, so use your brakes carefully. Brake early, brake slowly, brake correctly, and never slam on the brakes.

* Look farther ahead in traffic than you normally do. Actions by other vehicles will alert you to problems more quickly, and give you that split-second of extra time to react safely.

* Avoid distracted driving – texting, eating, handheld devices, etc.

* Winter conditions call for different driving tactics. “When there’s ice and snow, take it slow” is sound advice from the NH car crash attorneys at the Law Office of Manning & Zimmerman, PLLC.

Safe Travel Around Snowplows

* Don’t crowd the plow. Snowplows plow far and wide – sometimes very wide. The front plow extends several feet in front of the truck and may cross the center line and shoulders during plowing operations.

* Don’t tailgate or stop too close behind snowplows. Snowplows are usually spreading deicing materials from the back of the truck may need to stop or take evasive action to avoid stranded vehicles. If you find yourself behind a snowplow, stay behind it or use caution when passing. The road behind a snowplow will be safer to drive on.

* On multiple lane roads, watch for snowplows operating in either lane.

* Snowplows can throw up a cloud of snow that can reduce your visibility to zero in less time than you can react. Drive smart. Never drive into a snow cloud – it could conceal a snowplow.

* Snowplows travel much slower than posted speeds while removing snow and ice from the roads. When you spot a plow, allow plenty of time to slow down.

* A snowplow operator’s field of vision is restricted. You may see them but they may not see you.

* Plows turn and exit the road frequently. Give them plenty of room.

Trip Preparedness

* Before leaving home, find out about the driving conditions. Safe drivers know the weather, and they know their limits. If the weather is bad, remember, ice and snow, take it slow, or just don’t go.

* Before venturing out onto snowy roadways, make sure you’ve cleared the snow off all of your vehicle’s windows and lights, including brake lights and turn signals. Make sure you can see and be seen. Always buckle up, and remember, when driving in winter, ice and snow, take it slow.

* Give yourself extra time to reach your destination safely. It’s not worth putting yourself and others in a dangerous situation, just to be on time.

* Winter conditions can be taxing on your vehicle. Check your vehicle’s tires, brakes, fluids, wiper blades, lights, belts, and hoses to make sure they‘re in good condition before the start of the winter season. A breakdown is bad on a good day, and can be dangerous on a bad-weather day.

* Wear your seat belt! Nearly three-quarters (71%) of all traffic fatalities in New Hampshire over the past 10 years have involved non-seat belt use.

Contact Experienced NH Car Crash Attorneys

If you or a loved one have been injured through no fault of your own, contact the New Hampshire car accident lawyers at the Law Office of Manning and Zimmerman, PLLC. There are no up-front costs for our services.  All personal injury and workers’ compensation cases are handled on a contingency basis, meaning that we are only paid for our services if we successfully recover damages from the responsible party. For a free consultation, call (603) 624-7200.

Source: https://www.nh.gov/dot/



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NH Injury Attorneys: Holiday Fire Facts

NH injury attorneys offer holiday season fire information


Holiday fire facts

According to the National Safety Council, fires started by Christmas trees and holiday lights damage more than 400 homes and cause more than 20 deaths each season. While fire danger may be more prevalent during the holidays, there are steps you can take to reduce the risk to you, your family, and your home.

Lighting solutions
According to the Red Cross, more candles start fires over the holidays than at any other time of year. Lit candles near trees, holiday decorations, and window curtains pose a major fire hazard. It’s easy for pets or children to knock a tree over or for an unstable tree to tip over on its own. If you have lit candles near your tree, invest in a good stand and make sure to extinguish all candles throughout your home before going to bed. A safer choice would be to use an electric substitute such as LED lights instead of live candles.

Artificial trees
Flame retardant artificial Christmas trees are the most effective fire resistant trees and are an excellent alternative to live Christmas trees. They look real and require little maintenance, while a live tree can dry out and become combustible. If you or your family have a live tree, one with supple, flexible needles is desirable. Also, the NH injury attorneys at the Law Office of Manning & Zimmerman urge you to keep the tree watered while it is on display.

Kitchen stove-tops
The second most likely place for fires to start over the holidays is the kitchen stove-top. According to the Red Cross, potholders, hand towels, wooden bowls, paper plates, paper bags, food boxes, and even nearby curtains have started on fire in the past. Removing combustible items from the stove-top eliminates the possibility of fire. Fires start in microwave ovens when metal objects are placed inside by mistake, even during defrosting. Check any food destined for the microwave for metal ties or skewers.

Inspect electrical cords
The National Safety Council and the Red Cross suggest that people inspect the Christmas lights, or other electrical decorations that go up around the house, for wear and tear. Repair frayed electrical wires, and if a repair is impossible, consider throwing the decoration away or displaying it without plugging it in. The adults in the household should take responsibility for extinguishing candles and turning off Christmas lights before going to bed.

Check smoke alarms
More importantly, smoke alarms are an effective weapon to fight holiday fires. With working smoke alarms, the chances of surviving a fire are greatly enhanced. With the increased incidence of home fires during this time of year, it is a good idea check smoke alarms and replace dead batteries. It is recommended to test smoke alarms once a month as a routine. Give yourself a holiday gift of a working smoke alarm.

Contact Experienced NH Injury Attorneys
If you or a loved one have been injured through no fault of your own, contact the New Hampshire injury attorneys at the Law Office of Manning and Zimmerman, PLLC. There are no up-front costs for our services. All personal injury and workers’ compensation cases are handled on a contingency basis, meaning that we are only paid for our services if we successfully recover damages from the responsible party. For a free consultation, call (603) 624-7200 or email us at info@manningzimmermanlaw.com.

Content courtesy of Homestructions

New Hampshire Personal Injury Damages

New Hampshire Personal Injury Damages

New Hampshire personal injury damagesAccording to the New Hampshire personal injury damages attorneys at the Law Office of Manning & Zimmerman, under New Hampshire law, injured plaintiffs are entitled to compensation for the injuries they sustain as a result of someone else’s wrongdoing. The main purpose of monetary damages is to make an injured plaintiff whole – to the greatest extent possible under the law. While money may be a poor substitute for the loss of a limb, spinal cord injury, severe brain damage, or other catastrophic injury, it is unfortunately the only means of compensating injured plaintiffs under the law.

In this article, the New Hampshire accident lawyers at Manning & Zimmerman Law will explore some common types of economic and non-economic damages that are available in New Hampshire personal injury cases, as well as some basic techniques for proving these types of damages.

Economic vs Non-Economic New Hampshire Personal Injury Damages

Economic damages are those types of damages that can readily be calculated in dollars and cents. These damages include compensation for medical treatment, medical bills, and lost wages sustained as a result of the plaintiff’s injuries.  Non-economic damages are not as easily calculated and proving these damages will often require the in-court testimony of lay witnesses and experts.  Non-economic damages include compensation for loss of enjoyment of life, for pain and suffering, psychological/psychiatric harm, permanent injury, loss of future earning capacity, and loss of companionship.

Medical Bills

An injured plaintiff in New Hampshire is entitled to payment of related medical and physical therapy bills that result from injuries sustained in an accident.  The first step to proving these types of New Hampshire personal injury damages is for all medical records and bills to be submitted to the insurance company’s adjuster.  Assuming that liability is uncontested, these bills, along with information about how the injury affected you, will assist the adjuster in placing an initial settlement offer on the case.  Since initial settlement offers made by adjusters are typically very low, it may be necessary to file a lawsuit in order to trigger a more favorable response from the insurance company or to prepare for trial by jury.

In cases where the insurance company is contesting certain medical treatment, procedures, or bills, it may be necessary to retain an  expert witness, such as a treating doctor or other healthcare provider, who can testify about the necessity of the disputed medical treatment.

Loss of Enjoyment of Life

These harms and losses can be the most damaging and will typically require witnesses to talk about what was life like before the injury and afterwards. Testimony about the injured’s passions, like golfing, hiking, skiing, fishing, etc., their family life, the pursuit of their “bucket list”, etc. is important in telling the adjuster or the jury what happened and how life has been impacted.

Psychological or Psychiatric Harm

An injured plaintiff may also receive damages for psychological or psychiatric harm if that treatment can reasonably be connected to the accident.  This might include treatment for anxiety, depression, or post-traumatic stress disorder that post-date the accident that are documented by the medical records and bills. It is not unusual for people injured in car crashes to experience anxiety about driving fearing that if it happened once it can happen again.

Injured plaintiffs can also recover for missed time from work resulting from injuries sustained in an accident. The insurance company typically requests documentation from the injured plaintiff’s employer referencing the time missed from work and confirming the amount of the injured plaintiff’s daily, weekly, or monthly wages.

Lost Wages

In cases where the injured plaintiff is claiming a significant amount in lost wages, it may be necessary for a healthcare provider to testify in court about why he or she advised the injured plaintiff to be absent from work, including testimony about the extent and severity of the plaintiff’s injuries. It may also be necessary for an employer to testify about the injured plaintiff’s job duties before and after the accident, as well as any job limitations post-accident.

Past, Present, and Future Pain and Suffering

Injured plaintiffs in New Hampshire are also entitled to compensation for past, present, and future pain and suffering that occurs as a proximate result of injuries sustained in an accident.  These damages are called ‘non-economic damages’ because they cannot readily be measured by an exact dollar amount.  These New Hampshire personal injury damages include compensation for all of the inconvenience, pain, and aggravation caused by having to attend medical and physical therapy appointments – and undergoing and recovering from medical treatment. These damages also compensate the plaintiff for the general disruption to his or her life as a result of the injuries sustained.

In order to prove these damages, the most helpful kind of testimony is that of an experienced medical provider.  In cases where serious permanent injuries are claimed, the plaintiff’s attorney will often refer the plaintiff for a permanency evaluation.  The doctor who performs the permanency evaluation will generate a report which is also sent to the insurance adjuster and defense attorney, if one is involved at that point in the litigation process.  You should know, however, that when a doctor performs a permanency evaluation on an injured plaintiff, the insurance company’s doctor will subsequently perform a so-called independent medical examination (IME) on the plaintiff. The IME doctor’s report will typically not be as favorable as that of the permanency doctor and is usually not independent or an actual examination.

Witnesses and Life Tables

In addition, co-workers, family members, and friends of the injured plaintiff can also be helpful witnesses, and their testimony can be used to help prove the injured plaintiff’s social, family, and work limitations following the accident.  This may include testimony about social, work, household, or family activities that, in the witness’ observation, are impossible or much harder for the injured plaintiff to do since sustaining injuries in the accident.

Some attorneys may also introduce life tables or mortality tables into evidence to justify New Hampshire personal injury damages for future pain and suffering.  These tables approximate an injured plaintiff’s life expectancy given his or her current age and gender, among other factors.

Loss of Future Earning Capacity

Injured plaintiffs can also receive compensation for loss of future earning capacity.  These damages are usually available in catastrophic personal injury cases where an injured plaintiff, following an accident, is unable to return to the same job or the same line of work.  In the most serious of cases, the injured plaintiff may not be able to work in any capacity following the accident.  In order to prove these damages, it is often necessary to retain a vocational rehabilitation expert or economist who can testify about the plaintiff’s potential future earnings had he or she not sustained the injuries, as well as the amount of the injured plaintiff’s projected lost income measured over the remainder of his or her life. 

Loss of Consortium or Companionship

Injured plaintiffs can also receive compensation for spousal support, loss of companionship, and loss of consortium.  These New Hampshire personal injury damages compensate an injured plaintiff and their spouse for harm to the family or to a marital relationship, including the ability to socialize and spend time with children or be intimate with a spouse.  These damages are oftentimes hard to prove and will likely require the trial testimony of spouses, family members, or marital relationship experts.  These damages are only available in catastrophic personal injury cases.

Contact Experienced New Hampshire Personal Injury Damages Attorneys

If you or a loved one have been injured through no fault of your own, contact the New Hampshire personal injury damages attorneys at the Law Office of Manning and Zimmerman, PLLC. There are no up-front costs for our services.  All personal injury and workers’ compensation cases are handled on a contingency basis, meaning that we are only paid for our services if we successfully recover damages from the responsible party. For a free consultation, call (603) 624-7200.

Attorney Anna Goulet Zimmerman Marks 20 Years in Practice

The attorneys and staff of the Law Office of Manning & Zimmerman, PLLC are pleased to recognize Attorney Anna Goulet Zimmerman on 20 years in the practice of law. Anna represents victims in personal injury, workers’ compensation, wrongful death and medical malpractice cases. In addition to her law practice, Anna currently serves as President of the New Hampshire Association for Justice. #nhinjurylawNH injury attorney