In a properly managed personal injury case (PI case) there are two dates of importance. The first is 21 days or three weeks post-trauma. The other is at 91 days. When properly diagnosed, documented and managed, these are two milestones to watch for.
The first weakness on most personal injury cases is a failure to diagnose. Once a claim has been submitted by your client the insurance industry’s protocol includes three weeks as a threshold that can make or break a case. Before getting into the importance of this date, bear in mind that this three-week timeframe is from the date of the collision. This is not from the date of initial treatment or your first contact with them as a potential client.
Most medical doctors who are not well-versed in motor vehicle injuries will use a simplistic diagnosis of muscle strain. This can be applied to any area of the spine or extremities. Sadly, this holds true even in the emergency department where diagnosing more severe injuries is their objective but all too often not a product of their examination.
The first weakness on most personal injury cases is a failure to diagnose. Once a claim has been submitted by your client the insurance industry’s protocol includes three weeks as a threshold that can make or break a case.
The problem with this diagnosis is not just the insurance company’s position but also medical literature that supports the argument that a muscle strain will most likely heal in six-eight weeks. If your PI case is based on this simple diagnosis, without additional testing within the first three weeks, you will have an uphill battle on your hands.
Even for those patients who do go to the emergency department or an urgent care center most will then find their way to a chiropractor. Once again for those chiropractors who have not been properly trained on what to look for in a motor vehicle injury their diagnosis will most likely be a sprain.
Diagnosing the sprain has a similar damaging effect on your case. This diagnosis applies to ligament injuries rather than muscle injuries seen with a strain diagnosis. The insurance company will use the same argument that this should be expected to resolve within six-eight weeks.
You need to get over that hump of the three-week milestone after which your case can be locked into one that should have resolved within eight weeks. To do so the doctors you are working with need to perform additional testing to determine the more serious diagnoses that will deserve a better settlement offer. Remember that the threshold here is three weeks or 21 days from the date of the trauma.
When there is a delay in testing of three-six months post trauma that leaves the door open for the argument that any injuries found are not related to the crash. Herniated discs, compression fractures, ligament laxity, and traumatic brain injuries identified in the first three weeks add considerable value as opposed to those same diagnoses determined months after the fact.
If your doctors are not providing more serious diagnoses in the first three weeks, then they need to be evaluated by a chiropractor who has the information that we teach with the American Academy of Motor Vehicle Injuries.
So then, where does that 91-day threshold fit in?
Colossus and its 80-plus derivative programs add considerably more value to a PI case that is symptomatic and under continuous care for more than 90 days. While it is possible to get an acceptable settlement prior to 90 days, with the proper diagnoses, at 91 days the analog formula shifts and increases to an automatically higher offer.
If you are working with one of our doctors who knows what to look for, how to test for it, and how to properly document and manage that case your practice should be a lot easier. In a recent conversation with an attorney with whom I work, I was told that their caseload in the past year was way down. In spite of that, because of the documentation that is now being provided on cases, their income was way up. Dr. Bill Gallagher, DC, CMVI
