BEING A CAT ON A HOT TIN ROOF: A LAWYERS PERSPECTIVE

1. BEING A CAT ON A HOT TIN ROOF: A LAWYERS PERSPECTIVE ROBERT HOOPER HOOPER LAW OFFICES

2. PLAINTIFF’S PERSPECTIVE • KNOW THE LEGISLATION • PICK YOUR TEAM • COOPERATE WITH INSURER • KNOW YOUR CLIENT • COMMUNICATE WITH ALL PARTIES

3. THE LAW • PRE 2003 • POST 2003

4. PRE 2003 CATASTROPHIC IMPAIRMENT CAUSED BY AN ACCIDENT THAT OCCURS BEFORE OCTOBER 1, 2003 IS, (E) BRAIN IMPAIRMENT THAT, IN RESPECT OF AN ACCIDENT RESULTS IN, • A SCORE OF 9 OR LESS ON THE GLASGOW COMA SCALE…ACCORDING TO A TEST ADMINISTERED WITHIN A REASONABLE PERIOD OF TIME AFTER THE ACCIDENT BY A PERSON TRAINED FOR THAT PURPOSE • A SCORE OF 2(VEGETATIVE) OR 3 (SEVERE DISABILITY) ON THE GLASGOW COMA SCALE…ACCORDING TO A TEST ADMINISTERED MORE THAN SIX MONTHS AFTER THE ACCIDENT BY A PERSON TRAINED FOR THAT PURPOSE;

5. PRE 2003 • (F) SUBJECT TO SECTIONS (2) AND (3), AN IMPAIRMENT OR COMBINATION OF IMPAIRMENTS THAT, IN ACCORDANCE WITH THE AMA GUIDELINES 4TH EDITION RESULTS IN 55 PER CENT OR MORE IMPAIRMENT OF THE WHOLE PERSON ; OR

6. PRE 2003 • (G) SUBJECT TO SUBSECTIONS (2) AND (3) AN IMPAIRMENT THAT, IN ACCORDANCE WITH THE AMA GUIDELINES 4TH EDITION RESULTS IN A CLASS 4 IMPAIRMENT ( MARKED IMPAIRMENT) OR CLASS 5 (EXTREME IMPAIRMENT) DUE TO MENTAL OR BEHAVIOURAL DISORDER.

7. POST 2003 • TOTAL AND PERMANENT LOSS OR USE OF BOTH LEGS • CHILDREN UNDER 16 MAY BE DEEMED TO BE CATASTROPHICALLY IMPAIRED IF THEIR TREATING DOCTOR CONFIRMS THAT THE CHILD HAS SUFFERED AN IMPAIRMENT IN AN ACCIDENT THAT IS REASONABLY BELIEVED TO BE CATASTROPHIC AFTER TAKEN INTO ACCOUNT THE DEVELOPMENTAL IMPLICATIONS OF THE IMPAIRMENT • THE 55% TOTAL BODY IMPAIRMENT TIME LINE HAS BEEN REDUCED TO 2 YEARS FROM 3 YEARS • TOTAL AND PERMANENT LOSS OF USE OR ONE OR BOTH ARMS AND ONE OR BOTH LEGS

8. AMA GUIDELINES • IN THIS GUIDE IMPAIRMENTS ARE DEFINED AS CONDITIONS THAT INTERFERE WITH AN INDIVIDUALS ACTIVITIES OF DAILY LIVING • ADL’S INCLUDE BUT ARE NOT LIMITED TO SELF CARE AND PERSONAL HYGIENE, EATING AND PREPARING FOOD, COMMUNICATION, SPEAKING, WRITING, MAINTAING ONES POSTURE, STANDING AND SITTING, CARING FOR THE HOME AND PERSONAL FINANCES, WALKING, TRAVELING, AND MOVING ABOUT, RECREATIONAL AND SOCIAL ACTIVITIES, AND WORK ACTIVITIES

9. AMA GUIDELINES • CHAPTER 14 MENTAL AND BEHAVIOURAL DISORDERS • ACTIVITIES OF DAILY LIVING • SOCIAL FUNCTIONING • CONCENTRATION, PERSISTANCE AND PACE • DETERIORATION OR DECOMPOSITION IN WORK OR WORKLIKE SETTINGS

10. AMA GUIDELINES • CLASS 4 MARKED IMPAIRMENT =IMPAIRMENT LEVELS SIGNIFICANTLY IMPEDE USEFUL FUNCTIONING • CLASS 5 EXTREME IMPAIRMENT= IMPAIRMENT LEVELS PRECLUDE USEFUL FUNCTIONING

11. GSC OF 9 OR LESS • BEST EYE RESPONSE (4) • BEST VERBAL RESPONSE (5) • BEST MOTOR RESPONSE (6) • A COMA SCALE OF 13 OR HIGHER CORRELATES WITH A MILD BRAIN INJURY • 9 TO 12 IS A MODERATE INJURY • 8 OR LESS IS A SEVERE BRIAN INJURY

12. GCS CASES • HOLLAND V. PILOT • 15 YEAR OLD STRUCK BY A CAR • AT SCENE 7 • HOSPITAL 7 AND 8 • BLOOD ALCHOL LEVEL ABOVE LEGAL LIMIT • SMOKED DOPE

13. HOLLAND • DEBATE ABOUT ALCHOL AND DRUGS ON GCS • KEENAN, J. CONCLUDES HOLLAND IS CAT

14. YOUNG • MVA YOUNG TRAPPED IN VEHICLE • READINGS @ SCENE 3,4,3 • READING @ HOSPITAL POST SEIZURE 3 • DEBATE ABOUT VALIDITY OF TESTS • DEBATE ABOUT TIMING OF TESTS • HAVE AN ACCIDENT WITH A HEALTH CARE PROFESSIONAL

15. YOUNG • ARB DECISION UPHELD • YOUNG DEEMED CAT

16. TOURNAY • DAUGHTER SAYS MOMS DEAD @ SCENE • NO READINGS TILL HOSPITAL • READINGS DONE AFTER B/P DROP • READINGS AFTER INTUBATION • READINGS AFTER PARALYTIC DRUGS GIVEN

17. TOURNAY • REVIEW OF WHAT IS VALID SCORE • TOURNAY WAS CAT

18. F = 55% • YOUR INVOLVEMENT • OBSERVATIONS • REPORTS • TREATMENT • ASSESSMENTS • HELPFUL TO THOSE NOT ON THE GROUND FLOOR

19. G=MARKED OR EXTREME • ADLS • SOCIAL FUNCTIONING • CONCENTRATION • WORK OR WORK LIKE SETTING

20. YOUR INVOLVEMENT • BEST KNOWLEDGE • REGULAR REPORTING • GOOD NOTE TAKING ON THE AREAS ABOVE • REGULAR RE-ASSESSMENT • ATTENDANT CARE • WORK VOCATION

21. WHY • MEDICAL/ REHABILITATION • $100,000 OR 10 YEARS • $1,000,000 OR LIFETIME

22. WHY • ATTENDANT CARE • $3,000/ MONTH $72,000 MAX 2 YEARS • $6,000/ MONTH $1,000,000 LIFETIME

23. WHY • HOUSEKEEPING AND HOME MAINTENANCE • $100/WEEK 2 YEARS • $100/WEEK LIFETIME

24. WHY • CASE MANAGEMENT • NOT AVAILABLE • AVAILABLE AND IS INSURED’S CHOICE

25. HELPFUL HINTS • REPORTS • DOPE ON NIGHT STAND VS. INFO ON ADL’S AND OTHER AREAS FROM AMA GUIDELINES • YOU ARE ONE OF THE ONLY COMMUNITY OBSERVERS • ASSIST THE FAMILY DOCTOR • ASSIST THE TEAM • REASSESS REGULARLY • KEEP YOUR PROFESSIONALISM • BE ETHICAL • REPORT IN YOUR FIELD ONLY • ATTEND TEAM MEETINGS • REVIEW RECORDS FOR GCS ISSUES • REMEMBER AMA GUIDELINES • REMEMBER CASE LAW ABOUT MARKED IMPAIRMENT DESBRIENS AND WORK EXAMPLE • COOPERATE ON TIMELINES • KNOW TIMELINES AND ADHERE • DO NOT PRESUME ALL LAWYERS DO THIS EVERYDAY • GETTING TO CAT A GROUP EFFORT, LAWYER, CLIENT, REHAB PEOPLE