Final Demands Complete

Client:
FINALIZING DEMAND CLAIM PACKAGE

To whom it may concern,
Our firm has the pleasure of representing Glenn Zimmer who is our client in
connection with the above referenced accident.
The negotiation initiated by this demand package is for a bodily injury
settlement.
We are submitting this information solely for purposes of giving your company
a limited opportunity to offer to resolve this claim.
Any information or materials submitted herein are not to be utilized in a
later trial or proceeding without our consent.
In addition, no information should be considered a factual or legal admission
by my client.
Further, any materials submitted shall remain the property of my client and
should be returned upon our request.
Finally, unless otherwise specifically stated, all references to dollar
amounts in this demand and during negotiations shall be in USD.The
negotiation initiated by this demand package is for a bodily injury
settlement.
There are certain additional administrative claim considerations for future
medical expenses, physical and economic losses and mileage drivers.
In the event we reach a settlement of this claim, any release shall include
the following language:
This document demand package does not release any other parties except
releasee's insured(s) and their insurance company. Furthermore, this document
does not extinguish any rights for releasor's first party benefits. Finally,
Page 1 06/23/2012
Client: Glenn Zimmer
this document does not release releasor's rights or their insurance company's
subrogation right for property damage.
In the event the release fails to include this language, we will stamp the
release exactly as stated above. If you have any objection to this language,
please state your objection in writing so that we can stipulate to a mutually
acceptable release.
I. Medical History
Documents
1.01 Medical Office records X Reviewed
1.04 From Client X Reviewed
1.05 Delay in Seeking Care X Reviewed
II. Clinical Evaluation
Documents
2.01 Physical Examination X Reviewed
2.02 Injuries ICD-9 codes X Reviewed
2.03 Symptoms documented X Reviewed
2.06 Diagnostic Procedures X Reviewed
2.08 Medical Validation X Reviewed
III. Diagnoses
850.1: Concussion with no loss of consciousness (Mild TBI)
854.0: Closed Head Injury
339.20: Posttraumatic headache, unspecified
308.0: Predominant disturbance of emotions (Anxiety)
780.79: Other malaise and fatigue (Lethargy, Tiredness)
780.5: Sleep disturbance
780.4: Dizziness
739.1: nonallopathic lesion cervical
739.2: nonallopathic lesion thoracic
739.3: nonallopathic lesion lumbar
739.4: nonallopathic lesion sacral
739.5: nonallopathic lesion pelvic
847.0: Sprains and strains of cervical region
729.99: Soft tissue disorder contusion
920.0: Contusion of neck
922.3: Contusion of back
728.85: Spasm of muscle
728.4: Laxity of Ligament cervical region
723.1: Cervicalgia
723.9: Neck disorder/symptoms
729.1: Myalgia
Page 2 06/23/2012
729.1: Myofascitis
839.08: Multiple cervical vertebrae
839.20: Lumbar vertebrae, closed
839.21: Thoracic vertebrae
839.42: Sacrum, closed
719.46: Pain in joint; shoulder region
719.41: Pain in joint; shoulder region, Scapula
719.48: Pain in joint; other specified sites, Head, Neck, Ribs, Skull,
Trunk, Ve
IV. Complaints
Demonstrable and Non-demonstrable/soft tissue complaints were documented as:
Posttraumatic headache
Intensity: 4-6 Moderate
Frequency: Frequent, occurring 51-75% of the day
Further effects: The pain is further aggravated upon awakening Any
Movement
Right Temporal Headache
Intensity: 7-9 Intense
Frequency: Constant, occurring 76-100% of the day
Type: Shooting
Further effects: Bending Right
Occipital neuralgia
Type: Shooting
Radiation: The pain suffered by the patient is noted to radiate
bilaterally Shoulder
Further effects: The pain is further aggravated upon awakening Any
Movement
Neck pain
Type: Aching
Further effects: The pain is brought on by Any Movement
Thoracic spine pain
Type: Aching
Page 3 06/23/2012
Lumbar spine pain
Frequency: Intermittent, occurring 26-50% of the day
Type: Aching
Restricted range of motion of (six planes inthe cervical)
Pain on movement
Type: Shooting
Further effects: The pain is brought on by Any Movement
Soft tissue pain (contusion)
Type: Aching
Soft tissue changes, i.e. spasm
Type: Stabbing
Radiation: Neck
Soft tissue changes, i.e. tenderness
Dermatome Involvement
Sclerotomal pain
Cognitive, somatic, or psychological conditions
Sleep disturbance
Page 4 06/23/2012
Fatigue, tiring more easily
Forgetfullness, poor memory
Anxiety
Sleep disturbances
Fatigue
Dizziness
Lethargy
Fatigue
Tiredness
Change in sleeping patterns
Inability to make decisions
Irritability with children
Irritability with co-workers
Page 5 06/23/2012
Interference of ADL:
The determination of an impairment rating includes estimates that reflect the
severity of the medical condition and the degree to which it decreases an
individual's ability to perform common activities of daily living termed,
ADL's, that are not work related.
The patient experiences pain that interferes with activity
V. Duties Under Duress
The injured party has difficulty with Work Duties, Domestic Duties (inside
the home), Household Duties (outside the home) and Educational/studies in
School, and actually does one of the following activities while in pain and
pain interferes in these activities causing duties to be performed under
duress.
The Duties Under Duress the patient attests to experiencing during Domestic
Duties(Vacuuming, taking care of children, dishes, dusting, laundry,
preparing meals) are due to
difficulty with postural requirements
anxiety/depression
reduced concentration
The Duties Under Duress the patient attests to experiencing during Household
Duties(Mowing/Yard work, transporting family, shopping, taking out trash) are
due to
fatigue
anxiety/depression
The Duties Under Duress the patient attests to experiencing during
Study/School are due to
anxiety/depression
reduced concentration
These Duties Under Duress
are experienced daily
have been experienced since the incident
VI. Loss of Enjoyment:
The patient attests to suffering from a Loss of Enjoyment during Domestic
activities as
loss of interior cleaning
vacuuming
The patient attests to suffering from a Loss of Enjoyment during Study/School
Page 6 06/23/2012
as a result of
loss of attending class
loss of Gym class
Complaints
Frequency of Pain
Intensity of Pain
Radiation of Pain
Type of Pain
The patient attests to suffering from a Loss of Enjoyment in SPORTS as prior
to the accident the patient
played socially
The patient attests to suffering from a Loss of Enjoyment in SPORTS as since
the accident the patient
cannot play competitively
cannot play any sport
The patient attests to suffering from a Loss of Enjoyment during Hobbies as
socializing
These Loss of Life Enjoyment factors are
are experienced daily
have been experienced since the incident
VII. Treatment
Treatment to the patient included:
98942 Chiropractic Manipulation Treatment CMT 5
98943 Chiropractic Manipulation Treatment CMT Extra region
99204 Exam
97535 Education/ADL Patient Education:
Self Exercise
97110 Therapeutic Exercises
Referrals:
The patient was referred for:
CRMA.
Immobility Devices:
The patient was prescribed immobilization in the form of;
Cervical pillow
Page 7 06/23/2012
VIII. Stability of Medical Condition
The patient's medical records reveal a documented showing of ongoing
complaints and treatment with progressive improvement and the time period for
stabilization ranges;
12 to 18 months
IX. Medical Determination of Future Treatment
It is determined that due to the nature of the injuries, future passive care
must remain an option.
X. Prognosis Overall
The prognosis requires the need for treatment due to ligamentous injuries.
XI. Prognosis For each body area injured:
Neck 26-50%/ Possible
XII. Future Treatment Plan:
Future treatment is determined necessary when there is the presence of
moderate injuries; limitation of motion; ligamentous injury; neurological
findings and by type and frequency of pain.
According to the Croft Guidelines, this injury would fall into Grade III.
Treatment is determined necessary due to ligamentous injury/laxity.
Treatment is determined necessary due to limited range of motion.
Future Treatment Duration/Time
I estimate the patient will require future passive medical treatment to
continue for 4 months
XIII. MMI For Each Body Part (max.med.improv.)
When the MMI of a body part has been determined as static, it indicates that
a period of time has passed since treatment has stopped and the condition of
the injury has not improved. The degree of capacity is static, not likely to
increase in spite of continuing medical measures.
When the MMI of a body part has been determined as stable, it indicates that
the patient has stopped receiving treatment for the injury.
A patient may stop receiving treatment for one injury, however, other body
Page 8 06/23/2012
parts that have been injured as a direct result of accident will continue to
require both active and/or passive care.
The MMI has not yet been determined on this patient.
Upper back Stable
Mid back Stable
Shoulder Stable
XIV. % Impairment Rating
This represents a permanent medical condition resulting from accident or work
related trauma. Impairments are deviations from normal function of a body
part, organ, system or function. The presence of Impairment represents that a
function of the body part, organ, system or function can no longer be
performed normally.
The examinee must be at maximum medical improvement (MMI). The determination
of a Permanent Impairment should only be made when the injured is at a
Permanent and Stationary condition (P&S), and it has been determined that the
examinee is stable, and that no further restoration of function is probable.
The percentage of impairment in this patient is as follows:
Head % Impairment 8%
Cervical Diagnostic Related Estimate
DRE Category 3: 15-18% Impairment - Radiculopathy at the time of the
evaluation, surgery for radiculopaty, compression fracture between 25% and
50%.
XV: % Whole Body Impairment (WPI)
Total % Whole Body Impairment: 23
The medical impairment has had an impact on the client's Activities of
Daily Living, Duties Under Duress (DUD - disability) and Loss Of Enjoyment
(LOE).
As a result of the impairment, there are preclusions from duties under
duress and losses of life's enjoyment as continued within this report.
The degree of impairment is not likely to change by more than 3% within
the next year.
XV. LIABILITY
Also, as indicated on the accident report, the investigating officer
concluded that my client did not contribute to the accident and thus was not
negligent.
Page 9 06/23/2012
XVI. PHYSICAL IMPACT
The enclosed photographs which were taken of my client"s vehicle indicate
that there was a significant impact between the vehicles with resulting
property damage.
XVII. Monetary Damages:
Mileage Costs
Mileage driver costs are allocated to the total number of miles the client
has been required to drive in order to meet all appointment"s and
requirements as directly related to and necessary as a result of the
aforementioned accident and injuries as allowed by statute.
Miles driven to/from:
XVIII. Future Total Costs
The Doctor estimates the patient will be required to be seen for a total of
16 visits. The Doctor estimates the charges for the primary treatment to be $
131 per visit for a total of $ 2096. The Doctor estimates the charges for any
therapies/modalities to be $ for a total of $
XIX. Future Expenses:
It is determined that future treatments are recommended when there is a 51%
or greater chance of medically probable clinical occurrence.
XXII. DEMAND FOR SETTLEMENT
Based upon the liability, impact, well documented objective medical findings
inclusive of; Injuries, Diagnoses, Complaints by; intensity, frequency, type,
radiation and further effects on the individual including the documented
permanent impact and effect upon my clients Loss of Enjoyment of Life, Duties
under Duress, and given consideration to the treatment, plan, prescriptive
recommendations, stability of the medical condition, prognosis, future
treatment, current and future medical costs, economic losses, MMI, percentage
of whole person impairment and total monetary factors, please indicate your
willingness to offer to tender $34,500.00 of your insured's policy limits by
forwarding a release and settlement check made payable to our firm, August
2nd, 2012.
Upon receipt of your offer to tender, I will review your offer with my
client.
Sincerely,
Page 10 06/23/2012
Page 11 06/23/2012

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