Burnett & Williams - Experienced Accident Injury Lawyers in Winchester, Virginia

In nearly two decades of personal injury specialization, Burnett & Williams has achieved notable verdicts, settlements, and appellate results in cases arising from wrongful deaths, medical malpractice, tractor trailer accidents, traumatic brain injuries, defective products, serious orthopaedic injuries,
and other significant injuries. This specialization and the consequent investment in time and resources in each case have been instrumental in our ability to obtain full compensation for our clients.

How the Process Works
One of the most common questions we hear from people interested in pursuing a personal injury case is, “So, how does this whole process work?” Most people are not familiar with how legal claims work, either because they have never been involved in a legal case before or simply because the process and procedure of the law is complicated, to say the least.

We understand that it is important for you to know what to expect when you decide to pursue a personal injury case. Although no two cases are the same, we have outlined a typical case process to guide you through a typical case. We want you to understand what is happening every step of the way. Find out more...

If You've Been Injured
Choosing a lawyer can be time consuming, stressful, and confusing. If you've been injured, you need compassionate, experienced legal asistance. The attorneys at Burnett & Williams have extensive experience in all types of personal injury law. Contact us for more information and a free consultation. Having difficulty traveling? We will be happy to visit you at home or meet with you in a location that is convenient for you.

Personal Injury Lawyers in Winchester Va- Specialists in Auto & Truck Accident Cases - P.O. Box 3552 Winchester, VA 22604, Stephen's City VA, and Berryville Va

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Car accident

Every car accident case raises at least three questions:

1) Who was at fault?
To be entitled to damages under Virginia law, you must prove that someone else was at fault in causing the accident. Sometimes the question of fault is easily determined, such as when someone for no legitimate reason drives through a red light and collides with someone who is lawfully in the intersection. What, you might ask, could be a legitimate reason for driving through a red light? Well, the answers are endless - mechanical failure, sudden illness, or anything else that the driver is unable to control. Until your opponent concedes liability for the accident, you should take nothing for granted. For example, contrary to popular belief, a driver who drives into the rear of another car is not automatically at fault under the law. Fault is a threshold question without first establishing fault, the case cannot proceed.

2) What are the injuries?
The amount that an injury victim is entitled to recover from a negligent driver is usually determined by the extent of the injuries, although in some cases the defendant’s conduct is so outrageous that the injured victim can also assert a claim for punitive damages. The most common elements of compensatory damages in motor vehicle cases include bodily injuries and their effect, past and future medical expenses, past and future lost wages, future lessened earning capacity, disfigurement, inconvenience, pain, and suffering. Virginia law sets no limit on the dollar amount an injury victim can recover in compensatory damages.

3) Is there adequate insurance coverage to fully compensate you for your injuries?
There are many potential sources of insurance coverage from which you might receive compensation for your injuries. The insurance coverage types (click here for more info) available to automobile accident victims fall into three categories: liability coverage; uninsured/underinsured motorist coverage; and medical expense coverage (also known as medical payments coverage or "med pay"). Sources of potential insurance coverage can be found in some unexpected places, so when you meet with us, be sure to provide us with a copy of every policy that might apply. Because Virginia law sets such low limits on the amount of insurance that motor vehicle owners must have, we see too many people who have cases of clear liability, substantial injuries, but grossly inadequate insurance coverage. To ensure that this does not happen to you, please review your own policies and consider increasing the limits on your uninsured and underinsured motorist coverage.

If you have been involved in an auto accident in winchester va or an accident on a WInchester Rd pplease call us for a free consultation. We are specialists in truck accidents, semi truck accidents and auto accidents. Know your options before you speak to an insurance company. If you have accident reports in winchester virginia pertaining to your car accident, make sure you have them available for our discussion. If you or a loved one has susttained a car accident injury in winchester, va call us at 540) 667-3500 or write Burnett & Williams P.O. Box 3552 Winchester, VA 22604

Tractor Trailer Accidents

Although we ask the same three questions to victims of tractor trailer accidents as we do to those involved in automobile accidents, the extensive regulation of truckers by the state and federal departments of transportation add a significant layer of complexity to the proper presentation of a tractor trailer claim. Given the size and weight of most tractor trailers, the resultant injuries are frequently much more severe and the issues are often much more technical. We often consult with experienced tractor trailer drivers and accident reconstructionists to assist us in the evaluation and presentation of technically complex evidence.

For more tips Car Crash Facts from http://www-fars.nhtsa.dot.gov

• More than 6 million police-reported motor vehicle crashes occurred in the United States in 2007. Nearly 30 percent of those crashes (1.71 million) resulted in an injury, and fewer than 1 percent (37,248) resulted in a death. [Crashes : 2007]
• Fifty-nine percent of fatal crashes involved only one vehicle, as compared with 33 percent of injury crashes and 31 percent of property-damage-only crashes. [Crashes : 2007]
• Half of all fatal crashes in 2007 occurred on roads with posted speed limits of 55 mph or more, as compared with 23 percent of injury and property-damage-only crashes. [Crashes : 2007]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2007, with 1,251 and 1,383 fatal crashes, respectively. [Crashes : 2007]
• Thirty-two percent of all fatal crashes involved alcohol-impaired driving, where the highest blood alcohol concentration (BAC) among drivers involved in the crash was .08 grams per deciliter (g/dL) or higher. For fatal crashes occurring from midnight to 3 a.m., 65 percent involved alcohol-impaired driving. [Crashes : 2007]
• More than 6.1 million police-reported motor vehicle crashes occurred in the United States in 2005. Almost one-third of these crashes resulted in an injury, with less than 1 percent of total crashes (39,189) resulting in a death. [Crashes : 2005]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2005, with 1,320 and 1,275 fatal crashes, respectively. [Crashes : 2005]
• Fifty-eight percent of fatal crashes involved only one vehicle, compared to 31 percent of injury crashes and 31 percent of property-damage-only crashes. [Crashes : 2005]
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 23 percent of property-damage-only crashes occurred on these roads. [Crashes : 2005]
• Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 19 percent of all crashes, but they accounted for 44 percent of fatal crashes. [Crashes : 2005]

Personal Injury Lawyers - Specialists in Auto & Truck Accident Cases P.O. Box 3552 Winchester, VA 22604

• Thirty-nine percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 75 percent involved alcohol. [Crashes : 2005]
• Nearly 6.2 million police-reported motor vehicle crashes occurred in the United States in 2004. Almost one-third of these crashes resulted in an injury, with less than 1 percent of total crashes (38,253) resulting in a death. [Crashes : 2004]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2004, with 1,174 and 1,277 fatal crashes, respectively. [Crashes : 2004]
• Fifty-seven percent of fatal crashes involved only one vehicle, compared to 30 percent of injury crashes and 30 percent of property-damage-only crashes. [Crashes : 2004]
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 24 percent of property-damage-only crashes occurred on these roads. [Crashes : 2004]
• Thirty-nine percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 76 percent involved alcohol. [Crashes : 2004]
• More than 6.3 million police-reported motor vehicle crashes occurred in the United States in 2003. Almost one-third of these crashes resulted in an injury, with less than 1 percent of total crashes (38,252) resulting in a death. [Crashes : 2003]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2003, with 1,228 and 1,208 fatal crashes, respectively. [Crashes : 2003]
• Fifty-seven percent of fatal crashes involved only one vehicle, compared to 30 percent of injury crashes and 31 percent of property-damage-only crashes. [Crashes : 2003]
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 25 percent of property-damage-only crashes occurred on these roads. [Crashes : 2003]

Personal Injury Lawyers - Specialists in Auto & Truck Accident Cases P.O. Box 3552 Winchester, VA 22604

• Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 19 percent of all crashes, but they accounted for 44 percent of fatal crashes. [Crashes : 2003]
• Forty percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 77 percent involved alcohol. [Crashes : 2003]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2000, with 1,271 and 1,218 fatal crashes, respectively. [Crashes : 2000]
• Fifty-six percent of fatal crashes involved only one vehicle, compared to 30 percent of both injury crashes and property-damage-only crashes. [Crashes : 2000]
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 22 percent of property-damage-only crashes occurred on these roads. [Crashes : 2000]
• Forty percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 77 percent involved alcohol. [Crashes : 2000]
• Nearly 6.3 million police-reported motor vehicle crashes occurred in the United States in 1999. Almost one-third of these crashes resulted in an injury, with less than 1 percent of total crashes (37,043) resulting in a death. [Crashes : 1999]
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 1999, with 1,215 and 1,182 fatal crashes, respectively. [Crashes : 1999]
• Fifty-six percent of fatal crashes involved only one vehicle, compared to 28 percent of both injury crashes and property-damage-only crashes. [Crashes : 1999]
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 22 percent of property-damage-only crashes occurred on these roads. [Crashes : 1999]

Were you involved in an accident or crash in the Winchester VA 22604 Area? Burnett & Williams can help. Our experienced staff can assist you in understanding your rights. Accidents on I-81 can have tragic consequences. Contact us today.

Dangers of Cell Phone Use While Driving

In your circle of friends, name five people who don’t have a cell phone. Name one.
Can’t do it? Not surprising since, for most Americans (224 million in 2006), cell phones
are an indispensable tool for communicating anytime, anywhere.
One place Americans use cell phones is in the car. While driving, you can catch up with
an old friend, conduct business, order a pizza to arrive at home at the same time you do,
among countless other things. Cell phones allowyou to multi­task. But if you are
concentrating on something other than safely operating your vehicle, you are putting
yourself and others at risk. According to a recent study, driver inattention was a factor
in 80% of crashes and 65% of near­crashes. What distracted most drivers: their cell
phones.
A serious personal conversation or a business call shifts concentration away from your
driving. Additionally, the act of dialing a number on your cell phone requires you to
look at the cell phone, taking youreyes off the road. Even more distracting is text
messaging. Thirty­seven percent of teens cite text messaging as their biggest
distraction while driving.
Removing your focus from driving to make a call or read a text message could have
disastrousconsequences. A University of Utah study illustrates the extent of the
danger: it found that driving while using a cell phone(even one that is hands­free)isas
dangerous as drunk driving.
Recognizing the hazardscaused by careless cell phone use by drivers, many states,
including New York, New Jersey, Connecticut, and California (and the District of
Columbia), have institutedlaws banning or restricting the use of hand­held cellular
devices while driving. Businesses are taking notice too. Since 2004, American justice
has seen the emergence of lawsuits against businesses whose employees caused a car
crash due tocell phoneuse while driving. Beers Skanska Inc., a large construction firm,
recently paida $5million settlement to a plaintiff involved insuch an accident with one
of its employees.
Accidents such as these can be avoided if you think of your cell phone as a piece of safety
equipment to be used in the event of an emergency. In the moments following an
accident, youneed your cell phone tocall for help. At all other times while you are
driving, you should pull off the road to a safe location to make or return a call or text
message.

For more tips Car Crash Facts from http://www-fars.nhtsa.dot.gov

• More than 6.7 million police-reported motor vehicle crashes occurred in the United States in 1997. Almost one-third of these crashes resulted in an injury, with less than 1 percent of total crashes (37,280) resulting in a death.
• Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 1997, with 1,190 and 1,196 fatal crashes, respectively.
• Fifty-six percent of fatal crashes involved only one vehicle, compared to 28 percent of both injury crashes and property-damage-only crashes.
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 22 percent of property-damage-only crashes occurred on these roads.
• Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 18 percent of all crashes, but they accounted for 40 percent of fatal crashes.
• Thirty-nine percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 75 percent involved alcohol.
• More than 6.8 million police-reported motor vehicle crashes occurred in the United States in 1996. One-third of these crashes resulted in an injury, with less than 1 percent of total crashes (37,351) resulting in a death. [Crashes : 1996]
• Midnight to 3 a.m. on Saturdays proved to be the deadliest 3-hour period throughout 1996, with 1,250 fatal crashes. [Crashes : 1996]
• Fifty-six percent of fatal crashes involved only one vehicle, compared to 29 percent of both injury crashes and property-damage-only crashes.
• More than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 21 percent of property-damage-only crashes occurred on these roads.
• Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 17 percent of all crashes, but they accounted for 40 percent of fatal crashes.
• More than 6.6 million police-reported motor vehicle crashes occurred in the United States in 1995. One-third of these crashes resulted in an injury, with less than 1 percent of total crashes (37,221) resulting in a death. [Crashes : 1995]
• Fifty-seven percent of fatal crashes involved only one vehicle, compared to 28 percent of both injury crashes and property-damage-only crashes.
• Slightly more than half of fatal crashes occurred on roads with posted speed limits of 35 mph or more, while only 21 percent of property-damage-only crashes occurred on these roads.
• * Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 17 percent of all crashes, but they accounted for 40 percent of fatal crashes.
• Forty-one percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 78 percent involved alcohol.
• Midnight to 3 a.m. on Saturdays proved to be the deadliest 3-hour period throughout 1995, with 1,339 fatal crashes. [Crashes : 1995]
• Almost 6.5 million police-reported motor vehicle crashes occurred in the United States in 1994. One-third of these crashes resulted in an injury, with less than 1 percent of total crashes (36,223) resulting in a death. [Crashes : 1994]
• Midnight to 3 a.m. on Saturdays proved to be the deadliest 3-hour period throughout 1994, with 1,290 fatal crashes. [Crashes : 1994]
• Fifty-seven percent of fatal crashes involved only one vehicle, compared to 30 percent of both injury crashes and property-damage-only crashes.
• Slightly more than half of fatal crashes occurred on roads with posted speed limits of 55 mph or more, while only 22 percent of property-damage-only crashes occurred on these roads.
• Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 17 percent of all crashes, but they accounted for 39 percent of fatal crashes.
• Forty-one percent of fatal crashes involved alcohol. For fatal crashes occurring from midnight to 3 a.m., 78 percent involved alcohol on safe driving, go to
  www.nsc.org.

Aberrant Intersegmental Motion: Abnormal movement between two adjacent vertebral segments.

Acceleration-Deceleration Injury: Injury syndromes commonly associated with hyperextension-hyperflexion of the neck. Most often caused by a rear-end auto accident.

ACQUIRED BRAIN INJURY (ABI): Harm to the brain that occurs after birth. Usually it means harm caused by pressure on the brain from inside the body. Examples are harm to the brain as a result of heart attacks, strokes, illness, and near drowning.

Active Range of Motion: Range of motion in the cervical, thoracic, lumber spine, or any other joint of the body which patient does under his or her own power.

ACUITY: Sharpness or quality of a sensation.

Acute: A recent onset of an injury or problem. The precise time line of an acute condition can range from hours after onset to 16 weeks depending upon the standard of the particular physician or treatment provider.

Acute Exacerbation: A sudden aggravation of symptoms or increase in severity of an already existing condition without re-injury or trauma.

Adaptive Changes: Changes in a spinal segment which occur secondarily to another biomechanical problem in the spine. This usually involves loss of range  of motion in a specific direction to compensate for the trauma at another area.

Adhesions: Fibrosis tissue and scar tissue that bind together tissues which are usually not attached.

AFFIDAVIT: A written statement made under oath.

Allograft: A graft taken from another person (living or dead).

ANEURYSM: A balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.

Ankylosing Spondylitis: A chronic inflammatory disease wherein the spinal motion segments and the sacroiliac joints progressively fuse, resulting in painful restriction of spinal movement.

Ankylosis: A joint condition of decreased or full loss of range of motion, often due to advanced degenerative changes. A spinal segment which is fused can be said to be “ankylosed”. Also, the fusion of a joint either by advanced degeneration or by artificial means (surgery).

Annular Bulge: A bulging out of the annulus fibrosis, the tough fibrosis outer ring that provides support to the disc, which is diffuse and, usually due to degenerative changes or trauma, leading to degenerative changes. This condition may include partial rents or tears in the annulus fibrosis.

Annular Rent: Another way to describe a tear in the annulus, usually seen during discography, less commonly on MRI, or during surgery. These tears can be traumatic in origin. Also known as an annular fissure.

ANOXIA: A lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.

ANSWER: A formal pleading which states the defendant’s response to plaintiff’s complaint. The defendant, in the State of Washington, has twenty (20) days to answer, admit, or deny the allegations in plaintiff’s complaint.

Anterior Disc Herniation: An extrusion of the nucleus pulposus through the front side of the annulus of the disc.

Anterior Discectomy and Fusion: The surgical removal of an abnormal intervertebraldisc and replacement with bone graft and/or surgical hardware for fusion, using an anterior approach to the spine.

Anterior Scalene Syndrome: Compression of the bundle of nerves, veins and arteries as it passes between the anterior and middle scalene muscles. This is a cause of thoracic outlet syndrome or cervicobrachial syndrome, as this is one of the more common areas of entrapment.

Anterolisthesis: A vertebral segment which is moved forward relative to the segment below.

APPEAL: A request by a party for a higher court to review a lower court’s decisions regarding questions of law.

APRAXIA: Inability to carry out a complex or skilled movement, not due to paralysis, sensory changes or deficiencies in understanding.

ARBITRATION: Alternative to trial where parties agree to appoint an individual or panel to make a binding award or decision based on the evidence and testimony presented.

Arthralgia: Joint pain.

Arthrochondritis:Inflammation of the cartilage portion of a joint.

Arthrosis: A disorder of a joint.

Articular Dysfunction: A chiropractic term, which refers to an abnormality of spinal biomechanics involving a loss of normal movement of vertebral motion segment.

Articular Fixation: A loss of one or more joint motions. One of the components of the chiropractic diagnosis of subluxation. See Subluxation. See Hypomobility.

Articular Spondylolisthesis: A forward or anterior “slipping” of one vertebra in relation to another, due to trauma and/or degenerativechanges within the facet  joints and/or the discs.

Atlanto-Occipital: Referring to the articulation of the joint between the occiput of the skull and the C1 vertebra (atlas). See AO Joint.

Atlas: The first cervicalvertebra which moves with the occipital bone of the skull, and the second cervical vertebra in the neck. Also known as C1.

ATAXIA: A problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity, or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person’s ability to walk, talk, eat and perform other self-care tasks.

Autograft: A graft taken from the patient.

Avulsion: The pulling away of one tissue from another, either by trauma or surgery.

Bad Faith : Actions by an insurer designed to mislead an insured; refusal or negligence of insurer in fulfilling some duty or contractual obligation.

Bench Trial : A case heard and decided by a judge without a jury.

Brachial Plexus: A complex network of nerve tissues in the neck and armpit, which stem from the C5-T1 nerve roots. The brachial plexus contains the nerves going to the arms.

Brainstem: The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).

Brief: A written document prepared by an attorney to serve as the basis for a legal argument. It includes a summary of legal points and precedent, together with arguments to be presented to the court deciding the case or a particular issue of the case.

Bursitis: Inflammation of pad-like fluid-filled sacs (bursa) found within the connecting tissue of the joints, as in the shoulder and knee.

Capsulitis: Inflammation of tissues enclosing a joint.

Carpal Tunnel Syndrome: Soreness, tenderness, and weakness of the muscles of the thumb, index and middle fingers caused by pressure on the median nerve at the point at which it goes through the carpal tunnel of the wrist.

Cerebellum: The portion of the brain (located at the back) which helps coordinate movement. Damage may result in ataxia.

Cervical: Referring to the neck. The cervical spine has seven vertebrae (C1 through C-7) which allow for head and neck movement.

Cervicogenic Headache: A headache that originates in the neck.

Chronic: A condition of long standing. Health care providers consider injuries or conditions still existing 12 weeks after the occurrence to be chronic.

Civil Law: Law developed by governmental groups such as statutes, regulations and ordinances enacted by legislative bodies such as Congress, state legislatures, county and city officials. This is different from laws based on custom.

Claim: A demand for compensation.

Claimant: A person who makes a claim or asserts a right. The plaintiff in a personal injury case may also be known as the claimant.

Closing Argument : The chronological and psychological conclusion of a trial. The last opportunity for the attorneys representing each party to communicate directly with the jury and/or judge about their theory of the case, explain contested facts, and argue why their side should prevail.

Coma: A state of unconsciousness from which the person cannot be aroused, even by powerful stimulation; lack of any response to one’s environment.

Comparative Fault: An affirmative defense available to the defendant. Reduction of the plaintiff’s recovery in proportion to the percentage of negligence or fault attributed to the plaintiff.

Complaint: A formal statement filed by the plaintiff with the court that sets forth his/her injuries and damages and why he/she believes the defendant is liable.

Common Law: Body of law developed over a long period of time which derives its authority solely from usage and custom.

Concussion: Any alteration in cerebral function caused by direct or indirect (rotation) force transmitted to the head resulting in one or more of the following: a brief loss of consciousness, lightheadedness, vertigo, cognitive and memory dysfunction, tinnitus, difficulty concentrating, amnesia, headache, balance disorder, nausea or vomiting.

Contracture: Loss of range of motion in a joint due to abnormal shortening of soft tissues.

Contusion, Brain: A bruise. The result of a blow to the head which bruises the brain.

Cortical Blindness: Loss of vision resulting from a lesion of the primary visual areas of the occipital lobe. Light reflex is preserved.

Contrecoup: Bruising of brain tissue on the side opposite where the blow was struck.

Coup Damage: Damage to the brain at the point of impact.

Counter Claim: The defendant sues the plaintiff for damages for which the defendant claims the plaintiff is legally liable or at fault.

Court of Appeals: This court is established to review appeals from the trial court. It can affirm or overturn, in whole or in part, a trial court’s decision. A party has a legal right to appeal any final decision of a superior court to the Court of Appeals.

Craniosacral Therapy: A manipulation-based therapy first developed by William Sutherland, D.O. It is based upon the belief that cranial plates are mobile and connected to the spinal cord and sacrum through the meninges. Some techniques concentrate on detecting cranial plates that are “out of place” and correcting these dysfunctions. While controversial, many patients report relief of headaches and tempormandibular joint pain with the technique.

Crepitus: Crunching, rubbing or snapping sounds heard or felt when moving a joint.

Cross Claim: The defendant brings a claim against another defendant in the same lawsuit or identifies a new party not previously named by the plaintiff in the lawsuit, asserting that party is responsible for the plaintiff’s damages.

Cross Examination: The questioning of a witness by the adverse party.

CT Discogram: A discogram followed by a CT Scan. The CT scan allows visualization of the disc structure following the injection of radiographic dye during the discography procedure.

CT Myelogram: A myelogram followed by a CT scan. This technique visualizes the spinal nerves as they relate to the surrounding bony structures. This study is commonly used for surgical planning.

CT Scan: Also called CAT scan, Computer Tomography, Computer Assisted Tomography, or Computer Axial Tomography. The use of x-ray energy passing through the body at different angles and processed through a computer to produce a cross-sectional (axial) image of an area of the body. The current term, CT Scan, is the most accurate since reformatting has allowed other planes to be imaged besides just the axial plane.

Cubital Tunnel Syndrome: “Cubital tunnel” refers to a passageway along the inner part of the elbow bounded by bones, muscles and ligaments. Cubital Tunnel Syndrome involves symptoms of numbness, tingling, or weakness of the pinky and ring fingers due to compression of the ulnar nerve passing through the cubital tunnel.

Decerebrate Posture (Decerebrate Rigidity): Exaggerated posture of extension as a result of a lesion to the prepontine area of the brainstem, and is rarely seen fully developed in humans. In reporting, it is preferable to describe the posture seen.

Decompression: In spine surgery, the term refers to the lessening of pressure on a nerve root, spinal nerve or the spinal chord. This is also a manual therapy term referring to the lessening of pressure on a nerve or joint through manual traction.

Decorticate Posture (Decorticate Rigidity): Exaggerated posture of upper extremity flexion and lower extremity extension as a result of a lesion to the mesencephalon or above. In reporting, it is preferable to describe the posture seen.

Decree: A judgment or order issued by a court.

Decubitus: Pressure area, bed sore, skin opening, skin breakdown. A discolored or open area of skin damage caused by pressure. Common areas most prone to breakdown are buttocks or backside, hips, shoulder blades, heels, ankles and elbows.

Deep Tendon Reflex Test: A physical exam technique used to determine the existence and functioning of the nerves connected to the tested muscle. With proper technique, in normal patients, striking the tendon of the muscle will elicit a standard contraction of the muscle, thus assuring the reflex “arc” is intact. Disruption of either the sensory or motor pathways will affect the reflex.

Default Judgment: When a defendant fails to formally answer a plaintiff’s complaint in a timely manner, the plaintiff may ask the court to enter a judgment against the defendant. Most often in personal injury cases, these judgments are set aside once the defendant begins to comply with the rules and initiates a formal defense by filing an answer.

Defendant: The party the plaintiff claims is responsible for his/her damages and from whom the plaintiff seeks some form of relief.

Degenerative Changes: Degeneration of any joint due to wear and tear, trauma, or unusual postures. The degenerative changes include discspace narrowing, osteophytes or bony spurring. These type of changes can be seen both on x-ray and MRI imaging.

Degenerative Disc Disease: An intervertebral disc, which has suffered the effects of the aging process or the effects of trauma. A disc becomes degenerated over time, often spanning years. Often there are small circumferential tears in the annulus fibrosis, the tough outer covering of the disc. A degenerated disc is also characterized by a loss of its height due to a drying-out of the nucleus pulposus, the gelatinous material inside the disc. It is often caused by a loss of motion between the vertebrae above and below, thus decreasing the mechanical flow of nutrients to the disc.

Degenerative Facet Joints: Facet joints, which, as a result of age and time or trauma, have signs of arthritic changes. The degenerative arthritic changes may include thinning of joint spaces, changes in the joint and cartilage surfaces, and inflammation of the joint and connecting tissues of the joint. Degenerative facet joints may or may not be symptomatic.

Degenerative Joint Disease: (DJD) In the spine, DJD refers to the inflammatory changes in the facet joint, also known as the zygapophyseal joints of the vertebral bodies. These changes often lead to bone changes and reduced range of motion at the joint. Degenerative joint disease is not limited to the spine.

Degenerative Symptoms: Pain and physical restrictions are a result of degenerative changes usually in the weight-bearing joints of the body.

Demand Letter: A letter expressly stating a legal right and an amount due as reasonable compensation for injuries to person and/or property.

Denervation: The blocking of a nerve supply by trauma, degeneration or surgery.

Deposition: A form of discovery whereby the attorney calling for the deposition has the right to ask questions and obtain answers from a party, witness, or expert while that individual is under oath. Notice of the deposition must be served on the party or witness five (5) days in advance of the date of the deposition unless the parties agree otherwise. A court reporter makes a word-for-word record of all that is said at the deposition.

Dermatome: A specific sensory nerve distribution pattern, which can be outlined or traced on the skin.

Dessication: Dehydration of an intervertebral disc.

Diffuse Axonal Injury (DAI): A shearing injury of large nerve fibers (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing hemorrhage.

Diffuse Brain Injury: Injury to cells in many areas of the brain rather than in one specific location.

Diplopia: Seeing two images of a single object; double vision.

Direct Examination: The questioning of a witness by the attorney for the party on whose behalf the witness is called.

Disc Bulge: A broad-based enlargement of the annulus fibrosis extending past the edges of the adjoining vertebral end plates with herniation of the nucleus pulposus into or through the annulus fibrosis. See Bulging Disc.

Discectomy: The surgical removal of the bulging or extruding disc material (nucleus pulposus). Access to the bulging or extruding disc material may be had by removal of the lamina of the vertebral body (laminectomy) or the cutting of an opening in the lamina (laminotomy). Discectomy may be done in conjunction with a foraminotomy and/or a fusion.

Discogenic Pain: Pain coming from the nerves embedded in the annular wall of the disc. Pain can arise from chemical or mechanical irritation of these nerves as a result of damage to the intervertebral disc. The outer portion of the annulushas sensory nerves and trauma or degenerative changes to the annulus can cause pain.

Discography: An imaging procedure which reveals the inner structure and condition of an intervertebral disc by injecting dye through a needle placed into the disc. A CT Scan is then performed to image the disc more precisely. Discography can also be used to determine if the disc is a source of pain, in addition to revealing the disc’s inner structure. Discography is often employed to determine a patient’s suitability for fusion surgery in the neck, mid back, or low back.

Discovery Process: Procedure for examination of documentary and physical evidence, and questioning of witnesses and parties to uncover evidence which is reasonably calculated to lead to the discovery of admissible evidence. Discovery may be obtained by the parties through interrogatories, requests for production of documents, depositions, and defense medical examinations. Information that can be obtained in discovery is broader in scope than what is deemed to be admissible at trial.

Disc Space Narrowing: A narrowing of the space between the vertebrae, produced by disc dehydration (dessication) and is often imaged by x-rays. See Degenerative Disc Disease.

Distraction: (1) Application of a force to mildly and temporarily release pressure from a joint. This tractioning of a joint space is for the purpose of releasing entrapped soft tissues, such as the joint capsule or spinal nerve roots. This may be performed manually, by application of weight, or mechanically; (2) An orthopedic test wherein the examiner places his/her hands under the chin/jaw and gently pulls up. This maneuver may relieve pressure from the nerve roots and discs. If the patient feels relief of symptoms, the test is “positive”; or (3) The diversion of a patient’s attention from the primary activity being performed during physical examination.

Docket: A calendar or agenda of court proceedings prepared by the clerk of the court. For example, a trial docket is a list of cases set to be tried at a specified term.

Double Crush Syndrome: A nerve entrapment at two or more places along a nerve. Most typically the diagnosis refers to a carpal tunnel syndrome, cubital tunnel syndrome, and/or ulnar neuropathy nerve compression at the elbow, co-existing with pressure on the spinal nerve in the neck, causing numbness or tingling, muscle weakness or loss of reflex in the arm or hand.

Dura: The outermost, toughest, fibrosis layer covering of the brain, spinal cord and nerve roots. It also holds the brain in place and contains the cerebral spinal fluid.

Durable Power of Attorney: A legal document that appoints a person or agency to use your money to pay your bills and make medical decisions. Nursing homes or service providers are often appointed durable power of attorney to handle money and other decisions for the people with disabilities whom they serve.

Dural Impingement: Pressure or deformation of the dura caused by bulging disc, bone spurs, or thickened ligaments.

Dysesthesia: An abnormal sensation that a patient reports as uncomfortable that may include burning, tingling, numbness, or “pins and needles”.

Edema: Collection of fluid in the tissue causing swelling.

EMG: Electromyogram or Electromyelogram. A test to evaluate the motor function of the peripheral nerves and the related spinal nerves. The test involves use of a needle to test nerve conduction speed. The method of the EMG is to insert small needles in muscle groups and observe for electrical indications of denervation or loss of nerve function.

Encephalography: Non-invasive use of ultrasound waves to record echoes from brain tissue. Used to detect hematoma, tumor or ventricle problems.

Epidural: Outside the brain and its fibrous covering, but under the skull.

Epidural Block: The injection of anesthetic into the epidural space in order to block or desensitize a specific nerve at particular points of a nerve pathway.

Epidural Space: The space outside the dura of the brain and spinal cord. The dura is the outer membrane covering the spinal cord and the brain.

Epidural Steroid Injection: The injection of a potent anti-inflammation drug into the epidural space around the nerve or joint for therapeutic purposes. It is used to decrease inflammation in the spinal space and spinal nerves and reduce pain.

Evidence: Testimony, writings, material objects, etc. that are admissible and offered by a party to the trier of fact to prove the existence or non-existence of a fact.

Expert Witness: An individual who possesses specialized knowledge through skill, education, training, or experience beyond that of the ordinary person or juror, and whose knowledge will aid the triers of fact (jury, judge, arbitrator) in reaching a proper decision. Often, a health care provider who examines and evaluates a patient in anticipation of litigation.

Extradural Defect: Indentation of the thecal sac or dura by disc bulge, osteophyte, defect in the bone,ligament, cyst or tumor. This terminology is often used by radiologists noting abnormalities on imaging studies.

Fabere Test: An orthopedic physical examination test with the patient on his or her back, the thigh and knee are flexed and one ankle is placed over the opposite knee; the knee is depressed, and if pain is produced thereby, arthritis of the hip, psoas muscle or SI joint is indicated. The name comes from the initial letters of movements that are necessary to perform it, namely, flexion, abduction, external rotation, extension. Also called Patrick’s Sign.

Facet Arthrosis: Degenerative changes of the facetjoints.

Facet Block: The injection of anesthetic and/or steroid into a facet joint using video x-ray or CT scan to assist the practitioner in guiding a needle through the skin. This can be done for both diagnostic and therapeutic purposes.

Facet Hypertrophy: Enlargement of the facet joints as a result of degenerative changes.

Facet Joint Dysfunction: A vertebral motion segment whose joint does not move freely in all directions or moves excessively. Commonly used by treatment providers to refer to a syndrome producing facet joint pain.

Facet Joints: A set of paired joints representing the articulation (joining) of the back portions of two adjoining vertebrae at the back of each vertebra  articulating with the vertebra above and vertebra below. An injured or degenerative facet joint may be the source of spinal pain and stiffness. Also referred to as zygapophyseal joint.

Facet Neurotomy: A therapeutic technique whereby the medial branch nerve supply to the facet is cut. This is done surgically, most often with radio frequency current. See Medial Branch Neurotomy. Sometimes called Facet Rhizotomy.

Facet Syndrome: Pain coming from facet joints. Degenerated facet joints may also put pressure upon exiting spinal nerves and cause radiculopathy and/or stenosis.

Fibromyalgia: A syndrome involving diffuse systemic muscle pain. The diagnostic criteria has been defined by the American College of Rheumatology as pain at 11of 18 tender point sites, presence of subcutaneous nodules, and a history of widespread pain for more than three months. Trauma can be a cause of this syndrome.

Fibromyositis: An inflammatory muscle condition leading to fibrosis and muscle pain, commonly secondary to trauma.

Fibrosis: Abnormal formation of scar tissue.

Fibrositis: A term with multiple meanings that have been applied to myofascial pain, tendinitis, bursitis, capsulitis, and tenosynovitis. Generally it is understood to be an inflammation of connective tissue.

Flexion-Extension Injury: A sprain/strain injury of the cervical spine and adjacent structures caused by a hyperextension-hyperflexion injury. See Acceleration-Deceleration Injury, Whiplash Injury.

Flexion-Extension X-rays: Side view x-rays taken at the extremes of flexion and extension of the spine to detect abnormal movement between adjacent vertebrae suggestive of ligament damage or ligamentous laxity. These views are compared to a neutral view.

Fluoroscopy: An x-ray machine capable of producing both still images and “real-time” motion of the joints or vertebrae. Often used to visualize intervertebral joint motion through flexion and extension of the neck or back or to place a syringe needle at a targeted site.

Foramen: The opening between the vertebrae through which the spinal nerve root and spinal nerve sheath pass to exit the spinal canal. The size of the foramen may be reduced by degenerative joint disease, a herniated disc, bulging disc, bone spurs,facet joint hypertrophy, or by soft tissue (cyst, tumor, ligament, etc.).

Foraminal Compression Test: A physical examination technique which reduces the opening of the foramen which may demonstrate if there is pressure upon the exiting spinal nerve. The test is done to detect spinal nerve root involvement, a herniateddisc, bulging disc, or foraminal stenosis. The patient is seated with the head and neck in a neutral position. Pressure is increasingly applied on the head and neck in mild lateral flexion to either side. A positive result replicates numbness or tingling into a dermatome of the upper extremity. Also called Sparely’s Manuever.

Foraminal Stenosis: A decrease in the overall size of the intervertebral foramen (the bony window through which the spinal nerves pass) caused by enlargement of the facet or a degenerative disc. The spinal nerve passing through the foramen can become irritated or compressed. Severe foraminal stenosis can cause radiculopathy. Surgical management can include enlarging the foremen by removing bone (foraminotomy), and/or fusion to reduce continued facet joint degeneration.

Foraminotomy: A surgical opening of the intervertebral foramen to provide more space for the spinal nerve.

Frontal-Occipital Headaches: Pain emanating from the base of the skull or in the back of the head and radiating to the forehead. This headache pain is often secondary to acceleration-deceleration injuries (also know as hyperextension-hyperflexion injuries or whiplash) involving the upper joints of the neck (O-C1, C1-2, C2-3 joints).

Full Spine Radiography: A method of x-ray most commonly found in chiropractic practice in which a patient’s entire spine and pelvis are produced on a single x-ray film in both the anterior to posterior (AP) and lateral projections. The x-ray film size is typically 14”x 36”.

Functional Capacity Evaluation: A series of tests measuring physical strength, range of motion, stamina, and tolerance to functional activities, including lifting and carrying. These tests can be used to evaluate work tolerance, and the necessity for work restrictions. More commonly referred to as a Physical Capacities Evaluation (PCE).

Functional Leg Length Discrepancy: A short leg which is the result of a biomechanical subluxation complex (inclusive of a muscle imbalance, myospasm, segmental dysfunction or combination of these factors). It is not due to bone length. Chiropracticadjustment seeks to correct leg length difference.

Fusion: A surgical procedure performed to eliminate spinal pain or immobilize unstable joint segments. Can be used to treat degenerative disc disease and to immobilize injured vertebral segments. A bone graft is placed across a spinal segment which then grows together with the patient’s bone and the area is immobilized. There is a loss of motion between two vertebrae that are fused together. The graft can be an autograft (bone taken from the patient) or an allograft (cadaver bone).

Chronic neck pain following car crashes: a population-based study from Auckland, New Zealand.

Ameratunga S, Tin ST, Connor J, Norton R.

Associate Professor of Epidemiology and Deputy Head, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand.

Abstract Background: In a setting with a 'no fault' universal government-funded accident compensation system, we undertook a study to (a) estimate the prevalence and predictors of chronic neck pain in car occupants surviving serious injury-producing crashes, and (b) compare the longer-term health-related quality of life of crash survivors with and without neck discomfort. Methods: A prospective cohort study recruited hospitalised survivors aged >/=16 years and non-hospitalised drivers of cars involved in serious crashes in Auckland over a ten month period. Participants completed a structured questionnaire at recruitment and 5 and 18 months later. Results: Of the 268 participants, 50 (18.7%) reported neck pain or stiffness at 5 and 18 months following the crash. Of these, 70% noted the discomfort led to limitations in work and recreation. Depressive and post-traumatic stress symptoms at 5 months were associated with an increased risk of moderate to severe neck discomfort at 18 months. Participants with and without neck discomfort had significantly reduced health-related quality of life based on Short Form-36 scores. Conclusions: Significant neck discomfort limiting usual function is relatively common up to 18 months following crashes. The reductions in health status among crash survivors with and without neck pain reveal the complexities in attributing longer-term adverse outcomes to a particular condition in the absence of an appropriate comparison group. The findings indicate the need to judiciously manage co-morbid conditions while prioritising efforts to support crash survivors' return to their usual social roles and activities.

PMID: 19849753 [PubMed - as supplied by publisher]

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