Scarring and Disfigurement
Disfigurement is a change to the structure and visible appearance of the body. Examples include cases of amputation or paralysis. Severe fracture and ligament injuries can also leave visibly apparent limited use of limbs or body parts.
Juries are most generous when injury results in obvious deformity for the victim. In these cases, the medical presentation should be very detailed and must include testimony confirming the patient’s prognosis. Also, a functional capacity evaluation should be conducted by a physiatrist, a skilled orthopedic surgeon, or other relevant specialist to show with certainty how the deformity will limit physical ability, earning capacity, and quality of life. The case presentation should also provide a careful analysis of the victim’s hobbies and activities before the accident, and the limiting effect of injuries on the victim’s post-accident work duties, hobbies, travels, and day-to-day activities.
Scarring is a more limited type of deformity. Scars can arise from the initial traumatic injury or from subsequent surgery. Most scars also involve nerve damage, which can cause itching, pain, or numbness. Neurologists typically agree, after a two-year healing period, that any lingering nerve damage symptoms will be permanent.
Plastic surgeons have numerous techniques to reduce the appearance of scarring. The two most common approaches are dermabrasion and excision. Dermabrasion involves the use of course emollients to scour away the surface scar and all surrounding tissue. Thereafter, the entire region heals uniformly, which decreases the relative appearance of the scar.
Excision is a local surgical approach whereby the scar is cleanly and carefully cut away. Thereafter, the surgeon uses microsutures to bring the healthy tissue surrounding the scar together, creating a much finer and cleaner wound. Following excision, most scars remain visible but they are far less obvious.
In cases involving permanent scarring, photographs should be presented to support the injury claim. Ideally a series of photos will be offered to show the condition of the wound immediately after the accident, the wound with sutures or staples in place, the condition of the wound during the healing process, and the current scar appearance. The victim should also provide testimony concerning the emotional effect of scarring and any other limitations that the scar has caused.
Scarring cases are often defended by insurance carriers by utilizing social media evidence to suggest that the victim is not bothered by the scar. Adjusters cull the web for Facebook entries and other open-access social media. If the victim claims that the scar causes embarrassment or reduced physical ability, contrary online entries are often presented by the defense. For example, if a young lady suggests she never wears short sleeves due to the appearance of arm scars, the defense seeks to show online photos of the victim depicting brief moments where the scar is visible and the victim appears happy. Accident victims should always restrict their online presence to avoid their Facebook, Twitter, or other web entries and photos being taken out of context by insurance adjusters.