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Review from Lawyer's Weekly USA, August 9, 1999

"New Science Helps Whiplash Plaintiffs" Book About New Research Is a Useful Tool for Lawyers Book Review by Eric Berkman.

Whiplash is not a claim that makes your average defense attorney's blood run cold. That's because every lawyer knows the general public tends to view these claims as bogus. After all, the only symptoms that plaintiffs' lawyers typically have at their disposal are their clients' own protests that they're in pain. No wonder insurance companies routinely assert that whiplash claims are financially--and not medically--motivated.

But now comes Michael R. Melton with some new firepower for plaintiffs' attorneys.

Melton, publisher of the monthly Soft-Tissue Review of scientific literature, has just released "The Complete Guide to Whiplash," a 108-page compilation of current research that may not change everyone's minds, but should at least make doubters sit up and take notice.

The author's purpose in publishing this guide is threefold. First, he's seeking to streamline the immense body of scientific material on whiplash into a manageable symptom-by-symptom format for lawyers and medical professionals. Second, he's seeking to share knowledge that can help properly diagnose whiplash and even prevent it from occurring.

But most importantly for lawyers, Melton seeks to discredit long-held notions that whiplash victims are malingerers whose phony conditions mysteriously disappear once they get some cold, hard cash in their pockets. In doing so, Melton references nearly 400 scientific articles, including some of the most recent studies that tie whiplash to tangible medical conditions.

Relying on pages of charts and illustrations--as well as an extensive bibliography of medical studies--the guide thoroughly outlines the biomechanics and symptoms of whiplash injuries and brings to light new evidence that low-speed collisions can result in spine damage and less tangible injuries such as mild traumatic brain injury and posttraumatic stress disorder.

Whether Melton will succeed in convincing insurance companies and defense lawyers to take whiplash claims more seriously remains to be seen. But this guide is still a valuable tool for plaintiffs' lawyers who would otherwise face endless hours in a medical library attempting to locate, decipher and categorize reams of scientific data on their own.

Bumper-to-Bumper

Melton reports in his introduction that roughly a million whiplash injuries occur each year, many in low-speed crashes. So right off the bat he confronts the question of whether people can suffer provable injuries these collisions.

According to his data, they most certainly can--even in crashes that leave no vehicle damage. Using a simple three-panel illustration of the most basic whiplash scenario, Melton shows how--in a 10 mile-per-hour rear-ender--the occupant's body jerks forward while the head stays put, resulting in a sudden backward motion of the head relative to the body.

In fact, Melton reports, studies from the last five years show that even at 5 miles per hour, the sudden movement results in G-forces high enough to turn the average human head into a 150-pound load on the cervical spine.

Although claims adjusters often cite studies that the amount of force placed on the human head bears no correlation to spine injury, Melton points out that these studies were not conducted under conditions resulting in the whiplash motion. As added ammunition, Melton references a 1997 study showing that the less a car is damaged in a collision, the higher the acceleration of the struck vehicle and the greater the risk of spine injury.

In addition to these motion studies, Melton references a number of current medical studies showing the exact type of spinal damage that can occur from the whiplash motion. Primarily, he points to three 1996 studies that show a direct relationship between whiplash motion and damage to the spine's facet joints--which other studies show to be a common source of whiplash pain. In ensuing chapters, Melton looks at common whiplash symptoms such as headaches, lower-back pain and even carpal-tunnel syndrome, citing reports and articles showing how disturbances in the cervical spine can result in these conditions.

But most interestingly, he specifically addresses some of the more controversial topics, such as whether whiplash can actually result in brain injury and post-traumatic stress disorder. Obviously it takes a lot of nerve to make these claims when you're talking about a minor collision, but once again Melton is armed with studies conducted within the last three years showing that the whiplash motion at the lowest possible speeds can still cause significant impact on the brain as it moves suddenly within the skull.

And even if Melton does not definitively prove the correlation between whiplash and all these conditions, he at least seems to give practitioners something of substance they can negotiate with.

Malingering?

Melton specifically caters to plaintiffs' lawyers when he takes on popular notions that whiplash is the fabrication of malingerers.

As Melton notes, insurance companies have long maintained that whiplash symptoms miraculously disappear once the patient has recovered a financial settlement. Claims adjusters bolster this notion by pointing to British neurologist Henry Miller's popular "accident neurosis" theory that whiplash injuries have no organic basis.

However, Melton cites more contemporary studies that purportedly debunk Miller's anecdotally based theory. Melton also references recent reports that rebut the methodology in a widely-used 1996 Lithuanian study which--like Miller's--concluded that whiplash was not a real condition.

Melton gives further ammunition to plaintiffs' lawyers by calling attention to a three-year-old study concluding that it's impossible to successfully fake whiplash. In this study, a group of whiplash patients and a group of university students attempting to fake the condition reported a completely different battery of symptoms on a checklist.

Finally, Melton cites the latest statistical research to show that--contrary to the assertions of Miller and others--most whiplash symptoms do indeed remain long after plaintiffs have settled their litigation.

Helpful Tool

In the end, Melton's guide is a helpful, well-organized handbook for attorneys trying to figure out for themselves the complexities of whiplash injuries. As the publisher's promotional materials note, attorneys could otherwise expect to spend hours upon hours looking for the right materials for their case--and even more hours wading through these materials and deciphering the scientific jargon.

But with this guide, attorneys can quickly look up their clients' particular symptoms, read the explanation as to how whiplash might be responsible and turn to the footnotes to pinpoint the exact study that may prove their case. The only complaint is that Melton seldom notes in the text what year a particular study was conducted, forcing the reader to constantly flip to the back to search for the study and see if the point is bolstered by the most current information.

Other than that, Melton accomplishes what he has set out to do.