On Dec. 5, 2010, plaintiff Levan Kukava, 33, a taxi driver, was operating his Ford Fusion taxi on Fell Street when he entered an intersection with Divisadero Street and was struck by a 2008 Land Rover operated by Elspeth Hellerman. The force of the impact threw Kukava’s vehicle into a nearby Acura TL before it came to rest. As a result, Kukava claimed back . Kukava sued Hellerman and the owner of the Land Rover, Michael Scanlan. He alleged that Hellerman was negligent in the operation of the Land Rover and that Scanlan was negligent for entrusting Hellerman with the vehicle. Scanlan was later dismissed from the case. Thus, the matter continued against Hellerman only. Kukava claimed that he had a green light as he entered the intersection and that Hellerman ran a red light, causing the collision. Hellerman conceded liability., Immediately after the crash, Kukava was dazed and disoriented, and was subsequently brought home, where he attempted to rest. The following morning he awoke with a severe headache, neck, mid- and low back pain, and generalized weakness. He subsequently reported to his treating physician, who diagnosed Kukava with a cervical strain, a thoracic strain, a lumbosacral strain, chest wall contusions and post-traumatic anxiety. Kukava was then referred for a course of physical therapy, as well as the use of a transcutaneous electrical nerve stimulation unit and X-rays of the cervical and lumbar spine. On Dec. 14, 2010, Kukava began physical therapy. He claimed he experienced some relief, but still had pain in his lower back. An MRI was subsequently performed on Jan. 27, 2011, which revealed small lumbar disc bulges at L2-3, L3-4 and L4-5, with bilateral foraminal narrowing, mostly at L4-5, on the left. He was then told to continue physical therapy and, if there was no relief, epidural injections would be considered. On March 25, 2011, Kukava underwent a lumbar epidural steroid injection and a second lumbar epidural injection on April 23, 2011. However, he claimed that he only received 25 percent relief from the epidural injections and that the benefits were temporary. The plaintiff’s treating physician opined that Kukava would likely continue to be symptomatic from his lower back injury, and that significant flare-ups would require additional intervention of epidural steroid injections or ligamentous injections of the lumbosacral spine. He also opined that Kukava would require 10 to 14 sessions of physical therapy per year, over the next two years. Kukava claimed that he had no prior history of neck and back , but that he now continues to experience ongoing pain and limitation with daily activities, as well as experiences difficulty sleeping as a result of his lower back pain. He also claimed that his profession includes long shifts of sitting, which aggravates his lower back. Kukava’s cousin and coworker testified to the dramatic change in lifestyle Kukava had undergone since the accident and the impact his ongoing have on his life. Defense counsel argued that the treatment of Kukava’s alleged harm was excessive. Counsel noted that Kukava did not claim any injury at the scene and that the plaintiff waited four days before receiving any medical treatment. The defense’s orthopedic surgery expert testified that Kukava showed no objective signs of injury from the accident and opined that Kukava’s MRI showed degenerative changes that likely pre-existed the accident. The expert also testified that Kukava’s type of disc bulges and foraminal narrowing were common occurrences that were not caused by the accident. Thus, the defense’s expert orthopedist disputed the need for Kukava to undergo epidural steroid injections and the need for any future physical therapy, but otherwise found Kukava’s treatment to be reasonable.