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Why Following Your Treatment Plan Is Crucial For Your Personal Injury Claim In Benton County, AR

  • By: Bradley Mullins, Esq.
Image showing the treatment plan to patient for a personal injury case in Benton County, AR

Here are the essential details covered in this guide: 

  • Why a treatment plan is needed and how it impacts your claim. 
  • How not following your treatment plan could negatively affect your case.
  • Whether a treatment plan can help determine future treatment and costs. 

How Do Insurance Companies Evaluate Treatment Plan Adherence?

Medical costs make up a significant part of the compensation, and insurance companies try to undermine the claim by evaluating the treatment plan.

All insurance companies are moving to a more centralized computerized AI model. Each has its own proprietary computer program, which is fed every bit of information about your case. The computer looks for duplicate charges, overbilling, and gaps in treatment. 

It’s the attorney’s job to feed that information to the insurance company in a way that explains any inconsistencies, like gaps or delays. Insurance companies do anything they can to try to find a gap or delay and exploit it, and the attorney’s job is to help explain it.

How Does Following My Treatment Plan Strengthen My Personal Injury Case?

The first reason to follow your treatment plan is to ensure complete recovery and give yourself the best chances at a future life. However, it could also help with your case. 

It validates your credibility when you say that you’re too injured to do the things that you used to enjoy that you can no longer enjoy anymore because you’re constantly at the doctor trying to get better.

How Could Not Following My Treatment Plan Weaken My Personal Injury Case?

Not following a treatment plan can have the opposite effect. It shows inconsistency. It also suggests that you’re not as injured as you say you are because you’re not taking the necessary steps to try to get better. 

Juries like to see people trying to pull themselves up after an accident and trying to persevere and get through it. By not following up on your treatment, the jury may question the credibility of your injuries and how serious you are about your recovery.

What Role Does A Treatment Plan Play In Proving Pain And Suffering Damages?

Everything that you add to your damages will need to be proven for you to get compensation. A treatment plan can address many of your injuries and can also be used to prove pain and suffering damages. 

Many doctors will document your pain levels as you go into treatment. This provides reliable medical records from a medical professional that go on for three to four months and document your pain levels for three to four months. 

It helps to paint a stronger picture, a more credible picture of the pain levels that you experienced directly after and going through your treatment plan leading up to whatever your maximum medical improvement may be after an accident.

Following a consistent treatment plan allows an injured person to document everything along the way. The more consistently documented a case is, the more successful it will be at settlement or trial.

Can A Treatment Plan Help Calculate The Future Costs Of Care?

Just like accidents, injuries and treatment plans are not the same. It depends on your maximum medical improvement. 

People plateau in a treatment plan. If they are not progressing towards a maximum medical improvement, they may level out at an 80% maximum medical improvement, at which point they need a maintenance plan to maintain that level of functioning. 

What we can do is look at your past treatment plan that is helping you maintain a certain percentage of what’s called maximum medical improvement, MMI. From there, we can calculate the future cost of maintenance care that you will need to continue to function at maximum medical improvement based on the following: 

  • Your treatment plan
  • Future treatment plan 
  • Your doctor’s treatment plan 
  • Your doctor’s future advice.

Some providers even include this information in a last-visit note, which shows that you have reached a maximum medical improvement (MMI). They may also note what you need to maintain that MMI or address any future problems.

From this, it’s possible to calculate that you’ll need to come in X number of times for X number of months or years at whatever dollar cost. So, it’s often worth asking a provider if they’ll do that for you on the last visit as well.

How Do You Advise Clients Who Feel Their Treatment Plan Isn’t Working Or Is Too Costly?

Attorneys don’t have the professional training to predict the outcome of your treatment plan. However, a few things can be done to salvage the situation. 

One solution is to talk to your medical provider. Often, a medical provider can change your treatment plan or refer you to a different provider. If you’re seeing a physical therapist and your problems are more than they can handle, they may refer you to an orthopedic doctor, a pain management specialist, or a neurologist. 

Keeping an open line of communication with your medical providers is crucial to ensuring a successful recovery.

Are There Ways To Modify A Plan Without Jeopardizing A Claim?

Yes, there are ways to modify your treatment plan without jeopardizing your claim. You need to talk to your treating doctor and let them know your concerns, your pain levels, and how you feel your recovery is progressing. 

From there, they can make the necessary decisions to either order more diagnostics, try different providers, or otherwise utilize everything in their arsenal to help with your recovery.

Still Have Questions? Ready To Get Started?

For more information on Why Following Your Treatment Plan Is Crucial For Your Personal Injury Claim In Benton County, AR, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (479) 337-7077 today.