Legal MDs Consulting Response:
Few issues in personal injury litigation generate as much controversy as whiplash injuries from low-speed rear-end collisions. The defense bar has invested heavily in promoting the concept of “MIST” — Minor Impact Soft Tissue — cases, arguing that low property damage correlates with minimal or no injury. However, the medical and biomechanical literature does not support this correlation, and attorneys who accept this premise risk significantly undervaluing their clients’ cases.
The foundational research on whiplash injury mechanisms demonstrates that cervical spine injury can occur at impact speeds well below those necessary to cause significant vehicle damage. Croft et al. in the Journal of Musculoskeletal Pain (2002, Volume 10, Issue 3, pages 1–20) reviewed the biomechanical literature and concluded that the threshold for cervical injury is lower than the threshold for vehicle damage in many collision configurations. Modern vehicle bumpers are designed to absorb and distribute impact forces to minimize structural damage to the vehicle — which actually means that more of the kinetic energy is transferred to the occupants rather than being absorbed by the car.
The Quebec Task Force on Whiplash-Associated Disorders, led by Spitzer et al. in Spine (1995, Volume 20, Supplement 8, pages 1S–73S), established a grading system (WAD I through WAD IV) and found that a substantial percentage of whiplash patients develop chronic symptoms. The task force noted that psychological factors, pre-existing conditions, and the specific biomechanics of the collision all influence outcomes — but the key finding for attorneys is that chronicity is a recognized medical outcome of whiplash injury, not an indicator of malingering or exaggeration.
The legal landscape has increasingly rejected the “minor impact, minor injury” defense. In Becker v. American Airlines, Inc., 200 F. Supp. 2d 413 (D.N.J. 2002), the court excluded the defense’s biomechanical engineer from testifying that the plaintiff could not have been injured in a low-speed collision, finding that the testimony lacked adequate scientific foundation. Similarly, several state appellate courts have held that evidence of minimal vehicle damage alone is insufficient to support summary judgment against a plaintiff claiming injury.
In a case we recently reviewed, a 43-year-old teacher was rear-ended in a parking lot at approximately 8 miles per hour. Her vehicle sustained approximately $1,200 in bumper damage. The insurance adjuster initially offered a settlement that barely covered her emergency room visit. Our review identified cervical MRI findings consistent with disc protrusion and ligamentous injury. We cited the Croft biomechanical data to explain why the low vehicle damage did not preclude significant cervical injury, and the Quebec Task Force criteria to classify her injury and project her recovery trajectory. The resulting medical theory supported damages that were multiples of the initial offer.
If you have a case involving a “minor impact” collision where your client has sustained real injuries, our physician consultants can review the biomechanical literature relevant to the specific collision dynamics, evaluate the medical records for findings that support a traumatic etiology, and provide the evidence-based medical opinions necessary to counter the MIST defense.
References
Croft AC, Herring P, Freeman MD, et al. “The neck injury criterion: future considerations.” Journal of Musculoskeletal Pain. 2002;10(3):1-20.Spitzer WO, Skovron ML, Salmi LR, et al. “Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining ‘whiplash’ and its management.” Spine. 1995;20(8 Suppl):1S-73S.Becker v. American Airlines, Inc., 200 F. Supp. 2d 413 (D.N.J. 2002).
This situation is another example of how we can assist you with all the medical issues in your cases. Call (954) 649-5739 or email DrC@legalmds.com to schedule a time to talk about one of your cases.
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