Permissible Medical Treatments in a Personal Injury Claim

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[Below is a transcription of the podcast]

This is Ann Margaret Perkins with Perkins Law Firm and today I’m going to be talking about permissible medical treatments in a personal injury claim. We need to differentiate between what the law says if you’re trying a case and how the medical treatment you receive affects your ability to settle your claim outside of court.

If your case goes to court, the jury is entitled to determine if you were injured and the extent of that injury. You can have an expert testify about your injuries, but that’s not required. You can testify about what your symptoms are and how those affect you. You can’t, however, testify about your diagnoses. That is something only an expert can testify about. (Now if you happen to be a medical expert, you can testify about diagnoses.) An expert who testifies about diagnoses can be a chiropractor, a medical doctor, and maybe even a physical therapist. There’s no one specific degree or specialty that a person has to have to testify about the diagnoses. I frequently have both the doctor and physical therapist, if my client is seeing a physical therapist, testify because they talk about different things. The doctor primarily talks about what the injury is, and that therapist talks about the treatment.

You can testify about what bills you incurred for treatment that you receive from your injuries. No expert has to testify about that. So if your case goes to court you can testify about what you felt before an injury and after, what treatment you got and the amount of bills that you incurred. Based on your testimony a jury could return a verdict for you to compensate you for all of those things.

What if you don’t go to court? Most insurance companies are not going to evaluate a claim very high if there’s not some medical treatment and some expert who’s providing information about what the diagnoses are. My experience is that many insurers find medical doctors more believable than chiropractors. I think that is changing some over time as chiropractic becomes more accepted and appreciated,  but it’s still undervalued in terms of the insurance industry.

Insurers have opinions about the believability of specific doctors. If you treat with a doctor the insurer finds unbelievable, they are not going to evaluate your claim as high as if you treat with a medical provider they find to be believable. One particular type of doctor insurers are looking very hard at these days are pain management doctors who only prescribe narcotic pain medicine and give very expensive injections.

My advice with regard to your medical treatment is to get the treatment you need from a provider who is focused on helping you, not one who is focused on building your claim. Your claim will benefit more from treating with a reputable provider than one who is looking to run up the bills. You may have $10,000 in bills with a doctor or a chiropractor who the insurer doesn’t find believable and that claim is going to be worth less than a claim where you have $2500 in treatment with a doctor or chiropractor who is seen as credible. And odds are if a provider is not very credible with an insurer you have to wonder will they be seen as credible with the jury. So your focus needs to be on picking good, capable medical providers and getting the treatment they recommend.

Juries and insurers are very reluctant to pay for treatment that has been recommended but you haven’t gotten. That’s true even if you say you will get at some point down the road. Even if you are able to get a doctor to give you an estimate of the cost of that treatment, insurers are not going to pay you dollar for dollar what that estimate is since it is just a possibility.

The law doesn’t require any particular type of medical treatment in order for you to recover for your bodily injury, but there is certain treatment that insurers do consider more valuable than other when evaluating claims. That doesn’t need to drive your medical decisions, but you need to be aware of the things that can negatively affect your claim. If you have someone suggesting you see a medical provider for the purpose of building your claim.

I hope you have found this podcast to be helpful. If you want to talk about this or any other subject related to personal injury or wrongful death, you are certainly welcome to call us 770-834-2083 or check out our website injuryispersonal.com. Hope you have a great day.