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THE ATTORNEY'S GUIDECRMA®The future of Spinal Injury Cases. Don't get left behind.

CONTENTSTABLE OFIntroductionHow the CRMA® fits intoYour Standard WorkupPre-Litigation Value03040614Correlating to a Disc Injury1516Comparing SymptomsDaubert vs. Frye Standard17Guidelines & References

INTRODUCINGTHE CRMA®Spinal Kinetics Board-Certified Medical Radiologists perform theComputerized Radiographic Mensuration Analysis®, utilizing anFDA-Cleared AI-Assisted technology that enables the treatingdoctor to determine the severity and location of any non-discoligamentous spinal ligament injury that causes spinal instability. Dr. Jeffrey Cronk, DC JDCEO of Smart Injury DoctorsThis injury has been referenced in countlessnational guidelines and is widely accepted as serious trauma and can be responsible formany more complicated symptoms than thesimple disc injury.

Patient ConsultationPhysical ExamSpinal X-rays and/or MRILet's start with what your current full workup typicallylooks like:X-rays are a long-standing and necessarycomponent of the diagnostic work included in yourclient's case. This imaging helps identify fractures, discdegeneration, and other abnormalities. When pairedwith the CRMA® report, it can also show significantnon-disco ligamentous injuries, which, if present, cangreatly worsen a disc injury or otherwise lead to amyriad of symptoms not linked to disc injuries. This provides required documentation for extendedcare, therefore higher settlements and less early-carecut-offs.HOW THE CRMA® FITS INTOYOUR STANDARD WORKUP

Standard WorkupPatientConsultationPhysicalExamX-ray / MRICRMA® report isbased on the X-ray study.

ObjectivitySimplicityConsensusVALUEPRE-LIGITATIONThe report gives clear and measurablefindings of how many degrees or millimetersof abnormality exists, removing muchsubjective interpretation.Objective Report + Guidelines with Consensus= Very little room for refutability. The number of approved guidelines andreferences mentioning this injury are great innumber, some of which can be found later inthis booklet.The spinal ligament injury increases your pre-litigation value in the sameway a disc herniation or a fracture provides value to the case. It deliversobjective proof of injury and medical necessity for all treatment or careprovided.

"No competent personal injury lawyer can do justice tothese serious ligamentous injuries by dismissing them as"run-of-the-mill" soft tissue injuries."Many are serious injuries that can be objectively provenwith Computerized Radiographic Mensuration Analysiswhich can turn a $20,000 case into a $1 million case." - Douglas E. Schmidt, Esq.Douglas E. Schmidt has over 40 years ofexperience, in over 6,000 cases, inbringing justice to the victims of PersonalInjury and Wrongful Death.He is the recipient of the Award of Merit ofthe American Bar Association and hasreceived the Distinguished Service Awardof the Minnesota Trial LawyersAssociation.He has been AV rated by MartindaleHubbell for 35 years. He has beencertified by the National Board of TrialAdvocacy as a Civil Trial Advocate andby the Minnesota Bar as a Civil TrialSpecialist.He has successfully tried over 500 casesto a jury, judge or arbitrator in Minnesota,South Dakota, Wisconsin and Iowa.

OBJECTIVITYPRE-LITIGATION VALUE The findings are clearly objective and based on an FDA-Cleared AI-assistedprogram to determine measurements. The resulting report is based on facts, notopinions. See this quote as an example, "Atlas lateral shift is 2.73 mm during leftlateral bending and 1.44 mm during right lateral bending."

Mr. James Mathis has extensive professionalexperience in the Insurance Industry having heldmanagement positions with Allstate and FarmersInsurance and continues ongoing review of insuranceprocedures, processes, literature and claim files in hiscapacity as a consultant. Mr. Mathis has dedicated the last 25 years topersonally training doctors and attorneys how toexpertly manage PI cases to maximize settlementwhenever possible."If you process your claims through Spinal Kinetics to getthat objective identification, the settlements should go upunless the attorney just doesn't have the skills to get it intothat high range. If the settlements are higher, then you'reabsolutely going to see fewer reductions, fewer requests foryou to cut your bills back." - Mr. James MathisJames Mathis is an expert witness in all 50 states and consultant for trialdefenses and discovery preparation with extensive experience in discoveryprocess’ for bad faith, extra-contractual, breach of contract and consumerviolation lawsuits.

SIMPLICITYUp until recently, only the discs and bones were beingexamined for injury - however, the discs only make up forapproximately 10% of the spinal ligaments and thereforesignificant injuries were constantly being missed.PRE-LITIGATION VALUEBoneLigaments (discs and non-disc ligaments)There are only two componentsto the spine*:*Parts such as the spinal cord, nerves, and muscles are adjacent to the spine,and not the spine itself. Hear from one of our ownSmart Injury Lawyers on howsimple this is!Watch Now!Since this injury has alreadybeen researched andreferenced in guidelines suchas the AMA Guides for theEvaluation of PermanentImpairment and more, it can bea simple process for theadjusters to review this reportand effectively determine ahigher value for the case dueto better documentation of theinjury.

"And we have been able to use these Spinal Kinetics report[s] tomake a big immediate difference in an offer. Where in situations,we have an offer, and we were sort of at a standstill, then all wedid differently was give a Spinal Kinetics report and then thatultimately led to a big breakthrough in the negotiations. "So we definitely have seen the benefits of the reports, both whenwe do them early on in the stages, and also when we use them tosalvage an impasse."

CONSENSUSPRE-LITIGATION VALUENational guidelines & medical studies refer to spinalligamentous injuries as a serious injury. Case valueis greatly determined by well-documented,established injuries.

"By learning about a ligament injury and how todocument them for impairment it was just going offthe charts in terms of value." - Mark Blane, Esq.Mark Blane is solo-practicingattorney and a two-time bestselling legal author who specializesin personal injury law in downtownSan Diego. His book, "Wolf in Sheep's Clothing,"on the day of its release, hit the BestSellers List in two categories onAmazon reaching #1 in theInsurance category and #42 in thePersonal Finance category. He wasalso inducted into the NationalAcademy of Best-Selling Authors.His other book, "Protect & Defend"also hit the Best Sellers List onAmazon in two different categories.He is the author of 10 injuryconsumer guides.

TO THE DISCCORRELATINGMost attorneys are veryfamiliar with disc injuriesand their symptoms. Ifyour client does have adisc injury, you shouldknow that the non-discoligamentous injuries willusually make the discinjury a lot worse. It is imperative that thisnon-disco ligamentousinjury be found andtreated to preventfurther degradation ofthe disk.

SYMPTOMSCOMPARINGDISC INJURY SYMPTOMSLocal Pain Radiating PainSPINAL LIGAMENT INJURY SYMPTOMS (NON-DISC)Autonomic Nerve SystemAxial (local) PainBalance DifficultyCervical RadiculopathyCerviocranial SyndromeDizzinessDrop AttacksDysregulationEar FullnessIncreased Intracranial PressureMeniere's DiseaseMigraine HeadachesParasthesias (UpperExtremities)Post-Concussion SyndromeRadicular (radiating) PainSwallowing DifficultyTinnitiusTMJ PainVagus Nerve CompressionVertebrobasilar Artery IschemiaVertigoVisual DisturbancesWhiplash-Associated DisorderHave you ever encountered a client with continuous symptomsafter their injury, only to be disappointed by a negative MRIreport? The fact is, there are a lot more complicatedsymptoms associated with the non-disco ligamentous injurythan the disc injury.

STANDARDWhat about measuring X-rays? Have we beenmeasuring X-rays for yearswith accuracy to diagnoseand treat patients? YES.A CRMA® is an X-ray report. It is a specialized reportthat focuses on excessivemotion that indicatesdamage to the non-discspinal ligaments. Does this stand up to theDaubert vs. Frye standard?YES. Why? Well, is an X-ray test astandard and accepted testfor diagnosis, courtroomevidence, or treatmentplans? YES.DAUBERT VS. FRYE

REFERENCESGUIDELINES &Translational Damage Angulation DamageThe guidelines dictating the care and justified treatment for theseinjuries refer to the injury in terms of translational and angulationdamage as depicted below.Up to 1 mm of translation is normal, anything above is abnormal. Ifthere is 3.5 mm or more motion it is severe and could requiresurgery if not stabilized with conservative care.Up to 7° of angular difference is normal, anything above 7° isabnormal. Anything 11° or more can be surgical if not stabilized withcare.On the following pages are excerpts of several of these guidelinesand where they mention this injury.

EVICORE SURGICAL GUIDELINES

CROFT CARE GUIDELINES

AMA GUIDES FOR THE EVALUATIONOF PERMANENT IMPAIRMENT