As an attorney, hired by clients to manage their personal injury cases and try to negotiate the best settlement for their injuries, there are few things more frustrating than a client who seems hell bent on making my job more difficult by undermining their own personal injury case. Obviously (you hope), they aren’t doing it on purpose. But, by doing or not doing certain things, they are drastically reducing the odds of getting the best settlement offer available for their injuries.
In this series of posts, I would like to discuss a few key areas where the client’s cooperation in handling their own case can either improve or seriously undercut their settlement offers.
Simple things clients need to do to help their case in the area of medical treatment
Seek immediate medical treatment
The definition of “immediate” in this area will vary depending on how bad your accident and injuries are. If you are severely injured, you should go to the emergency room immediately following the accident, either by ambulance or other means. That means go straight to the hospital, do not stop, do not pass go, and if you do, you absolutely will not collect your $200. If the accident and injuries are less severe, then you should see a medical professional no later than 2 days after the accident.
The argument from the insurance agent’s perspective in this case is quite simple. If the client didn’t hurt bad enough to go to the doctor right away, then the injuries couldn’t have been that severe. The longer you wait to seek treatment, the more impact this argument has. Also, the longer you wait, the greater chance something else happens (like you falling down because your leg hurts from the accident) that allows the adjuster to argue that it wasn’t the accident that caused you to seek treatment, it was this new fall. So it makes this point very simple… When you get injured… Go see a medical professional as soon as possible!
Avoid having a “Gap” in your medical treatment whenever possible
What do I mean by a “Gap?” Lets say you are in the middle of treatment for your injuries, such as a physical therapy schedule. One day you start feeling better, so much better in fact that you don’t think you need to continue going to therapy. So, you stop making appointments. Time goes by, maybe 3 or 4 months, and you start feeling awful again. So, now you start making appointments again. Now you have a “treatment gap.” Similar to the argument above, any time you stop getting treatment for your injuries, it allows the insurance adjuster to argue that you had in fact gotten better and were completely healed, and the reason you are back in therapy has absolutely nothing to do with your original injury.
If you are feeling better and think that you are ready to end a specific treatment schedule, make an appointment with your doctor. Have him do a final exam and write a report. If he isn’t sure about the recovery being complete, he will write that in his report. It may sound something like, “patient appears to be doing better, advise stopping physical therapy for 6 weeks, will re-evaluate at that time.” Then if you are actually better in 6 weeks, you are covered. If you aren’t, and you need to go back to therapy, then you have medical documentation that shows why you stopped, not just because you (with your years of medical education) decided you were healed.
Follow the medical advice and instructions your Doctors give you
Now this may sound too simple to warrant spending any time discussing, but in reality it happens way too often for common sense to play a role. What I am referring to here is failing to do your part to ensure your recovery stays on track and is properly documented.
When you have an appointment, for an exam, a test, or physical therapy, go to the appointment! If you don’t, there is a record of the appointment being made and you not keeping it. If you aren’t going to your appointments, then you aren’t injured. That isn’t my opinion, that is what the insurance adjuster is going to argue!
If the doctor puts you on an activity restriction, such as light duty, follow it. If you are placed on light duty, you don’t go play rugby on the weekends. Because, when you show up at the doctors office the next week for a follow up and he notes in the report that you have scrapes and bruises on your body, the adjuster is going to know you are doing more than you should on your restriction. That gives them a chance to argue that your injuries would have healed faster if you had stayed on light duty and then they stop offering to compensate for any medical expenses after that appointment.
If the doctor prescribes you medication, fill the prescription and take the drugs! If there is a reason you don’t want to take them, let the doctor know and they will adjust your prescriptions as needed. But, if the insurance company reads the records and sees that you aren’t filling your pain medication prescriptions, then there is that familiar argument that you aren’t in pain, so you no longer injured.
Avoid over-exaggerating your recovery when describing how you feel
Unless you are a miserable curmudgeon who just likes to complain, it is natural to want to feel better as fast as possible. But, medical professionals are trained to document everything you say in terms of your condition. When a doctor asks how you are feeling, and you say “much better” or “I’m great” they write that down. What you might have meant was “I’m feeling much better… than I was,” or the “I’m great” comment could have been meant to be very sarcastic, but that doesn’t get conveyed in the records.
Now don’t misunderstand me, I’m not suggesting that you lie about your condition or recovery progress at all. What I am saying is that you should think about the answers you give to medical providers when they ask questions. If you are feeling better than before, but you are still in a significant amount of pain, make sure you say that in full, don’t just say you are feeling better. If you leave it at “feeling better,” there is an above average chance that your attorney will have to deal with that statement during negotiations, and a good chance that simple statement could cost you a few dollars in the end.
These 4 simple factors can have a drastic effect on the leverage your attorney has when trying to negotiate a settlement offer with the insurance company. If you do your part with each of them, it gives the attorney all the documentation they need to prove the extent of your injuries. If you fail to keep up your end of the bargain, the attorney has nothing to use as a defense when the insurance adjuster starts to point out that you obviously weren’t hurt that bad since you stopped taking your own medical treatment seriously.
You want your attorney to do everything in their power to get you the best settlement offer. Trust me when I say that your attorney wants the same thing, but can’t do it without a small amount of your cooperation.