Dr. Bill Gallagher 2014-05-06 23:24:26
Did You Miss These? The value of a personal injury case is dependent upon two major factors. First, is how complete a demand letter is and second or perhaps it should be first, is how well the treating doctor documents everything. If the doctor does not provide you the information the insurance company looks for, then there is no way for you to demand payment. When an adjuster receives your demand letter their job becomes one of data entry. If you have a diagnosis it will be entered and will be given a value. If you include supporting tests and symptomology the value will go up. If the doctor has not documented all the decision points and value drivers then the value will go down. It is that simple. That said there are things that are all too often missing. Sometimes that is because of the doctor and sometimes the attorney. So let’s take a look. MISSED DIAGNOSES • Concussion: 50 percent of occupants in a low speed collision will suffer a concussion. When there is damage to the vehicle that number goes up to 80 percent. The sad part is most cases I have reviewed, do have mentions of symptoms that add up to concussion. But if the doctor has not included the diagnosis, then it will not add any value to the case. • Contusions: Bruising across the shoulder from the seat belt or scrapes on the arms from the airbags are actually worth more in Colossus than many other injuries. Here a picture is worth a thousand words and probably another thousand dollars. • Supraspinatus: This muscle along the upper part of the scapula is the most commonly strained muscle in the body. The test is one of the easiest to do and when documented adds to the value. When not documented there will be no reimbursement. • Anxiety: What accident victim does not suffer from “white knuckles” after an accident? Sadly, few doctors include this diagnosis and less work with a therapist who can treat the condition. Anxiety can affect “loss of enjoyment” and that alone is 25 percent of the value of your case. • Failure to Treat: All too often a diagnosis is listed, but there is nothing in the notes to show treatment or referral. As important as a diagnosis code may be, not treating will invalidate that diagnosis and call the rest of care into question. MISSED LEGAL POINTS • Mileage: At 56.5 cents/mile this one adds up. Every trip to your office, the doctor, pharmacy or physical therapist is an expense and you should ask for reimbursement. On a typical case this can add one or two thousand dollars to the client’s losses. • Diminished Value: It is not enough to get your client’s vehicle repaired. When the time comes to sell it, the buyer will find that it has been in an accident and will pay a lot less. That diminished value needs to be part of your demand. • Settlement Value Factors: There are four main things the insurance company will pay for and if you don’t ask, they won’t tell you. These are (1) injury types, (2) loss of enjoyment, (3) duties under duress, and (4) whole person impairment. Leave one of these out and you are leaving 25 percent of the money on the table. Omit two of them and most demand letters do just that, and you will be leaving half the available funds in the insurance company’s account rather than yours. WHOLE PERSON IMPAIRMENT No case should be closed without this one. The AMA Guides provide ratings for every injury to the body. Sprained ligaments, once stretched stay stretched. Whiplash involves sprained ligaments and can be rated at up to 28 percent if properly documented. Without testing and having only the patient’s complaint of neck pain, that number gets capped at 3 percent. Hence the need for proper testing. These are only a sampling of what is covered in my classes for attorneys and chiropractors. To get the most out of a personal injury case there needs to be synergy between the doctor and the attorney. If the doctor fails to provide the documentation needed, then the attorney will be going into battle unarmed. Dr. Bill Gallagher, DC has been in practice using Directional Non-Force Technique for over 25 years. His research for the technique has led to improvements of adjustments in all areas of the body. He can be reached by email at email@example.com or (480) 664-6644. For more information visit, www.drbillgallagher.com
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