Hi everyone! Our good friend Martin Ginsburg has graciously agreed to join us once again to share his unique blend of legal and medical expertise. For today's topic, Mr. Ginsburg will be discussing the methods by which an injured claimant can tell if he or she is likely to need medical care in the future, as well as some pointers for integrating that information into a personal injury claim. Mr. Ginsburg continues to be extremely generous with his wealth of knowledge, and we're grateful for his help!
How can I tell if I'll need future care?
When people are ill or injured, there is always a concern about whether their recovery is “complete.” There are several ways to look at this question, and I’ll try to at least touch on the different perspectives.
Your care doctor will direct your care and recommend treatment to try to bring you a complete recovery from any injury or illness. Since this blog deals with injury, I’ll just use that phrase; but much of this information will apply to chronic illness too.
Some things heal completely; sprains, strains, cuts, scrapes, and so much more. One thing to remember is that damaged tissues in the body, despite healing, often have scarring (just like a deep cut in the skin). Tears in soft tissue (muscle, ligaments, or tendons), breaks in bone, breaks or tears in other tissues (spinal discs rupture; liver, kidney, colon, lung), or the classic hernia all leave this type of scar.
This doesn’t mean that there is necessarily any impact on the quality of someone’s life or their ability to do all the things they did before an injury, but there are often concerns for re-injury.
Some injuries, especially to joints, just don’t heal as completely as others. This is usually a function of how much that particular body part is used. In cases like this, a doctor can explain what impact an injury may have over time. Some injuries will require further treatment in the form of x-ray, pain management, and possibly even surgery. Joints that have already had surgery are more likely to need future surgeries. While not an absolute, there is a risk that your doctor should be asked about.
Future care is one of those things that really varies from patient to patient, and even different doctors may have differing opinions as to how much of what treatment is necessary. When I have discussed things like this with patients I’ve had over the years, I have always defaulted to teaching; you’re the one who has to live in the body you’ve got – you decide what is enough and what needs to be done to get you to where your life should be. Naturally, your doctor will not do surgery just because you say that’s what you want, but when you and your doctor discuss options, the choice among those options always belongs to the patient.
So how do you tell all this to the insurance company?
If a patient decides to represent themselves, I could only offer that the medical record will contain any recommendations for past, current, and future treatment by the doctor who knows you best and you agree with one of those recommendations.
I always suggest people keep diaries when they are undergoing treatment for something – even colds or flu – just so they remember when something happened and can be sure all their doctors have all the information they need to properly guide care. EDITOR'S NOTE: I absolutely agree with Marty here, which is why we created the Damages Diary! These diaries would include life changes after an injury. For example; “walked ¼ mile today – called spouse to pick me up – couldn't go farther because of pain in my leg/ankle/back - can’t seem to get back to 1.5 miles.” It doesn’t take a great deal of time to make this note, but it’s important to remember that this happened and what progress you’ve made when you’re trying to explain to a doctor, lawyer, or insurance company what has happened to you and what effect it has had on your life.
If you have an attorney, I would suggest being sure you have given your attorney a complete list of everyone who has provided you care during whatever period your attorney needs. I double as a paralegal and know that it is common to be asked (though your attorney might limit the time frame) to provide 3–10 years of past medical records. Your attorney will discuss this with you and make the appropriate plans.