Hi, I am Matt Powell and I want to share with youthe most common mistake I see people make in their personal injury case. And that is the mistake of allowing
"gaps" in their medical treatment. What do I mean when I
say Gaps in Treatment? A gap in treatment is a period of time in which a Patient
misses treatment with one of their health care providers. Sometimes a gap in treatment may have a
good explanation that won't hurt your case.
For example, a death in the family,
an Emergency, or a family vacation. If one of these situations were to arise
in your case and you miss a treatment, make sure you tell your doctor WHY
you missed the medical appointment so that your doctor can write the reason
you have a gap in your medical records. Now let me explain to you about the serious gaps in
treatment that in many situations can kill your case. I am talking about gaps that can cause you to
lose thousands of dollars off of your settlement.
And, some of these serious gaps are caused by your
doctors not knowing how to manage your care as it relates to your case. The biggest mistake I see, is when a client thinks they have been "Finalized"
or have reached "Maximum Medical Improvement." When this happens, they think,
hey, I am done with my treatment, now I don't have to do anything else,
and the lawyer will settle my case. This is an Expensive mistake to your health
and your settlement, and let me explain why. You need to know that there are
Two types of medical care.
The first is "Rehabilitative care"
and the Second is "Palliative care". Rehabilitative care is when the doctors are trying to
stabilize your injuries and keep you from getting worse. Once you are stabilized, then they
to try and heal your injuries. For example, a broken leg
may require surgery, followed by casting of the broken bone so it will
maintain alignment while the fracture heals.
Then, after your
cast is removed, your doctors will prescribe physical therapy
to improve your strength and flexibility, and to train your muscles and
ligaments to function better. In other types of injuries
without a broken bone, the treatment is usually designed to reduce the pain
and inflammation around the damaged part of your body. This is to help your muscles and ligaments return to
normal, to take the pressure off nerves that cause pain, and to break the pain cycles
caused by the injury. Then once the healing begins, the doctors will change your
treatment plan to help heal the body with strengthening and
flexibility types of treatment.
The American Medical Association says that
this first phase of treatment in most cases should take about six months. After six months of rehabilitative care,
you should reach a "Medical Plateau." In other words, you have reached "Maximum
Medical Improvement" commonly called "MMI." Unfortunately, some doctors and many patients think
that this is the END of their treatment, which is 100% Wrong. MMI just marks the shift in treatment from
Rehabilitative care to the Second type of care which is called "Palliative
or Maintenance Care." Palliative care is specialized care focusing on providing
patients with relief from their permanent symptoms and the permanent pain
caused by their injuries. The goal of palliative care is to improve
the quality of life for the patient, to prevent and slow down the effects
of degeneration such as arthritis, to keep your function and mobility as high
as possible and to prevent set-backs.
The palliative care is provided
by a team of doctors, nurses, and other specialists who work together with the
patient to provide an extra layer of health. This care is designed to maximize your
function, reduce flare ups and set-backs, and to promote the highest
level of health possible. Examples of this type of care can be stretching,
strengthening, massage, chiropractic adjustments, physical therapy, continued medication, and
occasional re-evaluations by orthopedic surgeons, neurologists and physiatrists. So, how do these different phases of
treatment relate to Your injury case? Everyone understands phase One
Rehabilitative treatment.
It is like you don't
have a choice. If you don't get treatment for your
injuries, they will get worse, not better. So, most everyone understands that if
you are hurt, you will seek treatment. But when the first phase
of treatment is over, many people stop because they don't
understand the value of maintenance care.
They simply think that they have gotten as good
as they are going to get, so they stop treating. This is a Big Mistake, because continued
treatment will prolong how long you feel good. In other words, if you don't maintain your
health, it will start its gradual decline. Sure, no one likes
going to the doctor.
But think about it this way. If you continue your
maintenance care, you will feel better, have more energy,
and function at a higher level. This will extend your good health and slow
down the long term effects of arthritis. However, if you don't do the
maintenance and palliative care, your body will experience the effects
of arthritis faster and sooner, as well as degeneration of the
joints, ligaments and tendons.
As a result of not getting
your maintenance care, you will experience a rapid
decline in your health and end up needing much more serious treatment in
the future, such as pain management or surgery. Let's look at this graph to help understand
the different phases of your health care. In this graph, we start with the green line
representing you being at 100% perfect health. You are living life, doing well, then suddenly,
you are involved in a serious accident.
You are injured badly, your
health drops immediately to 60%. You start going to the doctors,
you begin the healing process, your health slowly improves over
time. As you get close six months of treatment,
your healing begins to level off, it reaches a plateau. This plateau is called MMI, or
Maximum Medical Improvement.
MMI basically means that even though you could
get more treatment, you won't get much better. In this example you are
at 80% of your health. You have maximized all you can
from your "rehabilitative Care" Since you are at MMI, your treatment
needs to shift over to Maintenance care. At this point in time, you should begin
your "Palliative or Maintenance Care" Which is represented
by the blue line.
By continuing to get monthly care, you are able to
maintain the highest level of your health possible. You maintain your health
around the 80% level. In contrast to receiving ongoing maintenance
care, if you follow the Orange Line, which represents your health without palliative
care, your health begins to fail. Your body starts experiencing accelerated
degeneration of your spine, joints and ligaments.
Because you are not getting maintenance care,
your starting to slip back and lose your heath. You start feeling pain, you become
stiffer, lose your range of motion. Eventually, you may have so much pain that you have to
go see a pain management doctor for spinal injections. And if you still don't get palliative or
maintenance care after the pain management, your health will continue deteriorating
until you might need a surgery.
Then, after the surgery, you may find
that your health does not improve much. Your downward loss of health and quality of life
can be devastating, and totally debilitating. You may not be able to
work, or enjoy your life. My point is this, if you don't take care of your
health after a serious injury, you will sadly be surprised how quickly the irreversible
effects of arthritis and degeneration have on your body.
Now, let's look at this same graph again, but factor
in the medical costs between getting palliative care, and not getting the
maintenance care. In this example your maintenance care
cost are $3,000.00 Per year for life. So in the beginning, with maintenance care, your
medical costs are higher, and at year five, your total cost of
treatment is $15,000. While the person who choose not get
maintenance care has no expense.
But let's assume after 5 years
of ignoring their injuries, they start having bad pain and need
Spinal Injections that cost $25,000. Now, suddenly, they have higher medical expenses
caused by the need for pain management treatment. Also, their health has deteriorated
due to the lack of palliative care. Now their health is close to where
they were when the accident happened.
Then 5 more years, they need a spinal
surgery at a cost of $140,000.00. Now there is no comparison. The person who went without the palliative
care has much higher medical bills, $165,000 then add the cost of the reduced quality of life they have to endure all the long term effects of
arthritis, degeneration of their discs, joints, along with the pain associated with
pain management and spinal surgery. The person struggling with their deteriorating health is
probably not functioning at a very high quality of life.
Their income may be down. They may not have
health insurance. They may be required to get Medicaid
for their treatment. They may be forced
to stop working.
It is a sad situation
for these people. I think these two charts make it clear that life
without maintenance care is more expensive, to your health and finances Also, think about this. Star athletes, who are in
great health and injury free, still take advantage of palliative health care to
maintain their high quality health and maximum function. So, back to your injury case.
At the end of your Rehabilitative
care, when you reach MMI, the doctor will likely write down in your medical records
what he thinks your future medical needs will be as a result of this injury. He may be very specific. For example he may say monthly
massages and stretching, or six weeks of aggressive
palliative care once per year, one MRI every two years, or yearly evaluations
with a neurologist. And these future recommendations
are usually for the rest of your life.
So, as your lawyer, who is explaining how expensive your future palliative
and maintenance care will cost to an insurance adjuster or to a jury, I have a hard time with my
audience when your records show that even though your doctor has told you what you need
to do to maintain the highest level of health possible, you have not followed his recommendations, and
you now have a big gap in your treatment. This causes a jury or an insurance
company to say to themselves, "Hmmm, if I was hurt, I would keep treating, so your client must not be hurt too
bad since they have stopped treating, and they are not listening
to their doctors anyway." "So, let's not give Matts client any
money for future care and treatment." Or If the client acts like they dont need future
care, why should we give them any money for it? To Quote Benjamin Franklin, Well
Done is better than Well Said Now you understand that by allowing gaps in your
treatment, can cause a lot of problems for your case. First and foremost, your level of health declines, and
secondly, the value of your case drops dramatically. Think about how expensive your
treatment has been so far.
Now think about the cost of continued
treatment for the rest of your life. In my little example, the yearly cost of the minimum prescribed maintenance
care will easily be close to $3,000.00 Per year. And in many cases the maintenance care for serious
injuries can be as high as $20,000.00 Per year. So think about how many years you are going to live and
the total cost of the care that you are entitled to.
Remember, your injuries were caused
by some other person's negligence. And if you don't keep up your treatment, then why
should anyone pay you for your future medical care? If you don't treat at least one time per month,
even after MMI, you are Really hurting your case. So, if your doctor says you are through with your
treatment, let your lawyer know immediately. And ask your doctor about this.
Ask them, "well, what are we going to do now to help
maintain the level of health that I have today?" And ask them "What are we going to do to prevent the
degenerative process from taking over?" And ask "What are we going to do,
to delay arthritis and degeneration?" If your doctor says nothing,
look for another doctor. Find a doctor that is thinking about the long
term effects your injury will have on your life. When a doctor tells you that you
are Finalized or you are at MMI, what is really happening is that you
are not Through with treatment, you are just at the Second
Phase of your treatment. By understanding why continued care
and treatment is so important, I hope that you have a longer
healthier quality of life, and that the at fault party
should pay for all, and when I say all, I mean all of the future medical care and needs that you
will need to maintain the highest quality of health possible.
If you have more questions about
gaps in treatment, please call me. And my final advice is that you see at least one health
care provider once a month until your case is over. That will preserve the
value of your case. Thank you for watching my video..
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