Much of the country enjoyed a white Christmas and post-Christmas. Digging out from a heavy snow is not only a tiring chore, it can be downright dangerous. And the danger can be greater than just aching backs and frozen fingers.

“Each year thousands of people are treated in emergency departments across the United States for heart attacks, broken bones and other injuries related to snow shoveling,” said Dr. Thomas Esposito, chief of the Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, Loyola University Chicago Stritch School of Medicine.

Esposito recommends people with a history of back or heart problems ask someone else to do the heavy shoveling. If you have to do it yourself, know your limits and don’t overdo it.
Pumping snow

Shoveling is a very physical activity that is comparable to lifting heavy weights repeatedly and quickly. Unless you pump iron regularly at the gym, you might not be up to the task.

If you decide you’re fit enough to do your own shoveling, health experts suggest doing some warm up exercises first, as though you were preparing for a vigorous workout. At the very least, start with a brief walk or marching in place to get your body ready for the physical strain. Also, try adding arm movements and stretching your back to warm up the upper body.

Here are a few more tips to help you stay healthy during shoveling season:

* Dress appropriately. Wearing layers allows you to adjust to the temperature outside. When you are going to be outside for a long time, cover your skin to prevent frostbite.
* Use a small shovel that has a curved handle. A shovel with wet snow can weigh up to 15 pounds. A small shovel ensures you have a lighter load, which can prevent injury.
* Separate your hands on the shovel. By creating space between your hands, you can increase your leverage on the shovel.
* Lift with your legs, not your back. Make sure your knees are bending and straightening to lift the shovel instead of leaning forward and straightening with the back.
* Shovel frequently. Don’t wait till the snow piles up. Shovel intermittently, about every two inches.
* Push the snow. It is easier and better for your back to push the snow rather than lift it. Also, never throw snow over your shoulders.
* Pace yourself. Take breaks and gently stretch your back, arms and legs before returning to work.
* Stay hydrated. Drinking plenty of water is important when exercising regardless of the outside temperature.
* Avoid caffeine and nicotine. These stimulants increase the heart rate and constrict blood vessels, putting strain on your heart.
* Avoid alcoholic beverages. Alcohol can dull your senses and make you vulnerable to hypothermia and frostbite.

“Each season has its own particular set of risks, but winter with its snowstorms, plunging temperatures and wind chills can be especially daunting when it comes to safety,” said Esposito.

If you have any doubts, hire a youngster in the neighborhood to clear your walk, or seek your health care provider’s advice.

The American Physical Therapy Association (APTA) is pointing to a new study on low back pain in Medicare patients in its efforts to encourage the newly established Center for Medicare and Medicaid Innovation to promptly launch a demonstration project on direct access to physical therapist services that was recommended in the recent health reform law.

The study, published in the journal Spine, showed Medicare patients who received physical therapy in the acute phase following an episode of low back pain were less likely to receive epidural steroid injections, lumbar surgery, or frequent physician office visits in the year following their initial physician visit as compared with patients who received physical therapist treatment later.

“This study has demonstrated a decreased usage of medical services in patients who receive physical therapy early after an acute low back pain episode,” remarked APTA President R. Scott Ward, PT, PhD. “Therefore, we encourage the Center for Medicare and Medicaid Innovation to swiftly undertake the direct access for physical therapy demonstration project recommended by the health care reform law. The results of this project could significantly change the way physical therapy services are delivered to our nation’s seniors—putting them on a path to recovery sooner and decreasing future costs.”

Researchers examined a nationally representative, 20% sample of physician outpatient billing claims from the Centers for Medicare and Medicaid Services. The 431,195 enrollees were categorized into acute (having received physical therapy in less than 4 weeks after an episode); sub-acute (having received physical therapy between 4 weeks and 3 months after an episode), and chronic (receiving physical therapy between 3 and 12 months after an episode) treatment groups. There was also a category of patients who did not receive physical therapist treatment.

Researchers also found that patients who were initially evaluated by a generalist specialist (internal medicine
, family practice, emergency medicine, and general practice) were least likely to receive physical therapy within a year as compared with patients who were evaluated by physiatrists (physical medicine and rehabilitation), whose patients were most likely to receive physical therapy in the acute phase and also within 1 year of their initial evaluation.

“The study has also shown us that treatment practices among those who are utilizing less physical therapy, namely generalist specialties, may need to be modified since these providers also are responsible for evaluating the largest proportion of patients with acute low back pain,” said Ward.

The most common condition experienced by the patients was nonspecific backache (63.6%), followed by sciatica (14.5%), degenerative disc disease (10.5%), and spinal stenosis (6.2%).

In November, the Centers for Medicare and Medicaid Services formally established the Center for Medicare and Medicaid Innovation, which will examine new ways of delivering health care and paying health care providers who can save money on behalf of Medicare and Medicaid while improving the quality of care. Included in the Innovation Center’s initiatives is a demonstration project on direct access to physical therapists that was outlined in Section 3201 of the new health reform law, the Affordable Care Act, but no deadline was established regarding its implementation.

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While every case is different, you will need (at a minimum) the following:

* photos of the scene, ideally photos depicting the condition
* as many witnesses to the incident, or the dangerous condition, as you can find (remember, you yourself are also a witness)
* the “incident report” (if it occurred in a business establishment)
* proof of your injuries and damages; and
* reports of prior incidents (if they exist).

Many cases will also require bringing in an expert witness, especially if the dangerous or hazardous condition is not apparent (as in a slick surface), who can evaluate the condition and testify as to what caused you to fall, based on his/her technical education, training or experience. If you work with an injury attorney, he or she will have the necessary resources at hand to prove your case.

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Auto accidents can happen to anyone. You can protect your legal rights by taking the right steps after an accident occurs. The following list summarizes some of the steps you should take if involved in an auto accident.
1
DO Aid the Injured

If someone is injured, give first aid if you are qualified and call for an ambulance. Remember to make note of the location of the accident before you call for an ambulance. Tell the ambulance dispatcher the name and number of the street as well as the direction in which the cars were traveling at the time of the accident.
2
DO Stop Your Car

If your car is involved in an accident and you don’t stop, you may be subject to criminal charges. Leave your car as close as possible to the place of impact without blocking traffic. To avoid additional collisions, raise the hood of your car and put your hazard warning lights on. If the accident occurs at night, place flares or reflectors on the road.
3
DO Call the Police

A police report of the accident will aid your insurance claim and any liability claims. Note the officer’s name and badge number, and ask the officer how to obtain a copy of the accident report. If you do receive a traffic ticket, it does not mean you are guilty of a traffic offense or that you are responsible for the accident. Pleading guilty though, could very well hurt your claim for damages from the other driver. Consult your lawyer and insurance agent before pleading guilty to any traffic offense.
4
DO Exchange Information with the Other Driver

Exchange information with the driver of the other car. You should get the following information: * Other driver’s name, address, phone number, driver’s license number, name of insurance company and policy number. * Passenger’s name, address and phone number. * Witnesses’ name, address and phone number. * Owner’s (if not the driver) name, address, phone number, insurance company and policy number.
5
DO Get Medical Attention Right Away

Even if you feel O.K., the longer you delay seeing a doctor, the less documentation you have of your accident. It is best to go straight to the emergency room. It is likely that even if you don’t hurt at the scene, you will begin to “stiffen up” within an hour or two after the accident. It’s never a bad idea to be checked out by medical professionals because it’s better to be safe, than sorry…..
6
DO Notify Your Insurance Agent

Call your insurance agent as soon as possible after an accident. If you delay, your insurance company may have grounds to deny you coverage. Follow up the phone call with a written notice that should contain information about the date, time and place of the accident, with names and addresses of the other drivers, injured persons, passengers, and witnesses. If you were at fault, your liability insurance should pay for any injuries or property damages. If the other driver is at fault but does not have insurance, your insurance may pay for damages to your car (collision coverage), your medical expenses (medical payment coverage) and even for your pain and suffering (if you have uninsured motorist coverage).
7
DO Call Your Lawyer

Most lawyers offer a free consultation so you have nothing to lose by calling your lawyer first. Remember: the insurance companies have thousands of lawyers working to protect them so make sure you have an attorney working to protect YOU! If you don’t have a lawyer, you may call me (Jim Reed) at 1-800-ZIFFLAW or E-mail me at info@zifflaw.com and I will be happy to speak with you right away. Your lawyer can best advise you about your rights and responsibilities. Because witnesses may forget the details of the accident, the sooner you get the assistance of a lawyer, the better. Your lawyer can counsel you on how to respond to questions from insurance adjusters and help you recover compensation for your personal injuries and damages to your car.
8
DO NOT Admit Responsibility for the Accident

Do not admit responsibility, either at the scene of the accident, or with the police or others involved. If there is litigation, things you say may be used against you. Although you may think the accident was your fault, you may find out later that the other driver was actually to blame, or you were both equally at fault. This is not to say that you shouldn’t be truthful with the police about the FACTS of your accident– you just should not offer your OPINION that the accident was your fault.
9
DO NOT Give a Statement to the Other Driver’s Insurance Company

The insurance company is sure to be in contact with you soon after the accident regarding the property damage to your vehicle. That does not give them the right to ask you detailed questions about your injuries. It is best not to speak to them at all regarding your injuries until you seek the advice of an attorney who concentrates on personal injury.
10
DO NOT Take Money for Your Injuries or Settle Until You Have Finished Treatment

Insurance companies may try to offer you money for your injuries right away. The full extent of your injuries may not be apparent for weeks or months. Once you settle for your injuries, you can’t get any more money, no matter what they say.

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