Persistent pain after a slip and fall is one of the most common and difficult issues in medical-legal evaluations. A claimant may have no documented prior neck or back pain, sustain a fall, treat with chiropractic care for months, undergo MRI six months later showing multilevel degenerative changes, and continue reporting pain for two years.
Slip-and-fall cases often create difficult medical-legal causation questions. A floor-level fall can cause real injury. Healthy individuals may sustain wrist fractures, ankle fractures, hip fractures, pelvic fractures, femur fractures, shoulder injuries, head injuries, rib injuries, contusions, and soft tissue strains. A “simple” fall is not always medically simple.
Leg length discrepancy is frequently raised in orthopedic, chiropractic, Physical Therapy, occupational medicine, and independent medical examination settings. A claimant may allege that unequal leg length caused chronic low back pain, sacroiliac pain, pelvic tilt, lumbar facet arthropathy, or degenerative disc disease. Another examiner may find pain with lumbar extension, identify L4-5 facet changes, and attribute the pain to leg length discrepancy.
Superficial lacerations near the elbow can raise complex medical-legal causation questions when a claimant later reports chronic nerve pain, weakness, loss of dexterity, disfigurement concerns, or emotional distress. The issue becomes especially difficult when the initial injury was minor, healed uneventfully, early records were silent for ongoing symptoms, the first electrodiagnostic study was normal, and a later study years afterward reports a cutaneous mononeuropathy.
Spinal cord stimulation is increasingly requested in chronic pain cases, including personal injury, workers’ compensation, disability, and independent medical examination settings. The technology can be helpful in properly selected patients, especially when chronic neuropathic pain is present and conservative treatment has failed.
