All Pain, No Gain

They're usually called fender benders: Cars and trucks traveling at low speeds hit each other, causing dings and dents.

The worst of the physical injuries are often headaches from filling out insurance claim forms. In fact, low-speed accidents do no more damage than sneezing, coughing, riding a roller coaster or just standing up and sitting down, writes a forensic engineer at Thomas L. Alcorn, P.E. & Associates, which studied the effects of low-impact crashes on volunteers.

So why is Candace Salas, whose Geo Metro was hit by a car traveling at about six miles an hour, lying sideways on her couch, reeling from so much back pain that her voice quivers when she speaks?

Maybe because none of the tests studied by the accident-reconstruction firm were done on people with previous back problems. Someone like Salas, for example, who had metal rods inserted in her back when she was fourteen to fight the effects of crippling scoliosis.

On August 26, 1996, Salas picked up her two children from daycare after working eight hours at a Subway sandwich shop in Golden, where she was a manager. When she got to the parking lot of her Westminster apartment complex, Salas took off her seatbelt and turned to unbuckle her infant son from his car seat. Seconds later, her car rocked forward, stopping only after it passed over a concrete block.

The pain didn't register immediately, nor did the knowledge of what had happened. A Chevy Cavalier without its emergency brake on had been parked in a fire lane uphill and had rolled into Salas's car. Her son and her baby daughter, who was in the backseat, weren't injured.

"I woke up the next day with a tight feeling in my back," Salas recalls. The tight feeling eventually became constant soreness in her lower back and sharp pain beneath her right shoulder blade. Salas wasn't too concerned about medical care at first, because she had personal injury protection with American Family Mutual Insurance, entitling her to treatment and lost wages.

The insurance company referred Salas to Dr. Thomas Lowe, an orthopedic surgeon who confirmed that the jolt from the accident forced the metal rods to rub against injured tissue in Salas's back and concluded that the only way to relieve her pain would be surgery. If the rods in her back weren't moved up three vertebrae, he told her, they would continue to irritate the injured tissue. In a December 1996 report on Salas's medical condition, Lowe wrote: "Without the surgery, it is very unlikely that she will be able to return to work."

American Family paid for the initial appointment with Lowe and for a visit to another doctor who told Salas she didn't have to undergo surgery if she didn't want to. She had gone to the second doctor hoping he would tell her what she wanted to hear, and he did--back surgery was something she dreaded--but Salas, who is 23, later realized that surgery offered the only hope for her leading a normal life.

Salas was compensated for two months of lost wages, but the bucks stopped there. Four months after the accident, American Family sent her a letter denying her claim for medical treatment and lost wages. Now she is suing the insurance company.

After an accident, insurance companies typically refer clients to a doctor. If the company disagrees with the physician's prognosis, it can turn to an independent medical examiner for an unbiased second opinion.

But according to Salas's attorney, Leonard Martinez, American Family instead based its denial on a report commissioned by an accident reconstructionist. The engineer found that the car that hit Salas was traveling only between 6 and 6.5 miles per hour--an impact, he concluded, that wasn't forceful enough to warrant the injuries Dr. Lowe described.

"My client was seeing [the insurance company's] doctor, who said she needed surgery, and they relied on an accident reconstructionist," Martinez says in disbelief.

In March 1998, Salas filed a complaint against American Family with the Colorado Insurance Division. Since 1996, the insurance division has received 1,223 complaints about American Family--a "very high number," says insurance division spokeswoman Nancy Ryan. Of the 71 companies that sell auto insurance in Colorado, American Family received the fourth most complaints in 1997.

In May, the insurance division wrote to American Family asking why an independent medical examiner hadn't been used to determine Salas's condition. American Family responded the next month by paying all of Salas's medical bills. A jury will decide in June whether to make the company pay for her surgery as well.

Bob Harris, the attorney for American Family, said he can't comment while the case is in litigation. Stewart Brown, the insurance-company claims adjustor who is also named in the suit, also said he can't comment.

"My life is on hold until this surgery," says Salas.
She has tried office jobs and waitressing, but she can't sit or stand for long without pain. "I'm not a quitter," she says. "But I can't function without [feeling] pain."

In September 1997, Salas had to file for Chapter 11 bankruptcy as her debt piled up. She and her husband and their children moved to Pueblo to be close to family and save money.

"Basically, everything has been taken away from us. We can't even get a checking account. We have no credit, and we've had two cars repossessed," she says, the tears coming easily. Salas tried to pay for surgery with her husband's health-insurance plan, but that insurer refused because her back problem was deemed to be a pre-existing condition. "My kids have missed out on a lot because I can't do things with them. I can't even play with them on the floor," says Salas, who says she is fighting the pain each day while attending nursing classes at Pueblo Community College.

Salas doesn't know how much money her attorney will seek from American Family, but she says that considering what she has been through, "there couldn't be a dollar amount to put on it. I've had a lot of depression, my husband and I fight a lot, and I've had a miscarriage. I just don't want this to happen to someone else. It's wrecked my life.