When you’ve been injured in a car accident, slip and fall, or other incident caused by someone else’s negligence, getting proper medical treatment is important for your health. But it can also have a significant impact on your personal injury claim.
One of the first things an insurance company will look at when evaluating an injury claim is your medical treatment history. Unfortunately, missed appointments and significant gaps in treatment can give the insurance company an opportunity to question the seriousness of your injuries.
If you have questions about how your medical treatment may affect your personal injury claim, call the Law Offices of Scott M. Syat, P.C. at (617) 773-3500.
Insurance Companies Pay Attention to Gaps in Treatment
A “gap in treatment” generally refers to a period of time when an injured person stops receiving medical care despite continuing to claim that he or she is experiencing pain, limitations, or other symptoms.
For example, suppose you are treating for neck and back injuries following a motor vehicle accident. You attend physical therapy regularly for several weeks, but then stop going for a month or two before returning because your symptoms continue.
You may have had a perfectly legitimate reason for the interruption. Perhaps your work schedule made appointments difficult. Maybe you were caring for your children or another family member. You may have had transportation problems, been traveling, had difficulty obtaining an appointment, or simply hoped the injury would improve on its own.
The insurance company, however, may look at that same gap very differently.
An insurance adjuster may argue:
If you were really in that much pain, why weren’t you receiving treatment?
Did your injuries actually improve during the period when you weren’t seeing a doctor?
Did something else happen during the gap that caused your current symptoms?
Are your current complaints really related to the original accident?
These arguments can affect how an insurance company values your claim.
Your Medical Records Tell the Story of Your Injury
In most personal injury cases, medical records provide much of the documentation needed to establish the nature, severity, and duration of an injury.
Regular treatment can create a chronological record showing your symptoms, your doctors’ findings, the treatment you received, how you responded to that treatment, and whether you continued to experience limitations.
When there are lengthy unexplained gaps, that story becomes less complete.
Remember: months after an accident, an insurance adjuster was not there to see how much pain you were experiencing or how your injuries affected your everyday life. The adjuster is often evaluating your claim primarily through records and other documentation.
If there is little or no medical documentation for a significant period of time, the insurance company may use that absence of records against you.
If you have already experienced a gap in treatment, don’t assume that your case has been ruined. There may be legitimate reasons for the gap that can be explained and documented. Call the Law Offices of Scott M. Syat, P.C. at (617) 773-3500 to discuss your situation.
Follow Your Doctor’s Recommendations
It is also important to make reasonable efforts to follow the treatment plan recommended by your medical providers.
If your doctor recommends physical therapy, a specialist evaluation, diagnostic testing, or a follow-up appointment, failing to follow through may create another issue for the insurance company to raise.
An insurer may argue that your condition would have improved sooner if you had followed the recommended treatment.
Of course, every situation is different. There may be legitimate reasons why a particular treatment was delayed, discontinued, or never performed. The important thing is to communicate with your healthcare providers and your attorney when those circumstances arise.
What If You Have to Miss an Appointment?
Missing an occasional medical appointment does not automatically damage a personal injury case. Life happens.
If you cannot make an appointment, however, cancel it when possible and reschedule it promptly.
More importantly, don’t simply disappear from treatment for weeks or months while continuing to experience significant symptoms. If you believe you no longer need treatment, discuss that with your healthcare provider. If treatment isn’t helping, talk with your doctor about whether another approach may be appropriate.
Your medical decisions should always be based on your health and the advice of your healthcare providers—not simply on your personal injury claim.
Don’t Exaggerate or Treat Just to Build a Case
There is an equally important point on the other side of this issue: you should never seek unnecessary medical treatment simply because you have a personal injury claim.
Treatment should be reasonable and medically appropriate.
Be honest with your doctors about your symptoms. If you’re getting better, say so. If something still hurts, explain it. If certain activities are difficult, tell your healthcare provider specifically what you’re experiencing.
Credibility is extremely important in a personal injury case.
Talk to Your Attorney Before a Treatment Gap Becomes a Problem
If you’ve been injured in an accident and circumstances are making it difficult to continue treatment, talk to your personal injury attorney.
There may be legitimate reasons for a gap in treatment, and those circumstances can sometimes be documented and explained. It is much better to address the issue when it occurs than to try to reconstruct what happened months later when the insurance company is evaluating your claim.
At the Law Offices of Scott M. Syat, P.C., we help injured clients understand not only their legal rights, but also the practical issues that can affect the value of a personal injury claim.
Injured? Call Us Today
If you have been injured because of someone else’s negligence, don’t wait until the insurance company raises questions about your medical treatment.
Call the Law Offices of Scott M. Syat, P.C. at (617) 773-3500 to discuss your personal injury claim.
The consultation is free, and there is no attorney’s fee unless we recover compensation for you.
This article is for general informational purposes only and is not intended to constitute legal advice. Every personal injury case is different, and the outcome of a particular case depends upon its specific facts and circumstances.