When it comes to personal injury cases, your own medical history may come back to haunt you! What do I mean by that? Here are a few examples from some cases I recently handled:
I recently had a client who had a shoulder injury from a car accident. She eventually had surgery. Certainly, she had a significant injury since surgery was required. Everything in her medical records suggested injury from the car accident. For example, she complained at the accident scene of shoulder pain (as noted in the police report). At the hospital, she complained of pain to her shoulder. She endured painful cortisone injections to the shoulder which is something people generally won’t do unless they are having tremendous pain. Then she had the surgery and did weeks of rehabilitation. Again, people generally don’t do that unless they are truly injured.
Unfortunately, after reviewing this client's medical records over the last five years, we found that seven months prior to the accident, she had complained of shoulder pain in the exact same shoulder! In fact, the medical records indicated she had been having shoulder pain for six months prior! Of course, if you have surgery after an accident, the insurance company is going to want to see your medical records from the past. Generally, they want to see 5 to 10 years of medical records. Why do they want to see your prior records? Well, because many people try to blame pre-existing conditions on a car accident. In this particular case, my client had forgotten she had made that prior complaint. The truth is, the prior shoulder complaint may have been linked to a gastrointestinal problem that was causing "referred" pain. However, the notation was there, and you can bet the insurance company used it against her. They argued her shoulder pain probably pre-dated the accident and therefore, they should not be held responsible for it.
I had another client recently who was complaining of neck and back pain post accident. Eventually, after physical therapy failed, she had several cortisone shots to her neck and back. She assured me she had never had this type of pain before. Of course, I had to research her prior medical records because I wanted to make sure I was familiar with her past care so there would be no surprises.
Lo and behold, we found that two months prior to the accident, she had complained of the exact same problems to her neck and her back. In fact, the medical records indicated her prior neck and back pain were "chronic" and have been going on for well over three months (with radiating pain to her upper and lower extremities). That is not to say the client wasn't injured in the auto accident. I’m only raising these issues because we cannot ignore the historical medical records and how they might be used against us. A jury, a judge, or an insurance company is not going to like this kind of thing. The client was upset. However, I explained to her that her prior similar complaints found only 2 months prior to the accident could sink her entire case. She could then be on the hook for all our costs and all the defense costs.
Most people are already suspicious of personal injury accidents, and many people think accident victims are just trying to make a buck. The fewer uphill battles we have, the better. Pre-existing conditions that are denied (or sometimes forgotten, conveniently or otherwise) can destroy an entire car accident case.
Another client recently came to my office and explained he had smashed his knee into the dashboard as the result of a head on collision. Of course, this is a significant injury, and he told me he might need surgery. However, having worked for an insurance company myself, I asked him about his past medical care. He explained he did have prior complaints to the same knee. In fact, a few months before the accident, a doctor had recommended an MRI to the same knee. I explained that before I could take his case, and before he could make any significant decisions about whether or not he wanted to proceed with a car accident claim, the best thing we could do is obtain his prior medical records and study them carefully. After all, the insurance company is going to be pouring over them. It stands to reason that we should also be looking through them and learning what lurks in those records.
Here is the moral of the story: If you’re going to complain of any significant injury after an accident, and if you have similar issues in your medical past, they will certainly come back to haunt you. The insurance company will simply argue that your injuries pre-date the car accident and that you are simply trying to blame the car accident for all your previous problems.
If you have a previous problem, be candid about it and forthright. It could be that the car accident aggravated your previous problem or exacerbated an otherwise dormant injury. Then it becomes an issue of what kind of aggravation it was and whether or not you have a residual problem. Of course, sometimes it is difficult to ascertain whether or not you would have had the same problem even without a car accident (insurance companies always make that argument).
Ignoring your medical history or assuming no one is going to look at it, is one of the biggest mistakes I see clients make. If you have a significant medical history, it would be a great idea for you to obtain your own medical records so that you can review them before the insurance company does. That will help you outline your strategy and handling your personal injury case. Also, don't hide your medical history from your attorney. That doesn't do anyone any good! If you are not willing to confront your medical past, then perhaps you shouldn't be making a personal injury claim.
Hello, everyone. This is Robert Mansour, and I wanted to shoot a brief video today about the importance of making sure that your medical records accurately and fully reflect what you went through in your car accident, so not only should your medical records reflect all of your injuries, they should also reflect how the accident affected your daily life, so let's first start with the injuries. If you go to the hospital or the emergency room or the doctor or whoever, chiropractor, after an accident, you want to make sure that you walk in with a very detailed list of every single thing that was injured in the accident, no matter how minor. Here's why: An issue that may not seem significant on day 1 may become significant a few weeks later, so if you don't mention it on day 1 and then it comes up a few weeks later, an insurance adjuster might say, "Well, wait a minute. I think you fabricated that. That didn't really happen in the accident. That was something different."
You just want to make sure that you mention all of your injuries, because when the insurance adjuster is evaluating your case, they're going to look at your medical records very carefully, and they're going to see what did you complain of to the doctor, so you can't just say, "My neck." That doesn't really help. You've got to say, "My neck radiating into my shoulders, radiating into my upper back." You want to be very specific about what it is that your injury actually is, so make sure that you are very detailed about that. As a matter of fact, if the police officers come to the scene of an accident, it is very important to tell the police officer or the emergency personnel what your injuries were, because they will write that down in the police report, more often than not, and if your injuries are listed in the police report, it lends a lot more credibility to your claim that you were injured, and the consistency of those injuries across the board. Your injury complaints at the scene were the same at the hospital, were the same at the doctor, were the same at the physical therapist...
It's very important to be very complete about it. The next thing that you really need to make sure that you articulate is, what limitations are you having from the accident? When you go for physical therapy or you go to the doctor, and they say, "How are you doing? What's going on," and you say, "Well, not so good," or, "A little bit better," that doesn't really help paint a very good picture of what you're going through. So for example, you might say, "Well, I'm having trouble taking a shower. It hurts when I put my clothes on in the morning. I can't bend down to tie my shoes. I'm in excruciating pain on a daily basis. I can't even drive to work. I can't pick up my kids and play with them. I can't garden. I can't do X, Y, or Z. I'm having trouble doing chores at the house." I call that "putting ornaments on the tree," decorating the tree. The tree is the injuries, but the ornaments on the tree are how the injuries affected your daily life, your work, your schooling, your home life.
It is very important to articulate all of that to your doctors, because it's going to end up in the medical records, and that's what the insurance adjuster's going to be looking at. So the medical records are your opportunity to tell the adjuster the complete story of how the accident affected you. Not just the injuries, but the effects of those injuries. I always tell my clients, "When you go in for treatment after a car accident, whether it's for an evaluation, physical therapy, or anything like that, I want you to imagine the insurance adjuster sitting on your shoulder with a tablet, writing everything down that you say. They've got their clipboard right there, and they're writing everything down that you say to the doctor, so if you can imagine that, you're going to be more complete about it, because the adjuster's sitting there on your shoulder, basically being very skeptical that you were injured at all, as most of them often are. So this is your chance to be very complete about your injuries and how the accident affected you." I hope you found this video helpful. Thank you very much for watching.
Please call (661) 414-7100 if you've been injured in a serious car accident. Personal injury lawyer Robert Mansour helps clients involved in serious auto accidents in Santa Clarita, California and its surrounding communities.
I have some clients who call me on a weekly basis. They say, "My knee (or whatever body part) is killing me from the accident. The doctors don't know what's wrong. The physical therapy isn't helping. I'm in tremendous pain...." Of course, I'm not happy to hear about these things, but as a lawyer, there is only so much I can do. I don't have a medical degree so I can't prescribe medication or do surgery on the client. I empathize as much as I can with my clients, but I remind them that I'm handling the legal aspects of their case and they really should tell their doctors about their injuries.
Some of these same clients also want their case to be over as soon as possible. They say things like, "I just want to settle this case soon. I can't believe the insurance company hasn't made an offer yet! What's wrong with that adjuster? When is this all going to be over?!" In my 20 years as a lawyer, I've found that some clients believe that resolving their personal injury claim is going to "make everything better." They think there is a connection between the settlement of their case and their injury.
Over the years, I've had to explain to many clients that their knee (or whatever injury they have) is still going to bother them even if we resolve the case. I explain, "Just because we resolve your claim doesn't mean your neck or back isn't going to hurt tomorrow." Therefore, it is important to understand that rushing your personal injury claim to "put it behind you" or just be "done with it" isn't going to make you feel better. You need to focus on your injury and the medical treatment required to make you better. Getting a check in the mail from an insurance company is not going to help your injury.
It's probably one of the top five reasons people screw up their own personal injury case - waiting too long before seeing a doctor after they've been injured in a car accident. How long is too long? Generally, anything beyond a week is too long. Some insurance companies believe three days is too long.
The point is this - if you've been injured, and even if you are not sure, you MUST go seek health care immediately because any delay will be used against you. However, even if you did delay, all is not necessarily lost. Some insurance companies will entertain any kind of self-help you did as "active" treatment. In other words, you have to demonstrate what you did at home to alleviate your pain. Did you ice the injury, did you sleep in and rest, did you take ibuprofen, did you lay down on your couch to rest, etc? You need to explain that you didn't just sit around and do nothing for two weeks, then decide to see a doctor.
However, the key is "convincing" an insurance adjuster you did more than sit around. How can you do that? Well, the best way to convince the adjuster is by telling your doctor about your self-help remedies during your first visit. Therefore, you must not only tell the doctor or the intake person at the doctor's office but also write it down on any intake forms. Documentation is everything. Remind the doctor to include such information in any reports generated by the doctor. At the very least, it needs to be in your records. For example, the doctor's report can say, "Mr. Smith came to seem me two weeks after his accident. He tried pain medication and ice at home to no avail. He tried hot showers and laying down, again without significant improvement. He eventually decided to visit with a doctor as his pain wasn't getting better." Do you see how this is much better than the inference that you just sat around doing nothing? Remember one of the biggest rules when it comes to personal injury cases: If something is not in your medical records or the doctor's reports, then it basically never happened as far as the insurance adjuster is concerned.
Robert Mansour handles personal injury cases in Santa Clarita and its surrounding communities including Valencia, Saugus, Canyon Country, Newhall, Castaic, Stevenson Ranch, Palmdale, Lancaster and beyond. Call (661) 414-7100 for help with your accident case.
If you are injured after an accident, you should call for an ambulance or at the very least, seek medical assistance as soon as possible. In general, the insurance companies don’t want you to call for an ambulance. They also don't want you to go to the hospital.
The reason they don’t want you to call an ambulance is because it affects their ability to argue that you were not hurt. Insurance companies work very hard to minimize your injury claims. It’s hard for them to argue that you were not hurt if you were taken away by ambulance from the scene. As a general rule, ambulance personnel are not going to waste their time. They’re going to take you by ambulance if it is warranted, if there are serious complaints of pain, and if there are serious concerns at the scene – that’s when they take you by ambulance.
Also, if you go to the hospital immediately after an accident (or at the very least seek medical attention in some way VERY SOON after the accident), it’s further evidence that you were injured, so the insurance companies don’t like to see this because they can’t use it against you in the future. It just makes it harder for them to argue you were NOT injured since you were proactive about your injuries.
If you've suffered in a serious car accident in the Santa Clarita area, please consider calling our office at (661) 414-7100 for a free consultation.
Whenever I get a new personal injury client, I always remind them to keep all their doctor's appointments and to fully complete their medical treatment. In my experience, many clients simply stop going to the doctor after a while because life gets in the way. In other words, they are too busy, work is too hectic, or they have too many other obligations. They simply stop going to the doctor and they are never formally discharged from care. Sometimes, they stop going to physical therapy for the same reasons.
I totally understand that life is complicated and scheduling doctor's appointments can be very difficult. However, if you stop going to the doctor, juries and insurance adjusters will assume you stopped going because you must be healed from your injuries. If you have an injury, you should seek medical treatment until you are healed and/or until a doctor formally discharges you from his/her care. Also, if your doctor suggests you return if you still have pain, ask the doctor how long you should wait before coming back to see them if the pain doesn't go away or resurfaces. That way, when you return for care, you are truly following the doctor's instructions and recommendations.
Always remember, insurance companies don't care how busy you are. They don't care how hard it is to find time to go to the doctor. You don't get reimbursed for how hectic your life is or has become after an auto accident. The insurance companies are looking for reasons not to pay your claim. If they see you simply stopped going to the doctor on your own volition, that will be used against you. They will assume the reason you stopped is because you were healed.
If you need help with your personal injury case, call Robert Mansour at (661) 414-7100. Robert serves Santa Clarita and its communities of Valencia, Saugus, Canyon Country, Castaic, Newhall, Stevenson Ranch and surrounding areas.
When I was a defense lawyer for a major insurance company, one of the first things we looked for when defending personal injury claims was "gaps" in treatment. That means, we would look at every single date of treatment and try to find "gaps" of 10 days or more. Sometimes, we'd see gaps of 2 weeks or much more. We would use those against the person making the claim. Also, we would look to see when treatment commenced after an accident. We would sink our teeth into delays of over 10 or more days. Why do insurance companies use gaps in treatment and delay in commencement in treatment against you? Because they want to minimize your case. They will argue, "Well, if you were REALLY hurt, you wouldn't have waited 2 weeks to get treatment." Or they might say, "Well, if you were in any REAL pain, you would have treated more regularly without missing appointments etc."
The insurance companies will do anything they can to minimize your claim. My clients are often surprised by this tactic. My clients will say, "Well, I couldn't get in to see the doctor for a long time" or "I couldn't get a physical therapy appointment for a month..." The excuses are legitimate and understandable, but that doesn't mean insurance companies will be easy on you or "understanding." They simply don't care. They will use it against you because at the end of the day, they aren't really interested in compensating you. They are interested in minimizing their losses. Therefore, the lesson here is to commence treatment as soon as possible after an accident, even if you only suspect an injury. You don't want to take chances. Also, once you start treatment, be diligent about your health care and follow up visits. In all fairness, there are some insurance adjusters who do understand there are sometimes legitimate reasons for delays in treatment, but most of them won't see the big picture.
I met with a new prospective client today. She got into a pretty bad rear end accident and suffered some severe neck pain. She was taken by ambulance to the ER and they recommended she follow up with her doctors. Every time she tried to call, she got poor service. They would not schedule her or would claim her health insurance didn't cover this or that. Essentially, she was given the run around. While it certainly wasn't her fault, she waited 2 months before she saw me for a consultation. As a result, she had not had any physical therapy for about 2 months. I told her the insurance company for the other party would certainly use that gap against her. Even though she had perfectly legitimate explanations, and had suffered a strong impact, her case would probably be worth less because of the delay in commencement of treatment. That isn't always the case, but the insurance companies routinely use lags in treatment to defend and minimize accident claims.
Hi. My name is Robert Mansour, and I’m a personal injury lawyer. Sometimes people say, “Rob what should I do when I go to the doctor’s office?
First of all, make sure you mention all of your injuries to the doctor. This is not the time to hold back. Also make sure you go to the doctor soon after your accident. Don’t wait too long or else the insurance company for the other party is going to doubt that you were injured. Also, when you first go to the doctor, they’re going to give you an “intake form” that you have to fill out. You want to make sure that you fill that out completely. Put all of your complaints – everything that happened from the car accident you should write it down. Here is the reason: The absence of information leads some insurance adjusters to think that something never happened. So if you don’t complain about your neck pain, if you don’t complain about your back pain, the insurance adjuster might say, “Well, he must have not had any neck pain. He must have not had any back pain.”
So be very, very thorough when you first go to the doctor. Whether you go to your own doctor or an attorney-referred doctor is something you should discuss with your personal injury lawyer. If you have any questions about this please feel free to contact my office. Thank you very much.
Hi, this is Robert Mansour. There are five common mistakes I see in personal injury cases that I want to share with you.
The first one: Giving far too much information to the adjuster during that very first phone call. Not a very good idea.
No. 2: Failing to take pictures of all the vehicle damage, injuries, etc. You’ve got to document those things.
No. 3: Waiting too long to go to the doctor if you’ve been injured. The longer you wait, the more the insurance company is going to say that you had no injury whatsoever.
Also, not mentioning your injuries to the doctor. You go to the doctor but you forget to mention something or you figure you’re going to tough it out and not say anything to the doctor. A very common mistake.
Finally, you have to have reasonable expectations when it comes to your personal injury case. This is not the lottery. No one is going to get rich. It’s all about fair compensation.
If you have any questions about this or anything else, please contact my office. Thank you.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia, Saugus, Canyon Country, Newhall, Stevenson Ranch, Castaic and surrounding communities.