I'm often asked if not being fully and completely compliant with the terms of your medical care can have an impact on the value of your car accident or other personal injury claim. An analogous scenario is one in which a car accident victim waits and does not seek prompt medical attention after an accident. An insurance claim adjuster will frequently seize upon this delay in the initial provision of medical care and use it as evidence in an argument that the individual was not seriously injured. The insurance rationale here is that
....if they were hurt, they would have gotten medical care immediately.
Insurance claims adjusters, and the very effective insurance defense attorneys they hire, frequently couple this argument with a contention that the injured individual did not actually seek medical care until after consulting with an attorney. The suggestion here, of course, is that the individual was not seriously injured, but rather sought medical care simply for the purposes of building a personal injury case.
The focus of this article, though, involves a situation in which an individual who very well may have gotten immediate medical care after having been involved in an accident, nevertheless misses scheduled physical therapy, chiropractic adjustments, diagnostic testing or other medical appointments. A common scenario that I see is for a doctor to recommend that an individual attend physical therapy, for example, 3 times per week.
- What happens where that individual only attends therapy 1 time per week?
- What happens where that individual waits 7, 8, or 9 days before commencing that physical therapy course?
- What happens if that individual attends therapy regularly for a period of a week or two, then misses several weeks of treatment and returns later to complete the course of therapy.
I can tell you from experience what happens. Here the door is thrown wide open for the careful and observant insurance claims adjuster, or skilled defense lawyer, to use those gaps and delays in medical care to argue that the individual simply was not hurt, for surely, if they were as injured as claimed, they would have fully availed themselves to the benefit of prompt and consistent medical care and attendance. It should be understood and accepted that attending physical therapy or chiropractic appointments when also having the burdens of everyday life: jobs, children, and other obligations can be difficult. Unfortunately, it is a fact that many judges and jurors will view gaps, or uneven attendance, with a less than sympathetic eye. Judges sometimes adopt the arguments of defense counsel, literally word for word, and rule that the delay in treatment means that the individual was not hurt, or that gaps in the treatment suggest that they are not injured or that the reason for the medical care provided has nothing to do with a car accident.
A related situation is one in which an individual completes a course of recommended treatment, whatever that might be, and is released by thedoctor. The typical instruction from a physician they circumstances is to return to care should their condition worsen, or if a flare-up occurs. This seems like perfectly reasonable advice, and indeed is a time-honored tradition in medicine – sometimes called a P.R.N. release. If an individual relates waits “too long” to return to that doctor, the savvy insurance claims representative, or seasoned defense counsel, will likely argue that the individual waited to return, and therefore any additional treatment, virtually by definition, cannot be related to the accident. Judges sometimes adopt the arguments of defense counsel, literally word for word, and rule that because an individual waited “too long” to seek follow-up care, therefore, the additional symptoms cannot be related to the accident. What constitutes “too long” may well depend on the proclivities and leanings of the individual judge or jury hearing the case- not a very precise standard.
Accordingly, my standard advice to those who have questions after being involved in an automobile accident is twofold:
- If you have been injured, or realistically think there is a possibility that you might have sustained an injury, get checked out by a doctor and do so immediately. It just makes sense from a practical, and medical, perspective to quickly identify and begin to cure or remedy any injury.
- Secondly, if a doctor recommends that you do something- do it. Follow the doctor's orders in each of the particulars. If a test is recommended, promptly schedule the test. If home exercise and medications are recommended, engage in the home exercise and take the medications as prescribed. If a course of physical therapy or chiropractic care at a given interval at a given frequency is ordered, then complete that course and attend each scheduled visit. If circumstances arise that cause you to miss a single visit, then reschedule promptly. Again, putting any legal considerations aside, it just makes good sense to do what the doctor says and to fully avail yourself of the benefits of medical treatment to assist in the process of recuperation, and to aid in a speedy and complete recovery.