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Law Office of Robert Mansour
Santa Clarita Personal Injury Blog

Make Sure to Keep you Doctor's Appointments After Your Accident Case

8/15/2011

 
Why Consistent Medical Treatment Matters After a California Car Accident

Seeking appropriate medical care promptly after a car accident—and following through with recommended treatment—can help document your injuries and prevent avoidable questions about the severity and cause of your symptoms.

After a car accident, one of the most important things you can do if you are injured is to seek appropriate medical attention promptly and follow your healthcare provider's recommendations. Just as important, however, is following through with your treatment and attending your scheduled medical appointments.

Insurance companies closely examine medical records when evaluating personal injury claims. Adjusters may look at the timing of your first medical visit, the frequency of your treatment, missed appointments, and gaps between examinations or therapy sessions. These details can become part of the insurer's evaluation of whether your injuries are serious and whether the treatment you received was related to the accident.

Key Takeaways
  • Seek appropriate medical attention promptly if you experience pain or other symptoms after a car accident.
  • There is no universal California rule requiring treatment within a specific number of days, but lengthy delays can give an insurance company an argument that your injuries were unrelated to the accident.
  • In my experience, waiting more than approximately 10 days to seek active medical care can create unnecessary problems for a personal injury claim.
  • Attend your scheduled medical appointments and follow your healthcare provider's recommendations when medically appropriate.
  • Significant gaps in treatment can be used by an insurance company to argue that your injuries were not as serious as claimed.
  • Treatment gaps do not automatically destroy a personal injury claim. Legitimate reasons for an interruption in care should be accurately documented.
  • Do not obtain unnecessary medical treatment simply to increase the value of your claim. Treatment should be based on your actual medical needs.
  • Keep copies of your medical records, bills, appointment information, and other documentation relating to your treatment.
  • If you miss an appointment, communicate with your provider and reschedule when appropriate.
  • An experienced personal injury attorney can help evaluate how delays or gaps in treatment may affect your claim.

How Long Should You Wait to Seek Medical Treatment After an Accident?

There is no universal legal rule stating that you must see a doctor within a specific number of days after a California car accident. However, the longer you wait to seek medical attention, the more questions an insurance company may raise about your injuries and their connection to the collision.

In my experience handling personal injury claims, waiting more than approximately 10 days before seeking active medical care can create unnecessary problems for a claim. An insurance adjuster may ask:
  • Why didn't you seek treatment sooner?
  • Were you actually experiencing significant symptoms immediately after the accident?
  • Could your symptoms have been caused by something other than the collision?
  • Did another injury or medical condition cause your complaints?
  • If you were seriously injured, why did you wait so long to see a medical provider?

These questions do not necessarily mean your claim is invalid. People respond to accidents differently, and some injuries may not become apparent immediately. But a substantial delay can give the insurance company an argument that otherwise might not exist.

Why You Should Attend Your Medical Appointments

Prompt treatment is only part of the equation. Consistent treatment can also be important. If your doctor recommends physical therapy, follow-up examinations, diagnostic testing, or other treatment, make a reasonable effort to attend those appointments. If you repeatedly miss appointments or stop treatment for extended periods, the insurance company may use those gaps to argue that your injuries were less serious than you claim.

For example, imagine that you report significant neck and back pain following a collision and your doctor recommends six weeks of physical therapy. You attend the first two sessions, miss several appointments, and then do not return for another month.

The insurance adjuster may point to that treatment history and argue that your symptoms must have improved or that the injury was not particularly serious.

That may not be a fair conclusion. You might have missed appointments because of work, transportation problems, family responsibilities, scheduling conflicts, or other legitimate reasons. But the medical records may not tell that entire story unless the circumstances are documented.

What Happens When There Are Gaps in Treatment?

Treatment gaps do not automatically destroy a personal injury claim. There can be legitimate reasons for interruptions in care.

For example, you might:
  • Have difficulty getting time away from work.
  • Have transportation problems.
  • Experience a temporary improvement in your symptoms.
  • Have difficulty scheduling an appointment.
  • Be referred from one provider to another.
  • Be unable to afford treatment.
  • Have another legitimate reason for temporarily stopping treatment.

If something interferes with your treatment, communicate with your healthcare provider and, when appropriate, explain the reason for the interruption. Your medical records should accurately reflect your treatment and your condition.

The important point is that a significant unexplained gap can become evidence the insurance company uses against you.

Insurance Companies Look Closely at Your Medical Records

When an insurance company evaluates a personal injury claim, the adjuster may review the medical records looking for information that affects the value of the claim.

The adjuster may examine:
  • The date of your first medical treatment.
  • The symptoms you reported to your first provider.
  • The diagnoses made by your healthcare providers.
  • The frequency of your treatment.
  • Missed or canceled appointments.
  • Gaps between treatment sessions.
  • Gaps between medical examinations.
  • Whether you followed your provider's recommendations.
  • Whether your symptoms improved or worsened over time.
  • Prior injuries or medical conditions that may be relevant.

An insurance adjuster is not a doctor and cannot independently diagnose your condition. Nevertheless, the adjuster is responsible for evaluating the claim on behalf of the insurance company. Medical records therefore become an important part of the evidence used to determine whether the insurer will make a settlement offer and how much it is willing to pay.

Don't Give the Insurance Company an Unnecessary Argument

When I meet with personal injury clients for the first time, I emphasize two things:

First, seek appropriate medical care promptly after an accident if you are experiencing symptoms or believe you have been injured.

Second, once you begin treatment, make a reasonable effort to follow your healthcare provider's recommendations and attend your scheduled appointments.

Neither of these principles means that you should obtain unnecessary medical treatment simply to increase the value of a claim. Your treatment should be based on your actual medical needs and the recommendations of qualified healthcare professionals. The goal is to make sure that your medical care accurately reflects your injuries and that your medical records provide a clear, consistent picture of what happened after the accident.

What If You Already Have a Gap in Treatment?

Don't assume that a treatment gap means your personal injury claim is over. If you have already missed appointments or experienced an interruption in treatment, the important thing is to be honest about what happened. Explain the circumstances to your healthcare provider and discuss whether additional treatment is medically appropriate.

You should also avoid trying to "catch up" by obtaining unnecessary treatment solely for purposes of your personal injury claim. Your medical treatment should be driven by your actual medical condition, not by what you think will make your claim more valuable. An experienced personal injury attorney can also review the treatment history and help determine how a gap in care may affect the claim.

Your Medical Records Can Tell the Story of Your Injury

A personal injury claim is ultimately supported by evidence. Medical records can help establish the timeline of an injury:

Accident → symptoms → medical evaluation → diagnosis → treatment → follow-up → recovery or continuing symptoms

When that timeline is reasonably consistent, it can make it easier to explain the relationship between the accident and your injuries. When there are significant unexplained gaps, however, the insurance company may argue that the connection is less clear.

That is why I tell my clients that seeking appropriate treatment promptly and following through with recommended care are two of the most important things they can do to protect their personal injury claim.

What Should I Do After a California Car Accident?

If you are experiencing pain or other symptoms after a car accident, seek appropriate medical attention and follow your healthcare provider's recommendations. Keep track of your appointments and retain copies of your medical records and bills. If you cannot attend an appointment, communicate with the provider and reschedule when appropriate. If there is a significant interruption in your treatment, make sure there is an accurate explanation for what happened.

Most importantly, do not ignore your injuries simply because you initially think they are minor. At the same time, do not seek unnecessary treatment merely because you believe it will increase the value of your claim.

The best approach is straightforward: get appropriate medical care, follow your doctor's recommendations, and be consistent and honest about your symptoms and treatment.

If you need assistance after a car accident or would like to discuss a personal injury claim, contact personal injury attorney Robert Mansour for a candid evaluation of your matter.

Frequently Asked Questions

How soon should I see a doctor after a car accident?

There is no universal California law requiring you to see a doctor within a particular number of days. However, if you are experiencing symptoms or believe you have been injured, seeking appropriate medical attention promptly can help document the timing and nature of your injuries. In my experience, waiting more than approximately 10 days to seek active medical care can create unnecessary problems for a claim.

Can a delay in medical treatment hurt my personal injury claim?

Yes. A significant delay can give the insurance company an argument that your injuries were not caused by the accident or were not as serious as you claim. A delay does not automatically defeat a claim, however. There may be legitimate reasons why someone did not seek treatment immediately.

What happens if I miss a doctor's appointment after an accident?

Missing an occasional appointment does not necessarily have a major effect on your claim. However, repeated missed appointments or lengthy gaps in treatment may be cited by an insurance company as evidence that your injuries were not significant or that you recovered sooner than claimed.

Can I still recover compensation if there is a gap in my medical treatment?

Potentially, yes. A treatment gap does not automatically eliminate your right to pursue compensation. The circumstances surrounding the gap, the nature of your injuries, your overall treatment history, and the medical evidence supporting your claim can all be relevant.

What if I couldn't afford medical treatment after my accident?

Financial difficulty can be a legitimate reason for an interruption or delay in treatment. If this happens, be honest with your healthcare provider and discuss available treatment options. An attorney can also help you understand what options may be available for obtaining appropriate medical care while a personal injury claim is pending.

Should I continue physical therapy even if I start feeling better?

You should follow your healthcare provider's recommendations and discuss any improvement in your symptoms with your provider. You should not continue treatment solely to increase the value of a personal injury claim, but you also should not stop medically recommended treatment without discussing it with your healthcare provider.

Should I get additional medical treatment to make my personal injury claim stronger?

No. Medical treatment should be based on your actual medical condition and the recommendations of qualified healthcare professionals. Unnecessary treatment can create its own problems and may undermine the credibility of your claim.

Why do insurance adjusters care about gaps in medical treatment?

Insurance adjusters evaluate whether the medical evidence supports the claimed injuries and their connection to the accident. A significant unexplained gap may allow an adjuster to argue that the person recovered, was not seriously injured, or developed the symptoms for another reason.

What should I do if I cannot attend a scheduled medical appointment?

Contact your healthcare provider as soon as possible, explain the circumstances, and reschedule when appropriate. Keeping your appointments as consistently as reasonably possible can help create a clearer medical history of your injuries and treatment.

Can an insurance company use my medical records against me?

Insurance companies can review medical records that are relevant to evaluating a personal injury claim. They may examine the timing and consistency of treatment, prior injuries, diagnoses, and other information when evaluating causation and damages. This is one reason it is important for your medical records to accurately reflect your symptoms, treatment, and medical history.

What should I do if the insurance company questions a gap in my treatment?

​Be honest about why the gap occurred. If there was a legitimate reason—such as work obligations, transportation problems, financial difficulties, scheduling issues, or an improvement in symptoms—explain the circumstances to your attorney and healthcare provider as appropriate. Your attorney can help address the issue with the insurance company.

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    Attorney Robert Mansour

    Robert Mansour (CA State Bar #169118) is an attorney in Santa Clarita, California who has been practicing law since 1993.  After working 13 years for a major insurance company, he now counsels victims of personal injury. Click here to learn more about Robert Mansour.

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