How do I convince the insurance adjuster that I truly AM in pain and have a long-term injury?

I was in a car accident 4 months ago. A young guy rear-ended my car while I was stopped and he was going about 40 MPH (his insurance company immediately admitted 100% fault). My car and his car were both totaled. We both went by ambulance to the ER, but were released with pain meds. I've been going to a physical therapist, chiropractor, and orthopedist for about 4 months now, and while my lower back has improved somewhat, my neck has actually gotten surprisingly much worse. An MRI showed a herniated disk in my neck and a bulging disk in my lower back. My PT thinks I also have messed up joints because my neck and back crackle constantly and lock up. I have severe muscle spasms. Okay, my question--especially for you insurance adjusters out there--how can I make the insurance adjuster realize that I really am in pain and not just milking it? Obviously they will see the MRI report, but that alone doesn't convey just how much pain I'm in (burning sensation in my neck and head, bad headaches, crackling spine, weakness and tingling in my limbs, and just plain old pain in my neck and back). I am in moderate pain more than half the time and have mild pain the rest of the time. The crackling every time I turn my head is disgusting. Thank you all for any help.

The Judge

I am sorry to hear what you are going through.
You just need a lawyer that'll make them see three times the pain you are suffering, then let them think whatever they want.
I hope you get a million for this.

M-2

You should see a doctor not a Pt and have them show the insurance company the results.

mamaflutey

You hire an attorney to make them see.

I am in the same boat - 10 months (actually next week it's 11) out of my accident & I'm still hurting.
My dr says I'm OK and ther'es nothing WRONG with me but just a simple trip to the zoo (which I used to enjoy before the accident) sent me to limping :(

Kizzy is very wrong - their job is to save the insurance company money - PERIOD. They do not care about you.

I know for a fact all the insurance adjuster has done to me is lie to me. I've been straight with him from the get-go and they're taking advantage of my kindness - I am providing them with free services, actually have been for 11 months now.
What's fair about that?

I am so fed up with this accident.
I imagine you are too ((hugs))

mistify

You are right that MRI reports are insufficient to describe someone's symptoms because many of the things you describe can also be found on people who are pain free.

You need to have your PT perform specialized tests that identify for those who are possible "maligerers" and identify those who have high levels of fear-avoidance or analyze for "overt pain behaviors" while also undergoing tests for funcitonal performance or disability. There are several standardized tests by which a practicioner help weed out who is "milking it" need psychological counseling or who actually has a functional impariment.

Some suggestions are the "McGill Pain questionaire", "Oswestry Disability Index" and "Waddell's signs of non-organic pain" and whether your pain centralizes or is "non-centralizing" (as described by Robin McKenzie)

These things are typically surveys and clusters of signs that can identify those who are "milking it" and those who might have a strong psychosocial compenent to their pain or those who do have a high risk of chronic disability.

These will help your case have more substance.

jtexas

They rely on reports from PT, chiro, orthopedist. They send you to a doc of their choosing. They send an investigator to watch your house & videotape your movements.

MSAD

If you are seeing a chiro and pt at the same time...that's really over treating and if the pain is getting worse an not better -- that's the first sign that somethings not right with your course of treatment.

I'd stop seeing the chiro and work directly with the ortho and physical therapist.

Once you are done treating - the adjuster will gather copies of your medical bills and reports. They will use that to evaluate you injury claim. If you want to tell them about how the injury has affected you - that's fine. There is no such thing as too much info.

But while you are still treating-- all the adjuster can do is call you from time to time just to touch base and see how the treatment is going.

**not legal advice -only an attorney can give legal advice -- just my 2 cents**

Kizzy

You shouldn't have to 'convince' them of anything....the doctor's chart notes and medical reports can do that.

I have to disagree with the comment that it's an adjuster's job is to rip people off. You can't imagine that fraud that we adjusters see every day. It gets a bit weary to try and weed out the people trying to 'get rich quick' and it makes it very difficult for the people that are actually injured. These attorneys that are representing these people are just as bad.

Just let the adjuster know that your doctor's can answer any questions they have in regards to the injury you sustained. If the chiropractic and ortho put your injury and your progress in their notes and relate it directly to the motor vehicle accident, that should suffice.

Clara Casey

The insurance adjuster's job is to deny people their benefits, regardless of how real their pain is. They are EVIL.

CwboyBill

You really need to see a REAL doctor.

mudbug

Hi. I have the same predicament. My accident was 13 months ago. I still hurt. My Licensed Massage Therapist gives me more pain relief than my PT sessions. I also have a friend who is an adjuster for another insurance company than mine. He advises that I should submit a written statement from each of my medical people. The insurance rep is only authorized to offer a certain settlement amount. ( I am working on finding this amount from my friend) Stage two is that you litigate. The problem is that the medical people are reluctant to be involved in a lawsuit and with this type of injury is hard to determine how long you will be in pain. Surprisingly many doctors are not trained in diagnosing this type of injury in medical school. Have you consulted an orthopedic sugeon? If not, do so. Every patient is different. It may not be temporary. You may need surgery down the line. I am older so I am worried that my condition will get worse as I age. I am at the stage where I have submitted the medical statements. It has been two weeks and no response.

Enter Your Message or Comment

User Name:
User Email:
Post a comment: