tag:blogger.com,1999:blog-10594643006378020312024-03-19T08:07:11.820-04:00THE FLORIDA CAR ACCIDENT PIP NO-FAULT TREATMENT BLOG Here we discuss the injuries that occur from car accidents and how to effectively treat them. Some aspects of the Florida PIP law are discussed.
Disclaimer: I am not an attorney, nor is this site intended for legal information. If you want legal advice, please consult with an attorney.Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.comBlogger75125tag:blogger.com,1999:blog-1059464300637802031.post-16885056041013157962019-11-22T23:35:00.003-05:002021-11-30T22:33:33.780-05:00Car Accident Injuries<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Car Accident Injuries</b></div>
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<b style="font-family: inherit; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit;">DEFINITION OF ACCIDENT</b><span style="font-family: inherit; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;">: <span face=""arial" , sans-serif" style="color: #222222; letter-spacing: normal;">an unfortunate incident that happens unexpectedly and unintentionally, typically resulting in damage or injury</span><span face=""arial" , sans-serif" style="color: #222222; font-size: x-small; letter-spacing: normal;">.</span></span></div>
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Don't underestimate the injuries that even a small low-speed accident can cause. that can last a lifetime,</div>
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<span style="font-family: inherit; font-size: inherit; font-style: inherit; font-weight: inherit;">Current research bears that chronic back and neck pain is due to auto accidents almost 37% of the time and that these auto injury traumas are a primary contributor. These types of injuries are called whiplash injuries in laymen's terms, whether the injury is to the neck or the back.</span></div>
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<strong style="border: 0px rgb(235, 235, 235); box-sizing: border-box; color: #2b436d; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">What type of pain do people feel?</strong></div>
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Generally, my office treats "soft tissue" injuries of the body. These injuries are to the structures of the body that are not hard tissue or bone. So, the injuries are to the muscles, ligaments, tendons, discs, cartilage, and nerves. Often times, these types of injuries cause pain which is sharp in nature, burning, radiating, or aching. Other symptoms include stiffness, headaches, shoulder pain, tightness, and loss of balance. Advanced imaging could be necessary to diagnose the injury. P<span style="font-family: inherit; font-size: inherit; font-style: inherit; font-weight: inherit;">lease don't underestimate the severity of these types of injuries as if you leave them alone untreated, they can become chronic and lasting forever. </span></div>
<div style="border: 0px rgb(235, 235, 235); box-sizing: border-box; font: inherit; margin-bottom: 0.85em; margin-top: 0.85em; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px rgb(235, 235, 235); box-sizing: border-box; color: #2b436d; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Whiplash </strong>is one of the most common vehicular-accident related injuries. This is a neck sprain/strain syndrome and it occurs when there is an abrupt jerking of the head, or body either forward or backward. Treatment usually requires chiropractic and physiotherapy treatments.</div>
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<strong style="border: 0px rgb(235, 235, 235); box-sizing: border-box; color: #2b436d; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">What we see quite often with car accident injuries</strong>. Common spinal injuries include disc herniation and or movement of the vertebra forward or back. These injuries which cause bones to move forward and back are often the result of damaged supporting ligaments. The shifts of the vertebra may cause pinched nerves, pain, and weakness. In some rare cases, this injury can lead to a loss of bowel and bladder control, which is a medical emergency.</div>
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Disc herniations occur when the jelly donut-like discs between the vertebra rupture and cause the jelly-like substance to come out. When the disc jelly comes out or protrudes, it can push on structures like the spinal cord or nerves. This injury may cause weakness and numbing of arms or legs. Chiropractic treatment works wonderfully on this type of injury.</div>
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<strong style="border: 0px rgb(235, 235, 235); box-sizing: border-box; color: #2b436d; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">How to treat Treat Chronic Pain after an Accident</strong></div>
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When the pain becomes chronic, it is generally much more difficult to treat. One reason is that the muscles and joints become chronically inflamed from the injury. Thus, if you are feeling any stiffness or discomfort or pain, it is critical to seek the advice of a chiropractor who is experienced in these types of injuries and how to treat them.</div>
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Please <a href="http://www.emergency-chiropractor-florida.com/home.html" target="_blank">contact an emergency chiropractor</a> if you or someone you know has had a car accident. </div>
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Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-90703286686606947222017-05-10T14:29:00.002-04:002017-05-10T14:29:55.693-04:00Statin Use Increases Odds of Back Disorder: Cohort Study<div class="title-area" style="border-bottom: 1px solid rgb(216, 216, 216); box-sizing: border-box; color: #2a2a2a; font-family: proxima_nova_rgregular, arial, sans-serif; position: relative;">
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This is not new news, however this is further evidence that statin drugs (cholesterol lowering drugs) are associated with back pain. The article goes on to state that statins have now been shown to be related to a greater risk of "spondylosis, intervertebral disc disorders, herniated discs, and spinal stenosis," whereas before, the use of statins were associated with back pain without arthritis. </div>
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Chiropractors, don't overlook the use of cholesterol lowering drugs when trying to find the cause of your patient's back pain. </div>
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<a href="http://www.pembrokepines-chiropractor.com/" target="_blank">Dr. Alan Himmel</a></div>
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Statin Use Increases Odds of Back Disorder: Cohort Study</h1>
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<span style="font-size: 1.25rem;">DALLAS, TX — </span>In a large observational study of insured individuals in the military and their family members, statin use was associated with increased odds of having a back disorder, including spondylosis, intervertebral disc disorders, herniated discs, and spinal stenosis<sup style="box-sizing: border-box; line-height: 1;">[<a href="https://www.blogger.com/null" style="box-sizing: border-box; color: #5757a6;">1</a>]</sup>.</div>
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Specifically, for every 17 individuals who were prescribed a statin, one person had a diagnosed back disorder, in this study published online May 1, 2017 as a research letter in <em style="box-sizing: border-box;">JAMA Internal Medicine</em>.</div>
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"Some of these adverse effects [from statins] can greatly impact day-to-day quality of life for our patients," especially in those who are physically active, lead author Dr Una E Makris (VA North Texas Health Care System and UT Southwestern Medical Center, Dallas) told <a href="http://www.medscape.com/cardiology/news" style="box-sizing: border-box; color: #5757a6; text-decoration-line: none;"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">heart<em style="box-sizing: border-box;">wire</em> </span></a>from Medscape in an email. "We hope that musculoskeletal adverse events will be part of the patient-provider discussion on the risk/benefit ratio" of these drugs.</div>
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"Our results provide additional motivation to further investigate the overall influence of statin therapy on musculoskeletal health, specifically if prescribed for primary prevention in physically active individuals," the researchers summarize.</div>
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<span style="box-sizing: border-box;">Can Statins Cause Back Pain?</span></span></h3>
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Two previous studies based on NHANES data reported that statin use was associated with musculoskeletal pain including back pain among individuals without arthritis<sup style="box-sizing: border-box; line-height: 1;">[<a href="https://www.blogger.com/null" style="box-sizing: border-box; color: #5757a6;">2</a>,<a href="https://www.blogger.com/null" style="box-sizing: border-box; color: #5757a6;">3</a>]</sup>.</div>
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Severe back pain is both debilitating and costly. In 2005, it was estimated that back pain cost the healthcare system more than $100 billion, Makris noted.</div>
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The researchers retrieved data from 60,455 individuals who were at least 30 years old, lived in the San Antonio area, and were enrolled in the TRICARE health insurance system from 2003 to 2012. Of these, 17% were active military personnel and the rest were family members and veterans.</div>
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About one in six individuals (10,910) had been prescribed a statin, usually simvastatin (in 72% of prescriptions), and on average, they had been taking this drug for 3.7 years.</div>
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The researchers matched 6728 statin users with an equal number of statin nonusers. They had a mean age of 52 and 47% were women. A quarter were overweight or obese; 53% had hypertension; 20% had diabetes; and 40% had osteoarthritis.</div>
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Close to a third (30%) had a back disorder.</div>
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In the propensity-matched cohort, being prescribed a statin (as opposed to not being prescribed this drug) significantly raised the odds of having a back disorder (odds ratio 1.27; 95% CI 1.19–1.36).</div>
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In the overall cohort and in prespecified subgroups (such as nonobese individuals, healthy individuals, or those without musculoskeletal conditions at baseline, statin use was consistently associated with increased odds of being diagnosed with a back disorder.</div>
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In an analysis of the overall cohort, but with adjustment for propensity scores, the risk increase for a back disorder went from 30% among statin users to 47% among those taking high-intensity statins. It also increased with duration to as high as 59% with <u style="box-sizing: border-box;">></u>4 years of use.</div>
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<span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">Adjusted* Odds Ratio (OR) of a Back Disorder, Statin Users vs Nonusers</span></div>
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<tr style="box-sizing: border-box;"><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="156"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">Group</span></td><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="168"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">OR (95% CI)*</span></td></tr>
<tr style="box-sizing: border-box;"><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="156"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">Overall cohort</span></td><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="168">1.30 (1.23–1.38)</td></tr>
<tr style="box-sizing: border-box;"><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="156"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;"><u style="box-sizing: border-box;">></u>2 y statin use</span></td><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="168">1.47 (1.39–1.56)</td></tr>
<tr style="box-sizing: border-box;"><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="156"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;"><u style="box-sizing: border-box;">></u>4 y statin use</span></td><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="168">1.59 (1.47–1.71)</td></tr>
<tr style="box-sizing: border-box;"><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="156"><span style="box-sizing: border-box; font-family: "proxima_nova_rgbold" , sans-serif;">High-intensity statin</span></td><td style="border: 1px solid rgb(216, 216, 216); box-sizing: border-box; line-height: 1.88; padding: 9px 17px;" valign="top" width="168">1.47 (1.34–1.62)</td></tr>
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*Adjusted for propensity score, medications used, and use of revascularization procedures during follow-up</div>
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"Further prospective studies are needed to better understand the mechanism of how statins can contribute to back disorder diagnoses," said Makris.</div>
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"We are not advocating for taking patients off statins if they have cardiovascular risk factors. As clinicians we should be aware of these potential associations and understand the spectrum of potential adverse effects."</div>
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<em style="box-sizing: border-box;">The study was supported by grants and awards from the US Department of Veterans Affairs, the National Institutes of Health, the UT Southwestern Center, VA Health Services Research and Development, and the Agency for Healthcare Research and Quality. The authors report that they have no relevant financial relationships.</em></div>
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Heartwire from Medscape © 2017 </div>
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Cite this article: Statin Use Increases Odds of Back Disorder: Cohort Study - <i style="box-sizing: border-box;">Medscape</i> - May 08, 2017.</div>
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http://www.medscape.com/viewarticle/879387?nlid=114770_4502&src=wnl_dne_170509_mscpedit&uac=5165DT&impID=1344127&faf=1Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com1Florida, USA27.6648274 -81.51575350000001720.441620399999998 -91.886847500000016 34.8880344 -71.144659500000017tag:blogger.com,1999:blog-1059464300637802031.post-30199931948525784962017-05-03T16:20:00.001-04:002021-11-30T22:32:19.545-05:00I hear THIS complaint about lawyers virtually EVERY DAY.<h2>
Biggest Complaint Clients Have About Their Lawyer...</h2>
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The biggest complaint I hear from patients regarding their attorney is lack of communication. Multiple calls with no response. The response from the lawyer's office is that the "lawyer is in court." Could be true or maybe it's not true, but either way, most clients can handle that, as long as they get a call back at some point.<br />
<br />
But many times, the call never comes.<br />
<br />
Now, I know that if you asked most lawyers, they would tell you that the number one question they get when a client calls, is "How is my case doing?" And, I get it. It's the same question over and over again, and its exhausting to have to be bothered with the redundancy of answering the same question over and over again.<br />
<br />
But, come on. As an attorney, you are getting paid very well to answer a few stupid questions. It's not like it's that difficult. What I am trying to say in a nice way, is that it could be worse, and for what fees that your client's are going to pay you, at least give them good customer service. It's not so bad and it okay to take a few minutes out of your day to reach out to your clients...even if you just leave a message on voicemail.<br />
<br />
So, I have a suggestion: Take a little bit of time once every two or three weeks, and try and make a preemptive call out to your client. Simply give a quick update. For example, "Hey, its Attorney xyz, I just wanted to let you know that everything looks good on my end. I sent out the letters of representation and requested policy information. Just make sure you continue to take care of your injury, and I'll keep you posted in a couple of weeks if I have any updates. But, don't worry, I'm on top of it."<br />
<br />
If you did THAT, and that ONLY, you would be providing a great service to the client, and at the very least you will be easing their mind. If you made a call like that one or two times a month, not only would you satisfy the client, but they would also be more inclined to stay more compliant with treatment, make referrals to you, and EVEN if the case did not turn out wonderful, at least the client would know that you were working very hard and staying on top of their case, and did the best you could do.<br />
<br />
I have been treating accident patients in S. Florida for almost 22 years now. If any of your client's need a treating doctor in the S. Florida area, please have them give me a call. <br />
<br />
Thank you.<br />
<br />
<a href="http://www.emergency-chiropractor-florida.com/home.html" target="_blank">Dr. Alan Himmel</a><br />
954-659-8600 Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-20686725655075312922017-01-19T13:32:00.003-05:002022-04-06T18:25:40.121-04:00Another Insurance Scam Story....I'm so tired of this.<b>I'm Fired Up</b><br />
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It's been a while since I posted, but yesterday something happened which fired me up, and not it a good way. One of my patients came in and told me about some lady he heard of, who had a car accident a few weeks ago. This person lives somewhere in Cutler Ridge, which is South West Dade County, FL.<br />
<br />
So, she had an accident, and she is now treating at a chiro office with her boyfriend, who was the passenger. So, for a few minutes we were discussing the way the PIP works, and difference between first party insurance, and the at fault party's insurance, etc. And then, out of the blue, my patient asked me about the $2000 dollars that this woman got, and the $2000 her boyfriend got, UP FRONT for their "settlement", at the chiro office. The reason my patient was asking about this, is because, as an ex insurance utilization employee, he was wondering why these two people were ALSO told to come in to the office five times a week, for what appeared to him to be a minor car accident.<br />
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Now, I am a pretty calm person 99% of the time. Very mellow. Maybe even too mellow.<br />
<br />
Considering the unbelievable nature of this story, I actually think I controlled myself fairly well. But, I think that by the end of the visit with my patient, he was a little rattled up, because he has never seen this side of me. <br />
<br />
As a doctor who has been practicing chiropractic for over 20 years now, I feel I have a good grasp of the way these scams work. And, if you are reading this and you are not either a doctor or a lawyer, and you are maybe a little naive, I will explain to you what is actually happening at this office in Miami with these patients, and probably also to lot of other patients who are coming in for treatment over there.<br />
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This is likely the sequence of events and facts that surround this crime:<br />
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The patients are in their car and are in an accident. Maybe the accident was staged, maybe not.<br />
<br />
The injured patients called one of the lawyers who advertise on TV during the time when the Jerry Springer Show, or similar is on. Or, maybe they called 411-Pain, 1-800-NEED-HELP or one of the other ones that are popular these days. The patients THEN are referred to a doctor's office and are told that the office will take very good care of them.<br />
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The doctor's office looks at the "case"after also communicating with the lawyer's office and realizes the at-fault party has a small or bad insurance company, or maybe that at-fault vehicle has no insurance at all. However, the patients have one of the larger carrier well known insurance companies like Allstate, Geico, State Farm, or Progressive. From this very quick investigation, the office quickly learns that the patients have a very bad case because of the bad coverage on the other side, and the patient's policy has no uninsured motorist coverage, but the two patients do have $10,000 in coverage, EACH, in fact.<br />
<br />
Since the doctor's office knows that if the patients find out they have a bad case, they won't come in for treatment, the office offers the patients up front cash to come in, and come in frequently and a lot, so the office can quickly bill through the entire insurance benefit until the insurance benefit is exhausted. <br />
<br />
There is also a possibility that this inducement or kickback is also provided when the patient actually KNOWS they have no case. YES, lots of times patients know about their lousy case, and these patients come in expecting this cash kickback, for simply becoming a patient, because they heard that some offices do this. In other words, they shop around for it, until they find an office who will pay them, and an office that will pay the most.<br />
<br />
Either way the kickback is provided because the doctor knows that the patient will have no "incentive to treat" because they really don't have pain, but they just want money.<br />
<br />
So, the doctor's office pays out $4000 and then bills $20,000. This leaves the office with $16,000.<br />
<br />
Yes, this scam happens. Not always, but it does happen. For those who are reading this and are thinking that all personal injury is a scam, YOU ARE WRONG about that. Please don't group the legit medical and legal offices with total scam insurance fraud scheme offices. It is unfortunate, but there are bad players in every profession.<br />
<br />
The truth is that there are patients who are injured and who are treated correctly, legally, professionally, and who are helped. You just have to make sure you go to a good office, and if you are using an attorney to help compensate you for your injury, you go to a good, and legit attorney. <br />
<br />
If you are a patient and are tempted to accept a kickback from the medical office or someone working outside the medical office, be aware, that not only is the office committing insurance fraud, but YOU ARE TOO. This means that you will be subject to prosecution and face the possibility of jail time, the same as the person who gave you the money. And if you think you will not get caught, THINK AGAIN. The insurance companies and the insurance fraud task force know the offices who are doing this, and they are waiting for the right time to rush into the office with guns drawn, and with the news crew present, to make an example out of you, and place your face and name on the front page of the news paper and the 5 o'clock news, and RUIN YOUR LIFE.<br />
<br />
I have been treating patients who have been injured in car accidents for over 20 years. If you would like information, please call my office and I would be happy to discuss how I can help you, the right way.<br />
<br />
Professionally yours,<br />
<a href="http://www.emergency-chiropractor-florida.com/">Dr. Alan Himmel</a><br />
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0Fort Lauderdale, FL 33327, USA26.1119237 -80.421524625.9978512 -80.5828861 26.225996199999997 -80.2601631tag:blogger.com,1999:blog-1059464300637802031.post-41646326586408663522016-09-16T15:56:00.001-04:002022-04-06T18:26:31.769-04:00How to Properly Manage a Personal Injury PatientProper management of an injury patient is an important part of patient care that should not be overlooked. When a new patient comes into my office, I always make sure that the patient has a clear understanding of the process.<br />
<br />
The procedure involves detailed documentation of the patient's history, which includes finding out about prior injuries, car accidents, prior medical treatment for any body part, even if the treated body part was not accident related. The reason behind this, is that all parties involved will want to know whether the patient's new injury overlaps with any prior medically treated areas of the patient's body.<br />
<br />
Moreover, included in the history are any other medical conditions, as well as family history, and prescriptions currently being taken. From this, you can learn a lot. For example, a patient recently told me that she has a family history of aneurysm resulting in death to her sister and father. Chiropractors should never overlook this history, and blatantly do cervical adjustments on these types of patients.<br />
<br />
At the end of the initial visit, there should be an initial report written and each subsequent visit with the doctor should be documented in standard SOAP form. The patient always signs the chart note for the visit. No signature and no visit ever happened.<br />
<br />
I almost always make sure the patient is quickly referred to an orthopedic specialist or his medical doctor who could also diagnose emergency medical condition if necessary. Emergency medical condition or EMC, is specific to Florida, and is required if the patient has a more serious injury, and its purpose is that it frees up the patient's full insurance benefit, if extensive treatment is necessary. The insurance company is counting on the fact that the patient will not have an EMC and will only be responsible for 25% of the claim. Without it, the insurance company takes away 75% of the patents insurance benefit.<br />
<br />
Soft tissue injuries are better diagnosed with objective tests, like MRI. Sometimes, X-rays are ordered if fracture or dislocation is suspected. Most of the time however, x-rays do not turn up injury in patients that have injuries that are soft tissue in nature. Over the years, I have seen some broken ribs, sternums, and bones in the hands and feet, but this is rare. X-rays have shown dislocations, over the years,<br />
<br />
Depending on the frequency of the visit, the course of treatment can vary between a couple months and upward of 6 months or more.<br />
<br />
Any other referrals will be made if necessary, including orthopedic doctors, neurologists, podiatrists, mental health doctors, etc.<br />
<br />
Finally, a report is generated when the patient is released from standard care, at maximum medical improvement, MMI. If there is a request for an impairment rating, I will provide the rating in the report, and forward the report to the attorney who is helping to resolve any claims.<br />
<br />
During this whole process, COMMUNICATION is key so that everyone is on the same page, and nothing is missed.<br />
<br />
I have been seeing mainly personal injury type patients for 20+ years. If you have been involved in a car accident, don't hesitate. Please call my office to schedule your first visit. If you are a lawyer and have a client who you think could benefit from an experienced doctor in regard to accident care, I will love to see that person. It is NOT my goal to provide GOOD care to my patients; it IS my goal to provide EXCELLENT care to my patients.<br />
<br />
<a href="http://www.emergency-chiropractor-florida.com/">Alan Himmel, DC PA.</a><br />
954-659-8600<br /><br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-49291809547789706332016-09-01T18:11:00.003-04:002022-04-06T18:27:02.109-04:00 "I WANT MONEY," is not the Right Message to Send to an Insurance Company. <h2>
I WANT MONEY</h2>
<br />
The Statute of Limitations for filing suit in a personal injury case in Florida is 4 Years. However, in the same state, here in Florida, there is a 14 DAY limit to wait, to begin treatment, after a car accident.<br />
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Think about this for a second, please. You will see the point I am trying to make. WHY? Why would you first seek an attorney before a doctor? You are injured, RIGHT?<br />
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Do you know what kind of a message that this sends to an insurance company?<br />
<br />
PLEASE DON'T DO THIS! You have 4 WHOLE YEARS to get the paperwork in with an attorney and file against an insurance company. This is 4 years! The law is very clear on this topic.<br />
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And, it's very clear on this also: You only have 14 DAYS to get under care for an auto accident in Florida. ONLY 14 days. And, it goes by very quick. Injured car accident patients SHOULD seek treatment right away. And, when you seek treatment right away, you send an entirely different message to the insurance company.<br />
<br />
The message that you send when you seek treatment first, is "I am injured."<br />
The message that you send when you seek an attorney first, is "I want Money."<br />
<br />
I have been treating car accident patients for 20+ years. I know the rules and the laws, and have a lot of experience with this. You can contact me and I will personally explain this to you, or better yet, call me and set up your appointment.<br />
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<a href="http://www.emergency-chiropractor-florida.com/">Alan Himmel, DC PA</a><br />
954-659-8600--Call me directly.Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-4090183401563723702016-08-22T17:50:00.002-04:002022-04-06T18:27:49.118-04:00Is there such thing as a Florida PIP No-Fault Insurance Provider?<h2>
What is a Florida PIP No-Fault Insurance Provider?</h2>
<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Miramar Chiropractor Accident Doctor</a><br />
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Can a doctor be a provider of PIP No Fault Insurance? I know there are Blue Cross Blue Shield providers, and Aetna, and Humana, for example. But what about PIP? I say, yes.<br />
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We are a Florida No Fault PIP Provider. I say this as IF it requires a special designation or certification to see car accident patients and communicate with PIP carriers for reimbursement. Well, of course it turns out that it does NOT take any special certification to this. So, why do I call myself a Florida PIP No-Fault Provider? It is because over the years I have met many doctors, yes, chiropractors as well, who do not handle these types of patients. When asked why, do you know what the number one reason was? It is that they don't know how to do it, and they never get paid. This usually results in the doctor chasing the patient around for payment. It means sending several bills to a patient and then collections, and it usually ends up a total waste of time. The doctor's office loses, and of course, the patient loses as well. <br />
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I have actually gotten several patients over the last 20 years because when they went to their regular doctor, they were told, "Sorry, we don't take accident patients." That's when they were referred to me for care, and I handled not only the communication and payment from the proper insurance carrier, but also handled the intricate documentation and proper referrals that are often times needed throughout the period of care of the patient. This is not to mention the writing of a very detailed report which outlines the details of the accident, the injuries, the diagnosis, prognosis, future costs of health care, possible loss of work which will cost the patient income in the future.<br />
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Knowing what I know, and what I have seen over the years, I would encourage anyone who has been injured in a car accident to make sure they go to a provider who is experienced and knowledgeable on dealing with PIP. It is entirely different than HMO or PPO or medicare rules. PIP billing, in a sense, is a specialty. It is not well taught in billing and coding schools, and you would not expect an average insurance biller or doctor, to know how to handle it.<br />
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I have been dealing with nothing but PIP for 20 years now. I am very experienced in the rules and correct procedures that are often changed by the Florida Legislature almost once a year.<br />
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If you have been in an accident, please call me first. I will explain everything to you so you will be up to speed on the topic, and you don't make any mistakes which could cost you a lot of money down the road.<br />
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<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Dr. Alan Himmel, DC, PA.</a><br />
954-659-8600<br />
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0florida30.448673679287587 -82.2656252.1928236792875886 -123.574219 58.70452367928759 -40.957031tag:blogger.com,1999:blog-1059464300637802031.post-89584795937603905752016-06-16T12:28:00.002-04:002022-04-06T18:28:54.638-04:00More Disruption Coming-- Autonomous Cars Will Change Auto Insurance Among Other Things...<h2>
More Disruption Coming-- Autonomous Cars Will Change Auto Insurance Among Other Things...</h2>
<a href="http://www.emergency-chiropractor-florida.com/">Dr. Alan Himmel-West Miramar Car Accident Injury Doctor</a><br />
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Autonomous cars are coming. Get ready. It is estimated that by 2025 there could be 600,000 autonomous cars on the road, and by 2035, there could be 21 million cars on the road. (1)<br />
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What is an autonomous car? Well, it's a self driving car. To paint the picture, this is probably what driving will be like in the future: We will step into our cars with probably some futuristic doors which open up in Lamborghini style in order for us to easily slide in with handfuls of carry-ons. Think of getting onto an airport shuttle bus. We will step in, place our stuff on the side, and simply have a seat. From there we will likely just speak our destination out loud, so that the navigation (GPS) hears us and figures out the best route. A voice will come on and say, please buckle your seat belt, and inform us that we will be at our destination in 23 minutes and 16 seconds. Ehh....no speeding anymore since we are not in control of the gas pedal. And, at this point, the doors will shut, the system will make sure all passengers are safely secured, and we will be on our way.<br />
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Since we are no longer in control of our car, we could, if we want to just sit back and read the newspaper (if they still exist), do some computer work, watch a movie, or do anything else we want.<br />
Even Sleep.<br />
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The trip will probably be very boring. I figure it will be like being on a tour bus, with only one big difference; we have seen this city all before, since we live here. This won't be like being on a tour bus travelling through Rome, unless you live in Rome. There will be no reason to take your camera with you.<br />
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So, let's talk about how the autonomous car will change things, and there are plenty: The first thing that comes to mind, is that automated cars will reduce the amount of human error, since our cars will be controlled by computer software and hardware. I know what you are thinking... GPS is very inaccurate and most of the time it sends you to the wrong place. Believe me, this is a system which is in progress, and I would expect there to be gigantic improvements in GPS technology. Eliminate human error and there are less injuries, and fatalities, because there are less accidents of all kinds. Car insurance companies will have to restructure the policies to account for the possibility of computer error, and those tech companies who created the system would be held liable for accidents. <br />
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And, I would expect cars with combustion engines (again, if they still exist) to be more efficient. Keeping you at a constant 45mph in a 45mph zone will save you gas. It will also save your brakes.<br />
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How else would we expect life to change with autonomous cars? Fewer car accidents mean fewer trips to a body shop. Fewer car wrecks would mean fewer tow trucks on the road. Calling a UBER driver (sorry Taxi Companies, it was good while it lasted but your days are numbered), will mean a driverless UBER car comes to you and picks you up. There are billions of dollars going into making this happen. Postal, UPS, and small package delivery will probably use these driverless vehicles also.<br />
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What if we don't want this? Sorry, its coming. Just about every car manufacturer is working on this to make it a reality, along with Apple, Google, Microsoft, just to name the obvious. (2) (3)<br />
Let me put it to you this way: When Google pays a billion dollars for a traffic app called Waze, do you think it is entirely for watching where the police are? No. Its all about the data that that app provides back to Google. And, don't forget that just about everyone has a smart phone, which uses wifi and data, which is continuously sending information back to Apple and Google plotting your exact coordinates. The information that these companies are gathering will one day be crucial to making these systems work. <br />
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For now, we are just starting to see a sprinkling of this new technology in our cars. There have been self parking cars out for a few years now. Also, blind spot monitoring in side view mirrors has been out for a while. My 2014 Mazda has this feature. I just saw a commercial on TV (can't remember the car company) showing a car that is available right now, that will completely avoid colliding into something. They were demonstrating how the car automatically stops if a person walks out in front of a car which was driving straight ahead, and while the driver took his eyes off the road for a few seconds. Pretty awesome, and that would prevent a rear end collision, too.<br />
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What if you are the type of person who likes to keep his car forever or you like the classic cars? I doubt if these older cars would ever disappear completely, but you would expect them to be less and less common, just like we don't see many Model T's on the road very often. <br />
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In summary, we are living in some exciting times in terms of technology. I am not sure if I am ready for it, because I still enjoy driving, and being in control of my car. Our grandkids will likely look back and find it amusing that we actually use to drive our own cars. <br />
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<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Miramar Chiropractor</a><br />
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References:<br />
1. http://fortune.com/2016/06/07/autonomous-car-sales-ihs/<br />
2. https://www.cbinsights.com/blog/autonomous-driverless-vehicles-corporations-list/<br />
3. http://www.fastcompany.com/3024362/innovation-agents/10-autonomous-driving-companies-to-watchAlan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0United States37.09024 -95.712891000000013-36.4186355 99.052733999999987 90 69.521483999999987tag:blogger.com,1999:blog-1059464300637802031.post-12950761261436768072016-05-17T16:06:00.002-04:002016-05-19T14:12:40.776-04:00Fat Belly? Your bigger concern should be Fatty Liver.<h2 style="text-align: center;">
<b>Fat Belly? Your bigger concern should be Fatty Liver.</b></h2>
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<b><a href="http://www.miramarchiropractor.com/" target="_blank">Alan Himmel, DC.</a></b></div>
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The next time you look in the mirror and look at your gut, you should be more concerned about what's happening on the inside, particularly to you liver. The condition I am talking about is called Fatty Liver Disease, or Hepatic Steatosis.<br />
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What is normal? </h3>
There is always a small amount of fat surrounding your liver. A small amount (5-10%) of fat in the liver is considered normal. <br />
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Who is at risk?</h3>
If you drink alcohol (alcoholic liver disease), you are at risk, and this condition is clinically significant, because this may lead to cirrhosis, over time.<br />
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In pregnancy, fatty liver can be common. If you are obese or even overweight, you are at risk. These two causes are (NAFLD) or Non-alcoholic Fatty Liver Disease, and are clinically less significant and considered by some sources to be benign, although there is a causative link between fatty liver and type two diabetes, hepatitis, and advanced liver disease, such as cirrhosis as well.<br />
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What are the symptoms of fatty liver?</h3>
Generally, there are no symptoms. It is one of those silent diseases. If you carry a large amount of fat around your midsection, there is a good chance you have fatty liver. In extreme cases, you may feel some fatigue, abdominal discomfort, enlargement of the liver, weakness, poor appetite, or weight loss. <br />
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What are the long term consequences?</h3>
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In most cases of NAFLD, the long term clinical outcome is minimal with not much evidence of increased mortality. However, there is a group of the population with with NAFLD that progresses to a more inflammatory liver disease called <span style="background-color: white; font-family: "arial" , sans-serif;">nonalcoholic steatohepatitis</span> (NASH) which leads to hepatitis, end stage liver disease, and a lower chance of survival.<br />
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How is fatty liver diagnosed? </h3>
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Liver enzymes (transaminases) can be checked, but in many cases, the levels appear normal. Clinically, the signs of Fatty Liver would include high triglycerides, high cholesterol levels. Another way to check would be the use of ultrasound. Lastly, MRI or CAT scan can be used.<br />
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What can I do to prevent it fatty liver, and is it reversible?</h3>
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Fatty liver is one of those diseases which is preventable and often times reversible. It is highly advised to stay away from a diet high in sugars, and in particular, high fructose corn syrup sweeteners which are found in many foods we eat, from soft drinks to tomato sauce. Within the liver, these sugars undergo a process called lipogenesis, and much of that fat is stored in the liver and the viscera. In order to reverse fatty liver, a diet devoid of high sugars and high fructose corn syrup, along with exercise, can lead to weight loss, and ultimately a reduction of fat in the liver.<br />
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Do you need some advice or counseling on effective ways to reduce or prevent fatty liver disease? I have been in practice since 1996. You can contact my office and make an appointment: 954-659-8600<br />
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Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-14327658696133510312016-03-10T18:17:00.002-05:002022-04-06T18:29:53.628-04:00Will Florida PIP Cover Me if I am Traveling out of Florida?<h2>
Will Florida PIP Cover Me if I am Traveling out of Florida?</h2>
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<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Alan Himmel, DC PA</a></div>
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In your own car: YES.<br />In a car that is not yours, including a rental: NO<br />In Mexico: NO<br />In Canada: YES</h3>
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Here is a scenario: You are a Florida resident and have a Florida registered and insured car and travel north to go skiing in the Smoky Mountains. You decide to pile your family into the family SUV, and make a trip. You manage to get through Florida and Georgia safely, but when you get into Tennessee, someone runs a red light and smashes into your car causing injuries. In this scenario, you were in your own car, so there IS coverage for you and your family.</h4>
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Let's say you find that there is no snow in North Carolina and decide to travel into Canada? Yes, there is PIP coverage for injuries to you and your family if you have an accident in Canada.</h4>
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<br />HOWEVER, lets say you decide to FLY to North Carolina, and rent a car. You have an accident in North Carolina while occupying a rental car. NO, there is no coverage under your Florida PIP policy. Same is true if you are in a friend's car in NC, It's not your car, so no PIP. </h4>
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Let's say you are in your relative's car in NC, providing that the relative is a NC resident, No Florida PIP here either. How about if you are in a relative's car in NC and the relative is a Florida resident with car insurance coming from Florida? No coverage here either unless you and the relative LIVE together.</h4>
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In Mexico in your own car and there is NO coverage.</h4>
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In regard to resident relatives: There are some companies that will deny a claim if they determine that the policyholder did not disclose all people in the household when the policy was purchased. They will deny the claim based on "material misrepresentation." So, always let the company know all people living in the house, no matter if the addition of these extra people in the house will increase the cost of the policy. If you hide this information from them, they will find out and may deny your claim.</h4>
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<u><b>I'm not a lawyer. I am a chiropractor with 26 years experience treating auto accident patients, and I have been exposed to many different coverage scenarios. Get all legal opinions from a licensed attorney.</b></u></div>
Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-29479942676659178722015-08-18T18:29:00.002-04:002022-04-06T18:30:40.406-04:00Nursemaid's Elbow in a Young Child. Cause, signs, and reduction.<h2>
<span style="font-size: large;"> Nursemaid's Elbow</span></h2>
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<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Dr. Alan Himmel</a><br />
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<span style="font-size: large;">It is never a good idea to pull or tug a young child by the arm. This action may create what is called a nursemaid's elbow. </span><br />
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<span style="font-size: large;">What essentially happens is that a person, who is trying to control an uncooperative child, grabs the child by the arm. The child of course, still is not cooperative, and fights back, by pulling. The resulting injury is that the head of the radius, subluxates at the elbow causing a lot of pain, guarding, and the inability of the child to want to use the arm or hand.</span><br />
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<span style="font-size: large;">Often times, the radial head pops back in by itself and the pain and guarding will disappear on its own, allowing for almost instantaneous pain relief. But, sometimes, the joint will not "go back in" without a little help.</span><br />
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<span style="font-size: large;">I don't recommend doing trying to fix this at home, because without knowing for sure whether it is truly a radial head subluxation or a fracture, it is possible to cause more pain and injury. However, if you are confident the child has a nursemaid's elbow, or if it has happened before (children who have had this injury, may tend to have it again) then this is what you can do to fix it.</span><br />
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<span style="font-size: large;">Carefully supinate the hand in front of the child. Then, while palpating the radial head with your fingertip and just a little bit of pressure, use your other hand to slowly flex the arm at the elbow. You may have to go past 90 degrees of flexion, but you will feel, with very little effort, the radial head click, and pop back into the correct position. The child may cry a little, but the relief is instantaneous, and within a few minutes, the child should be acting normal again and giving high fives with the injured hand.</span>Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-45026353774042840312015-02-04T18:20:00.001-05:002015-02-04T18:24:56.409-05:00See this Fantastic Whiplash Video Infographic. This is Why you have so Much Pain!<h4>
<span style="color: red;"><a href="http://www.miramarchiropractor.com/" target="_blank">Dr. Himmel</a></span></h4>
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<span style="color: red;">I have been treating patients who have sustained whiplash for practically the last 2 decades. </span></h4>
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<span style="color: red;"> Many people are unaware that even a small impact rear end collision can cause significant pain and impairment in certain cases. Symptoms include pain, stiffness, headache, shoulder pain, arm pain, numbness, tingling, and weakness in the upper extremities.</span></h4>
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<span style="color: red; font-size: x-large;">If you have been injured in a rear end collision, do not hesitate. You must get examined and if treatment is necessary, you should begin as soon as possible to try and prevent future, permanent, chronic problems. </span><br />
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<span style="color: blue; font-size: x-large;">Call our office Today: 954-659-8600</span></div>
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<iframe allowfullscreen="" allowtransparency="true" class="wistia_embed" frameborder="0" height="360" mozallowfullscreen="" msallowfullscreen="" name="wistia_embed" oallowfullscreen="" scrolling="no" src="//fast.wistia.net/embed/iframe/os3p3cpw42" webkitallowfullscreen="" width="640"></iframe>
Compliments of Accident Injury Centers of Atlanta,</div>
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Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-6933177257264016432014-11-05T14:22:00.000-05:002014-11-05T14:22:01.041-05:00Florida Governor Race. Scott Wins. Keep your eye on PIP.<h2>
Florida Governor Race. Scott Wins. Keep your eye on PIP.</h2>
<a href="http://www.miramarchiropractor.com/" target="_blank">Dr. Alan Himmel</a><br />
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Well, not much to say about the results of the Florida Governor race. For the sake of Florida drivers and doctors who treat accident patients, lets hope that we have another four years of PIP.<br />
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The fact that Rick Scott was the former CEO of a gigantic hospital company may be of benefit. He likely still has ties to that company, whether it be his buddies who are in favor of first party PIP coverage for accident victims, or he still has his hands directly in the pot; he most likely is not in favor of a total elimination of PIP.<br />
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It just bothers me that a man who plead the 5th in an investigation of his company, can still be the governor of a state. If a person is put on the stand and pleads the 5th, it simply tells you they are hiding information which will be incriminating. Note the breakdown of the word inCRIMINating.<br />
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Ok, so he is a crook and got away with it. He is not the first person to commit crimes and get away with it and he wont be the last. But, become governor twice after this? Amazing, but I wish I could say I am surprised.<br />
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-80153407396087030782014-09-18T12:07:00.004-04:002015-02-06T17:39:05.736-05:00Forget being a Chiropractor, be a Neurobiologist<div class="contentHeaderContainer" style="background: rgb(255, 255, 255); border: 0px; line-height: 13px; margin: 0px; padding: 0px; vertical-align: baseline;">
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<span class="contentType" style="border: 0px; font-family: inherit; font-style: inherit; font-variant: inherit; font-weight: bold; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><span class="contentType" style="border: 0px; font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.miramarchiropractor.com/" style="font-family: Helvetica, Arial, Verdana, sans-serif; font-size: medium;" target="_blank">Dr. Alan Himmel</a></span></span><br />
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<div class="contentSection" style="border: 0px; color: #333333; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 10px 0px 0px; vertical-align: baseline;">
<span class="contentType" style="border: 0px; font-family: inherit; font-style: inherit; font-variant: inherit; font-weight: bold; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><span class="contentType" style="border: 0px; font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">I am a subscriber to Medscape, which for those who don't know, is an email digest of significant new medical research that comes out almost daily from the medical community. I have been a subscriber for at least the last 10 years, and I highly recommend that anyone who is involved in healthcare should also check this thing out. </span></span></div>
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<span class="contentType" style="border: 0px; font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">The reason I am writing this post, is that this is the first time since I have been a subscriber, that I have seen Medscape distribute this as news (front page headline, by the way) of an article written by chiropractors (half-doctors) and published in a distinguished and respected journal such as The Annals of Internal Medicine. I mean, everyone knows that this is a journal that only real and "serious doctors" get their information. </span></div>
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<span style="font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit;">The article is written by CHIROPRACTORS (plus a MD and a PhD in Biostatistics). So maybe they got in the journal because they "carefully" placed an MD on the list of authors? Still, the head authors are DC's and the journal accepted the research and published it.</span></div>
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<span style="font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit;">Anyway, let me tell you how difficult this is: Medical journals have a board of "peer" reviewers who read over submissions to the journal, slice it up with comments, and often times, stamp a big denial on the paper and send it back to the author. In other words, just because you can write well and you are articulate, and you can back up your paper with actual results and referenced research at the end of your manuscript, these distinguished doctors who make up the peer reviewers and editors often times deny your paper if they simply don't like you or don't agree.</span></div>
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<span style="font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit;">So, I think this is a significant event. Medscape's subscribers are made up mainly of medical doctors and specialists. Maybe more than 100,000 doctors read this paper. </span></div>
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<span style="font-family: inherit; font-size: 1em; font-style: inherit; font-variant: inherit; line-height: inherit;">When you try and subscribe to Medscape, you will see that "DC" is not even on the dropdown list where it asks, what your specialty is. Hint: pick another specialty when you become a subscriber--maybe someone you have always wanted to be like a Neurobiologist. </span></div>
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<h1 class="aTitle" style="border: 0px; color: #333333; font-family: Georgia, Times, serif; font-size: 24px; font-variant: inherit; font-weight: normal; line-height: 1.3; margin: 0px 0px 5px; padding: 5px 0px 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblArticleTitle" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain<span class="titleSeparator" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">: </span><span class="subTitle" style="border: 0px; font-family: inherit; font-size: 20px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">A Trial With Adaptive Allocation</span></span></h1>
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<div class="contentContainer" id="tab1" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"></span><br />
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Background:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Back-related leg pain (BRLP) is often disabling and costly, and there is a paucity of research to guide its management.</span></span></div>
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">
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<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Objective:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">To determine whether spinal manipulative therapy (SMT) plus home exercise and advice (HEA) compared with HEA alone reduces leg pain in the short and long term in adults with BRLP.</span></span></div>
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">
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<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Design:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Controlled pragmatic trial with allocation by minimization conducted from 2007 to 2011. (ClinicalTrials.gov: NCT00494065)</span></span></div>
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<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Setting:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">2 research centers (Minnesota and Iowa).</span></span></div>
<span id="ctl00_scm6MainContent_lblExtract" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Patients:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Persons aged 21 years or older with BRLP for least 4 weeks.</span></div>
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Intervention:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">12 weeks of SMT plus HEA or HEA alone.</span></div>
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Measurements:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">The primary outcome was patient-rated BRLP at 12 and 52 weeks. Secondary outcomes were self-reported low back pain, disability, global improvement, satisfaction, medication use, and general health status at 12 and 52 weeks. Blinded objective tests were done at 12 weeks.</span></div>
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Results:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Of the 192 enrolled patients, 191 (99%) provided follow-up data at 12 weeks and 179 (93%) at 52 weeks. For leg pain, SMT plus HEA had a clinically important advantage over HEA (difference, 10 percentage points [95% CI, 2 to 19]; <em style="border: 0px; font-family: inherit; font-size: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">P</em> = 0.008) at 12 weeks but not at 52 weeks (difference, 7 percentage points [CI, −2 to 15]; <em style="border: 0px; font-family: inherit; font-size: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">P</em> = 0.146). Nearly all secondary outcomes improved more with SMT plus HEA at 12 weeks, but only global improvement, satisfaction, and medication use had sustained improvements at 52 weeks. No serious treatment-related adverse events or deaths occurred.</span></div>
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Limitation:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Patients and providers could not be blinded.</span></div>
<div style="border: 0px; font-family: Helvetica, sans-serif; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.5; margin-bottom: 10px; padding: 0px; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Conclusion:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">For patients with BRLP, SMT plus HEA was more effective than HEA alone after 12 weeks, but the benefit was sustained only for some secondary outcomes at 52 weeks.</span></div>
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<strong style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Primary Funding Source:</strong> <span style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">U.S. Department of Health and Human Services.</span></div>
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Topics</h2>
<a href="http://annals.org/Solr/searchresults.aspx?q=back+pain&fd_JournalID=90" id="ctl00_scm6MainContent_rptSigninTopics_ctl00_aTopiclinks" style="border: 0px; color: #006699; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">back pain</a> ; <a href="http://annals.org/Solr/searchresults.aspx?q=exercise&fd_JournalID=90" id="ctl00_scm6MainContent_rptSigninTopics_ctl02_aTopiclinks" style="border: 0px; color: #006699; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">exercise</a> ; <a href="http://annals.org/Solr/searchresults.aspx?q=lower+limb+pain&fd_JournalID=90" id="ctl00_scm6MainContent_rptSigninTopics_ctl04_aTopiclinks" style="border: 0px; color: #006699; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">lower limb pain</a> ; <a href="http://annals.org/Solr/searchresults.aspx?q=manipulation%2c+spinal&fd_JournalID=90" id="ctl00_scm6MainContent_rptSigninTopics_ctl06_aTopiclinks" style="border: 0px; color: #006699; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">manipulation, spinal</a></div>
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Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-85229927758206349652014-08-31T00:35:00.000-04:002014-10-07T10:34:24.852-04:002 Easy steps to dealing with Right and Left Lower Back Pain<h2>
2 Easy steps to dealing with Right and Left Lower Back Pain</h2>
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<a href="http://www.miramarchiropractor.com/" target="_blank">Dr. Alan Himmel</a></div>
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Statistically left and right lower back pain accounts for up to 40% of missed days at work in the US. Notwithstanding any serious injury including fracture, I decided to summarize a series of things that may be done at home in order to speed the healing process and potentially decrease the disability associated with these types of acute injuries. <br />
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First. Keep moving.</h3>
Chances are that if you hurt your back, you went to your doctor and he prescribed you pain medication, anti inflammatory pills, and possibly a muscle relaxer. He then told you to lay down in bed and rest your back for a week. It turns out that often times is the wrong plan. Although I won't comment on the use of prescription medication, I can tell you that laying in bed can actually delay your recovery.<br />
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I suggest to most of my patients to get up and try and walk when they have acute left or right lower back pain. You shouldn't necessarily do any type of exercise that requires physical exertion, but you should get up on your feet and at least just try walking. This does wonders for back pain, and I have found that the quicker you get on your feet and walk, possibly even before the inflammation sets in, the better you are going to be.<br />
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Second. Do some stretching.</h3>
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1. I like the torso twist. You can sit or lay on your back and slowly twist your body. Think of it like you are gently ringing out a towel. You would need to do the twist to the left and right and just hold yourself in that twisted position on each side for at least 30 seconds.</div>
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2. Do a cat stretch. The way you do this is to get on the ground or your bed on your knees and hands. You will then try and arch your back toward the ceiling and hold for at least 30 seconds. Next you are going to stay in the hands and knees position and arch your back downward toward the floor.</div>
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3. Last, I usually recommend lower extremity stretches. The usual sitting down and touching toes. This gets the hamstrings. Also I recommend trying to stretch the quadriceps by lying face up and trying to flex the knee and put the foot behind your thigh. Lastly, I advise people to do groin stretches and the best way to do this is in the sitting position on the floor, taking both feet in toward your body and trying to place the soles of the feet together. From this point, you can slowly and gently pull the feet in toward the body. Hold for at least 30 seconds to a minute.</div>
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So. Walk and stretch. The formula is to keep moving. </div>
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I have been in practice since 1996. I am located in Miramar Florida. My office number is 954-659-8600. My cell phone is 305-979-5549</div>
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-20869789389275277952014-04-11T15:29:00.002-04:002014-04-11T15:29:50.863-04:00What Does it Mean when they say PIP is Primary?<h2>
What Does it Mean when they say PIP is Primary?</h2>
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<a href="http://www.miramarchiropractor.com/14_Day_Accident_PIP-Rule.html" target="_blank">Dr. Alan Himmel</a><br />
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PIP No-Fault Insurance is primary in Florida. What this means is, if you are involved in a car accident in the State of Florida, and you either have your own car with insurance or are living with a resident relative (living in a house with family member who has a car with insurance) you are required by law to have all claims for injuries filed through PIP. PIP is primary, meaning that even if you have your own health insurance, Medicare, Medicaid, or group plan, you have no choice but to use PIP first.<br />
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Most doctors who treat trauma/accident patients know this, unless they are new and have not been trained or have no experience with these types of patients.<br />
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So, what happens if you go see a doctor after a car accident, and hand them your health insurance card? Well, if the doctor bills health insurance instead of PIP, there is actually a chance that the bill will get paid. Why? Because at this point, the insurance company is unaware of the fact that the patient is being treated for a car accident. They process they claim as they do any other claim.<br />
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But, this is what I have seen over and over again over the years. After a few weeks or months, the health insurance company will send a letter out to the policyholder and ask him a few questions, the most important one being describe the circumstances that led to your injury, and were you in a vehicle at the time of your injury?<br />
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If, through these questions, the insurance company learns that the patient was indeed in a car accident, the insurance company will usually proceed in one of two ways: First, they can ask for the money back from the doctor. Or second, they can wait to see if there is a legal settlement which will be paid out to the patient, and if so, they can put a lien on the settlement in order to be paid back.<br />
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If you have health insurance, you can use it for claims that are over and above the PIP payable amount (Secondary, not Primary). In other words, since PIP mainly pays 80% of the claim, health insurance can pick up the 20%. You can also submit deductibles to them, and you can submit all claims to health insurance that exceed the $2500 or $10,000 in coverage. If PIP denies the claim completely for reasons of failure to pay policy premium, or failure to carry, or anything, then health insurance can be billed in these circumstances. But, remember, if you have a settlement pending that is due to this accident, you will pay the insurance company back from your settlement.<br />
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If you are one of those patients who just does not want to use your PIP car insurance for one reason or another, you will find yourself in one of the two scenarios up above. Chances are, your health insurance will request the money back from the doctor or you will have to pay it out of any settlement you receive.<br />
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I have been treating car accident patients since 1996.<br />
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Consult with me for injuries relating to car accidents. I can be reached directly at 954-659-8600. Always consult with an attorney with issues regarding the law. I am not an attorney.<br />
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My office address is:<br />
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Alan Himmel, DC, PA.<br />
3161 Dykes Road<br />
Miramar, FL. 33027Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-68147546609362872712014-04-09T12:58:00.001-04:002014-10-07T10:34:57.263-04:00Can Whiplash Cause Concussion?<h2>
Can Whiplash Cause Concussion?</h2>
<a href="http://www.pembrokepines-chiropractor.com/" target="_blank">Dr. Alan Himmel</a><br />
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Talked about it before. Let's talk about it again. Can a mild whiplash cause a concussion? The literature says, yes. And, I have had several patients over the years, and one currently, who has the affects of post concussion syndrome. <br />
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Attorneys who represent injury clients need to be aware of this issue as well. The most recent patient that I am treating who I am sure has suffered a concussion, has all of the symptoms of this injury, including headache, vertigo, disorientation, and confusion. This will be a patient who will tell you that their head just doesn't feel the same since the accident. It can be very frustrating to the patient, and the patient may find themselves searching doctors who could figure it out. Oddly enough, attorneys will very often dismiss concussion, wanting to focus the claim on disc injuries and the usual soft tissue findings. Why?<br />
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I think that the major sticking point for attorneys is simply not understanding the physics involved in a car accident, and not knowing what a concussion actually is.<br />
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You don't have to strike your head against the inside of the car and you don't have to get hit in the head by something to cause concussion. Think of it like this: The brain is encased within the skull and around the brain is a thin layer of fluid which separates the brain from the inside of the skull so it does not touch (among other purposes of the fluid). The fluid is called cerebral spinal fluid or CSF. So, the brain, in a way, is swimming in this fluid and the small fluid space between the brain and the inside surface of the skull is like a barrier because you don't want the brain to touch anything.<br />
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Okay, now think about what will happen to a person's head when at rest, when the car he is in is hit from behind. The person's head will move in the direction of where the force came from. This is one of Newton's laws of motion. Every action has an equal and opposite reaction. But, what about the brain which is "floating" within the skull? It too, must obey the laws of physics, and at this point, the brain will then crash into the inside of the skull on the opposite side. Right there is your concussion.<br />
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<img alt="Concussion mechanics.svg" src="http://upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Concussion_mechanics.svg/230px-Concussion_mechanics.svg.png" /><br />
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Now, keep in mind that concussion is not always possible to see on MRI or CAT scan. Concussion is regularly diagnosed based on neurological symptoms, signs, and complaints. Lawyers and insurance companies want objective proof, but they cannot always have it with concussion. The lawyer who is representing the client with concussion, must be aware of these things. A lawyer who is representing injury clients must be an expert in the law, and although its not required to be trained like a physician, he should also have a working knowledge of different types of injuries involved.<br />
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So, keep an eye out for a concussion when whiplash is involved. They are generally not life threatening, but concussions can be quite serious, and recurrent concussions can be even worse.<br />
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I can be reached at 954-659-8600<br />
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My office address is:<br />
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Alan Himmel, DC, PA.<br />
3161 Dykes Road<br />
Miramar, FL. 33027Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-62708702763079446922014-04-07T12:32:00.000-04:002014-10-07T10:35:20.713-04:00The Changes to the Florida PIP law have worked to stop fraud: True or False?<h3>
The Changes to the Florida PIP law have worked to stop fraud: True or False?</h3>
<a href="https://plus.google.com/103343933512785917582/posts" target="_blank">Dr. Alan Himmel</a><br />
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The articles are beginning to come out stating that the changes in the PIP laws that occurred in 2012 have decreased the rate of fraud, and costs to insurance companies, and ultimately to consumers. This is a good thing if its true. It may be that the decreases in payouts are due to the $2500 insurance cut off, or the 14 day rule, which states that you better get to a doctor within 14 days or you get $0.00 in coverage. It may also be due to the fact that now, there is no coverage for acupuncture or massage, two effective, safe, alternatives to medications and surgery. <br />
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As a practitioner who sees accident patients in FL, doctors now have two less options to offer patients when they are suffering from painful injuries from automobile trauma. Plus, patients have to get better with 75% less insurance coverage than they had in the past, since not all patients will have an "emergency medical condition" (EMC) which is supposed to allow the patient to have their full benefit.<br />
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So, I ask you: What do you think is the true reason that insurance companies are reporting savings? Could the answer be that there is now more opportunity for the insurance carriers to deny coverage, since the payouts are capped now in many cases? Or, could it be true that the savings is due to less fraud? I would be one of the first to start celebrating if I was sure that the savings to insurance companies was about the reduction in crime, but I am not 100% sure about that one. <br />
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-682793724783129652014-02-25T01:16:00.001-05:002014-10-07T10:36:56.632-04:00Emergency Chiropractic Florida<a href="http://emergency-chiropractor-florida.com/#.UwwwPEJRhZM.blogger">Emergency Chiropractic Florida</a><br />
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<a href="http://dr.%20alan%20himmel/" target="_blank">Dr. Alan Himmel</a><br />
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I decided to create another website: <b>www.emergency-chiropractor-florida.com</b><br />
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I named it Emergency Chiropractic of Florida because I continue to see patients who have been to the hospital or other doctor after a car accident, and it has been determined that they have an "emergency medical condition." The designation of emergency medical condition or (EMC) allows the patient to seek follow up care and be covered by his PIP insurance up to his full coverage limits. Without the EMC, he is limited to only 25% of the coverage he pays for. Not all of my car accident patients actually do have a bonafide EMC, and as a matter of fact, the EMC is only present if certain medical providers such as an MD or DO say it is present. <br />
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Nevertheless, these emergency patients often end up calling me because of my experience and my knowledge in regard to the proper treatment, management, and documentation of these types of injuries. This comes with practically 18 years experience. If you have been injured in a car accident, please call my office. The number is 954-659-8600.<br />
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Dr. Alan HimmelAlan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-1703527327846639032014-01-30T13:41:00.000-05:002014-10-07T10:37:18.915-04:00FL EMERGENCY MEDICAL CONDITION PIP DENIALS BEGIN<h3>
FL EMERGENCY MEDICAL CONDITION PIP DENIALS BEGIN</h3>
<a href="http://www.miramarchiropractor.com/" target="_blank">Dr. Alan Himmel</a><br />
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Just as predicted, there are some companies who are ignoring Emergency Medical Conditions and denying PIP coverage beyond $2500. So, a medical provider, in many cases a specialist, will look at and examine a patient, and say, "Yes, without medical treatment, this patient is likely going to suffer long term permanent impairments," and write it exactly as the law is written, and certain insurance companies are having the doctor's notes and records reviewed by one of their doctors to say that its not true. <br />
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I just had a patient with an shoulder impingement syndrome denied. The patient cannot raise her arm up past 90 degrees in any direction. She cannot take a half gallon of milk out of the fridge due to pain and weakness in her shoulder, and an insurance company doctor says she needs no further treatment. The MRI alone was more than half her PIP benefit. <br />
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Surprisingly, this denial is happening with major providers. You would think that the small rip-off companies would be doing this, but as I said, even the big boys are doing it.<br />
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So, what do you do? As a doctor who spends a lot of time with patients one on one (sometimes more than an hour), I have to make a decision. The decision is whether to release the patient from care, or to continue treating in the hopes that in the end, a suit can be filed, and the insurance company will eventually pay. SInce this whole EMC thing is a new thing in Florida, there are a lot of unknowns. <br />
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The first unknown is whether a suit can be won in the first place. Lawyers cannot guarantee a win. And, as I said, this is a new program in FL, so there is not a whole lot of new case law. Secondly, if a suit is won, will the WHOLE bill be paid, or will only part of it be paid? What if a Judge says, pay the bill, but only 20% of it? Can they do that? A colleague of mine seems to think so. He may be right.<br />
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My patient with shoulder impingement I am continuing to see and treat. She is doing better and better. Without treatment her condition would likely turn into frozen shoulder.Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-29286931289890388262013-12-11T17:35:00.003-05:002015-03-20T14:41:06.732-04:00Florida PIP EMERGENCY MEDICAL CONDITION (EMC) Form<h2 style="text-align: center;">
EMERGENCY MEDICAL CONDITION (EMC)</h2>
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<a href="http://www.pembrokepines-chiropractor.com/" target="_blank">Dr. Alan Himmel</a> <a href="http://www.miramarchiropractor.com/" target="_blank">@ MiramarChiropractor.com</a></div>
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For those physicians providing care to Florida patients involved in automobile accidents, this is important information:</div>
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THERE IS NO SPECIAL EMC FORM.</div>
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1. The new law states that if the MD, DO, PA, Nurse, or dentist does not notate the patient file that the injured patient has an "emergency medical condition", the patient is limited to only $2500 of the full $10k in PIP insurance that the patient paid for. </div>
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2. This means that if in the future, the patient requires further medical care including diagnostic imaging, or surgical procedures, the patient will likely be cut off at $2500 from medical care.</div>
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3. There is no rule that says that the EMC must be completed within 14 days. Only that the first visit to a doctor must be within 14 days. So, as long as the patient was initially seen within 14 days of his accident, he is covered under his FL PIP coverage. </div>
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4. If you see the patient and the patient comes in (up to 5 years) post accident beginning Jan 1, 2013, you should still designate the EMC (if the patient's condition warrants it) in the patient file or you will most likely NOT get your bill paid.</div>
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5. There is no special form for the EMC. Just document it in the patient's file. Just write, "medical emergency" if the patient's condition warrants it. It is recommended that you state that your decision to write that the patient has an EMC agrees with one or more of these below:<br />
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<span style="background-color: white;"><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px;">(a) Serious Jeopardy to the patient health.</span></span><br />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px;">(b) Serious impairment to bodily functions.</span><br />
<span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 12px;">(c) Serious dysfunction of any bodily organ or part.</span></div>
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6. I am not a lawyer, so my disclaimer to you is that you should contact a PIP litigation lawyer in the state of Florida regarding any legal matter including this one. </div>
Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-90097103598914241402013-12-06T01:16:00.002-05:002014-01-20T23:43:57.731-05:00Nelson Mandela, RIP. Dies "peacefully" at 95.<h2>
Nelson Mandela, RIP.</h2>
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<a href="http://www.miramarchiropractor.com/">Dr. Alan Himmel</a></div>
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One of my favorite Nelson Mandela Quotes. <br />
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<span class="bqQuoteLink" style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 20px; line-height: 26px;">"<a href="http://www.brainyquote.com/quotes/quotes/n/nelsonmand178791.html" style="color: rgb(0, 51, 153) !important; text-decoration: none;" title="view quote">In my country we go to prison first and then become President.</a>"</span><br />
<span class="bodybold" style="font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 14px; font-weight: bold; line-height: 20px;"><a href="http://www.brainyquote.com/quotes/quotes/n/nelsonmand178791.html" style="color: rgb(0, 51, 153) !important; text-decoration: none;" title="view quote">Nelson Mandela</a></span><span style="background-color: white; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 14px; line-height: 20px;"> </span><br />
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Certainly there are many politicians in FL alone that should be behind bars, starting with the bald skinny guy in Tallahassee. Honestly, its been a long while since the US has produced a politician who we can be proud of as a country. We can only hope. Until then, we have to deal with a bunch of crooks, liars, and greedy dirtbags.Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-23628167953465268102013-11-21T23:59:00.000-05:002013-12-06T01:18:33.763-05:00RESPECT<div class="separator" style="clear: both; text-align: center;">
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Respect.</h2>
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<b>Dr. Alan Himmel</b></div>
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<b>Two Things:</b><br />
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<b>1. Patients: Why is respect such a difficult thing for people? I mean is it too much to ask, that if you cannot make it to an appointment, you call and let the office know? It takes 30 seconds out of your day. Thats it. Its just basic consideration. </b><br />
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<b>2. Lawyers: Again, respect. Its not okay to divert your client away from their treating doctor. You do not hold a license to practice any kind of medicine. By making referrals to a health care provider, you are practicing medicine without a license. You can try any type of lawyering to try and convince me otherwise, but you are wasting your time.</b>Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-12214598325865146982013-10-23T22:38:00.002-04:002014-02-24T16:32:23.232-05:00FL PIP Statute is upheld in appeals court. EMC stands. Massage and Acupuncture are out.<h2>
FL PIP Statute is upheld in appeals court. EMC stands. Massage and Acupuncture are out.</h2>
<a href="http://www.emergency-chiropractor-florida.com/" target="_blank">Dr. Alan Himmel</a><br />
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Well, here it is. Actually it was no big surprise. The three judges upheld the PIP law. They say that the plaintiffs did not convince them that denial based on EMC, and the elimination of massage and acupuncture is unconstitutional. <br />
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<a href="http://www.orlandosentinel.com/news/blogs/political-pulse/sfl-appeals-court-upholds-pip-reforms-20131023,0,7339611.post?track=rss">http://www.orlandosentinel.com/news/blogs/political-pulse/sfl-appeals-court-upholds-pip-reforms-20131023,0,7339611.post?track=rss</a><br />
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This was an appellate court ruling.<br />
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You can watch the hearing at:<br />
<a href="http://florida-no-fault-pip.blogspot.com/2013/09/video-of-pip-appeal-hearing.html">http://florida-no-fault-pip.blogspot.com/2013/09/video-of-pip-appeal-hearing.html</a><br />
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I am not going to spend a lot of time discussing my thoughts on this, because at this point, it makes no difference anyway. I am not going to say that the plaintiffs argument was weak and confusing--I'm not a lawyer, so I couldn't have done any better (even though it was weak and confusing); I am not going to complain that the judges already seemed to have made their decision before the hearing even started; I am not going to suggest that three judges, who were picked by Bush, Crist, and Scott, were going to come up with anything other than the decision that they came up with. <br />
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I do have mixed feelings about the fight against the EMC ruling and elimination of massage and acupuncture from reimbursement. I think that the injunction was a nice solid stepping stone, or transition into the complete repeal of FL pip. Now that the law has been upheld, its 'possible' that we will have a year or two more before they again try and drive the nails into the coffin of PIP. It will likely come, but maybe since they got what they want for now, they will leave it alone for a bit. But, I also believe in the fight. That's where I am conflicted. If you don't fight, then whats the point? In this case, the more you fight, the quicker your death. Its like you just gotta give them something, or they will come back just to rape and kill you in the end. You just are not going to win in the long or short run.<br />
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There will still be PIP suits regarding the PIP, so the attorneys that do PIP litigation will still be needed. And, thank the lord for these people. If you are a chiropractor and treating auto trauma patients, you still have some hope that you will see first party insurance payment beyond the $2500, for your hard work. <br />
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Later for now. I have to concentrate on more positive things.<br />
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<br />Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0tag:blogger.com,1999:blog-1059464300637802031.post-79849122248564252022013-09-18T00:53:00.001-04:002013-09-19T20:43:38.171-04:00VIDEO OF PIP APPEAL HEARING <h3>
VIDEO OF FL PIP APPEAL HEARING: SEPT 17, 2013 </h3>
<a href="http://www.miramarchiropractor.com/">Dr. Alan Himmel</a><br />
<br />
<span style="font-family: Verdana, sans-serif;">FL PIP Appellate hearing video. I don't know why the video was cut off before Attorneys Levine and Lirot were allowed to speak.</span><br />
<br />
<a href="http://oavideo.1dca.org/OAPlayer.aspx?ID=1307&CaseID=43680&File=131355.smil">http://oavideo.1dca.org/OAPlayer.aspx?ID=1307&CaseID=43680&File=131355.smil</a><br />
<br />
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<br />
<span style="font-family: Verdana, sans-serif;">Also, please take a look at the what I copied off the court calendar for September 17, 2013. Take a look at the name on the top of the list for the appellant. Folks, I see it like this: If Paul Lambert is on the side of the insurance companies, then he is probably there because he would rather deal with the EMC, than deal with no PIP insurance at all. Maybe its all over. Maybe its just a matter of time before PIP is repealed and BI becomes mandatory. The way I see it, however, I would rather go down with a fight. </span><br />
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KEVIN M. MCCARTY, IN HIS OFFICIAL CAPACITY, ETC.<br />
<br />
<b><u>Paul Watson Lambert</u></b>; C. Timothy Gray, A.G.C.; Katherine<br />
E. Giddings, Marcy L. Aldrich of Akerman Senterfitt; James<br />
Bruce Culpepper of Department Of Insurance Reg; Nancy<br />
M. Wallace of Akerman & Senterfitt; Maria Elena Abate,<br />
Matthew C. Scarfone of Colodny, Fass, Talenfeld; Allen C.<br />
Winsor of Deputy Solicitor General; Rachel E Nordby;<br />
Theodore "Ted" E. Karatinos of Holliday, Bomhoff &<br />
Karatinos; Kimberly A. Driggers,<br />
<br />
<b> For Appellant,</b><br />
<br />
<br />
- VS - 1D13-1355<br />
<br />
ROBIN A. MYERS, D.C., ET AL<br />
<br />
Luke Lirot; Jessie L. Harrell of Creed & Gowdy, P.A.; Bryan<br />
S. Gowdy of Creed & Gowdy, P. A.; Adam S. Levine; Mark<br />
S. Sussman,<br />
<br />
<b>For Appellee.</b><br />
<br />
15 MINUTES PER SIDE<br />
------------------------------------------------------------------------ -----------------------------------------Alan Himmelhttp://www.blogger.com/profile/05721300168671936714noreply@blogger.com0