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$1,750,000
for closed head injury in rollover.
Dr. X was a
belted passenger in a high-speed, roll-over,
freeway accident. His multiple fractures of C-6
and C-7 and his closed head injury made it
difficult for him to continue working as a
physician. Since his insurance company could not
effectively contest the cause of the rollover,
or his medical condition, they tried to deny
full coverage by arguing that at 56 he was near
retirement anyway, didn't need to work, and had
previously announced an intent to retire even
before the collision. Our task was to establish
that without the accident he would have
continued to work, and that with the accident
his loss of earning capacity was the insurance
carrier's responsibility.
Dr. X had
graduated from an Ivy League university,
followed by medical school at a state
university, then moved to a small town to join a
family practice clinic, which eventually became
the largest family practice group in the area.
He worked hard and was well compensated.
When he attempted
to return to work, three hours per day for three
days per week, his own doctor noted that he was
"having significant difficulty with
multi-tasking." His treating neurologist
noted "difficulties with cognition that are
interfering with his work activities." His
neuropsychologist noted that "Given this
man's cognitive and neurological conditions, it
is likely that he will be unable to return to
his pre-accident function as a physician. As
leader of a medical team, he cannot afford to
delay decision making in critical emergency
situations. Yet his attentional problems,
particularly when he becomes fatigued, may very
well lead to increased errors and lapses in
judgment. Given that he is a perfectionist, and
given his sense of responsibility, the emotional
burden of high level performance expectations
will likely impact him, making it even more
difficult for him to perform." These
treating physician's conclusions were supported
by the fact that his partners at the clinic that
he founded, after allowing him to try working
part time, asked him to retire.
The critical
question then became: how long would he have
continued to work as a physician, had the
accident not occurred, i.e. what amount of
income had he lost?
We cited data
from the Bureau of Labor Statistics indicating
that 56-year old white males with l5 years or
more of schooling have a work life expectancy of
an additional ten years. The BLS data indicated
that more highly educated individuals tend to
have a longer work-life expectancy, however the
BLS did not look at education beyond 15 years,
even though doctors typically have over 20 years
of schooling and a medical degree. Consequently
we had to find more specific information on
physician work-life expectancy. The best
available data on physician retirement
probabilities was in the article "The
Effect of HMO Penetration on Physician
Retirement" published in the December 2000
issue of Health Services Research. We asked a
professor teaching Statistics and Research
Methodology to pull out the data in that article
to determine the likely remaining career
expectancy of a physician such as Dr. X: age 56,
male, board-certified, AMA member, practicing
general family medicine, in a small community.
It turned out
that Dr. X was in the exact category of
physicians who tend to work longest before
retiring:
- Males
work longer than females;
- General
practitioners work longer than surgeons;
-
Caucasians work longer than minority
members;
- AMA
members work longer than non-AMA
members;
- Board Certified physicians work longer
than non-Board Certified physicians.
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In short, the
highly qualified, board-certified, AMA member,
male general practice physicians working in
small towns tend to work essentially forever --
perhaps because this is a personally rewarding
practice style. The professor of statistics
estimated the remaining career expectancy of
someone with these characteristics as
approximately 17 years. (In contrast, female
surgeons, who are not board certified, retire
approximately five years earlier, on average.)
The data
supported Dr. X's stated intention that had the
accident not occurred he would have worked at
least an additional ten years prior to
retirement.
The post-accident
vocational assessment was performed by Stan
Owings, M.A., past Administrator of
Rehabilitation Services for the Washington State
Department of Labor & Industries, where he
supervised a staff of 110, past President of the
Professional Rehabilitation Organization of
Washington. His conclusion:
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inability to work effectively in regard
to multi-tasking and in stimulus that
exists in any work environment make
employment in any job in a usual
competitive employment setting
questionable. . .The research completed
identified no medically related
employment areas that are reasonably
available... |
After extensive
research, it was the opinion of Owings &
Associates that Dr. X's probable future earning
capacity would be limited to $30,000 per year, a
loss of $120,000 per year.
Based on his
consistent earnings history, the Bureau of Labor
Statistics work life estimates, the vocational
assessment, Dr. X's life-long, strong work
ethic, and his stated intention, forensic
economists estimated the economic loss
occasioned by this disabling closed-head injury
and multiple spinal fracture, high-speed
rollover as $1,274,087.
In addition to
the loss of future earning capacity, Dr. X lost
the intangible rewards of practicing medicine.
What does it mean for a man who has spent his
entire life working to become a doctor to no
longer be able to function as a doctor? What
impact does that have on his self-esteem and
self-worth? Here was a man who had delivered
over 800 babies, but who could no longer work in
an operating room.
Mediation was
scheduled before Larry Levy of Washington
Arbitration and Mediation Services, with an
arbitration with John Cooper of the same
organization should the mediation not lead to a
settlement. Based on the expert testimony
regarding likely future earnings, the claim
settled for $1,750,000. Dr. X was represented by
WSTLA Eagle member Dean Brett of Bellingham's
Brett & Coats PLLC.
For more information
on serious personal injury claims, please see
our Automobile
Accidents page or our
Personal
Injury page.
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