July 12, 2019 | Friday
In this issue...

-Former Aetna Director denied claims without review

-Airbags are not for children!

-ACE Lit Tip: Accident Reconstruction
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Former Aetna Medical Director Admits to never Reviewing Medical Records Before Denying Claims
Former Aetna Medical Director Dr. Jay Ken Iinuma admitted under oath that he, "never looked" at patient(s)' records when deciding to approve or deny care.
CNN reported that nurses made recommendations to him instead. Aetna was sued by a patient denied care of an immune deficiency. Gillen Washington is a 23-year-old with common variable immune deficiency (CVID) who was denied coverage for an infusion of intravenous immunoglobulin (IVIG) four years ago. Dr. Iinuma admitted he knew nothing of the disease when he denied care.

Dr. Iinuma admitted under oath that he was following Aetna’s training. Aetna’s policy was to have an MD in name only to deny claims without having a backing ground in the disease at issue nor to read the medical records.

The California Insurance Commission announced he would open an investigation against Aetna. Aetna is the nation’s third largest insurance provider with 23.1 million customers. 
Air Bags; Not for Children
Air bags for children under 13 can be very dangerous. In fact, according to the Stanford University Children’s Health, kids under 13 or under 65 pounds should not sit in the front seat!

The safest place for children is in the center of the back seat. Children under 4 feet, 9 inches should ride in a booster seat, according to the NTSB. 

If the child must sit in front, the seat should be moved as far back as it can go and the buckled up properly, says the NTSB. 

In crashes, kids are propelled forward and get hit by air bags in less than 1/20th of a second with speeds at up to 200 mph. This does lots of damage to adults – at least causing concussions – but much more damage for children. 

For a copy of this report contact  lisabrown@shawnsteel.com.
Essentials of Post Whiplash Rehabilitation
Studies on whiplash related disorders indicate up to 40% of people will experience pain for 6 months and 10%-30% will continue to have pain or symptoms for longer than 2 years. Woodhouse and Vasseljen showed reduced motor control patterns particularly with cervical rotation in whiplash and chronic neck pain patients(1), while Elliott and Jull showed fatty infiltration of the deep cervical extensor muscles in patients with whiplash associated disorders (2). Altered neuro-motor control due to impaired activation of the deep cervical flexor muscles in chronic neck pain patients has also been demonstrated by Falla and Farina (3).
Begin by lying on your back. Perform a small chin tuck with the motion of nodding “yes.” Then allow this movement to continue lifting the head off the floor. Concentrate on using the muscles in the front of the neck, moving in a slow and controlled motion. Do not push the head straight upward allowing the chin to jut forward. Slowly return to start position and repeat for 3 sets of 10 reps.
Head Retraction in Quadruped Position

Begin by positioning yourself in quadruped position on hands and knees with hips aligned over knees and shoulders aligned over hands. Draw head upward toward the ceiling in a straight-line movement. Pause at end range. Slowly return to start position and repeat for 3 sets of 10 repetitions. 

The above displayed exercises are easy to perform and include minimal risks if performed as described. To achieve satisfying results, it is important do them on a regular basis and for a minimum of 4-6 weeks.

References

1. Elliott, J., et al. 2006. Fatty Infiltration in the Cervical Extensor Muscles in Persistent Whiplash-Associated Disorders. Spine

2. Woodhouse, A., Vasseljen, O. 2008. Altered motor control patterns in whiplash and chronic neck pain. BMC Musculoskeletal Disorders.

3. Falla, D., Farina, D. 2008. Neuromuscular adaptation in experimental and clinical neck pain. Journal of Electromyography and Kinesiology.

To find these exercises or more visit www.webexercises.com.
ACE LIT TIPS
All doctors learned about body mechanics in school. Currently, Accident Reconstruction is the field of scientifically analyzing the causes and effects of car accidents. Often reconstructionists’ research culminate in the calculation of a Delta-V value often thought to measure the crash severity (literally measuring the change of pre- and post- collision velocities). Because Delta-V values can be an important but not definitive indicator of injuries or fatalities in an accident, they are often used in PI cases to explain or attempt to discredit the injuries you and your patients’ claim resulted from collision. Possessing a working understanding of accident reconstruction can be helpful when drafting reports in disputed liability PI cases and/or when being deposed or testifying in such cases. 

To learn more, tune into our teleconference next month (August 28 at 1 pm) when Zachary Moore, P.E. (Senior Forensic Engineer, accident reconstructionist, and human factors expert) speaks about his expertise in PI. 

For questions, email me at alexandereisner@shawnsteel.com .
A Sample Demand Package for Insurance Companies to settle PI claims: What This Can Tell You About What Makes a Successful PI Case - By Lewkovich, DC
How big insurance companies analyze PI cases is an art and science. 

Most doctors probably have not seen this type of analysis nor have many attorneys. 

The questions to be answered:

  • What is a Demand Package? 
  • What are ‘hard’ medical bills?
  • How is “crush” car damage defined? 
  • How do PI attorneys come up with a money demand figure? 

Contact lisabrown@shawnsteel.com for your copy.
Foundation for Chiropractic Progress Announces DC & CA Webinars
Click HERE for dates and registration.

To register when Shawn speaks, click here .
SHAWN IS SPEAKING & you're invited!
Cal Chiro Districts

Alameda
(2 hrs. mandated CE)
Tuesday, August 27

HJ Ross Insurance Seminars

San Jose, CA
Saturday, July 20


Sacramento
Thursday, Sept. 5

Los Angeles
Saturday, Sept. 7

San Francisco
Saturday, Sept. 14


All doctors are welcome to join us!

For questions, email: johntawlian@shawnsteel.com .
SHAWN STEEL LAW FIRM