Posted 2/25/2008 12:32 PM (GMT -7)

Hello IAQ and welcome to HW. I worked for attys for over 20yrs in personal and worker's compensation. We also did medical malpractice claims.

I will offer you some advice from my own personal knowledge, but I am not an atty. You will have 2 claims; 1. propoerty damage to your vehicle and 2. bodily injury claim. The only money you will see up front is for your damage to your vehicle. They will not pay for your medical expenses as you incur them. Your medical expenses, lost wages and pain & suffering is how they deterrmine any settlement offer on your claim.

Each state is different on their laws concerning auto accidents. I don't know where you live but you can get online for your state and find out what the laws are. Usually when a claim is made with the city they have their own claim form and a time limit on getting the form mailed back to them. Find out if the city their has a claim form for you to fill out.  Any paperwork you recive thats needs to be completed and returned to the city or insurance company, always make a copy and keep it for your records. You need to make a folder for all the accident related expenses. You need to find out what the time limit is for your state to settle your claim, thats called the statute of limitations. Here in Tx we have 2yrs to settle before having to file a lawsuit.

The city may want to take a recorded statement from you over the telephone. This is simply to get your side of what happened in the accident. Now a days nearly all ins comp take a recorded statment and the cities I dealt with required it. This is just part of the claims issues. DO NOT GIVE A RECORDED STATEMENT IF YOU HAVE TAKEN MEDS AND ARE GROGGY. Arrange a time you can do it with a clear head. You will be assigned a claim number on your claim with the city, this is how they identify you.

Yes, you could have gone to ER but at best a simple plain film x-rays would have been taken which would only show broken bones or a fracture. Maybe given something for pain and out the door you would have went. Don't worry about documenting your injuries, you did this by going to PCP's office.

From now on, stick with the PCP that knows you and make it very clear you only want to see him. He knows your previous history and he can make a determination on whats new since the accident and what was there prior to the accident. Request that your PCP makes a second chart with your accident date. I would make an appt and get in to see the PCP.

You may use your health insurance to get all of your medical treatment related to the auto accident. In return the health insurance company will subrogate at the end to get their money back off the top of any settlement. By law they are entitled to be reinbursed. This is called subrogation. You may get a letter from your health ins wanting to know if this is a third party claim and they will ask for that info which you will need to give them.

On your own personal vehicle you need to look at your insurance policy and see if you have Personal Injury Protection coverage. This will be an extra insurance you paid for and its a no fault insurance. You can file this and get 80% of any lost wages reimbursed to you as long as a dr says you are unable to work. Or you may use this to be reimbursed for any out of pocket medical expenses. You do not have to reimburse your ins coverage back if you have Personal Injury protection, its a no fault coverage. If you only have Med Pay, you really don't need to file it since you are using your health insurance for your medical care. Med Pay is what it states, it pays for medical expenses you pay out of pocket but at the time of settlement they get their money back. If there is any questions I can help with let me know. Susie

 


Posted 2/25/2008 2:51 PM (GMT -7)
Thank you for discussing your surgery, Mochiah. I need to pull out my old MRI, but I'm pretty sure you described almost exactly what that test read. I don't know if the osteophytes are the same, but on mine, I believe I had something referred to as "spiny nodules" that were compressing my spinal cord. It sounds like your case was more advanced or severe than mine, though, as I don't believe they are pinching off the cord at that level. The disc herniations sounds word-for-word as I remember it on my report and I have a very similar condition in my lumbar area.

straydog, I can't thank you enough for the information. I appreciate you taking the time to provide me with so much valuable advice and insight. I spent the morning in the ER and it went exactly as you said it would. I went early in the morning, which turned out great, so there was only one other person there when I arrived. By the time I left there were no seats available in the waiting room and they were hurrying me out of the room to get someone into it who had overdosed. I only ended up spending about 3 hours and $100 there, so it was probably worth it, as I now have more detailed documentation of my injury, a written statement advising me to take at least 4 days off of work (which I think I will need for the settlement) and they did give me shots of Toradol and Valium...they were going to give me Norflex, but I was afraid it would be too similar to Flexeril, which has weird effects on me. So they did that, took X-rays, like you said, and gave me a rx for a small supply of Percocet, Motrin, & Skelaxin. The Percocets seem to be stronger than the Vicodin ES that I normally take...at least it seems to be working better, so that part is good. They gave me a referral to an orthopedist and that was that. But I received none of those things from my PCP office, so it wasn't a total waste. A return visit to my PCP may have resulted in more help, though. Again, I really appreciate the advice. Having never gone through this before, I'm a bit naive regarding how it all works. Your information is helpful and thank you for the offer to answer further questions. I have still not heard back from the city and I still haven't decided whether or not I need to retain an attorney. I have been keeping a file of all of my paperwork and expenses. The hospital required me to use my health insurance during registration. They said they would bill my auto insurance instead if I faxed them a copy of my card within 24 hours. I don't know if this matters and after your info on subrogation, I'm thinking it would just be more simple to keep all of the personal injury part going through my health insurance. My auto insurance agent said I could have them handle collecting from the other driver, requiring me to pay my $500 deductible up front for things, or I could deal directly with the city. They advised dealing with the city, so I don't know if the bill going to them would be problematic. Thank you in advance if you have any thoughts on this. I'm looking up statute of limitation laws in Florida now. I'm also glad you mentioned the recorded statement. I wouldn't have been prepared for that. I have only read and been told not to answer any questions from their insurance adjuster. That advice seemed a bit odd to me, as the story is pretty straight forward...but now I'm not really clear on what I should and shouldn't say. It would be clear if I didn't have a pre-existing condition...that is what fogs it up for me. I guess this is where an attorney would come in handy. I'm also double-checking my auto policy for the Personal Injury Protection and Med Pay information.

Thanks again to everyone who has chimed in. I know this isn't the most compelling topic, but I appreciate the insight.

Oh, one more question for the forum, can anyone speak to how different an orthopedist and pain management doctor are from your experience? I only have real experience with PM. I only saw an orthopedist once, at the very beginning of my neck and back issues, and it wasn't a positive experience. He was abrasive, hurried, and gave me an unsolicited and condescending lecture on the evils of pain medication after I asked him if the Motrin he prescribed me was going to be strong enough for my level of pain. He worked off of two x-rays, taken in his office, and from looking at them, was convinced that there was nothing wrong with me. I'll be providing this new orthopedist with copies of my past MRIs. Hopefully those + the accident will keep me from being blown off.
Posted 2/25/2008 4:58 PM (GMT -7)

Hi again, Florida has a 2 yr statute, we had a case that hapened down there.

I can only tell you this, if you don't cooperate with the city you are not going get anywhere. Like the R/S if that is part of their program of working up a claim to decide liability, if you decide not to talk to them, then you get nothing done. They ask standard questions including have you had any prior accidents or claims. You must tell them of any, they have already done a check and know of any claim made. If you have a speaker phone at home, you can get a little handheld recorder and record the statement too.

I see a pain mgt specialist. Pain is what they treat, they can order tests such MRI's, they can also ref you to specialists. Have you ever seen a neurologist for your neck pain? Personally I have never found an orthopedic to be helpfull on a neck problem, but did with a neurologist. Te difference is alot between an ortho & pain mgt. Pain mgt drs are deal with nothing but pain problems, they know a great deal more about pain medications than an ortho or neuro. They are not afraid to write a script for pain meds either. Orthos on the other hand is not going to give anything more than vicodan and those will be very few and not for very long. They don't like giving meds. One of our ladies on here is a transciption specialist and one dr sent a woman home with plain tylenol as her pain meds from a major back surgery. Someone should shoot him.

I think you are right in using your health insurance for your medical care. You need to have proff from your mployer to document your lost wages. The city should send you a wage statement that needs to be completed by your employer, not by you.

Don't be surprised if you don't have any MRI right away. In fact, I would not push for one right now. Things develope over time and most of the time will not show up right away. Good luck and let us know how you are. Susie

 

 

 


Posted 2/26/2008 3:37 AM (GMT -7)

Welcome to the forum IAQ! Sorry to hear of your accident but wanted to chime in here re just that!

First I am glad you went to the ER and found some help there at least and as for the advice re: Ortho/Neuro for a neck injury I would definately say Neuro here.

If you were rearended it was not a matter of fault as that is cut and dried and should you use your medical to cover a accident you can find yourself with a load of unpaid medical bills.

I would call an Attorney and take all of the guess work out of figuring out who is to pay and who isnt and the run around from the city and their adjuster. You are entitled to medical comp for the accident andything related to it and the PIP can be set up to pay for any and all expenses you occur as you incur them and for alot of states there is a limit moneywise here so it would be to your advantage to have an Attorney to help you pick and chose what treaments are going to be beneficial to your claim and in proving it.

The other option is using your insurance company and letting them pay for your bills at this point and then their Attorneys will collect from the city's insurance but either way you should not have to be dealing with these issues yourself as you were in no way at fault in this accident. And remember the old adage of "anything you say" may be used against you and that is especially tru when an insurance company is trying to get out of NOT paying. Please be careful what you say to the city and anyone in their employee at this point.

They may even go so far as trying to say your injuries were predisposed due to your prior injury/or disease another way of not paying for your care.

Your local phone book can give you names of Attorneys that take on these kinds of cases and be sure to ask how they expect to get paid as money at this point is an issue so one that reuires a cut should be fine just shop around as to how much of a cut they are asking for as it will vary even if most states have a ceiling on how much.

Hoping this works to your advantage here and remember alot of these tests such as MRI's can be extremely expensive and your medical can refuse to pay since it was an auto accident and again this is what I meant by an Attorney knowing which test to request from your treating Doc and alot of them have their own Docs on retainer lists that specialize in court cases and what to look for as you certainly dont want to run thru the insurance limits and not get anything that would do your claim any good.

 

Good luck to you!


2 knee replacements & a hip.
spondylosis at L-4,5 & S1
arthritis,sciatica all that being a CPer entails!
 
If you stumble make it part of the dance!

Posted 2/27/2008 12:50 PM (GMT -7)
Thanks for the followup, Susie. I still have not heard back from the city's adjuster. I was promised a return call on Friday. I left another message yesterday, but still no response...so no recorded statement to make yet. It looks like I'll be starting off with an orthopaedic surgeon...as I have three recommendations...one of which is from a co-worker who was in an accident and found his doctor really helpful. He also says he never had a problem getting medication from him, which I can certainly appreciate after my first ortho experience. I don't know if that will be the answer, but it will be a start. I am going to try to find a good PM in the meantime. If anyone has any South Florida recommendations, please PM me. I'd like to find someone who is multi-disciplined, offers different treatments, but doesn't rely solely on injections and isn't scared to prescribe.

Ruth Thomas, I've enjoyed your posts in other threads. Thank you for your thoughts. My mother-in-law agrees with you that I should be seeing a neuro. Would this be a neurologist or a neurosurgeon or are they one in the same? I don't have any experience with this field of medicine. I have gone ahead and secured the services of an attorney. She is a friend of the family, so I feel comfortable with the decision. I don't have any intention of filing any lawsuits, but I do want to make sure that I have my i's dotted and my t's crossed and make sure that I don't make any errors during this process that could leave me holding the bill for anything resulting from the accident. She has advised me to go ahead and get a claim filed with my own insurance company, rather than dealing directly with the city, even though it means paying the deductible for the damage. That allows all medical bills to be processed through them as well and lifts the limitations of having to get referrals, etc. as I do when dealing with my HMO. Much like Susie warned, she told me to expect to be asked to make a recorded statement, but by my own insurance company. She advised me to refuse until it could be scheduled when she would be able to be on the phone and after she's had a chance to prepare me. She asked if I had prior MRIs and since I had, she seems to think they'll want another one for comparison purposes. She discussed the no-fault laws, what should be covered, etc., and now that I have her helping me, I'm glad I chose to go that route. There was just too much uncertainty on too many issues and I didn't want to do something to negatively effect then chances of my expenses getting covered.

Gramps, I can't believe you had trouble logging in. Don't they know who you are?! I kid, but I have seen you help so many people already during my few days on the forum...I'm glad to now be one of them. The ER advice is good. It is what my PCP told me and what I've heard several times since. If anything like this ever happens again, I will be going to the ER immediately. I didn't feel a bit of pain after the collision. While the impact was pretty good because I was stopped and the other driver was trying to stop from interstate speed, I really didn't even think about injury at the time. His car looked so much worse and because of that I was more concerned about him. Then once all the paperwork was finished and I pulled away, I became distracted by my A/C not working (I don't know if the accident caused it, but it is dead) and really just tried to get to work and go about my business until I started feeling the beginnings of a problem around midday. By evening I was in pain, and by morning my wife had to help support the weight of my head while helping me out of bed and my left arm was useless and hurting on top of it. I laughed at your story about being hit by a city vehicle. I've had two different people say things like "cha-ching!" when I mentioned it. I'm guessing they would have been lying on the bus with the others. HA! My only concern is my expenses, getting some relief from this pain, and hopefully getting to the bottom of what is causing it. Thank you for the welcome. I hope you and your family are well as possible.
Posted 2/27/2008 2:44 PM (GMT -7)
If you are not a surgical candidate those drs will not be interested in taking you on as a long term patient either. Like Gramps said, their money comes from surgery not conservative care. Glad you got an atty. Yes, at some point you will need another MRI most likely to set the record straight. They will be very interested in all of your past medical care and they are entitled to this info as well. If you refuse then your claim sits w/no action on it. The city here requires 3 estimates of property damage, not sure what you have done at this point,. Be sure to take photos of the damage to your vehicle, they may be needed later on. Susie (I think a neurologist is the way to go too)

Posted 2/28/2008 2:18 AM (GMT -7)
Thanks for the remark about reading my posts, I truly love to "talk" and anytime I can make a difference in someones day even for a brief moment it makes my problems a little less significant for a moment.
 
Glad you got an Attorney and even if a lawsuit wasnt on the agenda it sure makes it easier for yourself when you can refer all those questions to someone else!  When your trying to deal with pain issues there just isnt the time nor energy to answer calls and questions and menial stuff can be handled by someone else.
 
I havent the foggiest notion when it comes to anything legal so my motto is to leave it to someone who does,lowers the risk of making mistakes that may be harmful for me down the road.
 
As for the deductable on your insurance they may reimburse you for that later when the city gets around to admitting fault in the accident and getting all the paperwork and red tape out of the way and really begin to help you!
 
At least you can get meds and see Docs without having to worry about who is paying and as I am sure you know that is usually a offices 1st priority!
 
Anyway rambling here and want to say I hope your doing some better then at the start of this thread and it sounds as if your getting the right appointments set up.
 
Good luck to you!
2 knee replacements & a hip.
spondylosis at L-4,5 & S1
arthritis,sciatica all that being a CPer entails!
 
If you stumble make it part of the dance!

Posted 2/29/2008 6:45 PM (GMT -7)

IA, I forgot to tell you. My very first auto accident, I felt exactly as you did, I was also rear-ended. Mine was a hit & run, they left the car at the scene, a couple of illegal Mexicans were driving someone else's car and of course no insurance. That one cost me some dough. Had it not been for PIP I had which was only $2,500 I would have really been up a creek.

I did not go to ER, I went to work and by 5:00, I could not turn my head, I had a H/A from hell, in alot of pain, I was just miserable. I saw an ortho for 3 months which was useless, did 3 months of PT that only felt good while doing it. I next saw my sister's dr who did the chinese accupuncture with the needles. He had me totally pain free in 9 visits. Bear in mind, i had alot of muscles involved and not disc problems. It can work well for some people with musclular damage and I was one of them.But boy, did that accident ever set me up and predispose me to futher injuries later on.

Glad you found an atty to help you. Be sure to continue to keep your own file of records & receipts.  To say the least you do have a complicated case because of pre-existing conditions. If you have not been seeking active treatment in a awhile, then that will nip that little problem in the bud.

Yes, its normal for your own insurance to want a statement. Remember, the purpose of these statements are to get everyone's side of the story as to what happened. You would be amazaed at how much people will lie when being involved in an accident.For instance, had a case where a man hit a woman head on, he managed to drive from the scene to his home. He reported to his insurance company that he hit a tree. They paid to fix his car, after all he was their insured. Fortunately, their was a witness to the whole thing, who not only got his license # but followed him to his house and got that address. Yes, people don't always tell the truth.

Hope you start feeling better soon. Susie 


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