How to Handle Your Own Injury Claim: Part 2 Treatment Phase

Disclaimer: This information offered in this post is for offered for informational purposes only, and does not constitute legal advice nor does it create an attorney/client relationship. I am admitted in the state of North Carolina only and make no attempt to opine on matters of law that are not relevant to that state. This advice is based on general principles of law that may or may not relate to your specific situation. You should not rely on this advice alone and nothing in these communications creates an attorney client relationship. Seeking direct advice from an attorney in person may be advised.

The number one thing to remember here is that if you feel injured, you should seek treatment. Period. Don’t worry about what an insurance adjuster says, don’t worry about who’s going to pay for what. Your health is the most important thing and if you are injured, or even think you are injured, making sure your health needs are met should be your number one priority.

So where should you go? The answer is wherever you want. I often explain to clients that my job as an attorney isn’t to direct your medical care; after all, what qualifications would I have to do that? My job in this context, however, is to tell you what impact your health care decisions may have on your claim.

At the outset, depending on how badly you are hurt, you may not have any choice about health care. If you are taken by EMS to a hospital, that’s done. No choosing there. Just remember, if you can, to ask about all of the different entities involved in your care. You will want to know from whom to request bills and records when this is all said and done. More on that later.

Afterward, your injury will guide your care. You may seek advice from your family doctor. You may go to a chiropractor, you might get physical therapy, acupuncture, massage therapy. You may need surgery. There are many options, dependent of course on your injury.

Much of what you would need to know here is situation-specific, so it’s difficult to generalize and give good information. However, there is some amount of general info that you may find useful in determining where to seek treatment:

• The sooner you seek treatment, the better. Insurance companies use “gaps in treatment” (time between the accident and treatment, or large time period between treatment) to devalue your claim. So if you’re hurt, get treated ASAP; don’t play tough.
• If possible, it can be helpful to follow up with your primary care doc, who can then make treatment referrals for you. It will look better if someone else is saying you need the treatment, not just you choosing to get treated.
• Many victims with soft tissue injuries (sprain/strains, generally in the neck and back) choose to go to a chiropractor.
  • Positives: They are specialists in these types of injuries and are very knowledgeable, generally. They will often withhold collection on their bill pending settlement, which helps with reducing out of pocket expenses.
  • Negatives: Insurance companies often discount chiropractic bills unilaterally, making it hard to get their bills paid in full, and for whatever reason don’t respect them as much as other providers, which can make settlement more difficult.
• You can get reimbursed for massage, but it is normally best to couple it with    chiropractic or PT, and it is always best to have it prescribed, if possible, by a physician or health care provider of some type.
• If it’s different than it was before the accident, it needs checking out. Many victims walk around with traumatic brain injuries, wondering what happened to them, simply never putting the accident together with their symptoms, as they can sometimes be delayed. If it doesn’t feel right, get it checked out!

There is a phrase you should learn right now: Maximum Medical Improvement. This means the point at which you have reached a plateau in your recovery from these injuries. You should not even think about valuing your claim or documenting your medical treatment until AFTER you have reached this point. How do you know you’ve reached it? You will know, or your doc will tell you – one or the other.

Remember: It is best NOT to sign a blanket release for the insurance company to get your records and bills. Get them and provide them to the insurance company yourself! EVEN if the release says it’s only for these injuries, health care providers almost never read them, and if the insurance company asks for unrelated stuff that may hurt your claim, they may give it up!

Whatever you send may be used against you…but you have to send something…so do it.