Medical Treatment after an Auto Accident
A personal injury attorney has several responsibilities once retained by an accident victim. One of the most important is to ensure that you get the proper medical treatment after an auto accident.
In the past several months, I’ve taken on 3 injury accident cases from the Dixon, Illinois area (1 in Dixon, 1 in Sterling and the other in Rock Falls). All 3 cases share a common theme, and that is, it’s critical to get the right medical treatment.
It’s all about the medical records
My client “Sam” was injured when a car ran over her foot causing an avulsion fracture. She was treated at the emergency room at CGH Medical Center and her foot was placed in a cast. Unfortunately, due to various hardships, she was unable to keep several of her appointments with her orthopedist and she did not follow her doctor’s instructions to stay off her foot and go to physical therapy.
We overcame these difficulties and obtained a just settlement with the defendant’s insurance company which was double their original offer. But it highlights a significant point – if your doctor tells you to do something, do it.
Insurance companies are seldom moved by stories of hardship. They are interested in what your injuries are – specifically, they want to see the ICD Codes describing your injury.
ICD stands for International Classification of Diseases. It was created to track international health trends but insurance companies use it to evaluate the severity of injuries.
When you are done with your medical treatment, your attorney will provide the insurance company with your medical records. The insurance company will enter the data, including the ICD Codes (and other data provided by your attorney), into a computer which will estimate the value of your injury.
The ICD code for our client’s injury – “S92.254A: Nondisplaced fracture of navicular of right foot” – was the basis of their settlement offer.
My other client “Rob” was injured when a taxi cab took a left turn in front of his motorcycle. He suffered a severe wrist fracture that has required two years of treatment. The case is in litigation and as such I won’t comment more other than to point out that Rob had “medpay”(medical payments) insurance on his auto policy and also had health insurance. As such, his auto insurance covered the first $5,000.00 of his medical bills and his health insurance has covered the rest.
However, both insurance companies have filed liens with our office. This means that it is mandatory that we reimburse them for the money they paid his medical providers. If you receive a lien from an insurance company or health care provider, inform your attorney at once.
See your primary care physician first
My third example highlights what not to do after an accident. We ultimately did not retain this individual as a client as she ended up being at fault for her accident. However, after her accident, she did not see her primary care physician first. Instead, she went directly to a chiropractor for treatment.
Chiropractors are generally frowned upon by insurance companies though they provide legitimate treatment. This is especially so if the injured party does not seek guidance from his or her primary care physician first.
As such, if you are in an accident, always go to your primary care physician before seeing a chiropractor, getting a MRI or going to physical therapy.
- It’s important to avoid “gaps in treatment.” A gap in treatment is a long delay between the date of the accident and the treatment you obtain. This is a big reason why insurance companies deny claims.
- When you settle your case, you must pay back your medical providers out of the settlement. It’s unfair – you’ve paid your insurance premiums for years. But when you purchased your insurance plan, it likely contained a subrogation provision that required reimbursement for medical treatment caused by another party’s negligence.
- The defendant’s automobile insurance company will NOT pay your medical bills until you settle your case. As such, you must pay your deductible and co-pays or they will go to collections.
Finally, all these issues are secondary to your health – that’s what’s important. As such, when deciding to obtain or not obtain medical care, base it on your goal of getting yourself healthy, not on whether it’s good or bad for your case.
This blog is for entertainment and informational purposes only. It is not intended as legal advice and the accuracy thereof is not warranted or guaranteed. This information is prone to errors and omissions. Use this information at your own risk. Reading this blog does not create an attorney-client relationship. All content in this blog is owned by the creator. This blog may include copyrighted information. Use of this information constitutes a “fair use” of this material.