Treatment FAQ

how to dispute gaps in treatment personal injury

by Mr. Eloy Goldner Published 2 years ago Updated 2 years ago
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One thing you need to do is let your personal injury lawyer know if you have a gap in treatment for any reason. Your attorney can properly document any gaps in treatment following a car accident and will note if it was for a legitimate reason. This will prevent the insurance carrier from using that against you while negotiating the injury claim.

Full Answer

What is a gap in treatment in a personal injury claim?

Secondary to that, if you decide to file a personal injury claim, a gap in treatment could lessen your compensation greatly. What's a Gap? There are two types of gaps in treatment; one is the gap between when you got in the accident and when you first start treating injuries from that accident.

Are gaps in treatment destroying your case?

How gaps in treatment destroy your health and your case. The most common mistake people make during their personal injury case is allowing gaps in their medical treatment. A gap in treatment is a period of time where a patient misses treatment with one of their health care providers.

Why is there a gap in my appointment schedule?

Sometimes a gap simply cannot be avoided. You may experience a sickness or illness that prevents you from making your appointments. For example, maybe you had an unrelated surgery that required extended healing time, that would be an acceptable explanation for the gap.

What are the most common mistakes people make in personal injury cases?

The most common mistake people make during their personal injury case is allowing gaps in their medical treatment. A gap in treatment is a period of time where a patient misses treatment with one of their health care providers.

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How do you explain a gap in treatment?

The term “Gap in Treatment” is insurance industry lingo. It means there has been a long period of time between an injury and when you go to the doctor or hospital. Or alternatively, a long delay between one medical visit and the next.

Can I negotiate an injury settlement?

Indeed, it means you're ready to demand the compensation you deserve for your suffering and losses. If you are determined to seek fair compensation for your losses, you must be prepared to negotiate with the insurance company (or, more specifically, the claims adjuster) to get what you want.

What is the injury gap?

A “gap,” in this scenario, is a period of time during which you do not receive medical treatment. In a personal injury case, the insurance company assigns an insurance adjuster to evaluate and make a determination on the value of your claim.

How do you negotiate pain and suffering?

10 Tips for Negotiating Pain and Suffering:Manage Your Expectations for Compensation.Know What Counts as Pain and Suffering.Support Your Claim with Outside Factors.Tell a Vivid Story of Your Pain and Suffering.Describe Your Distress During Recovery.Link Evidence to Your Pain and Suffering.More items...•

How do you respond to a low settlement offer?

Steps to Respond to a Low Settlement OfferRemain Calm and Analyze Your Offer. Just like anything in life, it's never a good idea to respond emotionally after receiving a low offer. ... Ask Questions. ... Present the Facts. ... Develop a Counteroffer. ... Respond in Writing.

How do you ask for a bigger settlement?

Let's look at how to best position your claim for success.Have a Settlement Amount in Mind. ... Do Not Jump at a First Offer. ... Get the Adjuster to Justify a Low Offer. ... Emphasize Emotional Points. ... Put the Settlement in Writing. ... More Information About Negotiating Your Personal Injury Claim.

Should I accept the first offer on a personal injury claim?

Unless you have taken independent legal advice on the whole value of your claim, you should not accept a first offer from an insurance company.

How much pain and suffering should I ask for?

For example, if you had $50,000 in medical costs and other hard costs, and your suffering was rated at about a 3, then the pain and suffering damages should come to about $150,000 (3 x $50,000 = $150,000).

How do you scare insurance adjusters?

The best way to scare insurance carriers or adjusters is to have an attorney by your side to fight for you. You should not settle for less.

Why do I have a gap in my treatment?

A gap in treatment does not mean you are not injured. Chances are that if you have a gap in treatment it was not because you weren't experiencing pain and problems. Sometimes a gap simply cannot be avoided.

Why is it important to avoid gaps in treatment?

Put simply, your health and well-being are the most important reason behind avoiding gaps in treatment. When you have injuries from an accident you may be living with them for the rest of your life. The severity may lessen with treatment, but chances are the residual effects will continue to affect you. It is in your best interest to take care of your health and stick with the treatment your doctor suggests, and if you do decide to file a claim it will really help your case.

What is the purpose of an insurance adjuster in a personal injury case?

In a personal injury case, the insurance adjuster will be looking for ways to devalue your claim. If they see that there is a gap in your medical treatment they will try to use this as evidence that your injuries are not as severe as you are claiming. That is why it is important not only to meet with your doctor regularly, ...

What happens if you have an accident?

When you have injuries from an accident you may be living with them for the rest of your life. The severity may lessen with treatment, but chances are the residual effects will continue to affect you. It is in your best interest to take care of your health and stick with the treatment your doctor suggests, and if you do decide to file ...

Why is it important to keep up with appointments?

It is extremely important that you keep up with these appointments, because consistency of care is going to benefit you greatly. Secondary to that, if you decide to file a personal injury claim, a gap in treatment could lessen your compensation greatly.

What Defines a Gap and How It Affects Your Claim

A “gap,” in this scenario, is a period of time during which you do not receive medical treatment. In a personal injury case, the insurance company assigns an insurance adjuster to evaluate and make a determination on the value of your claim.

Reasons for a Gap

There are many legitimate reasons for gaps to exist in a personal injury victim’s healthcare timeline. Some people experience unrelated illnesses, family concerns, transportation issues, or other unavoidable matters which prevent them from making their medical appointments.

Tips for Managing Your Medical Care in a Personal Injury Case

We strive to empower our clients to do all they can to put themselves on a path of success toward optimum health and maximum recovery of damages. When it comes to health and legal matters, being attentive, dutiful, conscientious, and proactive makes all the difference.

Get Expert Legal Advice from Belsky, Weinberg & Horowitz, LLC

The best reason to properly manage your healthcare regimen is to protect your health. Your physical wellbeing is the all-important issue following an injury-causing accident. You may have been hurt in a work-related event, car or other vehicle accident, medical malpractice case, or slip and fall incident.

Gaps in Medical Treatment and Your Personal Injury Claim

After an accident, you should seek emergency medical evaluation. In some cases, an accident victim may only feel sore at first and not go in for such an evaluation until later on when the pain gets worse. The delay between the accident and seeking medical attention is one type of medical treatment gap that can be present in a personal injury claim.

New York Personal Injury Attorney

Attorney Michael LoGiudice fights for the injured. He doesn’t let insurance companies try to get out of paying his clients full and fair compensation for the harm they have suffered. Contact us today.

What is the best treatment for a broken leg?

There are two types of medical care: rehabilitative care and palliative care. Rehabilitative care is when the doctors are trying to stabilize your injuries to keep you from getting worse. Once stable, doctors try to heal your injuries. For example, a broken leg may require surgery and then a cast to maintain alignment while the fracture heals. After the cast removal, doctors prescribe physical therapy to improve your strength, flexibility, and muscle function. In other types of injuries without a broken bone, the treatment is designed to reduce the pain and inflammation. Reducing pain and inflammation helps your muscles return to normal. This takes pressure off nerves and breaks the pain cycle. Once the healing process begins, the doctors will change your treatment plan. This helps the body strengthen and increases flexibility.

What happens if you don't take care of your body?

If you don’t do the maintenance and palliative care, your body will experience the effects of arthritis sooner. You may also experience degeneration of the joints, ligaments, and tendons. As a result, you will experience a rapid decline in your health. This may require more serious treatment such as pain management or surgery. From a purely logical standpoint, it is extremely important to maintain your health at the highest level possible. Think about this: star athletes who are in great health and injury-free, take advantage of palliative health care to maintain high-quality health and maximum bodily function.

Why do people delay medical treatment?

The two most common reasons why people have delayed medical treatment in an injury case are: 1. Their pain is not greater than the “inconvenience” in getting medical treatment. Many clients who I have settled cases for have told me that they did not have the time to see or follow-up with a doctor. I try to be as sympathetic to this as possible ...

Does delay in treatment affect settlement?

A delay in treatment may not affect your settlement if the value of your case, after all reductions, is greater than the available liability insurance coverage. I settled a case involved in a herniated disc for $16,500 (gross) with Geico.

Treatment Plans & Personal Injury Claims

The prescribed treatment plan can vary significantly depending on the severity of the injuries sustained in an accident. Someone who breaks an ankle in a slip and fall accident may only need a cast for the joint and a couple of months of physical therapy to restore full mobility.

What Qualifies as a Gap in Treatment?

During the evaluation of a personal injury claim, the insurance carrier will look for two types of gaps in treatment:

Typical Injury Treatment Timeline Following an Accident in Florida

As we mentioned before, the timeline and recommended course of treatment will vary depending on the severity of injuries and physical characteristics of the individual (age, physical condition, pre-existing illnesses, etc).

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