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Understanding The Total Impact Of A Car Accident Injury

When it comes claiming no-fault PIP benefits and filing a car accident injury lawsuit for damages against an at-fault driver, many Michigan auto accident attorneys tend to compartmentalize the injury into two “silos”: 1) the objective evidence of the injury and 2) the life impact of the injury.

Car accident lawyers in Michigan tend to first focus on the anatomical nature of the injury, any surgery and therapy that’s required, and the long-term residual deficits. Attorneys then shift their focus to how the car accident injury has diminished the person’s quality of life.

However, this “silo” way of thinking prevents lawyers from appreciating the full extent of a significant car accident injury. There are numerous long-term health risks caused by the lifestyle changes that follow a serious injury in an auto accident. In fact, recent medical research shows that a change in one aspect of a person’s lifestyle has ripple effects throughout the entire body, thereby impacting the victim’s overall health.

As advocates for the injured, the Sinas Dramis team of Michigan auto accident lawyers recognizes that all these ripple effects — that is, the total impact of the car accident injury — must be fully understood. This way, the health consequences that accompany a serious auto accident injury can be minimized. Some of these health consequences are explained below.

Physical Inactivity Following A Car Accident Injury

A medical study published in the July 2012 edition of The Lancet, the world’s leading independent medical journal, quantified the effect of physical inactivity on non-communicable diseases, including coronary artery disease, diabetes and cancer.

According to the study, physical inactivity is responsible for: 6% of coronary artery disease; 7% of type-2 diabetes; 10% of breast cancer; and 10% of colon cancer. The study also found that physical inactivity causes 9% of premature deaths and a total of 5.3 million deaths each year.

Perhaps the most significant finding was the quantitative similarity between physical inactivity and other serious health risks. The study found that physical inactivity is as detrimental to a person’s health as smoking or obesity.

Diminished Relationships, Poor Health And Depression

Our Lansing car accident attorneys and Grand Rapids auto accident lawyers often witness how a serious auto accident injury can erode a victim’s social support networks. It is all too common for us to see persons seriously injured in a car accident withdraw from those around them.

Unfortunately, poor social relationships can cause serious health risks. A 2010 medical study published in PLoS Medicine found that poor or inadequate social relationships reduce a person’s chances of survival by 50%. The study further indicated that poor social relationships are equivalent to smoking, and even more harmful to a person’s health than obesity or physical inactivity.

Moreover, there also appears to be lasting health consequences when a person injured in an auto accident becomes depressed. In 2015, the Journal of the American Heart Association published a study examining the relationship between depression and stroke. The study noted that medical science has long known that depression predicts an elevated risk of stroke. The unanswered question, however, was whether this elevated risk of stroke remains even after the depressive symptoms are resolved. In other words: does the existence of long-term depression mean that a person faces a permanent increased chance of stroke?

The study found that:

  • patients who experience long-term depression doubled their risk of stroke.
  • this doubled risk of stroke remained even if the depression was successfully treated.
  • this two-fold increased risk of stroke affects everyone equally — that is, the effects of depression did not vary across race and there was not a statistically significant difference between men and women.

The study concluded that people who experience long-term depression, no matter how successfully the depression is treated, doubled their risk of stroke.

The Collateral Damage Caused By A Car Accident Injury

Personal injury lawyers have long understood that the lifestyle effect of a significant injury is not limited to the injured person alone. The injured person’s spouse, children and extended family experience their own lifestyle changes as well.

This collateral effect is perhaps most clearly shown in the working habits of an injured person’s spouse. While most families depend on income from two people in order to make ends meet, a serious injury often affects a person’s ability to work. Unfortunately, it is all too common to see injured persons suffer a complete loss or substantial diminishment of their return to work. Despite this, under Michigan’s no-fault system, a victim of a motor vehicle collision is entitled to collect only three years of lost wages under the no-fault law.

What happens when a family loses the income of one working spouse? Usually, the other spouse is required to work more. What few of us know or consider, however, is the effect that having to work more has on the health of the uninjured spouse. Does working more than 40 hours per week subject a person to an increased risk of serious disease?

This question was posed in a study published in The Lancet, which found that employees who work long hours have a higher risk of stroke than those who work standard hours — and the risk of stroke increases the more hours that a person works. For those who work more than 55 hours per week, the risk of stroke was 1-3 times greater than that for the normal population. This risk affected all races and genders equally.

Putting It All Together

Considering the information above, suppose a car accident victim is a young, married mother who suffered serious orthopedic injuries. Before her injury, she worked full-time, regularly exercised and had a healthy social network of friends and family. But her orthopedic injuries have prevented her from returning to work, made it impossible to exercise and, because she cannot get out, caused her to be become isolated from her social network. She then becomes depressed. Suppose further that her husband must now work 60 hours each week to pay the bills.

According to the medical studies, the motor vehicle collision caused the following health changes to both the wife and husband:

  • the wife’s lack of physical activity has rendered her the health equivalent of an obese person.
  • the wife’s lack of social relationships has turned her into the health equivalent of a smoker.
  • the wife’s depression has doubled her risk of stroke.
  • the husband’s long work hours has tripled his risk for stroke.

In terms of lifestyle changes alone, the woman’s injury has turned an otherwise healthy couple into a wife who is now the health equivalent of an obese smoker with a two-fold increased risk of stroke, and a husband with a tripled risk of stroke.

Why Lawyers Need To Understand The “Whole” Car Accident Injury

It is critical that attorneys who represent auto accident victims understand the total impact of a victim’s auto accident injury. By understanding the “whole” injury, lawyers can establish that certain services are compensable under the Michigan No-Fault Act and that certain damages from the at-fault driver are recoverable (non-economic loss damages and excess economic loss damages).

Under the no-fault law (MCL 500.3107(1)(a)), a no-fault insurer must pay “allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation. Michigan courts have held that these statutory words control, and only those services that fall within the realm of “care, recovery, and rehabilitation” are payable.

So what exactly do the words “care, recovery, and rehabilitation” mean? In Griffith v State Farm Mut Ins Co, 472 Mich 521 (2005), the Michigan Supreme Court provided this definition: “Expenses for ‘recovery’ or ‘rehabilitation’ are costs expended in order to bring an insured to a condition of health or ability sufficient to resume his preinjury life.”

Looking at the Michigan Supreme Court’s definition, suppose a car crash victim’s pre-accident life was full of physical activity and, by definition, free of the serious health risks of physical inactivity. Should a no-fault insurer pay for the services, like therapeutic recreation, that enable the physical activity needed to bring the patient’s health profile back to her pre-injury state? Using the language from the Michigan Supreme Court, the answer would appear to be “yes.”

Suppose further that the no-fault insurer refuses to pay for these services and the patient goes on to develop coronary artery disease or diabetes – conditions that are known to follow from physical inactivity. Would the no-fault insurer be required to pay for treatment of those serious health conditions? Under current case law, the answer appears to be “yes.” For example, in Scott v State Farm Mut Ins Co, 278 Mich App 578 (2008), the Michigan Court of Appeals held that a no-fault insurer could be obligated to pay for hyperlipidemia treatment that the plaintiff’s treating physicians testified was caused by the patient’s brain injury.

In the end, by understanding a car crash victim’s “whole” injury, Michigan auto accident attorneys can:

  • forcefully argue that it is more cost effective to treat the physical inactivity by giving the patient access to therapeutic recreation, as opposed to waiting for the patient to develop known sequelae of physical inactivity, like coronary artery disease or diabetes.
  • accurately assess the non-economic loss damages and excess economic loss damages that may be claimed in a liability lawsuit against the negligent driver.