Importance of Seeking Medical Treatment



Why is Medical Treatment so Important to my Personal Injury Claim?

If you have been injured in a motor vehicle accident in North Carolina, it is likely that you are confused, stressed and concerned about what to do next. The reality of being in a car accident is that your life could be turned upside down. Just yesterday, you were healthy and carefree. Today, you are nursing your bruises, cuts and injuries.

Look at your car accident-related injuries as you would any other traumatic illness or injury. Ask yourself whether or not you need medical treatment. It is important to ask yourself this question as early as possible. It is also essential to consider whether you need emergency medical services, such as an ambulance, as early as possible.

One of the most common mistakes made by accident victims is to refuse or delay medical treatment. After years of speaking to accident victims, I have discovered that most people delay seeking medical care because of the costs associated with seeking treatment. It is recommended that after an accident you seek medical treatment regardless of the cost, so long as the treatment is reasonable and necessary. While treatment may be expensive, there are several options that may provide you with a way to receive treatment on a lien basis, which would require no money upfront.

Get Immediate Medical Attention

If you have been injured in a car accident, it is important to consider what medical attention you may need and to seek that medical treatment as soon as possible. If you need emergency medical care, consider calling 911. Seeking medical treatment immediately after your accident is important for the following reasons:

  1. Your injuries need to be treated as soon as possible.
  2. Showing a causal connection between the accident and your injuries is more difficult if you have delayed seeking medical treatment.
  3. Failing to seek medical treatment could result in a failure to mitigate damages.

If your vehicle has been damaged or destroyed in the accident, it is important to seek the assistance of your friends and family to get to and from your medical appointments. If your friends or family are unable to assist you, consider using a taxi or purchasing a bus pass in order to get to your appointments. However, please be sure to keep your receipts and to track your mileage and appointment duration so that you may claim out-of-pocket expenses.

If you do in fact have health insurance, whether it is private health insurance, Medicaid, Medicare, TriCare or State Employee’s Health Plan, it is recommended that you give this information to the medical provider when seeking treatment. If you do not have health insurance, the medical provider who is treating your injuries will likely bill you directly or claim a lien on the treatment rendered.

It is essential to remember that the medical treatment you receive for your accident is the most important evidence in your personal injury claim. Your medical treatment will be reviewed, analyzed, audited and even debated by the insurance company and their medical experts when considering your personal injury claim’s value. As such, it is paramount to ensure that each and every aspect of your medical care is as appropriate and reasonable as possible.

IMPORTANT NOTE: Your medical care is the fuel in your personal injury case’s gas tank. It is not only important to put lots of fuel in your tank; it is also vital to put the right kind of fuel in the case’s tank.

Remember that if you need treatment, you should seek treatment. Only a licensed medical professional can properly diagnose your injuries, and delaying your recovery could actually cause your injuries to become worse.

Be Careful What You Say About the Case to Your Doctor

As a practical piece of advice, your medical providers are treating your medical concerns and tend to be unconcerned by the legal aspects of your personal injury case. As such, be careful when discussing the facts and circumstances related to your accident. It is far too common that my client’s medical records contain notes from the doctor that attempt to describe the mechanics of the car accident but fail to do so accurately. As a precaution, be careful when describing the accident to your doctor and make sure all the details you share are completely accurate.

Ask yourself: Is it important that the doctor knows each and every fact related to the mechanics of your accident, or is it essential that they only know the fact that you were rear-ended and suffered injuries as a result?

What if I Don’t Have Health Insurance?

There are many factors to be concerned about after an accident, and the most notable among them is the decision to seek medical care even though you do not have health insurance. While your principle concern is how you will afford the expensive medical treatment, consider the cost of not seeking medical treatment and delaying your recovery. In most situations, there are two ways to seek medical treatment without health insurance: (1) receive the treatment and the medical provider will bill you, or (2) receive the treatment and the medical provider will claim a medical lien.

Regardless, your medical treatment without health insurance under North Carolina Rule of Evidence 414 may actually be more beneficial to your overall recovery than medical treatment paid by a health insurance company. For more information about this information and Rule 414, visit our Billed Versus Paid page.

Should I Use My Health Insurance?

Generally speaking, you should use your health insurance to pay for accident-related medical treatment. However, this does not mean that the medical provider is obligated to bill your health insurance. It is not uncommon for accident victims who provide their Medicaid information when receiving medical care to later discover that the medical provider did not bill Medicaid. Medical providers are exceptionally clever when it comes to getting paid for their services.

First, a medical provider may not be obligated to bill your health insurance. Secondly, a medical provider may receive more money from you if they refrain from billing your health insurance and claim a medical or physician lien (link). While this may be surprising, consider what the medical provider will likely receive from the Division of Medical Assistance (Medicaid) as payment for services rendered on a $1,000.00 bill. The answer is rather surprising. Depending on the provider, Medicaid may pay a few hundred dollars at most on their $1,000.00 bill. The reason being is that Medicaid has negotiated significant cuts with the medical providers to keep costs low.

On the flip side, a medical provider who refrains from billing Medicaid and receiving a significant cut to their $1,000.00 bill can claim a medical lien and seek reimbursement for the entire $1,000.00 bill. If this seems unfair, stop for a moment and read our Billed Versus Paid article. While no one wants to pay more for the same treatment, being able to claim $1,000.00 of damages as opposed to a few hundred dollars may actually be more beneficial to your claim for damages.

However, this does not mean that you should refuse to use your health insurance. Most insurance companies will refrain or delay settlement negotiations with an accident victim until it has been determined whether the victim has health insurance or not. Even if you do not, the insurance company may request that you sign an affidavit of no health insurance. An affidavit of no health insurance is a sworn statement by an accident victim attesting to the fact that they have no health insurance.

Which Doctor Should I Go To?

If you have been injured in an accident, assess the severity of your injuries. If you feel that you need emergency medical services, it is important to go directly to the emergency room. However, if you do not need emergency medical care, consider calling your primary care physician and making an appointment.

If you have called your primary care physician and your appointment will be in three weeks, consider going to an urgent care facility or calling another primary care physician for an earlier appointment.

However, once you have visited your first doctor, whether it was in the emergency room or the urgent care facility, be sure to ask the doctor when you should follow up. If your follow-up is in several weeks, and you are feeling worse before that appointment, do not hesitate to go back sooner. While following your doctor’s advice is always recommended, consider your pain and injuries and feel free to seek additional care when needed.

How Long is Too Long After the Accident to Go See a Doctor?

As a general rule of thumb, and in my opinion, any accident claim involving an individual who has not received some kind of medical treatment within the first seven (7) to ten (10) days will experience some difficulty in making a claim and/or proving damages.

This general rule does not mean that you should forego or refrain from seeking medical treatment if you are unable to receive medical care within the first seven to ten days after an accident. There are many exceptions to and factors that affect this general rule. On a practical note, general rules do not apply to all facts and circumstances.

Follow Your Doctor’s Instructions

After your accident and while seeking medical treatment, it is important to follow your doctor’s instructions. If your physician recommends that you should be written out from work, you should refrain from working. Being written out from work by your physician may result in a lost wage claim. The most common mistake made in personal injury claims in North Carolina arises when the accident victim fails to follow up and adhere to the recommended treatment plan. Should your physician recommend that you follow up in a week, you should do so. By the same token, should your doctor recommend that you receive physical therapy three (3) times per week for four (4) weeks, it is important that you do so. Failing to follow your doctor’s instructions can and will be used against you in your claim with the insurance company.

IMPORTANT NOTE: Visiting your doctor’s office and seeking treatment may be stressful or even pain-inducing (depending on the procedures), so you may consider bringing a notebook and documenting what the doctor recommends that you do so that you will be able to reference the doctor’s specific instructions later.

Should your doctor provide you a referral to a different physician or directly to a specialist, contact that medical provider immediately. Many specialists are extremely busy, and appointments may not be available for some time. If the medical specialist that you contact has no availability, consider contacting your doctor again and asking for a referral to another specialist.

Treatment Mistakes to Avoid

Through years of dealing with insurance adjusters and evaluating our clients’ medical records, we’ve noticed that the most common mistakes accident victims make are:

  • Over-treating (continuing to seek treatment past what is deemed reasonable and necessary to reach your maximum medical improvement)
  • Double treating (treating with two or more similar providers for the same injuries)
  • Missing appointments (constantly cancelling your scheduled appointments or not showing up to scheduled appointments)
  • Having large gaps in treatment (waiting too long to seek medical treatment or having lengthy gaps between scheduled appointments)
  • Not following doctor’s orders (not following up when scheduled, not using prescriptions per instruction, not utilizing referrals to specialists as needed and not complying with home exercise plans).

These mistakes can not only delay your recovery but can also severely harm your personal injury case.


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