Your Personal Injury Claim and Medical Treatment - How Insurance Companies Review Comments in Your Medical Records

Posted Monday, October 10, 2011 by Chris Thayer

As previously discussed, the contents of your medical records will play a large role in how the insurance companies evaluate your personal injury claim. Most people go their whole lives without ever looking at their medical chart and really have no idea what their doctors and other healthcare providers write down. Insurance adjusters frequently seek to take comments in medical records out of context or to overemphasize offhand notes referenced by your healthcare provider.

A common scenario: you are injured in a motor vehicle accident and receiving physical therapy. After a few months of treatment, you start to experience some improvement, but you have “good” days and “bad” days. You find that even limited activity aggravates your symptoms, but you are managing to get through the day and function. During one of your PT appointments you are asked at the beginning, how you are feeling. This is one of your “good” days, so you tell your PT “pretty good”. Later, when pursuing your personal injury claim, the insurance adjuster latches onto this and draws the conclusion that, based on this statement, you must have been doing fine and have been recovered from your symptoms. Obviously, this is an oversimplification, but this is a very common situation that I see played out over and over again with insurance adjusters who are evaluating personal injury claims.

What should you do? A few pieces of key advice:

(1) Be completely honest and forthcoming about how you are feeling. Don’t feel an obligation to be the “tough guy” or to minimize any complaints you have.
(2) At the same time, do not exaggerate your symptoms - just provide a complete and accurate explanation.(3) If you are still having symptoms but are having a “good” day, make sure that is clear with your healthcare provider. Let them know you have “good” days and “bad” days. If you are generally improving, then certainly let your healthcare provider know that; but it is equally important to let your provider know if you are still suffering significant symptoms and have had to curtail your activities as a result.(4) Ask for copies of your records if you have any concerns or questions