How Gaps in Medical Treatment Affect Your Injury Claim
After being injured in an accident, your doctor may want you to go for additional testing, come back for follow-ups and even see other doctors.
You may be tempted to cancel your doctor’s appointment or skip your treatment sessions because you are starting to feel better. Or, you may have trouble making appointments because of work or family commitments. Missing appointments can quickly lead to “gaps” in treatment that the insurance company will use to deny all or part of your claim.
What is a Gap in Treatment?
Although there are different types of gaps in treatment, not all are created equal. It is normal to have time between appointments or delays while waiting for testing, but it is the amount of time, or manner of delay, that can impact your case.
In particular, the two primary gaps in treatment that an insurance company will try to use against you are illustrated in the following examples:
You were in an accident, but let several days or even weeks pass before you first sought medical care for your injuries. Often these victims think they just need a little time to feel better.
You saw a doctor for your injuries, but then let several weeks, or months, go by before you saw them again. This example often involves missed or canceled appointments that were otherwise scheduled.
Put simply, your health and well-being are the most important reasons behind avoiding gaps in treatment. But it is also important to attend your medical appointments for the benefit of your claim. Your medical treatments are documentation of your injuries – and insurance companies will use “gaps” in your treatment against you to pay you less than you deserve.
There is a very simple way to avoid all of these problems: commit to attending all of your scheduled medical appointments – from the very beginning of your medical treatment until the very last appointment when you are finally released from your doctor’s care. We also recommend you keep a journal of your visits, pain, and symptoms – new or existing.
If there is a reason you cannot keep a scheduled medical appointment, be sure to contact your medical provider and detail your reasons why you cannot make the appointment. (Also, be sure to reschedule the appointment.)
Many gaps in treatment occur because of miscommunications with a doctor. If your doctor’s advice isn’t clear on when you should return to his office, be sure to ask at the end of your appointment. You should also call your doctor to make a return appointment if you are still having symptoms from your injuries or your symptoms are getting worse than what you or the doctor expected based on your last office visit.
Now, there are two common reasons we often hear clients explaining gaps in treatment:
Not having insurance to pay for medical treatment (or not being aware of existing insurance)
Not knowing medical providers that clients feel they can trust, or not knowing what type of providers they may need to see in the first place
We can help with both and are often advising our clients around insurance and medical resources they didn’t know were available.
Whether you have a gap in treatment or not, you will need to talk to a good personal injury attorney who will present your case for you and help you claim the maximum compensation possible.