What Is A Pain Management Specialist: And When Do You Need One?

We can have pain as a result of all kinds of problems including chronic illness or surgery. However, for the purposes of this discussion, let’s focus on pain as a result of accident or injury.

All too frequently, after an accident or injury, and well after all physical wounds are healed, pain continues. Sometimes, pain eventually dissipates, but sometimes pain lingers for months or even years after the accident or injury occurred. When that happens and it is obvious that your neurologist or orthopedist cannot relieve the pain, it may be time to see a pain management specialist.

A pain management specialist has special training in assessing, diagnosing and, of course, treating pain. He or she also has knowledge of the latest and most effective treatment modalities such as epidural steroid injections, nerve block injections, pain medication, and physical rehabilitation; and has the expertise to oversee any physical therapy that may be necessary.

How To Choose A Doctor

First, discuss your chronic pain with the doctor you currently are treating with such as your orthopedist, neurologist, or primary care physician. Ask your treating doctor whether a pain management specialist might be a wise course of action. If so, then likely your doctor will provide you with a referral. However, there are a few things to keep in mind.

First, make sure your pain management specialist is board certified. That is an important consideration not only for your own treatment, but also for any potential litigation you may pursue. The Courts tend to look more favorably on opinions offered by physicians who are board certified in their fields when considering the medical facts of the case.

Keep in mind that most pain management specialists have medical training in anesthesiology or physical medicine and rehabilitation. He or she will have had to become board certified in their primary specialty first. Then, they obtain a sub-specialty board certification in pain management.

After you’ve had the opportunity to check out credentials (visit: nydoctorprofile.com), you can have an initial evaluation performed and ask about the pain management physician’s treatment philosophy, i.e., does he or she support conservative or more invasive treatment methods, and what, exactly are those treatment methods?

Like all first-time doctor visits, your pain management specialist will want your full medical history, and likely will conduct a comprehensive interview to determine the severity of the pain, the location of the pain, and the frequency of the pain. This will help him or her to create a highly personalized treatment regimen for your specific impairment.

Be prepared to complete a lengthy impairment questionnaire which your pain management specialist will include as a part of your medical record. Relieving your pain can take some time. Your pain management doctor may try several different treatment options before finding one that is most appropriate for you. So, be a patient patient. Generally, it is well worth the wait.

It Happens Every Day: Nursing Home Abuse

“At 83 years old, unable to speak, unable to fight back, she was even more vulnerable than she was as a little girl fleeing her homeland. In fact, she was as vulnerable as an infant when she was raped. The dignity which she always displayed during her life, which was already being assaulted so unrelentingly by Alzheimer’s disease, was dealt a final devastating blow by this man. The horrific irony is not lost upon me … that the very thing she feared most as a young girl fleeing her homeland happened to her in the final, most vulnerable days of her life.”
– Mary Fischer, at the sentencing of the man who raped her mother.

Tragically, it happens every day across America: elderly patients suffer from abuse and neglect at the hands of their caretakers. In the above instance, 83-year old Sonja Fischer, suffering from Alzheimer’s, was raped by the man whose job it was to attend to her well-being. After an investigation, it was discovered that the abuser had been working for the facility for eight years, and his vile conduct had gone unnoticed. That is not surprising because many nursing home patients, like Sonja Fischer, are afflicted with Alzheimer’s or dementia, making them unable to communicate with their families.

However, even when a nursing home patient does have the ability to communicate, too often they are too fearful to do so. Instead, they suffer extreme loneliness and depression. That is why it is up to their families to be diligent and carefully monitor their loved ones.

How To Handle It

First, visit your family member often, not just during holidays or birthdays. He or she needs to continue to feel connected, and frequent visits are the only way to notice changes in behavior or even signs of physical neglect. And while visiting, do a little investigative work of your own. Ask your elderly relative questions. Inspect them for bruises, cuts, or bedsores. Look around the room to see whether it is clean. Make sure the food menu lines up with nutritional needs.

Also, ask your elderly relative whether someone responds when he or she calls for help, and how long it takes for that response. Ignoring repeated calls for help is often a sign of neglect.

Second, if you suspect abuse or neglect, immediately report it to the administrator, and make sure that report is documented in black and white. Your complaint then becomes a part of the record, should you need it.

Finally, stay on top of it! A nursing home should not be a warehouse; it should be a welcoming, comforting environment where your loved one is safe and cared for. The more you show up and show an interest, the less likely it is your mother, father, aunt or uncle will suffer abuse or neglect.

Suffering In Silence: When An Accident Messes With Your Head

We talk a lot about the physical manifestations of accidents from minor to serious injuries. However, never overlook the potential psychological effects that arise from accidents that can have even more long lasting consequences.

An accident, almost by definition, is an unexpected trauma. You wake up, get ready for work or school, or prepare to drop off the kids, and suddenly, without warning, your car is hit while you’re waiting for a light to change. Or, you’re walking to the bus stop and fall over a faulty piece of concrete. Either way, that unexpected event can change life as you’ve always known it.

If you suffer serious injury, that accident can put you in the emergency room; or, it can prompt you to hire a personal injury attorney and begin a lengthy litigation. But it also, sometimes unknowingly, can make you scared to death of having another accident. In fact, I have had clients that have developed phobias around driving cars or even leaving their houses. Aside from any physical damage they may have suffered, the lingering psychological effects can ruin their lives.

How To Know You Have A Problem

This may very well be the problem. During the trauma you and nearly everyone else is solely focused on your physical well-being. Is anything broken? Do you have full control over your senses? Do you have headaches? Those are the questions that arise first.

Somewhat like traumatic brain injury, psychological trauma may go undetected. If you have ever had the tragic experience of losing a loved one, this phenomenon is similar. In the beginning, you are consumed with stress. You may make funeral arrangements, and greet friends and family in the process. Then, days or even weeks later, the grief sets in. In other words, that very loss keeps your brain focused on what you have to do until you no longer have to do it. Then, you are left just with the grief and the psychological damage that results from that loss.

So, you may have a serious accident, get through the physical stress of hospitals, doctors, diagnostic tests. Then, you are left with the traumatic memories of how your life changed in an instant.

What To Do

Be aware of how you feel. Are you more anxious? Are you depressed? Can you bounce back into your routine of work or school? If not; if you find yourself more and more isolated; more and more disinterested in leaving the house, or terrified of getting in the car, it is time to seek psychiatric help. Just like physical injuries, psychological injuries only get worse when they go untreated.

When A Pedestrian Is Injured

Much like motorcycle accidents, pedestrian accidents give little to no cover to the pedestrian to prevent serious injury. Despite stricter traffic laws in recent years including slower speed limits and increased pedestrian walk-ways, people continue to get hit by motor vehicles simply by walking down the street, and those injuries can be anywhere from serious to deadly.

Distracted Driving

Even at low speed, a driver can be distracted. And today, there are more sources of distraction than ever before. Just glance around at a traffic light to see how many of your fellow drivers are answering cell phones, or worse – texting. That split second when you check your messages or call a friend can sometimes mean the difference between being aware of the road and the people on it, and running someone over. And, according to the law, there is little doubt that should you drive distracted, you are culpable when, not if, someone gets seriously hurt.

In A Hurry

In today’s fast-paced world, everyone is in a hurry: in a hurry to get to work; in a hurry to get to a doctor’s appointment; in a hurry to pick up the kids; or, in a hurry to meet friends for dinner. Therefore, the temptation to drive fast and above the speed limit is more than tempting – it sometimes becomes an imperative. However, that three to five minutes you may save getting to your destination, may very well be some innocent person’s loss if you cannot stop in time. And again, the law mostly looks upon speeding, then hitting a pedestrian as your fault.

What Happens?

It is wise to think for a moment about what can happen to an individual if he is struck by a car, truck, or motorcycle. Optimistically, he may just be pushed out of the way and sustain few if any injuries. However, in too many instances, that is not the case, and the impact of even a vehicle as small as a Smart Car, can be devastating – that is, on average, about 1,000 pounds of moving metal against an average 150 pound human being. Simply no contest. That man or woman may sustain broken bones, multiple herniations, or worse, a head injury from which he or she may never recover. And not only will that injured individual suffer physical trauma, he or she may be out of work for a time, or forever, extending the impact of that accident to a family he or she may be responsible for. His personal life and his professional life may be forever changed.

We all should drive with care. And, should you be a pedestrian struck by a motor vehicle, make sure to consult with a knowledgeable personal injury attorney.

Riding The Bus May Be Hazardous

In New York, mass transit is a convenient, economical and environmentally smart way of getting around. On any given day, hundreds of thousands of New Yorkers board trains, subways and buses to get to work, get to school, or just to get somewhere quickly. However, no system is fool-proof. And when you board a bus that typically travels in high traffic areas, there always is a risk of an accident. Your best defense? Pay attention and try, to the extent that you can, to minimize any injuries that may result.

Most times, despite what looks and feels like close calls, people get to where they want to go unscathed. But, buses do have collisions with other vehicles on the road due to bad weather, another driver’s recklessness, bad road conditions, or simply bad driving on the part of the bus driver. Another potential accident might arise from the bus driver dropping off passengers on parts of the route that are not safe. For instance, high traffic areas or uneven road conditions may cause a passenger to get hit by another vehicle or to fall on the pavement. In those instances, the bus driver may be negligent.

If something like that ever happens to you, remember that you may have a personal injury claim. You may also have a personal injury claim if the Transportation Authority did not properly maintain the vehicle, or failed to adequately train its driver. But navigating this trail is a difficult and winding road.

No-fault medical insurance, for example, has very specific rules for filing claims that result from bus accidents. And when the bus is owned by a municipality, let’s just say they don’t make it easy. Much like insurance companies, municipalities are not necessarily on your side.

There are detailed, sometimes convoluted Notice of Claim requirements that you are expected to follow before bringing your personal injury claim. That is why it is vital to retain a law firm with in-depth knowledge of the whole process to represent your interests.

So, while riding the bus makes a lot of sense in a crowded, bustling metropolitan area, so does arming yourself with information in the event of an accident that results in your personal injury. Remember, you have a right to seek compensation if you prove that bus accident happened due to negligence on the part of the driver, the bus company or the municipality. But, there may be multiple parties at fault – it’s complicated. And, if you miss the filing deadlines, you also will miss your chance for any compensation and be forced to live with the consequences.

When Your Spine Is Injured

When most people think about serious spinal cord injuries, they generally think about someone confined to a wheelchair; Christopher Reeves comes to mind. Reeves suffered a serious spinal cord injury when he was thrown from a horse. That left him a paraplegic which also shortened his life span.

However, more often, other serious and debilitating conditions can result from spinal cord injuries that do not always take away one’s ability to walk, but do significantly interfere with one’s life, just the same. Every part of the human body you need to move or feel is related to your spine. Critical abilities such as walking, moving your arms, and even breathing depend upon your spine functioning properly.

The types of injuries that often result from motor vehicle accidents are referred to as soft tissue injuries. And while that might sound far more benign than what happened to Christopher Reeves, soft tissue injuries can have a devastating impact on your life. Think of what can happen if, due to an accident, you suffer back pain every single day. How would that affect your life? Could you work again? What if, due to that severe back pain, you could not sit for more than one hour at a time? What if the pain took away your ability to stand or walk for more than a half hour at a time?

How would an injury like this affect you if your job required you to sit at a desk all day long? More problematic, how would it affect you if you had a highly physical job such as firefighter, for example?

Any spinal cord injury that causes that kind of pain will have a profound effect on your future and also will affect your ability to interact with family, have a social life, work, travel, and even sleep soundly through the night. That can lead to isolation, financial problems, sleep disorders and not surprisingly depression – your life will be changed forever.

Spinal injuries that cause severe back trauma such as herniated discs or ruptured discs, are the kinds of injuries, unfortunately, that insurance carriers will resist. Carriers will try to claim that such impairments would most likely have resulted from a pre-existing, degenerative condition and not from a motor vehicle accident. Once again, insurance carriers are not your friend.

That is why should you suffer such an injury, the wise thing to do is to seek the counsel of an experienced personal injury attorney who not only understands the law, but also the anatomy and mechanics of your spine. When it comes to a life-changing accident, you need an attorney who also is your fiercest advocate.

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Verdicts & Settlements

$3 Million in Fall from Ladder

$3,000,000 in Fall From Ladder in Westchester County: Plaintiff was an HVAC worker who fell from an interior, wall mounted ladder that lead to a roof hatch in a refrigerated warehouse. The ladder did not have a safety cage. As plaintiff climbed the ladder his hand struck an unknown object affixed to the wall next to the ladder causing him to lose his balance and fall 15 feet to the floor below. As a result of the fall, the HVAC worker suffered a complicated fracture of his right wrist that required multiple surgeries. He also sustained a knee injury that required two arthroscopic procedures and disc herniations in his neck and back that required surgery. The neck and back injuries were not diagnosed for nine months after the accident. As a result of this accident, plaintiff became disabled from his employment and underwent extensive medical care. Defendants argued that this case was not one contemplated by the Labor Law and that all of plaintiff’s injuries, with the exception of his wrist, were not related to the accident. Richard Noll was successful in obtaining summary judgment under Labor Law 240(1) that was affirmed on appeal where the court held that this accident occurred during the “repair” of a building rather than ordinary maintenance. This settlement was then negotiated on the eve of trial in Westchester County Supreme Court.

$1.04 Million for Wrist Fracture

$1,040,000 for wrist fracture in car accident in Richmond County: Plaintiff was a young teacher in her early twenties when her car was struck by defendant’s car. As a result of the collision, plaintiff’s radius and ulna (bones in the forearm) were fractured after becoming caught in the steering wheel. She developed compartment syndrome in her forearm that required emergency fasciotomy surgery and an eventual skin graft. Defendants refused to settle her claim prior to trial for a fair and just amount of money since the case was pending in “conservative Richmond County”. Our tenacious trial preparation finally pushed defendant’s insurance carrier to tender $1,040,000 out of their $1,050,000 in coverage.

$1.02 Million for Internal Injuries

$1,020,000 for internal injuries from car accident in Queens County: Our client was an unemployed young woman passenger in a car involved in an intersection accident. As the result of the negligence of both cars she sustained multiple internal injuries including a rupture of her aorta. Thanks to the quick actions of emergency personnel and hospital staff, her life threatening injuries were resolved and after a short hospital stay, had no further limitations. However, she was left with surgical scars to her abdomen and back. Both defendants initially argued that her injuries did not rise to the level of “serious injury” and that she made an excellent recovery. After jury selection, the insurance carriers tendered all but $5,000 of the available insurance coverage.

$1 Million for Fractured Vertebrae

$1,000,000 for fractured vertebrae in Kings County: Our 21 year old, unemployed client who had just moved to the United States, was the front seat passenger in a car being operated by a young man she just met that evening. As the defendant rounded a curve on the Grand Central Parkway he veered off the road and struck a tree. The defendant driver claimed that his young passenger had grabbed the steering wheel of his car, causing the crash. As a result of this collision, our client suffered a fracture of her T12 vertebrae that required the surgical insertion of a “Harrington Rod” and left her with a permanent scar to her back. Defendants also claimed that our client failed to use an available seat belt. Richard Noll persuaded the jury to hold the defendant completely at fault for causing the accident and to award her one million dollars for her pain and suffering.

$925K for Intoxicated Pedestrian

$925,000 for intoxicated pedestrian in Suffolk County: Our client was a 30 year old, unemployed mother of five children with a documented history of drug and alcohol addiction. Just before midnight, she was crossing Bellport Road in Suffolk County with a family member. They had just left a party where she admitted to consuming five alcoholic drinks. As she crossed into the lane of traffic, she was struck by one car and knocked into the oncoming lane of travel. After some time, her motionless body was run over a second time by the second defendant. As a result of these two impacts, our client suffered multiple fractures of her legs and pelvis that required several surgeries. The hospital records listed her blood alcohol content as three times the legal limit. Defendants claimed plaintiff’s intoxication was an absolute defense to the accident. Richard Noll crafted an argument that the lapse in time between the first impact and the second impact, as plaintiff lay unconscious on the ground, made her intoxication irrelevant to any claim for her comparative fault. After five days of jury selection and pre-trial arguments, this settlement was achieved with gratitude from our client.

$531K for Pain & Suffering

531,000 verdict against the State of New York in the Court of Claims, Westchester County: Our client was no angel. He grew up on the streets of upstate Beacon and had been in serious trouble with the law on several occasions, even serving several years in prison. Then in 1984 he was arrested, tried and convicted of rape and sodomy in the First Degree in Orange County, New York. In 1995, with the use of DNA evidence he was exonerated of all charges and set free. He then retained Richard Noll to prosecute his claim against the State of New York under the “Unjust Conviction Act”. We had to affirmatively prove our client’s innocence and establish that he did not contribute to his arrest or conviction in any way. With the use of DNA evidence and the testimony of forensic scientists retained from the New York City Medical Examiner’s office we were successful in establishing the State’s liability. Richard Noll then took a second verdict in the Court of Claims where our client was awarded $530,000.00 for his pain and suffering.

460K for Eye Injury

Kings County: After one week of trial against the City of New York, Richard Noll was able to settle this action on behalf of his client, a 42 year old taxi cab driver. The plaintiff’s taxi cab was struck by a marked police radio car as it was responding to a “10-13” radio call – “officer in need of assistance”. As a result of the collision, the plaintiff suffered a detached retina of his left eye that resulted in blindness to the eye. Thankfully he was still able to make a living as a livery driver. The City of New York initially denied liability claiming that its police car had the right to operate at an increased speed and to disobey red traffic lights since it was in an emergency operation. The law required plaintiff to prove the police violated the elevated standard of care of “recklessness” rather than ordinary negligence. Just prior to the cross examination of the defendant police officer the City of New York relented and agreed to pay $460,000 to our client.

$458K for Laborer Electrical Arc Event

$458,000 laborer electrical arc event in New York County: This Labor Law 241(6) claim was prosecuted based upon a violation of the Industrial Code that mandated that electrical power be turned off before any construction or demolition work. Our client was one of the electricians hired to turn off the power during the renovation of a commercial building in lower Manhattan. Our client’s supervisor went into the building of the basement to turn off the power. The plaintiff, knowing the power was still live, started to remove breakers from a live electrical panel. The panel exploded in an arc event causing third degree burns to his forearm requiring a skin graft surgery. Defendants all moved to dismiss the case arguing that a specific provision of the Industrial Code was not violated. They also argued plaintiff was the sole proximate cause of the accident. After defeating the summary judgment motions this case was settled on the eve of trial.

$400K for Science Experiment Gone Bad

$400,000 for science experiment gone bad against NYC in Queens County: The plaintiff was a fifth grade student at a NYC public school. His science teacher asked all students to prepare projects for the school science fair. This student asked the teacher for an idea for his project. After speaking to the teacher, our client left school, went home in the company of his parents and mixed vinegar and chloride bleach. The “science project” caused a cloud of noxious gas that when inhaled by the student resulted in respiratory distress and ARDS. After two months of hospitalization and one month of rehabilitation, the student returned to school and led an otherwise normal life. The case was prosecuted on the theory that the NYC school teacher directed the student to perform a dangerous experiment, not appropriate for his age and that it was liable even though the incident occurred after school hours, off of the school property while the student was under the care of his parents. One the eve of jury selection we secured the $400,000 in compensation for the student who was now sixteen years old.

$300K for Trip & Fall on Sidewalk

$300,000 settlement for trip and fall on sidewalk in New York County: Our client was a 79 year old resident of the upper west side walking to church when she tripped and fell on a crack in the sidewalk. The height differential was just less than one inch. There were no witnesses to the actual fall but she did report it to the members of her church immediately afterwards. She was taken to the emergency room where she was diagnosed with a four part humeral fracture (upper arm). She was admitted to the hospital and underwent a hemiarthroplasty (partial shoulder replacement surgery). Defendants argued that the accident was not witnessed; the defect was minimal and it was on a sidewalk that the plaintiff walked across many times before the date of accident so she should have been able to avoid the crack. We successfully argued that the defendant building owner was liable for the sidewalk condition under the New York City Administrative Code as the owner of a multiple dwelling and that the defect was in excess of one half inch – therefore a dangerous condition as defined by the Code. On the eve of jury selection, the client accepted $300,000 in settlement of her claim.

$200K for Trip & Fall

$200,000 settlement after liability verdict against Keyspan in Queens County: Plaintiff, 63 years of age, tripped and fell on a depressed gas main valve box cover in a crosswalk causing a three part fracture of the humerus of her non-dominant arm. The case was presented to a Queens County jury arguing that Keyspan made a special use of the roadway by its ownership and use of the utility cover installed in the roadway. We also argued that Keyspan created the dangerous condition when it installed the gas main pipes four years earlier but then failed to properly back fill, compact and repave the roadway. Defendant argued that plaintiff never actually saw what caused her to fall and that she caused her own accident. It also tried to shift the blame for the dangerous roadway condition to another utility company that excavated a trench next to the gas line installation. The jury returned a verdict after only fifty minutes of deliberation finding Keyspan negligent and that its negligence was a substantial factor in causing the accident. The jury also determined that plaintiff was not negligent. The case was then settled for $200,000 compensating plaintiff for her pain and suffering.

Suzanne Bidart

My role at the Noll Law Firm is to gather, review, and assess medical documentation attached to every client. We strive to ascertain and understand the fundamental aspects of client’s medical history and injuries sustained to support each of our client’s cases.

Prior to joining the Noll Law Firm, I spent many years working as a Registered Nurse in emergency rooms and critical care units. Additionally, I spent several years working as a Rehabilitation Nurse for insurance companies with the main goal of getting our respective clients back to work, if possible. This goal was accomplished with assessing the needs of each individual client, such as attending medical visits to better understand the physicians’ goals in his treatment and making sure these goals were implemented and maintained. These experiences afforded me the ability to understand the science and treatments behind many of our client’s injuries.

What Should I Do After Being Bit By A Dog in Suffolk County?

  • You should immediately ask the dog’s owner if their pet is licensed, in order to track to dog’s health and bite history
  • You may also ask the owner if the dog has a history of biting any other individuals
  • It is important to determine who the dog’s veterinarian is to verify that you are not at risk for any serious injuries
  • You may get the police involved if you are having trouble obtaining any of this information