personal injury claim denied due to lack of medical care | Dallas Fort-Worth personal injury lawyer

Our Dallas-Fort Worth Personal Injury Lawyer Discusses the Importance of Prompt Medical Care After an Accident

Traffic accidents and on-the-job injuries can be very scary. Whether it is your first or you have been down this road before, there are some things you should know as you make medical decisions going forward. This article will help you understand your options as well as what actions are important for you to take promptly. If you'd like to discuss your case in detail, we encourage you to schedule a consultation with our experienced Dallas-Fort Worth personal injury lawyer

Seek Immediate Medical Attention

If you suspect you are injured as a result of an accident someone else caused, you should seek medical care immediately for two reasons:

  1. Some injuries do not manifest immediately.
  2. Insurance companies use delays and gaps in care against you.

Reasons for Unseen Injury or Delaying Feeling of Pain

The human body is an amazing work of art. It has the capacity to protect and heal itself in many respects. As a result of this, we often have a tendency to blow off injuries and assume our body will just heal itself with time and rest. Many times when a person suffers an injury in a car accident, however, the body has a difficult time healing by itself.

Injuries from auto collisions and work accidents are extremely common. The forces involved in 4000-5000 lb. vehicle collisions are immense, even at seemingly slow speeds. While manufacturers are doing more and more to design vehicles to take these impacts with less damage, the human body remains the same. It is not designed for the pulling, twisting, and tearing of muscles and ligaments that a whiplash injury can produce. Injuries on the job, such as injuries from defective or faulty machines, improperly guarded machines, or other dangerous conditions, are also very common.

Pain From the Body’s Reaction

Sometimes the effects of a whiplash injury are not fully realized at the scene of an accident. There are several reasons for this. First off, the muscle and ligament stretching and tearing cause the human body to go into a healing mode. Your body begins to produce fluids in the damaged area. Swelling occurs and the site of injury. As your body stiffens up from these effects, you often begin to feel more and more discomfort. This may take hours or even days.

Stress-Induced Analgesia Masking the Pain

There is a condition known as “stress-induced analgesia” that sometimes occurs following the scare of an accident and enables an injured person to temporarily block out the pain mentally. When a person is in a very stressful situation, the body releases noradrenaline into the bloodstream. Noradrenaline, a/k/a norepinephrine, is a hormone that acts as a neurotransmitter in the central nervous system and sympathetic nervous system that blocks the transmission of pain to the brain. When a person is “stressed out” by an accident, they may block out the pain until a later point, at which point things calm down; the noradrenaline levels return to normal as suddenly pain is perceived by the brain again.

If you suspect injury at all or suspect that your body is causing pain, you should seek immediate medical attention. Emergency rooms for hospitals, as well as independent centers, are a good place to start.

Adjusters Use Lack of Care to Deny or Low-Ball Claims

Another reason to seek necessary medical care promptly is that it will benefit you when filing an auto accident claim. Thanks to tort reform in this country, juries are very distrusting of people claiming injuries in auto collisions—particularly injuries that they cannot see objectively. Insurance adjusters know this. The more they can misguide you into not seeking care in a prompt and reasonable manner, the lower the value of your claim in the eyes of jurors and adjusters. Additionally, many adjusters use computer software to analyze your claim. This software is just an algorithm that adds or decreases the settlement offer they will make based upon certain activities you took that they input into the system.

Here are some of the medical care mistakes they commonly deduct from your offer for:

  • Not calling an ambulance
  • Not going to a hospital from the scene
  • Delays in seeking the initial medical care
  • Delays in following up after the initial medical care
  • Not following doctor’s orders
  • Missing scheduled appointments
  • Gaps in your medical care
  • Not filling prescriptions
  • Seeking “alternative,” “holistic,” or “experimental” types of medical care

If you do not want to get treated unfairly, your best bet is to seek reasonable and appropriate medical care promptly for your injuries and follow the doctor’s orders. You should also consider consulting with a personal injury attorney if you have not already done so.

Should I Use Health Insurance?

When you are involved in an accident, health insurance policies will often pay the bills upfront and seek reimbursement from a third-party insurance carrier and/or out of any settlement later. This is called insurance subrogation. If your health insurance company refuses to pay, you should consider contacting the Texas Board of Insurance and reporting them.

Caveat: Some medical providers (like many primary care physicians) refuse to see you under health insurance for certain types of accidents. That is because they know that some health insurers will give them the runaround about paying when there is a third-party insurer involved. Again, consider a complaint to the State Board of Insurance if this is happening to you.

Will Car Insurance or My Employer Cover My Medical Expenses?

In an automobile or trucking accident, the other party’s insurance company will generally not pay for your medical care as you get treatment. They will also not give you advice on seeking care generally. More specifically, you should not ask for their advice in obtaining care because they owe a duty to their insured to hold down your cost, not to help you get better. Delays and gaps in your care work to their benefit.

Your own insurance can be helpful in seeking medical care if you have personal injury protection or medpay coverage. Both of these can help cover initial bills, copays and deductibles for medical care. Be aware you need to check your limits of coverage. Most of these policies we see are very low, ranging from $2,500 to $10,000, but some personal injury protection policies go up to 50,000 or 100,000. These policies can also cover therapy and chiropractic costs.

In workplace accidents, if your employer has workers’ compensation insurance, then your employer and this insurance will cover your medical expenses and treatment. In this case, under Texas law, you will be precluded from asserting legal actions against your employer. If your employer does not have workers’ compensation but some other form of employee injury plan, your employer and this plan will cover your medical expenses and treatment. In this case, under Texas law, you CAN assert legal actions against your employer. Often times the employer does not inform the employee whether the medical care is being paid for by a workers’ compensation insurance company or an injury plan. This is deliberate.

What Happens When I Have No Medical Coverage?

If you do not have health insurance, PIP/med pay, Medicare, or Medicaid, there are still ways to obtain the medical care you need to recover from your injury. An attorney can issue a letter of protection (LOP) to medical providers who accept LOPs. A letter of protection is simply a letter promising that the bills will be paid out of any settlement or judgment obtained. If no recovery is made, however, the person receiving the treatment is still responsible for the bills.