VIDEO TRANSCRIPT: Hi, this is Robert Mansour. I'm a lawyer in the Los Angeles area. One of my areas of practice is personal injury. I wanted to spend a few minutes with you on this brief video to talk to you about things you need to keep in mind when treating with doctors and physical therapists after your personal injury case.
What you want to make sure you understand is that the insurance companies are going to be evaluating your case partly on what's called the diagnostic codes, which means that what the doctor writes down as your diagnosis is going to be considered by the insurance adjuster.
That's why when you go to the doctor you have to tell the doctor everything that's bothering you and with great specificity. So you can't just go in there and say, “Oh, my neck hurts.” Well, what is it exactly? “Oh, I have radiating pain into my shoulder and between my shoulder blades or my middle back, my upper back and my lower back hurt me” rather than oh, my back hurts me. What is it exactly that you're feeling? What are your symptoms? The doctor has to write all this stuff down. It's transferred into a diagnostic code that is written in your medical records.
The reason this is important is because if something is not in your medical records it's like it never happened. So, if there's a diagnostic code that is missing or some complaints that you have that are not documented in those medical records, then it's like it never happened. The insurance company will not consider it. You see, the insurance companies are using software more than ever to analyze their cases. So a lot of major insurance companies now are using software products in order to evaluate these cases.
What they do is they'll type in your age, where you live. They'll type in all the diagnostic codes. They'll type in all the treatment codes, any treatment that you received from any place. Also, they look in the medical records to see what kind of complaints you had. This is why it's very important to indicate in your intake forms when you go to the doctor. When you talk to the doctor, every time you see the doctor, you've got to mention what you're going through, what you're feeling.
I had a client. She called me and she said, “I'm having a really hard time at work. I'm having concentration issues and also my back is killing me when I drive for more than half an hour.” I told her, “You need to tell the doctors about this. It needs to be written in your records.” The reason once again, if it's not in your records it's like it never happened.
So, once again, please keep in mind that you're got to tell the doctor everything that's going on. Those diagnostic codes are very important. The way the accident has affected your daily life you want to make sure you tell the doctors and the physical therapists about that. You know, every time you go to the doctor they ask you. They say, “How you feeling?” You go to the physical therapist, “What's going on? How are you feeling? What's been going on since the last time we saw you?”
That's where you tell them with great specificity what's going on so they can document it. Of course, if it's not documented then it's not going to end up in the software and the software will not analyze your case and the insurance adjuster will just treat it like it never occurred.
I hope you found this video helpful. My name is Robert Mansour, and thank you very much for visiting today. If you want to learn more about my practice, you can visit www.valencialawyer.com, or you can call my office at 661-414-7100. Thank you very much for watching this video.
After a car accident, it would be a good idea to sit down and make an exhaustive list of all the injuries you had after the accident. Be very specific. For example, if you tell the doctor that you had "shoulder pain radiating into your neck," the doctor might simply indicate that you had "shoulder pain." However, you actually have two injuries - one to your shoulder and one to your neck. Therefore, the doctors records and reports may simply reflect one area of your body when in fact two areas were affected.
You have to segment your injuries into sub-parts. For example if you say "I have back pain," that may be simply be considered as one area of injury. However, your back can be broken up into three regions, the mid back, the low back, and the upper back. Also, you might have pain in your shoulder blades, or your waist area or your tailbone. Again you have to be very specific because each of these things can be considered a separate injury.
If you don't segment your injuries into sub-parts, you are allowing the adjuster to devalue your claim because the specific injuries are not listed. For example, if you say "my arm hurts," this may be problematic because the "arm" can involve pain in the fingers, the wrist, the hand, forearm, the bicep, the tricep, the shoulder, or the elbow. You see, the arm can be broken up into so many different regions that can be considered separate injuries. If the doctor only writes down "patient's arm hurts," then you have shortchanged your case by failing to mention all the subcategories of your arm that were also injured.
Most doctors are not this specific, so you might have to be. The doctors need to be very exhaustive in their documentation by segmenting your body into as many parts as possible and your injuries into as many sub-parts as possible. Otherwise, the insurance adjuster will be inputting incomplete information into their analysis software and therefore undervaluing your claim.
That is why it is a good idea to make a very detailed list of all the injuries you have from the accident. Do not only mention the injuries that currently bother you, but mention every single thing that bothered you from the very first day. Otherwise you might miss something. Also make a very detailed list of how the accident affected your daily life. Do not only mention how your daily life is currently affected, but also talk about how your daily life was affected shortly after the accident.
Be very specific about any limitations you might have had. You can include simple things like vacuuming, doing chores, gardening, lifting, bending, playing with the kids, and anything else that was affected, including your work. These effects on daily life may also affect the value of your personal injury case. Every time you go to the doctor, they will ask you how things are going. You want to make sure you mention to the doctor any limitations you're having and make sure they are noted in the records and in the doctor's reports. If they are not mentioning your records, it's almost like it never happened.
If you need help with your Santa Clarita personal injury case, please call my office for a free consultation at (661) 414-7100.
Immediately after a serious car accident, the injured person might receive some treatment. For example, they may get treatment at the scene of the accident or they might be taken to a hospital for treatment. They're treated by certain doctors at the emergency room, anesthesiologists, radiologists, etc. In some cases, the injured party is sent to an imaging center for an MRI or CT scan. All the activity that follows an accident is important and you should tell your attorney about it. In most cases, you want to make every effort to obtain your medical records AND billing from all the facilities and health care providers as soon as possible.
After that the client might find that they require further treatment. At this point, they would discuss their options with a lawyer to find out how they might want to proceed. Should they proceed on a lien? Should they go through their primary doctors? Should they go through their HMO, etc? A lien is where the doctors provide treatment to the client and defer payment - they will get paid at the end of the case when there is a recovery. The client, in most cases, is still on the hook for the balance, but at least they don't have to pay the doctor as they go along. And those options will be discussed with the lawyer.
The most important thing to do is to make sure you get the proper medical treatment after a serious car accident. Make sure you are proactive. Also, keep track of all your medical providers from Day One and make sure you get all your records and billing from each provider.
If you need help with your Santa Clarita car accident case, call (661) 414-7100 for a free evaluation of your personal injury case.
My parents got into a serious rear-end car accident about a week ago. They were making a left turn into a shopping complex when they got hit from behind by another vehicle. It was a moderate to severe impact that shook them up quite a bit. However, they did not feel much pain the first day.
My parents came home later in the day and found a message from the insurance adjuster for the responsible party. "Hello this is Susan from Geico Insurance. Please call me." My Dad called her right back. She started asking if they were feeling alright and if they were going to bring a claim. She insisted he give her a statement right on the spot. My Dad grew concerned and called me for advice.
I told my Dad the adjuster wasn't really interested in "how they were doing." Adjusters know that people often don't feel pain immediately after an accident - even if the accident was more serious. In some cases, the pain doesn't manifest itself until a day or two later! It's kind of like pulling a muscle or lifting more than you should - you often don't feel the effects until later.
The reason insurance adjusters call so quickly after an accident is because they are seeking a denial of injury - preferably "on the record" via a recorded statement. That's why they contact you so quickly...sometimes within hours of an accident!
About two days after the accident, my Dad called me with an update. He said that he and my mom (both in their mid 70s) weren't feeling very good. My Mom was especially in pain. She had orthopedic problems before, and this accident set her back. I later learned there was a problem - my Mom had spoken with the Geico adjuster the day before. I guess my Dad didn't relay my instructions to her.
According to my Mom, the adjuster was very friendly and insisted on knowing if my parents were hurt. My Mom said, "I told her we were fine. However, that was yesterday and today we are in pain." Guess what? If my parents try to bring a claim at this juncture, the insurance adjuster will likely use my mother's statement as a sword against them.
I reiterate, "There is NOTHING to be gained from giving a statement to the insurance company so early after an accident." There is only one reason insurance adjusters want a statement from you - to use it against you in the future.
Victims of accidents often don't realize they are hurt till a day or two after an accident. Sometimes the adrenaline or other factors may affect their awareness of the injury. Either way, prematurely denying injury is not the most prudent course of action. Even if you have an injury, there is little use in discussing it with the insurance adjuster because you have no idea what the extent of the injury is, what course of treatment will be necessary, whether you will fully heal or have to deal with residual pain for the foreseeable future, or if surgery will be necessary.
If you've been involved in serious car accident and want advice, please call my office at (661) 414-7100. I serve Santa Clarita and its communities of Valencia, Saugus, Canyon Country, Castaic, Newhall, Stevenson Ranch, and beyond.
A severe car accident can cause a herniated disc in your spine. Spinal discs are like cushions in between the vertebrae. These discs provide cushion to the vertebrae. Of course, over time, these discs start to degenerate. The discs are filled with fluid. But when a disc is damaged, it can bulge or break. This is a herniated disc. Sometimes a herniated disc is called a ruptured disc or slipped disc. When a disc is damaged in an auto accident, the fluid inside the disc can leak which affects the cushion between the vertebrae. If the herniation is significant, it can put pressure on the nerves running along the spinal column. This can cause significant pain running up and down the body since everything is connected to the spine. This pain can “radiate” throughout the body – through the extremities. The pressure on the nerve causes “radicular” pain which is pain that shoots through the body. Different nerves in the spine are generally associated with different parts of the body. Sometimes doctors can figure out which nerve is affected due to the area of the body having the most pain. For example, leg pain is associated with lumbar (back), or arm pain comes from a cervical (neck) herniated disc.
A disc injury is usually easy to diagnose. However, a herniated disc is tougher to diagnose. This is because the disc doesn’t show up on a basic x-ray. Therefore, herniated discs aren’t usually diagnosed in the hospital after a car accident. Sometimes a subsequent CT scan, MRI, discography, myelography, or an electromyography can help diagnose herniated discs. Even then, it is tough for a personal injury case because you have to show an “acute” injury which means the injury can be related to the auto accident. If the herniation pre-dates the accident, there is the argument it was asymptomatic until the accident. The car accident may have aggravated the condition in some way. Sometimes this is a tough sell, especially if a client has disc bulges at several disc levels as is often the case as we age.
Yes, you can indeed suffer a meniscus tear from a severe car accident. A meniscus tear occurs when the knee cartilage is torn. A meniscus tear is very painful because the tear leaves the knee with reduced cartilage, causing friction in the knee joint. The cartilage which usually protects can no longer offer the same degree of protection due to the meniscus tear.
Torn meniscus symptoms include swelling, knee pain, tenderness, popping, clicking from the knee, and of course, limited motion of the knee joint.
If you’ve had a car accident where meniscus injury may be present, it’s important to have the meniscus of the knee examined by either a hospital or your doctor. The examination will generally include a visual evaluation of the knee and oftentimes the doctor will order for an x-ray or perhaps an MRI to confirm the tear.
Treatment for a meniscus tear usually requires a surgical intervention. As with most knee injuries, the insurance company will always want to be convinced there was a mechanism of injury. The accident usually has to be pretty severe to prove the connection between the car accident and the meniscus tear. Absent excruciating pain reported at the scene of an accident or later at the hospital, they usually doubt meniscus tears from accidents.
Serious car accidents can cause knee injuries, especially if the knee is jammed into the dashboard of the car. This usually happens during frontal collisions and usually involving a twisting motion of the knee. A serious car accident can result in a tear of the Anterior Cruciate Ligament (ACL) of the knee joint.
The ACL offers stability to your knee. When the ACL is injured, many report the knee simply “gave way,” or they heard a loud pop, at the time of injury. ACL injury can lead to severe swelling, pain and tenderness of the knee.
Sometimes it is difficult to diagnose an ACL injury early in a personal injury case until the initial knee pain calms down. When the pain and swelling have diminished, the doctor can examine the knee to see if there is evidence of any ligament tear. An MRI will show the tear in the ligament, and may be helpful when proving your case to an insurance adjuster.
If the ACL tear from the accident is severe, a physician may recommend surgical intervention. Sometimes, the decision to have surgery involves not only the severity of the tear, but also the age of the patient and their normal level of activity.
The AC joint can be injured in a car accident. Generally speaking, the ligaments that support the AC joint can be injured in an auto accident. Sometimes, AC joint separation is also known as “shoulder separation.” The AC joint is formed where the clavicle and the scapular area meet. It’s generally in the highest part of the shoulder. The two bones that form the shoulder attach by a ligament that can be damaged. Sometimes there is damage to the muscle as well.
The AC joint is most often injured when there is direct contact the shoulder. Some insurance companies will doubt the AC joint injury if there is no evidence of direct impact to the shoulder. However, with the proper medical diagnosis, medical documentation, and the absence of joint separation in previous medical records, some insurance companies can be convinced that the AC joint injury was from the accident. They will doubt it at first in my experience, questioning the “mechanism of injury.”
Symptoms can include pain in the collarbone area that spreads through the shoulder. Sometimes there is swelling where the joint has been disrupted. Often there is pain when moving the shoulders, especially when trying to raise the arms high above the shoulders. Therefore, it is possible to have AC shoulder joint separation from an accident. Just make sure you tell all your doctors so that your injury can be well-documented. This isn’t the time to take a “wait and see” approach.
It is possible to have a rotator cuff injury from an automobile accident. The rotator cuff is the name of the four muscles and tendons that form the shoulder joint. Basically, the rotator cuff aids the shoulder’s ability to have a wide range of motion. Interestingly, the shoulder has a very wide range of motion when compared to other joints in the body. A healthy rotator cuff is very important for allowing you to do daily routine tasks such as getting dressed.
Sometimes there is a tear in the rotator cuff when one of the four muscles and tendons are injured. Most often, rotator cuff injuries occur from repetitive use, but sometimes they can be caused by traumatic injury. Repetitive use is often associated with such activities such as overhead lifting or sports, but sometimes a forceful collision like an automobile accident can cause a rotator cuff tear.
The accident most associated with a rotator cuff tear is the classic rear end accident. Sometimes, when anticipating a rear end collision, a person looks in their rearview mirror just before impact. At that moment, they brace their hands against the steering wheel in anticipation of the impact. Unfortunately, doing so can sometimes lead to injury of the rotator cuff. This is because the shoulder is in an “unrelaxed” state when the body braces for impact, and therefore, the shoulder absorbs a large amount of force from the accident. An acute tear can occur from this type of accident.
If you feel pain in the shoulder after a car accident and have trouble sleeping, putting pressure on your shoulder, rotating your arms, or you experience a popping or clicking sound in your arm, you may have a rotator cuff tear. Your physician can diagnose one, but early diagnosis is important.
Many of my clients often overlook the possibility of rotator cuff tear because they simply don’t consider it. Make sure you mention your injury to a doctor so they can diagnose it properly. Rotator cuff tears may require surgical intervention if physical therapy and other approaches are unsuccessful.
Soft tissue injuries are injuries to the muscles, ligaments and tendons, and are often sustained during car accidents. While most soft tissue injuries are generally not as serious as, say, bone or organ injuries, they can be very painful and may take a long time to heal. Soft tissue injuries include sprains, strains, tendonitis or bursitis, bruises, dislocation and nerve damage. Whiplash, which occurs commonly during car accidents, is a soft tissue injury of the cervical spine. Treatment for a soft tissue injury may consist of physical therapy, medication and/or rest, and in very severe cases, surgery.
Pursuing a legal case in order to obtain compensation for treatment of soft tissue injuries will likely require that you prove the responsible party’s negligence – that they were not driving safely and that you were injured as a result of their negligence. This is known as “causation.” If you choose to hire an attorney to represent you in your soft tissue injury case (or any personal injury case), the statute of limitations in California is currently two years, but you will have a better chance at success if you act immediately. Because soft tissue injuries are oftentimes not regarded as serious by insurance companies, as they usually can’t be seen by the naked eye or on an x-ray, waiting to pursue your case can only make it more difficult to get the compensation you need. Delaying may not be in your favor.
Seeking medical attention for your soft tissue injuries can be tough. A doctor may prescribe you pain medication automatically, numbing symptoms and lessening your motivation to seek further treatment or contact an attorney. If nothing shows up on your x-ray, it might be a good idea to see a chiropractor or physical therapist, even if you don’t feel any pain; they can help detect a soft tissue injury that could cause you trouble later on. Additionally, chiropractors and physical therapists generally offer a gentler therapy that can help tackle the root cause of your pain and help you regain your previous range of motion so scar tissue doesn’t build up. Painkillers often mask your symptoms, potentially exacerbating your condition – if a soft tissue injury isn’t treated properly, surgery may be in your future or you may not heal to pre-accident condition.
If you are involved in a car accident, seek medical help immediately, and keep a detailed record of how you feel and how you progress or regress. Remember, car insurance companies are notorious for scoffing at soft tissue injuries, regardless of how real your pain is to you. Don’t be surprised if they don’t treat your injuries seriously. Soft tissue cases can pose an “uphill battle” to any claimant, with or without a lawyer.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,