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SUPREME COURT OF THE $TATE OF NEW YORK
COUNTY OF ORANGE
__.---._____-______-________-______-_______x
LM., an Infant by her mother and
Natural Guardian IVANIA ALVAREZ-BERMEJO, and
IVANIA ALVAREZ-BERMEJO, INDIVIDUALLY,
Plaintiffs,
NOTICE OF PETITION
-against-
Index No.: EF004011-2019
LILIAN MARIE SAMUEL,
Defendant.
PLEASE TAKE NOTICE, thatupon the Petition of IVANIA ALVAREZ-BERMEJO, swom
August 14, 2019, the affirmation of Julie S. Raphael, Esq., the attorney forthe petitioner, dated August
9, 2019, and the exhibits annexed thereto, the undersigned will move thisCourt, before an Honorable
Justice of the Supreme Court, Orange County, at the Orange County Supreme Court, 285 Main Street,
2761
Goshen, New York on the day of August, 2019, at 9:00 AM or as soon thereafter as counsel can
be heard, for an Order Pursuant to CPLR § 1207 and 1208 granting leave to compromise andsettle
the claim of action of the infant L M., and for such other and future reliefas the Court deems just and
proper.
Dated: February 28, 2020 Respectfully yours, etc.
Middletown, New York
Júlie S. Raphael, Esq
SOBO & SOBO L.L.P.
Attorneys for Plaintiffs
One Dolson Avenue
Middletown, New York 10940
Filedin Orange 02/28/2020 06:01:22 PM $45.00 Bk: 5136 Pg: 787 Index: # EF00401 2019 Clerk: DK
County
At an IAS TennPart ofthe Supreme Court ofthe State
of New York, County of Orange at.285 Main Street,
Goshen,. New York, on the day of ,
2020.
PRESENT:
Honorable:
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF ORANGE
AMENDED
__----,___---________________-________-----..---,.-X
I. M,, an Infant by her mother and Natural Guardiañ IVANIA INFANT
ALVAREZ-BERMEJO, and
COMPROMISE
IVANIAALVAREZ-BERMEJO, INDIVIDUALLY,
ORDER
Plaintiffs,
-against-
Index No,: EF004011-
LILIAN MARIE SAMUEL, 2019
Defendant.
___ . .-__.-----------------------------X
Upon review and consideration of the following affidavits, documents, proofs, and other
exhibits submitted, received, and reviewed by the Court including; the Petition by the Plaintiff
IVANIA ALVAREZ-BERMEJO, the Mother, natural and custodial guardian of her daughter, the
infant Plaintiff, 1.M., which was duly verified and acknowledged on August 14, 2019; a supporting
Attorney's Affirmation of Julie S. Raphael, Esq., an associate of the law offices of Sobo and Sobo,
L.L.P., dated August 9, 2019; a further affirmation by counsel confir;ñing the exchange of the
Compromise"
within "Order of with the insurer for the Defendant, LILIAN MARIE SAMUEL,
dated August 9, 2019, in advance of itsreview by the Court; and upon the armered pleadings,
proceedings, and exhibits submitted herein; and
....
Along with the Court's review true and duplicate copies of all available health and
medical records which detail the health care, treatment, and attention received by the infant
Plaintiff herein following the motor vehicle accident as set forth in the attorney's
accompanying
affirmation;
And itappears that the best interests of the infant Plaintiff, I.M., will be best served by
allowing for a compromise of their respective claims for damage due to personal injury against
the named Defendant in the amount of SEVEN THOUSAND AND FIVE HUNDRED
DOLLARS ($7,500.00).
NOW, on the motion of SOBO & SOBO, L.L.P., as the retained attorneys for the
Plaintiffherein, itis hereby,
ORDERED, that IVANIA ALVAREZ-BERMEJO, as the Mother, natural and custodial
guardian of infant Plaintiff, LM., is hereby.duly authorized, empowered and directed to
compromise and settle the cause of action on behalf of her daughter for personal injuries
sustained in a motor vehicle accident which occurred at the intersection of East Avenue and
William Street, City of Middletown, County of Orange, State of New York on March 3, 2016 in
the gross sum of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00); and
itis further
ORDERED, that the total settlement payment in the sum of SEVEN THOUSAND AND
FIVE HUNDRED DOLLARS ($7,500.00), is to be paid by the Defendant, LILIAN MARIE
SAMUEL, be itdirectly and/or by and through any available liability insurance coverage for this
claim on behalf of said Defendant; and itis further
ORDERED, that from the aforesaid sum, the sum of FOUR HiJNDRED NINE
DOLLARS AND FORTY-EIGHT CENTS ($40948) be allowed and made paytele to SOBO
& SOBO, L.L.P. as full payment of the disbursements expended; and itis further
ORDERED, that from the aforesaid sum due to.infant Plaintiff, L M., and as was agreed
by written Retáine with the infant's Mother, that a legal fee of one-third (1/3) or thirty-three
percent (33%) of the net settlement offer in the sum of TWO THOUSAND FIVR HUNDRED
DOLLARS ($2,500.00) and shall be made payable to SOBO & SOBO, L.L.P. for professional
services; and itis further
ORDERED, that the entire balance temaining after the deductioñ of disbursements,
attorney's fees, and any Medicaid Lien, in the sum of FOUR THOUSAND FIVE HUNDRED
NINETY DOLLARS AND FIFTY-TWO CENTS ($4,590.52), is to be received and collected
by the Mother and custodial guardian, IVANIA ALVAREZ-BERMEJO, on behalf and for the
sole benefit and credit of the subject infant, LM., and that allof said funds are to be deposited in
the highest interest bearing savings account at Mid-Hudson Valley Federal Credit Union having
a branch located at 360 Route 211 East, Middletown, New York 10940 in the name of the
Mother and custodial guardian, IVANIA ALVAREZ-BERMEJO, in trust and for the sole benefit
of the subject infant, LM., subject to the further order of this Court or any other Court of
competent jurisdiction, and that such funds are required to remain in said bank account without
interference of any kind whatsoever; and itis further
ORDERED, that such funds shall remain in said account until such a time as the infant
Plaintiff, LM., reaches and attains.the age of eighteen on July .1,2030, at which titne control of
such funds are to be surrendered immediately to the infant Plaintiff upon presentation of
stañdrd, customary, and routinely accepted personal idenuncation; and itis further
ORDERED, that the filing of a bond is hereby dispensed with, in accordance with the
provision of CPLR §1210 (c); and itis further
ORDERED, that upon compliance with the terms of the IVANIA ALVAREZ-
Order,
BERMEJO,. as Mother, natural, and custodial guardian of her daughter, the infant Plaintiff, LM.,
be and hereby authorized to deliver the releases and any and all papers necessary to effectuate
such settlement and collect such money as has been noted above herein.
duly
ENTER:
Hon. Catherine Bartlett
SUPREME COURT OF THE STATE OF NEW YORIC
AFFIDAVIT
COUNTY OF ORANGE
-.------- ------ -----x OF PETITION
an Infant her mother and Natural Guardian IVANIA
LM., by OF GUARDIAN
ALVAREZ-BERMEJO, and
IVANIA ALVAREZ-BERMEJO, INDIVIDUALLY,
Index No.: EF004011-
2019
Plaintiffs,
-against-
LILIAN MARIE SAMUEL,.
Defendant.
STATE OF NEW YORK,
COUNTY OF ORANGE:
I,. IVANIA ALVAREZ-BERMEJO, being duly sworn hereby depose and say the following
under oath and the severe penalty of perjury:
1. I am the Mother of the infant Plaintiff, LM.. We reside together as a family at our
homelocated at 35 Crescent Place, #2, Middletown, New York 10940.
2. My daughter was a backseat car-seated passenger in Raul Marin-Camposi motor
vehicle when the defendant, LILIAN MARIE SAMUEL, struck the passenger side of the motor
yehicle, which was solely caused by the Defendants. This accident is a claim for damages due to
personal injury. The accident occurred on March 3, 2016 at the intersection of East Avenue and
Williatn Street, City of Middletown, County of Orange and State of New York.
3. The infant Plaintiff was 3 years of age, having been bom on July 1, 2012.
4. The circumstances giving rise to thisclaim are as follows: On March 3., 2016,
while this infant Plaintiff, LM., was a backseat car-seated passenger, the LILIAN
defendant,
MARIE SAMUEL, stmck the passenger side of the motor vehicle thereby causing the infant
plaintiff to sustain severe and serious personal injuries.
5. The Infant Plaintiff, LM-, sustained injury to her cervical spine, with additional
minimal complaints of pain to her thoracic an d lumbar spine. She was first seen on March 3,
2016 at Dolson Avenue Medical located at 201 Dolson Avenue in Middletown, New York on the
date of the acddent and completed a course of treatment with this facility. The medicalrecords
are attached hereto as "Exhibit 1".
6. No MRIs were ever performed.
7. On or about March 3, 2016 I retained SOBO & SOBO, LLP and agreed that
compensation in the event of recovery would be thirty-three percent (33%) of the amoüñt so
recovered on behalf of the Infant. A copy of said retaineris attached hereto as "Exhibit 2".
8. I have been advised by my daughter's Chiropractor that iny daughter requires no
additicnal treatment. The lastvisit to my daughters Chiropractorhas confirmed this.
9. My daughter's treatment in relation to this accident ended on February 2.8,2017.
10. In relation to her injuries resultant from this accident, she has not made any further
complaints of pain since.
11. No additional treatment has been recommended.
12, My attorney has informed me that an offer for seemmt has been made for the sum
of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00) and the proposed
distribution of the settlement is as follows: (i)the sum of FOUR HUNDRED NINE DOLLARS
AND FORTY-EIGHT CENTS ($409.48) and (ii) TWO THOUSAND FIVE HUNDRED
DOLLARS ($2,500.00) be made payable to SOBO & SOBO, LLP as fullpayment for professional
services; and the
(iii) entire bahnce of said settlement, to wit, the sum of FOUR THOUSAND FIVE
HUNDRED NINETY DOLLARS AND FIFTY-TWO CENTS ($4,590.52) be made payable to
the infant plaintiff and held in trust in Mid-Hudson Valley Federal Credit Union having a branch
located at 360 Route 211 East, Middletown, New York 10940 without interference of any kinduntil
the time that.she turns eighteen years of age, to wit: July 1, 2030. A copy of said expenses and costs
3"
is attached hereto as "Exhibit
13. I have been told that the settlement of this matter will end daughter's claim for
my
damages against the Defendant and that she will not be able to present a lawsuit against the
Defendant further comp= eticñ if the Court were to authorize an Order of Compromise
seeking
as requested.
14. I further understand that pending approval of the Coutt, said settlement funds due
my daughter shall remain in said account until such time as L M. reaches the age of eighteen (18)
on July 1, 2030 at which time control of such funds are to be surrendered immediately to my
daughter upon presentation of proper identification.
15. All in all, I believe that the settlement and proposed distribution is fairand in the bëst
legal interests ofiny daughter.
16. I can say that I approve this settlement and proposed distribution and .respectfully
request the Court's approval of the compromise offer rather than risk the uncenainty and expense of
protracted litigation.
17. Further, by acceptance of this offer, 1 am fully waiving and foregoing right or
any
entitlement which I may have for an award for loss of services related to my daughter's injury.
18. No other action or pwceeding has:been commêñced on behalf of my daughter, or for
that matter inembers of including the undersigned as a result of the accident in which
any my family
LM. suffered injury.
19. I can also statethat no reimbursement for tñedical or other expenses has been received
from anyother source.
20. I have no interest in any matter adverse to the Infant, nor have I becorne concerned or
interested herein at therequest of the opposing party, be it directly or indirectly.
21. Ihave not received, nor are weto receiveany monics from the opposing paty, directly
orindirectly.
22. No previous applicatioñ for the relief sought herein has been inade to any court or
judge.
WHEREFORE, I respectfully pray that the court make and enter an order approving and
authorizing the compréraisc as herein set forth and further pray for such other relief as the court may
deem fitting and proper.
Dated-
August 14, 2019
Middletown, New York
IVANIA ALVAREnBERMEJO
INDIVIDUAL ACKNOWLEDGEMENT AND VERIFICATION
STATE OF NEW YORK }
TOWN OF MIDDLETOWN }.SS:
COUNTY OF ORANGB }
That I,the undersigned, the Petitioner, IVANIA ALVAREZ-BERMEJOs the mother,
natural, and custodial güárdian of the infant Plaintiff, I.lyL, being duly swom, does hereby say
the follo wlug is truthful and acettrate under oath and the severe penalty of perjury:
i have read, reviewed, discu9ed, and came to fully understand the Supporting Petition
prepared in carsection with this matter which was drafted by our legal counsel, and the
statements.and claims madein the same were and remain truthfál and accurate, to the best of my
knowledge, except as to those matters stated to be alleged upon information and belief, and as to
such inatters, I fully believe them to be truthful and accurate as well.
Dated: August 14,2019
Middletown, New York
IVANIA ALVARE ERMEJO, as Mother
and Natural Guardian of I.M.
Dul sworn to before me on this the
. day of . 2019
MARY K TOMASICCHBO
Notary Public, State ofNewYork
No.01TO6314863
ff
Qualified in Orange County z
Commission Expires November 17, 207
SUPREME COURT OF THE STATE OF NEW YORK AFFIDAVIT OF
COUNTY OF ORANGE ATTORNEY
__---..--------------------------------- ------X
1. M., an Infant by her mother an(1 Index No.: EFD04011-
Natural Guardian IVANIA ALVAREZ-BERMEJO, and 2019
IVANIA ALVAREZ-BERMEJ0, INDIVIDUALLY,
Plaintiffs,
-against-
LILIAN MARIE SAMUEL,
Defendant.
----- -.-------------------------------------X
$TATE OF NEW YORK,
COUNTY OF ORANGE;
JULIE S. RAPHAEL, ESQ., an attorney admitted to practice before the Courts for the
State of New York, affirms the truth of the followiñg under the penalty of perjury:
1. I am an associate attorney with the finn of SOBO & SOBO, LLP, attorneys for
the Plaintiffs, and as such I am fully familiar with the facts and circumst.ances of this action based
upon a review of the case fileand the investigation materials contained therein.
2. I am not related to the Infant or to any party in this action or proceeding.
3. Oñ or about March 3, 2016, the Plaintiffs retaiñêd my firm by written Retainer to
pursue a claim for damages due to personal injury for the infant Plaintiff, I,11. A copy of said
Retainer is attached hereto as Exhibit "2".
4. By the material terms of the retainer, my law office is to receive, for legal services
rendered on behalf of the infants, one-third (1/3) of any recovery received by the infant Plaintiff,
including recovery for loss of services and medical expenses, before the dedu-ti-n of
any
disbursements incurred by the.firm.
....
5. This personal injury matter and the instant petition for a compromise arises out of
plaintiff a backseat car-seated passenger when the defendaw, LILIAN MARIE
being SAMUEL,
struck the passenger side of the motor vehicle thereby causing the infant plaintiff to sustain severe
and serious personal injuries.
6. Thereat, while theinfant Plaintiff, LM., was a backseat car-seated pacseger when the
defendant, LILIAN MARIE SAMUEL, stmck the passeñgct side of the motor vehicle, thereby
causing the infant plaintiff to sustain severe and serious personal injuries.
7. Following this motor incident, the subject infant began to experience severe physical
pain.
8. She received treatment from Dolson Avenue Medical, at 201 Delson Avenue,
Middletown, NY 10940.. The medical records are attached hereto as "Exhibit l''.
9. The infant received a diagnosis of cervical subluxation with minimal injury to her
thoracic and Inmbar spine which was addressed by chiropractic treatment.
10. Upon information and belief, alltreatment ended on February,28, 2017. Letter from
ChiroCare stating the infant Plaintiff was dismissed from care is attschëd hereto as "Exhibit 4".
11. No additional treatment has been recommended.
12. No additional treatment has been received to date.
13. The Petitioner has confirmed that no days of school were niissed due to the personal
injury suffered in this accident.
14. No request for a lien has been received by my office in connection with this matter
from any niedical provider, and none have been signed by this office or to the best of my
knowledge, the infant's Mother.
15. At the end of lengthy settlement negotiations and after a significant mnount of work
and time spent pursuing this action (detailed below), I received an offer in the total sum of SEVEN
T.HOUSAND AND FIVE HUNDRED DOLLARS ($7,500 00) to settle the claim of the infant
Plaintiff, I.M..
16. Further, the infant's Mother agrees with our represetation that itis best to accept this
offer rather than running up arid incurring needless costs, expenses and disbursements in a litigation
directed against the Defendant.
17. It is precisely for these reasons that I have wholeheartedly recommcñded the
acceptance of the settlement offer.
18. The Law Offices of Sobo & Sobo, L.L.P. expended a tremendous amount of time,
effort and resources in prosecuting thisaction, including:
a. Initial meetings with Plaintiffs;
b. Filing Retainer Statement and Opening Statement with the Court of
Adininistration;
c. Requested medical records and bills;
d. Provided written notice to the Defendant's Insurance Company of
Plaintiffs'
Claim;
e. Reviewed medical records and bills;
f. Case investigation;
g. Numerous communicatioñs with the imurance company and medicál
provider;.
h. Settletnent negotiations;
i. Multiple phone conferences with the Plaintiffs;
j, Researched case value;
k. Engaged in ongoing negotiations including numerous phone calls with the
Defendants'
Insurance Company;
1. Drafted Infant's Compromise Petition including Proposed Order and
Affidavits;
nL Filed Infant?s Coinpromise Petition;
n- Appearing at an Infant's Compromise Hearing; and
0. Distributing the proceeds of the settlement.
19. For the aformWiened reasons, in accordance with theterms of the signed retainer,
I respectfully request that this Court fix the legal fees at one-third (1/3) of the gross settlement on
behalf of the infant Plaintiff; I.M., and agree to authorize the proposed distribution of the proceeds
as follows: (i)the sum of FOUR HUNDRED NINE DOLLARS AND FORTY-EIGHT CENTS
($409.48) be allowed and made payable to SOBO & SOBO, L.L.P. as full payment of the
dishwsements expended (a listof the disbursamsts expended is attached hereto as "Exhibit 3"); (ii)
and as is consistest with the Retainer, one-third of the balance of said settlement after disbursements
is awarded for attomey's fees, such amount being TWO THOUSAND FIVR HUNDRED
DOLLARS ($2,500.00) be made payable to SOBO & SOBO, LLP. as full payment for
professional services; and (iii)the entire balance of said settlement, to wit, the sum 0.f FOUR
THOUSAND FIVE HUNDRED NINETV DOLLARS AND FIFTY-TWO CENTS ($4,59052)
is to be to paid to the Plaintiff and the same is to be deposited into a separate bank account bearing
solely the name of the infantplaintiff herein, as the sole and exclusive beneficiary, and such. funds
shall receive guaranteed interest at the applicable rate, and that such funds must remain in said
accountwithout interference of any kind without further Order of this Court.
20. Neither I,nor any 1ñêñiber of my law fùm, became concemed in the settlement at the
instancs of a party or person opposing, or with interests adverse to, the Infant, directly or indirectly;
nor received, nor will receive, any compensation from such party; tiorrepresented and do not now
represent any other person asserting a claim arising from the same occurrence.
21. No previous application for the relief sought herein has been made to this or to any
court.
WHEREFORE, your deponent prays the court to make and enter an order herein for the
relief sought.
Dated: August 9, 2019
Middletown, New York
Respectfully,
SOBO & SOBO, LLP
By
Julie S. Raphael, Esq
Attorneys for Plaintiffs
One Dolson Avenue
Middletown, NY 10940
P: (845) 343-7626
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF ORANGE
---------------------- ---------------------X
LM., an Infant by her rnother and
Natural Guardian IVANIA ALVAREZ-BERMEJO and
IVANIA ALVAREZ-BERMEJO, Individually,
ATTORNEY'SAFFIRMATION
ne: EXCHANGE OF ORDER
Plaintiffs Index No.: EF004011-2019
-against-
LILIAN MARIE SAMUEL,
Defendants.
JULIE S. RAPHAEL, ESQ., an attorney admitted to practice before the Courts of this
State, affirms the truth of the following under the penalty of perjury:
1. I am an associate of the law offices of SOBO & SOBO, L.L.P., the retained
attorneys for the Plaintiffs herein, and as such I am fully famili.ar with the facts and
circumstances of this action herein and the matters at bar.
2. Your affirinant cati attest and fully confirm that the within proposed Order of
Comproinise has been exchanged via regular U.S. Mail and by facsimile with the liability insurer
for the Defendants, to wit, State Farm Insurance Company, in advance of the presentation of
such papers to Court.
3. As such, this Hon. Court should take note that the Defendant's insurer has been
afforded an opportunity to review the same and voice any objections to the relief sought herein.
Dated: August9, 2019
Middletown, New York
Julie S..Raphael, E dg)
SOBO & SOBO L.L.P.
Attorneys for Plaintiffs
One Dolson Avenue
Middletown, New York 10940
Exhibit 1
ChiroCare
'
INITIAL CHIROPRACTIC
c h Iropractic
CONSULTATION
52 D.ason Avenue,:Suite 200 call:
(845) 342-2225
Middletown,NY 10940 Fax: (845) 343-8759
Date: March 3, 2016
Patient's Name:
Patient's Account #: 87632 CX105015
Date of Birth:
Case Type: Motor Vehicle Accident (Geico)
Date of Accident: March 3, 2016
Subject: INITIAL CHIROPRACTIC CONSULTATION
History of_Present Injury
The patient is a 3-year-old right-handed Hispanic female, stands 2 ft6 in, weighs 32 lbs. The
patient is being seen for Injuries sustained fro.m a motor vehicle accident on 03/03/16.
is here today for the injuriessustained on a prior motor vehicle accident, her mother is present
due to her age. Her mother explain she was the front seat belted driver of the vehicle, her
daughterelibAllmllMBIlillinevas the car seatbelted, passenger located behind the front passenger
seat. As anniandla's mother was driving, she states another vehicle pulled out running a stop
sign, impacting their vehicle on the front driver's side. Her mother imrñêdjately grabbed onto
Isabella's head and neck trying to testrain her daughter. Unfortunately, the car seat was tossed
around the vehicle with the 3 year old baby, upon irnpact. was taken to the nearest
emergency facility,where she was examined and released the same day. She now suffers from
localized neck paindlmansneshrange of motion is noted to be limited, when turriingher head from
leftto right Daily activitieswill worsen her condition.
Subjective Symptoms
The patient presents to the office today with the following symptoms:
trequent (51% to 75% of the time) pain and stiffness in her neck rated as a 7/10 on the
Numeric Pain Intensity Scale
Page 1
. ...........
Orthopedic Tests
Range of matica or (ROM) is the measurement of the achievable distance between the flexed
position and the extended positish of a particular jointor muscle group. ROM. studies conducted
on the patient yielded the following results:
Cervical N A Pain
Flexion 60 50 E
Extension 5.0 40 E
R Lat Flexion 45 40 El
L Lat Rex 45 40
R Rotation 80 60
L Botation 80 60 E
. ..
The shoulder depression test looks for a painresponse by compressing the nerves/vessels into
arms. This test produced a positive response bilaterally.
Palpation Evaluatfor1
Palpation of thecervical region revealed,+2 spasms and +2 tendemess.
Further examinaGen reveals hyperirritable taut bands in the paracervical muscles which elicit
radiating pains upon stimulation.
Palpation of the splnal ragians reveals misalignments/asymmetry and taut and tender fibers in
the folicwiñg areas: C5 and CS, Chiropractic Manipulative Thsrapy was applied to these levels
of the spine to correct th.a rnotion irrthe joints giving proper alignment and function to the
affected areas.
Other Objective Findings
Moderate swelling is noted in the cervical grea.
Diagnosis
Based on the patient history and examination results, the following cliagñcsis can be posited:
Cervical Subluxation
Page 2
Treatment Plan and Recommendations
The diagnosis and treatment plan was formulated based on information presented by the
patient and her guardian and on objective examination findings. The diagnosis and treatment
plan was shared with the patient and her guardian. The benefits and risks of care were
expia|ñed to them, and differerit options or alternate types of treatment were discussed, aswell
as possible outcomes if thepatient chose to remain untreated. The patient and her guardian
had the opportunity to ask questions regarding the diagnosis and treatment plan and any
concerns were addressed. Informed consent discussion took. place and the patient and her
guardian verbalized consent to commence with-the recornmended treatment plan,
The patient 1s scheduled to receive chiropractic care three (3) times a week for six weeks at
which time a reexamination will be performed.. Re-examinations willbe performsd periodiusily to
re-assess tha patient's response to the treatment plan. Due to individual and genetic
differences, some patients respond faster to care, and some do at a slower pace. The
treatment plan will also be re-assessed and updated according to the patient's response.
will be receiving Chiropractic Manipulative Therapy to correct the motion in the joint
giving proper alignrnent and function to the affected area of the spine and help optimize
biomechanics and relieve pressure on pinched nerves to allow the inflamed nerves to heal.
enlilmannonillalso be receiving the following therapeutic m.odalities:
Manual Therapeutic Techniques such as manual stretching to relax opastic muscles, improve
jointplay and reduce pain associated with tissue impingement; manual trigger point release of
tightknots and bands in the muscles to increase blood flow and uncornpress nerves;
strengthening using counter-resistance to increase stren.gth and improve muscle tone;
myofascial release to relieve tension in tha fascia, improve or normalize movement pattems
through the reduction of soft tissue pain and restrictions, improve physiologic function and
support homeostasis; and manual traction.to open the affected joint/disc spaces causing
compression, irritation,and inflammation to the affected nerve roots to improve joint mobility
and decrease muscle tightness and tension associated with pain and decreased range of
motion.
Superficial Heat to raise the temperature of soft tissues to Increase circulation and relax muscle
tension thereby reducing painful muscle spasrns.
In 4 weeks, the patient's pain level willbe reduced by 2 points on a pain scale, range of motion
will improve by 10%, strength willimprove by 10%, endurance will improve by 10%, tolerance to
sitting wiliimprove by 10%, tolerance to standing willimprove by 10%, functional abilitieswill
improve by 10% and overall condition wiltimprove by 10%
The initialgoals of treatment are.to glleviate pain, decrease muscle spasms, increase range of
motion and reduce inflamrnation. Long-term goals of treatment are to eliminate pain, eliminate
muscle spasms, restore normai range of motion and eliminate inflammation.
Prognosis
The possibility of the patient's condition becorning permañêñt cannot be ruled out at this time.
The patient's activities of daily living have been limited by the severity of her sympto.ms. As a
Page 3
result of the traumatic injury, there were extremes of joint movement with c0iicomitant
stretching and tear|ñg of the musculo-"gamëñtous structures of the carvical spine. Itappears
that these areas may be weakened for an ladefiniteperiod of t
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SUPREME COURT OF THE $TATE OF NEW YORK COUNTY OF ORANGE __.---._____-______-________-______-_______x LM., an Infant by her mother and Natural Guardian IVANIA ALVAREZ-BERMEJO, and IVANIA ALVAREZ-BERMEJO, INDIVIDUALLY, Plaintiffs, NOTICE OF PETITION -against- Index No.: EF004011-2019 LILIAN MARIE SAMUEL, Defendant. PLEASE TAKE NOTICE, thatupon the Petition of IVANIA ALVAREZ-BERMEJO, swom August 14, 2019, the affirmation of Julie S. Raphael, Esq., the attorney forthe petitioner, dated August 9, 2019, and the exhibits annexed thereto, the undersigned will move thisCourt, before an Honorable Justice of the Supreme Court, Orange County, at the Orange County Supreme Court, 285 Main Street, 2761 Goshen, New York on the day of August, 2019, at 9:00 AM or as soon thereafter as counsel can be heard, for an Order Pursuant to CPLR § 1207 and 1208 granting leave to compromise andsettle the claim of action of the infant L M., and for such other and future reliefas the Court deems just and proper. Dated: February 28, 2020 Respectfully yours, etc. Middletown, New York Júlie S. Raphael, Esq SOBO & SOBO L.L.P. Attorneys for Plaintiffs One Dolson Avenue Middletown, New York 10940 Filedin Orange 02/28/2020 06:01:22 PM $45.00 Bk: 5136 Pg: 787 Index: # EF00401 2019 Clerk: DK County At an IAS TennPart ofthe Supreme Court ofthe State of New York, County of Orange at.285 Main Street, Goshen,. New York, on the day of , 2020. PRESENT: Honorable: SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF ORANGE AMENDED __----,___---________________-________-----..---,.-X I. M,, an Infant by her mother and Natural Guardiañ IVANIA INFANT ALVAREZ-BERMEJO, and COMPROMISE IVANIAALVAREZ-BERMEJO, INDIVIDUALLY, ORDER Plaintiffs, -against- Index No,: EF004011- LILIAN MARIE SAMUEL, 2019 Defendant. ___ . .-__.-----------------------------X Upon review and consideration of the following affidavits, documents, proofs, and other exhibits submitted, received, and reviewed by the Court including; the Petition by the Plaintiff IVANIA ALVAREZ-BERMEJO, the Mother, natural and custodial guardian of her daughter, the infant Plaintiff, 1.M., which was duly verified and acknowledged on August 14, 2019; a supporting Attorney's Affirmation of Julie S. Raphael, Esq., an associate of the law offices of Sobo and Sobo, L.L.P., dated August 9, 2019; a further affirmation by counsel confir;ñing the exchange of the Compromise" within "Order of with the insurer for the Defendant, LILIAN MARIE SAMUEL, dated August 9, 2019, in advance of itsreview by the Court; and upon the armered pleadings, proceedings, and exhibits submitted herein; and .... Along with the Court's review true and duplicate copies of all available health and medical records which detail the health care, treatment, and attention received by the infant Plaintiff herein following the motor vehicle accident as set forth in the attorney's accompanying affirmation; And itappears that the best interests of the infant Plaintiff, I.M., will be best served by allowing for a compromise of their respective claims for damage due to personal injury against the named Defendant in the amount of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00). NOW, on the motion of SOBO & SOBO, L.L.P., as the retained attorneys for the Plaintiffherein, itis hereby, ORDERED, that IVANIA ALVAREZ-BERMEJO, as the Mother, natural and custodial guardian of infant Plaintiff, LM., is hereby.duly authorized, empowered and directed to compromise and settle the cause of action on behalf of her daughter for personal injuries sustained in a motor vehicle accident which occurred at the intersection of East Avenue and William Street, City of Middletown, County of Orange, State of New York on March 3, 2016 in the gross sum of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00); and itis further ORDERED, that the total settlement payment in the sum of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00), is to be paid by the Defendant, LILIAN MARIE SAMUEL, be itdirectly and/or by and through any available liability insurance coverage for this claim on behalf of said Defendant; and itis further ORDERED, that from the aforesaid sum, the sum of FOUR HiJNDRED NINE DOLLARS AND FORTY-EIGHT CENTS ($40948) be allowed and made paytele to SOBO & SOBO, L.L.P. as full payment of the disbursements expended; and itis further ORDERED, that from the aforesaid sum due to.infant Plaintiff, L M., and as was agreed by written Retáine with the infant's Mother, that a legal fee of one-third (1/3) or thirty-three percent (33%) of the net settlement offer in the sum of TWO THOUSAND FIVR HUNDRED DOLLARS ($2,500.00) and shall be made payable to SOBO & SOBO, L.L.P. for professional services; and itis further ORDERED, that the entire balance temaining after the deductioñ of disbursements, attorney's fees, and any Medicaid Lien, in the sum of FOUR THOUSAND FIVE HUNDRED NINETY DOLLARS AND FIFTY-TWO CENTS ($4,590.52), is to be received and collected by the Mother and custodial guardian, IVANIA ALVAREZ-BERMEJO, on behalf and for the sole benefit and credit of the subject infant, LM., and that allof said funds are to be deposited in the highest interest bearing savings account at Mid-Hudson Valley Federal Credit Union having a branch located at 360 Route 211 East, Middletown, New York 10940 in the name of the Mother and custodial guardian, IVANIA ALVAREZ-BERMEJO, in trust and for the sole benefit of the subject infant, LM., subject to the further order of this Court or any other Court of competent jurisdiction, and that such funds are required to remain in said bank account without interference of any kind whatsoever; and itis further ORDERED, that such funds shall remain in said account until such a time as the infant Plaintiff, LM., reaches and attains.the age of eighteen on July .1,2030, at which titne control of such funds are to be surrendered immediately to the infant Plaintiff upon presentation of stañdrd, customary, and routinely accepted personal idenuncation; and itis further ORDERED, that the filing of a bond is hereby dispensed with, in accordance with the provision of CPLR §1210 (c); and itis further ORDERED, that upon compliance with the terms of the IVANIA ALVAREZ- Order, BERMEJO,. as Mother, natural, and custodial guardian of her daughter, the infant Plaintiff, LM., be and hereby authorized to deliver the releases and any and all papers necessary to effectuate such settlement and collect such money as has been noted above herein. duly ENTER: Hon. Catherine Bartlett SUPREME COURT OF THE STATE OF NEW YORIC AFFIDAVIT COUNTY OF ORANGE -.------- ------ -----x OF PETITION an Infant her mother and Natural Guardian IVANIA LM., by OF GUARDIAN ALVAREZ-BERMEJO, and IVANIA ALVAREZ-BERMEJO, INDIVIDUALLY, Index No.: EF004011- 2019 Plaintiffs, -against- LILIAN MARIE SAMUEL,. Defendant. STATE OF NEW YORK, COUNTY OF ORANGE: I,. IVANIA ALVAREZ-BERMEJO, being duly sworn hereby depose and say the following under oath and the severe penalty of perjury: 1. I am the Mother of the infant Plaintiff, LM.. We reside together as a family at our homelocated at 35 Crescent Place, #2, Middletown, New York 10940. 2. My daughter was a backseat car-seated passenger in Raul Marin-Camposi motor vehicle when the defendant, LILIAN MARIE SAMUEL, struck the passenger side of the motor yehicle, which was solely caused by the Defendants. This accident is a claim for damages due to personal injury. The accident occurred on March 3, 2016 at the intersection of East Avenue and Williatn Street, City of Middletown, County of Orange and State of New York. 3. The infant Plaintiff was 3 years of age, having been bom on July 1, 2012. 4. The circumstances giving rise to thisclaim are as follows: On March 3., 2016, while this infant Plaintiff, LM., was a backseat car-seated passenger, the LILIAN defendant, MARIE SAMUEL, stmck the passenger side of the motor vehicle thereby causing the infant plaintiff to sustain severe and serious personal injuries. 5. The Infant Plaintiff, LM-, sustained injury to her cervical spine, with additional minimal complaints of pain to her thoracic an d lumbar spine. She was first seen on March 3, 2016 at Dolson Avenue Medical located at 201 Dolson Avenue in Middletown, New York on the date of the acddent and completed a course of treatment with this facility. The medicalrecords are attached hereto as "Exhibit 1". 6. No MRIs were ever performed. 7. On or about March 3, 2016 I retained SOBO & SOBO, LLP and agreed that compensation in the event of recovery would be thirty-three percent (33%) of the amoüñt so recovered on behalf of the Infant. A copy of said retaineris attached hereto as "Exhibit 2". 8. I have been advised by my daughter's Chiropractor that iny daughter requires no additicnal treatment. The lastvisit to my daughters Chiropractorhas confirmed this. 9. My daughter's treatment in relation to this accident ended on February 2.8,2017. 10. In relation to her injuries resultant from this accident, she has not made any further complaints of pain since. 11. No additional treatment has been recommended. 12, My attorney has informed me that an offer for seemmt has been made for the sum of SEVEN THOUSAND AND FIVE HUNDRED DOLLARS ($7,500.00) and the proposed distribution of the settlement is as follows: (i)the sum of FOUR HUNDRED NINE DOLLARS AND FORTY-EIGHT CENTS ($409.48) and (ii) TWO THOUSAND FIVE HUNDRED DOLLARS ($2,500.00) be made payable to SOBO & SOBO, LLP as fullpayment for professional services; and the (iii) entire bahnce of said settlement, to wit, the sum of FOUR THOUSAND FIVE HUNDRED NINETY DOLLARS AND FIFTY-TWO CENTS ($4,590.52) be made payable to the infant plaintiff and held in trust in Mid-Hudson Valley Federal Credit Union having a branch located at 360 Route 211 East, Middletown, New York 10940 without interference of any kinduntil the time that.she turns eighteen years of age, to wit: July 1, 2030. A copy of said expenses and costs 3" is attached hereto as "Exhibit 13. I have been told that the settlement of this matter will end daughter's claim for my damages against the Defendant and that she will not be able to present a lawsuit against the Defendant further comp= eticñ if the Court were to authorize an Order of Compromise seeking as requested. 14. I further understand that pending approval of the Coutt, said settlement funds due my daughter shall remain in said account until such time as L M. reaches the age of eighteen (18) on July 1, 2030 at which time control of such funds are to be surrendered immediately to my daughter upon presentation of proper identification. 15. All in all, I believe that the settlement and proposed distribution is fairand in the bëst legal interests ofiny daughter. 16. I can say that I approve this settlement and proposed distribution and .respectfully request the Court's approval of the compromise offer rather than risk the uncenainty and expense of protracted litigation. 17. Further, by acceptance of this offer, 1 am fully waiving and foregoing right or any entitlement which I may have for an award for loss of services related to my daughter's injury. 18. No other action or pwceeding has:been commêñced on behalf of my daughter, or for that matter inembers of including the undersigned as a result of the accident in which any my family LM. suffered injury. 19. I can also statethat no reimbursement for tñedical or other expenses has been received from anyother source. 20. I have no interest in any matter adverse to the Infant, nor have I becorne concerned or interested herein at therequest of the opposing party, be it directly or indirectly. 21. Ihave not received, nor are weto receiveany monics from the opposing paty, directly orindirectly. 22. No previous applicatioñ for the relief sought herein has been inade to any court or judge. WHEREFORE, I respectfully pray that the court make and enter an order approving and authorizing the compréraisc as herein set forth and further pray for such other relief as the court may deem fitting and proper. Dated- August 14, 2019 Middletown, New York IVANIA ALVAREnBERMEJO INDIVIDUAL ACKNOWLEDGEMENT AND VERIFICATION STATE OF NEW YORK } TOWN OF MIDDLETOWN }.SS: COUNTY OF ORANGB } That I,the undersigned, the Petitioner, IVANIA ALVAREZ-BERMEJOs the mother, natural, and custodial güárdian of the infant Plaintiff, I.lyL, being duly swom, does hereby say the follo wlug is truthful and acettrate under oath and the severe penalty of perjury: i have read, reviewed, discu9ed, and came to fully understand the Supporting Petition prepared in carsection with this matter which was drafted by our legal counsel, and the statements.and claims madein the same were and remain truthfál and accurate, to the best of my knowledge, except as to those matters stated to be alleged upon information and belief, and as to such inatters, I fully believe them to be truthful and accurate as well. Dated: August 14,2019 Middletown, New York IVANIA ALVARE ERMEJO, as Mother and Natural Guardian of I.M. Dul sworn to before me on this the . day of . 2019 MARY K TOMASICCHBO Notary Public, State ofNewYork No.01TO6314863 ff Qualified in Orange County z Commission Expires November 17, 207 SUPREME COURT OF THE STATE OF NEW YORK AFFIDAVIT OF COUNTY OF ORANGE ATTORNEY __---..--------------------------------- ------X 1. M., an Infant by her mother an(1 Index No.: EFD04011- Natural Guardian IVANIA ALVAREZ-BERMEJO, and 2019 IVANIA ALVAREZ-BERMEJ0, INDIVIDUALLY, Plaintiffs, -against- LILIAN MARIE SAMUEL, Defendant. ----- -.-------------------------------------X $TATE OF NEW YORK, COUNTY OF ORANGE; JULIE S. RAPHAEL, ESQ., an attorney admitted to practice before the Courts for the State of New York, affirms the truth of the followiñg under the penalty of perjury: 1. I am an associate attorney with the finn of SOBO & SOBO, LLP, attorneys for the Plaintiffs, and as such I am fully familiar with the facts and circumst.ances of this action based upon a review of the case fileand the investigation materials contained therein. 2. I am not related to the Infant or to any party in this action or proceeding. 3. Oñ or about March 3, 2016, the Plaintiffs retaiñêd my firm by written Retainer to pursue a claim for damages due to personal injury for the infant Plaintiff, I,11. A copy of said Retainer is attached hereto as Exhibit "2". 4. By the material terms of the retainer, my law office is to receive, for legal services rendered on behalf of the infants, one-third (1/3) of any recovery received by the infant Plaintiff, including recovery for loss of services and medical expenses, before the dedu-ti-n of any disbursements incurred by the.firm. .... 5. This personal injury matter and the instant petition for a compromise arises out of plaintiff a backseat car-seated passenger when the defendaw, LILIAN MARIE being SAMUEL, struck the passenger side of the motor vehicle thereby causing the infant plaintiff to sustain severe and serious personal injuries. 6. Thereat, while theinfant Plaintiff, LM., was a backseat car-seated pacseger when the defendant, LILIAN MARIE SAMUEL, stmck the passeñgct side of the motor vehicle, thereby causing the infant plaintiff to sustain severe and serious personal injuries. 7. Following this motor incident, the subject infant began to experience severe physical pain. 8. She received treatment from Dolson Avenue Medical, at 201 Delson Avenue, Middletown, NY 10940.. The medical records are attached hereto as "Exhibit l''. 9. The infant received a diagnosis of cervical subluxation with minimal injury to her thoracic and Inmbar spine which was addressed by chiropractic treatment. 10. Upon information and belief, alltreatment ended on February,28, 2017. Letter from ChiroCare stating the infant Plaintiff was dismissed from care is attschëd hereto as "Exhibit 4". 11. No additional treatment has been recommended. 12. No additional treatment has been received to date. 13. The Petitioner has confirmed that no days of school were niissed due to the personal injury suffered in this accident. 14. No request for a lien has been received by my office in connection with this matter from any niedical provider, and none have been signed by this office or to the best of my knowledge, the infant's Mother. 15. At the end of lengthy settlement negotiations and after a significant mnount of work and time spent pursuing this action (detailed below), I received an offer in the total sum of SEVEN T.HOUSAND AND FIVE HUNDRED DOLLARS ($7,500 00) to settle the claim of the infant Plaintiff, I.M.. 16. Further, the infant's Mother agrees with our represetation that itis best to accept this offer rather than running up arid incurring needless costs, expenses and disbursements in a litigation directed against the Defendant. 17. It is precisely for these reasons that I have wholeheartedly recommcñded the acceptance of the settlement offer. 18. The Law Offices of Sobo & Sobo, L.L.P. expended a tremendous amount of time, effort and resources in prosecuting thisaction, including: a. Initial meetings with Plaintiffs; b. Filing Retainer Statement and Opening Statement with the Court of Adininistration; c. Requested medical records and bills; d. Provided written notice to the Defendant's Insurance Company of Plaintiffs' Claim; e. Reviewed medical records and bills; f. Case investigation; g. Numerous communicatioñs with the imurance company and medicál provider;. h. Settletnent negotiations; i. Multiple phone conferences with the Plaintiffs; j, Researched case value; k. Engaged in ongoing negotiations including numerous phone calls with the Defendants' Insurance Company; 1. Drafted Infant's Compromise Petition including Proposed Order and Affidavits; nL Filed Infant?s Coinpromise Petition; n- Appearing at an Infant's Compromise Hearing; and 0. Distributing the proceeds of the settlement. 19. For the aformWiened reasons, in accordance with theterms of the signed retainer, I respectfully request that this Court fix the legal fees at one-third (1/3) of the gross settlement on behalf of the infant Plaintiff; I.M., and agree to authorize the proposed distribution of the proceeds as follows: (i)the sum of FOUR HUNDRED NINE DOLLARS AND FORTY-EIGHT CENTS ($409.48) be allowed and made payable to SOBO & SOBO, L.L.P. as full payment of the dishwsements expended (a listof the disbursamsts expended is attached hereto as "Exhibit 3"); (ii) and as is consistest with the Retainer, one-third of the balance of said settlement after disbursements is awarded for attomey's fees, such amount being TWO THOUSAND FIVR HUNDRED DOLLARS ($2,500.00) be made payable to SOBO & SOBO, LLP. as full payment for professional services; and (iii)the entire balance of said settlement, to wit, the sum 0.f FOUR THOUSAND FIVE HUNDRED NINETV DOLLARS AND FIFTY-TWO CENTS ($4,59052) is to be to paid to the Plaintiff and the same is to be deposited into a separate bank account bearing solely the name of the infantplaintiff herein, as the sole and exclusive beneficiary, and such. funds shall receive guaranteed interest at the applicable rate, and that such funds must remain in said accountwithout interference of any kind without further Order of this Court. 20. Neither I,nor any 1ñêñiber of my law fùm, became concemed in the settlement at the instancs of a party or person opposing, or with interests adverse to, the Infant, directly or indirectly; nor received, nor will receive, any compensation from such party; tiorrepresented and do not now represent any other person asserting a claim arising from the same occurrence. 21. No previous application for the relief sought herein has been made to this or to any court. WHEREFORE, your deponent prays the court to make and enter an order herein for the relief sought. Dated: August 9, 2019 Middletown, New York Respectfully, SOBO & SOBO, LLP By Julie S. Raphael, Esq Attorneys for Plaintiffs One Dolson Avenue Middletown, NY 10940 P: (845) 343-7626 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF ORANGE ---------------------- ---------------------X LM., an Infant by her rnother and Natural Guardian IVANIA ALVAREZ-BERMEJO and IVANIA ALVAREZ-BERMEJO, Individually, ATTORNEY'SAFFIRMATION ne: EXCHANGE OF ORDER Plaintiffs Index No.: EF004011-2019 -against- LILIAN MARIE SAMUEL, Defendants. JULIE S. RAPHAEL, ESQ., an attorney admitted to practice before the Courts of this State, affirms the truth of the following under the penalty of perjury: 1. I am an associate of the law offices of SOBO & SOBO, L.L.P., the retained attorneys for the Plaintiffs herein, and as such I am fully famili.ar with the facts and circumstances of this action herein and the matters at bar. 2. Your affirinant cati attest and fully confirm that the within proposed Order of Comproinise has been exchanged via regular U.S. Mail and by facsimile with the liability insurer for the Defendants, to wit, State Farm Insurance Company, in advance of the presentation of such papers to Court. 3. As such, this Hon. Court should take note that the Defendant's insurer has been afforded an opportunity to review the same and voice any objections to the relief sought herein. Dated: August9, 2019 Middletown, New York Julie S..Raphael, E dg) SOBO & SOBO L.L.P. Attorneys for Plaintiffs One Dolson Avenue Middletown, New York 10940 Exhibit 1 ChiroCare ' INITIAL CHIROPRACTIC c h Iropractic CONSULTATION 52 D.ason Avenue,:Suite 200 call: (845) 342-2225 Middletown,NY 10940 Fax: (845) 343-8759 Date: March 3, 2016 Patient's Name: Patient's Account #: 87632 CX105015 Date of Birth: Case Type: Motor Vehicle Accident (Geico) Date of Accident: March 3, 2016 Subject: INITIAL CHIROPRACTIC CONSULTATION History of_Present Injury The patient is a 3-year-old right-handed Hispanic female, stands 2 ft6 in, weighs 32 lbs. The patient is being seen for Injuries sustained fro.m a motor vehicle accident on 03/03/16. is here today for the injuriessustained on a prior motor vehicle accident, her mother is present due to her age. Her mother explain she was the front seat belted driver of the vehicle, her daughterelibAllmllMBIlillinevas the car seatbelted, passenger located behind the front passenger seat. As anniandla's mother was driving, she states another vehicle pulled out running a stop sign, impacting their vehicle on the front driver's side. Her mother imrñêdjately grabbed onto Isabella's head and neck trying to testrain her daughter. Unfortunately, the car seat was tossed around the vehicle with the 3 year old baby, upon irnpact. was taken to the nearest emergency facility,where she was examined and released the same day. She now suffers from localized neck paindlmansneshrange of motion is noted to be limited, when turriingher head from leftto right Daily activitieswill worsen her condition. Subjective Symptoms The patient presents to the office today with the following symptoms: trequent (51% to 75% of the time) pain and stiffness in her neck rated as a 7/10 on the Numeric Pain Intensity Scale Page 1 . ........... Orthopedic Tests Range of matica or (ROM) is the measurement of the achievable distance between the flexed position and the extended positish of a particular jointor muscle group. ROM. studies conducted on the patient yielded the following results: Cervical N A Pain Flexion 60 50 E Extension 5.0 40 E R Lat Flexion 45 40 El L Lat Rex 45 40 R Rotation 80 60 L Botation 80 60 E . .. The shoulder depression test looks for a painresponse by compressing the nerves/vessels into arms. This test produced a positive response bilaterally. Palpation Evaluatfor1 Palpation of thecervical region revealed,+2 spasms and +2 tendemess. Further examinaGen reveals hyperirritable taut bands in the paracervical muscles which elicit radiating pains upon stimulation. Palpation of the splnal ragians reveals misalignments/asymmetry and taut and tender fibers in the folicwiñg areas: C5 and CS, Chiropractic Manipulative Thsrapy was applied to these levels of the spine to correct th.a rnotion irrthe joints giving proper alignment and function to the affected areas. Other Objective Findings Moderate swelling is noted in the cervical grea. Diagnosis Based on the patient history and examination results, the following cliagñcsis can be posited: Cervical Subluxation Page 2 Treatment Plan and Recommendations The diagnosis and treatment plan was formulated based on information presented by the patient and her guardian and on objective examination findings. The diagnosis and treatment plan was shared with the patient and her guardian. The benefits and risks of care were expia|ñed to them, and differerit options or alternate types of treatment were discussed, aswell as possible outcomes if thepatient chose to remain untreated. The patient and her guardian had the opportunity to ask questions regarding the diagnosis and treatment plan and any concerns were addressed. Informed consent discussion took. place and the patient and her guardian verbalized consent to commence with-the recornmended treatment plan, The patient 1s scheduled to receive chiropractic care three (3) times a week for six weeks at which time a reexamination will be performed.. Re-examinations willbe performsd periodiusily to re-assess tha patient's response to the treatment plan. Due to individual and genetic differences, some patients respond faster to care, and some do at a slower pace. The treatment plan will also be re-assessed and updated according to the patient's response. will be receiving Chiropractic Manipulative Therapy to correct the motion in the joint giving proper alignrnent and function to the affected area of the spine and help optimize biomechanics and relieve pressure on pinched nerves to allow the inflamed nerves to heal. enlilmannonillalso be receiving the following therapeutic m.odalities: Manual Therapeutic Techniques such as manual stretching to relax opastic muscles, improve jointplay and reduce pain associated with tissue impingement; manual trigger point release of tightknots and bands in the muscles to increase blood flow and uncornpress nerves; strengthening using counter-resistance to increase stren.gth and improve muscle tone; myofascial release to relieve tension in tha fascia, improve or normalize movement pattems through the reduction of soft tissue pain and restrictions, improve physiologic function and support homeostasis; and manual traction.to open the affected joint/disc spaces causing compression, irritation,and inflammation to the affected nerve roots to improve joint mobility and decrease muscle tightness and tension associated with pain and decreased range of motion. Superficial Heat to raise the temperature of soft tissues to Increase circulation and relax muscle tension thereby reducing painful muscle spasrns. In 4 weeks, the patient's pain level willbe reduced by 2 points on a pain scale, range of motion will improve by 10%, strength willimprove by 10%, endurance will improve by 10%, tolerance to sitting wiliimprove by 10%, tolerance to standing willimprove by 10%, functional abilitieswill improve by 10% and overall condition wiltimprove by 10% The initialgoals of treatment are.to glleviate pain, decrease muscle spasms, increase range of motion and reduce inflamrnation. Long-term goals of treatment are to eliminate pain, eliminate muscle spasms, restore normai range of motion and eliminate inflammation. Prognosis The possibility of the patient's condition becorning permañêñt cannot be ruled out at this time. The patient's activities of daily living have been limited by the severity of her sympto.ms. As a Page 3 result of the traumatic injury, there were extremes of joint movement with c0iicomitant stretching and tear|ñg of the musculo-"gamëñtous structures of the carvical spine. Itappears that these areas may be weakened for an ladefiniteperiod of t