What is CRMA?

CRMA stands for Computerized Radiographic Mensuration Analysis.

This is a test that Analyzes the angles and distances between bones in the spine us a Computer and X-rays, which are a certain type of Radiograph. The purpose of the test is to accurately assess damage to the spine. 

Mensuration has been used by doctors for nearly 100 years to figure out when a patient’s spinal bones are misaligned due to injury, aging, or congenital defects. Mensuration compares a patient’s spine to a normal spine. Until the last 20 years or so, doctors performed mensuration by hand using x-rays, a light box, and a grease pencil.

In the last 20 years, more doctors and clinics started using x-ray machines that take x-rays digitally, rather than with film (just like digital cameras have replaced film cameras). With the computing power available today, it also made sense for doctors to use computers to perform mensuration calculations. The result is a more accurate and repeatable mensuration report. For this reason, CRMA is generally accepted in evidence-based medicine as a reliable method of assessing spine damage.

A mensuration report looks like this: 

CRMA can also be used to assess legal impairment. Courts in Arkansas follow the American Medical Association’s Guides to Permanent Impairment (the AMA Guides). The AMA Guides contain specific guidelines that tell when, and how much, a person is permanently impaired when their spine has been injured. So, a CRMA report like the one below shows that the patient has a 25–28% whole person impairment rating at two spinal levels:

CRMA gives doctors, lawyers, judges, and juries alike objective medical information proving permanent impairment. It is a valuable new tool that helps injury victims obtain full and fair justice for their injuries. 

Koch brothers hypocrisy knows no bounds

In 2013, special interest groups financed by the Koch Brothers tried to sneak tort reform through the house in the form of SJR5 on two hours’ notice during a severe weather outbreak across the state. The committee hearing had originally been set for Friday, April 5. When so many Arkansas farmers, businessmen, and other citizens showed up to testify against it the committee had to change rooms, the bill’s sponsor decided to postpone the vote. One of the Chaney Firm’s clients, a heavy machinery salesman, was there to testify against the bill.

Instead of giving 48 hours’ advance notice (as required by rule) where the farmers and businessmen could come again to testify, the sponsor suspended the rules and gave only 2 hours notice on Wednesday that the bill would be heard. The Arkansas farmers and businessmen couldn’t make it. Our client was in Mountain Home selling equipment that day and was too far away to come. Lawyers from the Chaney Firm and others around the state dropped everything to attend the committee hearing in opposition to the bill, and fortunately it was defeated in committee. The vote was very close, and it shows that special interest money from the Koch brothers can buy lots of access. 

Tort reformers such as the Koch brothers have spent, literally, billions of dollars in advertising campaigns trying to convince the public that jury awards are out of control. Ask yourself this — How many total runaway jury awards can you name? How many in Arkansas? How many involving someone you know, either as a party or on the jury? 

News out yesterday shows that the Koch brothers are a prime example of “do as I say, not as I do.” Billionaire William Koch sued a California wine distributor for punitive damages, claiming that the bottles of wine he never inspected at an auction were fake. Koch paid $29,500 for one bottle (more than the federal poverty level for a family of 5) and $380,000 (8 times the median U.S. annual income of about $46,000) for two cases. Koch stated, “I absolutely can’t stand being cheated.” Apparently the Koch family’s hypocrisy knows no bounds: their lobbying group American Legislative Exchange Council (ALEC) has spend millions of dollars across the country for decades lobbying for draconian tort form that would make it harder for ordinary Americans to receive compensation for their injuries. To put this in perspective, for a billionaire, this amount of money is equivalent to $17.48 to someone making the median American income, or about the price of a bottle of wine. Would you sue someone over a bottle of wine? If the Koch brothers really hated frivolous lawsuits, would they be doing so?

Incidentally, the Koch brothers made most of their money on oil and have been big proponents of the Keystone XL pipeline — the big brother to the Keystone pipeline that burst in Michigan in 2010 and right here in Arkansas in 2013. It is plainly obvious that these men don’t care about Arkansas citizens — otherwise, they’d worry more about the sanctity of the court system and the safety of their pipelines, and less about suing over a bottle of wine.

Jury finds health insurer discriminated against patient-advocate doctor

The LA Times reported today on a verdict against a health insurance company that discriminated against a doctor for being a patient advocate. The doctor’s wife was murdered and his children assaulted in 2005, which gave him an appreciation for the patient side of the medical profession.

The doctor challenged hundreds of health insurance claim denials in his provider network when the insurance company contended his treatment “wasn’t medically necessary and would not be covered.” According to the doctor, “many doctors are unwilling to challenge powerful insurance companies because their incomes are so dependent on being in these provider networks. ‘Physicians are so afraid to come forward,’ he said, ‘and I hope this changes that.’” 

A healthcare lawyer interviewed about the case believed it would send a message to insurance companies about the need to be able to justify claim denials and exclusion from provider networks. The loudness of that message will be determined tomorrow, when the jury decides the issue of punitive damages — punitive damages are designed to deter intentionally abusive conduct.

Why Distracted Driving is Dangerous

Thanks to the National Safety Council for this great mythbusting graphic:

On Spring Break, protect your kids from the sun

Spring Break is almost upon us here in Arkadelphia. Many of you (not me, sadly) will be headed to the beach or the mountains next week. Whichever is your destination, remember to use sunscreen! The worst sunburn I ever got was on the underside of my nose while on a Presbyterian church ski trip to Winter Park.

The FDA recommends keeping kids under 6 months old out of the sun completely. Use a beach umbrella and a hat for your baby.

For older folks, the FDA recommends that you pick a broad-spectrum, water-resistant sunscreen that has an SPF of 15 or higher, and reapply after swimming, sweating, or toweling off. The agency also recommends good-quality sunglasses.

Remember that you can still get sunburned when it’s cloudy, and the most intense rays are between 10 a.m. and 2 p.m.

Have lots of fun this week, and be safe!