Why Medical Treatment Compliance Is Critical for Your Injury Claim
After a car crash or any type of accident that causes you injury, any attorney worth their salt will advise you to seek medical treatment as soon as possible. The most obvious reason for this is your physical health – you need to address any immediate and traumatic injuries to ensure they do not become life-threatening, as well as mitigate the threat of any hidden or internal injuries. The other, perhaps less obvious, reason is to protect your potential legal claim.
A personal injury claim is a civil legal action you take against another person or entity when their negligence or wrongdoing causes you a serious or catastrophic injury. The point of this type of claim is to recoup the losses you experienced due to the other party’s negligence. This can include things like your medical expenses, lost wages, future earning ability, and pain and suffering.
However, at the risk of sounding glib, most people cannot just file a claim against a negligent party and expect a big and easy payout. The other party’s insurance company, their attorneys, or even your own insurance company will likely fight you the entire time in an effort to either undercompensate you or even deny you compensation altogether.
Not only is it crucial to have experienced Kentucky injury attorneys advocating for you, but it is also important to ensure you do everything “right” after your accident so the other side has as little ammunition as possible. One of the best things you can do to keep your claim – and your physical and mental wellbeing – strong is to follow your physician’s treatment program to the letter.
Why do some people delay medical treatment?
You or your loved one might decide to put off seeking medical attention after a car accident, slip and fall, or other accidental injury. This decision could be for any number of reasons, including:
- Not realizing they are badly injured
- An overall reluctance to seek medical treatment
- Assuming injuries will resolve on their own
- Not wanting to spend money on a doctor
- Being in denial that they are injured at all
Whether or not you feel seriously injured, you should always seek medical treatment after an accident.
The importance of medical treatment compliance
Seeing a doctor after an accident is typically only the beginning of your treatment journey, especially when you have severe injuries, like a traumatic brain injury or spinal cord injury. Your physician will set up a treatment plan that may include further testing, specialists, physical therapy, and other actions to help you recover from your injuries.
It is vital you take this treatment plan seriously and follow it to the letter. Doing so documents the following:
- You sought treatment as soon as possible
- A physician determined the extent of your injuries
- The physician determined a treatment program for your injuries
- You cooperated with that treatment plan
When taking legal action against the party that caused your damages, you have a duty to mitigate your injuries (meaning not making them worse) by seeking and following the treatment recommended by your medical provider. As we mentioned earlier, the insurance company is not going to take your word for it that you suffered a catastrophic injury. They will want to see hard evidence in the form of medical records and documents, and they will also want to ensure you have done everything you can to achieve maximum medical improvement (MMI) from your injuries.
Many insurance companies utilize sophisticated software when evaluating claims. The algorithms and programs do not consider the practical occurrences that can cause delays in medical treatment. Life happens and there are barriers to treatment that prevent people from getting needed medical attention. There are a number of factors that justify a lack of treatment including: lack of availability of a specialist, the lack of health insurance, or the inability of an injured person to recognize that an injury is simply not going to get better on its own.
Sophisticated computer programs incorporated by many insurance companies do not recognize these practical obstacles, which often delays medical treatment. In many cases, the programs penalize a person with a personal injury case for failure to get consistent medical treatment. For instance, in many cases, if medical treatment is not received at least once every 30 days, a lot of programs will devalue the claim. Other insurance companies penalize injured parties for what is called a “gap in treatment.” A gap in treatment occurs when a person does not receive any medical treatment in 30 days, 60 days, 90 days, or more.
While these issues can be overcome with a skilled personal injury attorney, it certainly makes the case more difficult and often leads to less-than-optimal results. During a personal injury lawsuit, it is usually beneficial to an injured person’s case if an injured party’s treatment is both timely and consistent.
What happens if you cannot access care?
If you fail to get medical attention after an accident, if you fail to get follow-up treatment, or if you only follow your treatment plan sporadically, this inaction can allow the insurance company to:
- Claim you were never injured
- You were not injured as seriously as you claim
- Offer less compensation than to which you are entitled
- Deny your claim altogether
They may also refuse to offer compensation for pain and suffering, alleging you experienced only minor injuries. To claim pain and suffering damages for a Kentucky motor vehicle accident claim you must have at least one of the following:
- At least $1,000 in medical expenses
- Permanent disfigurement
- Bone fracture
- Loss of a body part
- Permanent injury, to a reasonable medical probability
- Permanent loss of body function
Treatment compliance equals increased medical documentation
The more documentation you have regarding your injuries, the better. Every visit to your physician or specialist goes into your medical file, which helps build your personal injury case. In addition to help proving the existence and severity of your injuries, this documentation helps demonstrate that the defendant’s negligent action’s caused them.
It can also help show that you had no pre-existing conditions previous to the injury sustained in the accident. Or, if you did have a pre-existing condition, this medical documentation can demonstrate that these injuries are new and separate, and caused by the accident.
Finally, your medical records help your attorney, insurance company, or a jury determine the proper amount of compensation for your damages – including economic and non-economic, pain and suffering, and expenses you will incur in the future.
After any type of accident, ensure you or your loved one seek medical treatment immediately. Protect your health, your wellbeing, and your potential personal injury case. The Kentucky personal injury attorneys at Wilt & Associates, PLLC understand how to navigate the insurance claims process, and can provide the guidance you need to help keep your case on track. To schedule a consultation, call our offices, or reach out through our contact form. We serve people in Louisville and Lexington, and throughout the state.