Chain Rear-End Crash in the Baltimore Region: How a Disputed Fracture Was Handled

What happened?

Our client was stopped in traffic when a car hit him from behind at normal road speed. The impact pushed his truck into the car in front of him.

It was a hard hit. The at-fault car’s airbags went off, it was towed from the scene, and it was later declared a total loss. Our client’s truck needed significant repairs. Police wrote a crash report, but it listed no injuries. He didn’t take an ambulance. He went to urgent care the next day, and they sent him straight to the ER.

He hired us three days after the crash. We sent letters to both insurers that same day, and the at-fault driver’s insurer accepted liability within the first week.

Getting fault settled fast mattered. In Maryland, contributory negligence means a driver found even slightly at fault can be barred from recovering anything.

What injuries did our client suffer?

He had a mild compression fracture of one vertebra in his mid-back, a concussion with headaches afterward, and sprain and strain injuries to his neck, mid-back, and low back. He also had chest wall pain.

The fracture became the center of the case. The X-ray found it, but the radiologist couldn’t say when it happened. A later MRI called it chronic, meaning possibly older, and showed age-related wear in his spine. A head CT showed no bleeding.

His history mattered, too. Several years earlier, he’d had an episode of low-back and hip pain, with normal imaging at the time. But his most recent records before the crash showed no neck or back complaints and full spinal motion. Having a prior condition or age-related changes doesn’t bar a claim in Maryland. The question is what the crash caused or made worse.

His chest pain and blurry vision were checked, and neither was linked to lasting damage. He was discharged from orthopedic care at about five months, improved, on home exercises. His file had no formal impairment rating.

What treatment did our client need?

His care took about five months:

Urgent care, then the ER for a CT scan, X-rays, and a neck collar

That added up to dozens of therapy sessions with about a dozen providers. He had no surgery. His doctors recommended spinal injections, and he decided against them. Turning down a treatment doesn’t end your claim, but an insurer may argue it limits what the claim is worth.

Money was tight from the start. Maryland drivers can waive the wage and medical part of their own personal injury protection (PIP) coverage. PIP pays certain medical bills and lost wages no matter who caused the crash. He had waived it. His health plan paid the hospital and urgent care bills, and his other providers agreed to wait for payment from the settlement. We booked his first injury-care visit the day he hired us.

• Chiropractic care and physical therapy at an injury clinic
• An orthopedic spine evaluation for the fracture
• Neurology for the concussion and headaches
• MRIs of his neck and low back
• A work-hardening program with land and pool therapy
• Orthopedic follow-up and discharge

How did the injuries affect our client’s life and work?

He works a physically demanding job, and the crash took him off it for about seven weeks.

Sitting, bending, lifting, and driving all hurt. In the months after the crash, he had headaches, trouble sleeping, dizziness, and some forgetfulness. Because he’d waived PIP, no wage benefit came in while he was out. The bills didn’t stop, and the money stress was real.

He went back to full duty after about seven weeks, with no lasting change in what he can earn. We documented his lost wages with his employer and his pay stubs. His neck and back improved, but he still manages symptoms with home exercises.

In Maryland, an injured person can generally seek medical expenses, lost earnings, and non-economic damages such as pain, suffering, and loss of enjoyment of life. For someone who works with his body, weeks of pain and missed work are a big part of the claim.

What made this case difficult?

The insurer’s main argument was simple: it wouldn’t count the fracture, because no doctor could say when it happened. Several other issues gave it room to push.

A fracture of unknown age. The X-ray couldn’t date it, and the later MRI called it chronic. No doctor gave an opinion either way.

Age-related changes on his MRIs that the insurer could point to.

His medical history, including an earlier back and hip complaint the insurer could point to.

A police report with no injuries listed, and no ambulance at the scene.

No PIP money, so he had no cushion while the claim was pending.

Declined injections, which the insurer could use to argue his claim was worth less.

A low first offer, and then a new adjuster assigned in the middle of negotiations.

None of this meant he wasn’t hurt. It meant his records had to tell a clear before-and-after story.

How did we handle it?

Started the same day. We sent letters to both insurers, set up his first injury-care appointment, and got the at-fault coverage limits in writing early.

Steered his care. We found him a provider for his vision complaint and made sure the fracture got an orthopedic evaluation. When he declined injections, we backed his choice to finish treatment.

Collected every record and bill from about a dozen providers, chasing requests that were rejected or delayed.

Built a before-and-after timeline. We pulled years of his prior medical records and summarized them. They showed no recent back complaints, no fracture, and full motion before the crash.

Documented his lost wages with his employer and pay stubs, and sent a demand with his full bills and wages.

Pressed the claim and signaled suit. When the insurer stuck on the fracture’s age, Jason Plotkin met with our client to review the low offer and the option to file suit. We then worked the claim with the new adjuster.

The turning point was the prior records. They let us show the insurer what his back looked like before the crash. Paired with a clear signal that suit was next, the offer moved up to a settlement he accepted.

What was the result?

The case settled before any lawsuit, about nine months after he hired us. Most of his money was paid out right away, and the rest followed once his health plan’s claim was final. He avoided the cost and delay of a lawsuit.

Every case is different. Our past results are no assurance that we will reach a favorable result in any future case.

What this means if you’re in a similar situation

If an insurer says your injury is old, ask your lawyer to gather your prior medical records. They can show what changed.

Think hard before waiving PIP. It’s the money that can cover wages and bills while your claim is pending.

Tell your doctors about every symptom, even ones like blurry vision that seem minor.

Watch the clock. Maryland generally gives you three years from the crash to file a personal injury lawsuit.

Can I get some of my settlement before the health insurance lien is final?

Often, yes. Your lawyer can usually hold back enough to cover the health plan’s claim and pay you the rest first. Our client chose that option, so he didn’t have to wait months for the final number. The remaining balance went out once the plan’s claim was settled.