We thought it would be worthwhile to take a look at some of the common questions our clients have about how their medical treatment might affect their case. After all, medical treatment and documentation of that treatment are key to helping you potentially get the most out of your claim.
6 Key Questions About Medical Care After Your Injury
1. Why do I need to seek immediate medical care after an injury? What if I don't feel much pain?
There are two important reasons.
First, you should have a medical professional evaluate you to see if there are any potential issues you may not be aware of.
Second, you want to make sure a licensed physician documents your injuries immediately after an accident. If your condition worsens and you have to make a medical claim, this initial documentation is largely what insurance companies use to determine the extent of your injuries. It is very important.
When you're in a car accident, there's a lot going on in your body, and sometimes you may not feel pain right away – especially with soft tissue injuries, like whiplash. Your body is reacting on adrenaline, and adrenaline helps keep pain away, for a while. Your brain activity tends to focus on other things rather than your pain. You may be thinking, "I have to get to the day care to pick up my daughter before it closes," or "I have to be at that 9:00 presentation at work."
Or maybe you're like many of us and are just too busy to go to the doctor for what you think is just a bruised knee. That bruised knee could turn into something else when you start overcompensating for it.
Sometimes the pain may not seem like much at first. Maybe a 1 on a scale of 10. But the moment you feel pain or discomfort, that's a red flag. It's your body's way of telling you something is off. Something is wrong. You hurt something in your body. You may not feel any pain right away, but it can kick in later, maybe even one or two days later.
The longer you wait to go to the doctor about your pain, the more you could be hurting your recovery and your legal case.
2. Why is it so important what I tell the treating doctor?
Whatever you tell the doctor is what they usually write in your records.
You need to be specific and focus on your present injuries and exactly where you feel pain. Is your knee making a clicking or popping sound? Is there a dull ache or a stabbing burning pain? Does it give out? What is your pain level on a scale of 1 to 10? Don't try to "tough it out" and minimize your pain to the doctor. This information is what the doctor uses to determine your diagnosis and the treatment he or she thinks will help you recover. It is your responsibility to tell the doctor what you are feeling.
This is also the information the insurance company typically pays very careful attention to. Some insurance companies might try to look for something from your records that they can potentially use to try to minimize payment. And, that initial meeting with your doctor is where they have sometimes tended to focus their efforts.
Be truthful about your pain, but don't volunteer unnecessary information. Experience has taught us that what you say in your first few evaluations actually can count more than what you say seven months later. The insurance company may go back to the first day when you said "I have a little bit of pain." You know your mind was on something else – picking up your daughter or getting to that meeting – and you didn't even think of what you were saying. Regardless, the insurance company may try to use it anyway. We’ve seen this happen, and we don’t want to see it happen to you.
3. Why do I need to keep up consistent medical care?
Whether you were injured in a car wreck, hurt on the job, or have a Social Security Disability claim, one of the most important things you can do to help your case is to keep up your medical care. Doing this will not only put you on the path to recovery, but you will also have legitimate and accepted documentation that you are injured and undergoing treatment for your injuries.
Medical treatment is what helps bring value to your case. We rely on your treatments, medical records, and medical bills to help give value to your claim. If you don't have medical bills because you have not been to your treatments, that can sometimes make your claim all the more difficult.
The things we try to collect for are medical expenses, lost wages, and sometimes pain and suffering. But, the majority comes from medical treatments. That is one of the reasons people come to us for help. They can't pay their medical bills after a car wreck or work injury. Your medical records show the issues you suffered and how much you paid for treatment.
If a doctor prescribes treatment for any length of time and you don't abide by your doctor's orders, the insurance company may view this as negligence on your part and possibly claim you are impeding the healing process. And, they may not want to pay you as much or at all.
4. Why can't I see my chiropractor first if I only have a soft tissue injury, like whiplash?
If you are severely injured, you should go directly to the ER. Otherwise, go to your primary care doctor immediately. Urgent care would be a last resort just because they don't know your history, and they generally don't treat patients long term.
For a variety of reasons, you want to make sure you initially see a licensed medical provider, such as your primary care doctor, a physician's assistant, a nurse practitioner, or other licensed medical providers of this nature.
First, a primary care provider can prescribe you medicine for pain and inflammation, etc.
Second, as I mentioned earlier, your primary care provider will evaluate you, determine what they think is wrong, and develop a treatment plan to help you recover. That may or may not involve going to a chiropractor for adjustments. The doctor may feel your recovery plan should involve physical therapy instead of chiropractic treatment. It is your treating doctor who should be the one managing and monitoring you and your treatment plan with any other medical professionals.
Finally, what we have seen is that records from a primary care provider who has prescribed a sound treatment plan tend to hold more weight with the insurance companies than injured patients who self-diagnose or come up with their own recovery plan. In the insurance company's eyes, having a medical doctor advising you carries more weight and can potentially help your case.
5. Why can't I be in charge of my own medical treatment plan?
From the insurance company's perspective, having a licensed physician at the helm of your overall treatment plan is the best course of action for your recovery. It is the most credible evidence we can present to try to get them to pay your medical bills. Plus, a doctor should know what is best to help you try to get back to the state you were in before your injury.
Because we have dealt with insurance companies for so long, we know what they need to possibly pay your claims.
6. Why is my lawyer and paralegal so concerned with my medical care?
We act as our clients' advocate in so many ways. Without someone advocating for your medical treatments with the goal of helping you get better and trying to get compensation from the insurance company for you, we have seen some unfortunate situations.
For example, we once represented a client who came to us complaining of back, hip, and pelvic pain after a car accident. Our client had already been seeing a doctor who previously ordered an MRI of his back and hip.
For some reason, our client went back to the doctor's office just prior to the MRI and saw the physician's assistant (PA). (It is generally ordinary procedure to see the PA after the doctor has evaluated you first.) We don't know what transpired during that visit, but whatever it was led the PA to cancel the MRI. Our client went back and forth in pain, seeing the PA for months.
When he hired us, our medical review team scoured through all his medical records back to day one. We finally uncovered that the doctor had never given him an official diagnosis! That is very likely why he ordered the MRI – it would have potentially given the doctor an image of where the injury had occurred and what the client's treatment plan might have been going forward. He had been treating for back pain all this time, yet he was having hip and pelvic pain. That test could have been the linchpin our client needed to show the insurance company why he kept going back and forth to the doctor for all those months, as well as the documentation he needed to get them to pay for his medical bills.
Our first concern was how we could help our client get better. If we tried to get the doctor to order an MRI months later, insurance was not going to pay for it because there was no initial diagnosis. And, this poor man had no health insurance. Without an MRI, how could we say his pain was from an injury he had sustained in the car accident that happened so long ago?
At the end of the day, he did not get the treatment he needed because he did not have someone to advocate on his behalf from the beginning, like we do for our clients. By the time we stepped in to put all the puzzle pieces together, it was too late for him to get the MRI that could have helped show what was wrong. While we were able to collect from insurance*, sadly, this client was still in pain.
This story shows that it all goes back to initial communication, evaluation, and documentation from the doctor and to having someone like a good lawyer advocate on your behalf sooner rather than later.
Most people don't realize how important these things are to their recovery efforts.
As advocates, we are helping to encourage you to communicate what is necessary, follow up with your medical provider, and try to keep all your appointments. We collect all that documentation to show the insurance company the evidence and the proof they may need to calculate a potential compensation amount.
At the end of the day, it's hard to argue with well documented facts.
NC Personal Injury Lawyers Offer FREE Case Evaluation
It is for these and many other reasons we urge people to contact us immediately after they have been injured. We can try to get your case started on the right foot and potentially keep you from making some of the mistakes we have seen others make that have damaged their claim.
If you've been injured in an accident and need an advocate in your corner, contact us now to find out if we may be able to help you. Or call us at 1-866-900-7078.
*Each case is unique and must be evaluated on its own merits. The outcome of a particular case cannot be predicated upon a lawyer's or a law firm's past results. Client identity has been removed or changed to protect privacy.