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Auto Accident or Work Injury...?!

 

 

REMEMBER:  The Insurance Company Must PAY You for your “Pain and Suffering”


 

By: Dr M Shery

 

IN A MOTOR VEHICLE ACCIDENT YOU CAN BE COMPENSATED VERY GENEROUSLY BY CLAIMING ALL DESERVED “PAIN AND SUFFERING” – not just the physical injuries themselves:  To support your injury claim ask your doctor or psychologist to provide you with medical attention as soon as possible after you've been victimized in a crash. This decision can make the difference between ending up VERY WELL compensated for your accident claim, or getting just a “nuisance value” settlement - - a small payment made to close the case.

Your claim of bodily or psychological injury has no credibility with the insurance adjuster unless it’s been verified by the written report executed by your psychologist or physician. After an accident or injury, if you don’t see a doctor or psychologist, but still attempt to justify an injury that produced "pain and suffering" (and also contend you’ve lost time from work) the adjuster is not going to buy it. At the end of the day you won’t be paid much, if anything, for your loss.

IF YOUR INJURY IS MILD: Under normal, routine circumstances the doctor will probably see you five to eight times without providing any complicated treatment. Depending on the injury, you may receive psychological testing, psychotherapy, be x-rayed, prescribed some pills, told to rest a few days (or weeks) and possibly be advised to avail yourself of heat therapy for any neuro-muscular pain.

WHEN AN INJURY IS MORE SERIOUS: You may have to wear a cervical collar (a neck brace) for a few weeks. This can be uncomfortable but it will assist in your physical recovery and produce a higher settlement value of your claim. You may need intensive psychotherapy to resolve any trauma and serious emotional adjustment problems; your doctor may refer you to other specialists as well, such as an orthopedist (a bone doctor) or a neurologist (a specialist in nerve damage).

MINOR BODILY INJURIES: The vast majority of motor vehicle accidents cause minor injuries-both physical and mental. Bodily and psychological pain cannot be specifically measured (temperament and emotional factors are involved) nor can the limits of human endurance. Each one of us has a different pain threshold and emotional constitution. These influence the points at which we begin to feel physical and serious emotional discomfort.

The amount and quality of pain and anxiety you feel is not strictly dependent on the bodily injury inflicted. It has much to do with your previous experiences, how well you remember them, and your ability to understand the cause of the pain and its consequences. For example, the ex-athlete will probably experience a blow much differently than the individual who was never able to play contact sports.

HOW MUCH PAIN OR ANXIETY CAN A PERSON STAND? There’s no specific answer to that question. Sudden pain, even of less intensity than, for example, a serious burn, can overwhelm the higher nerve centers; so much so that a man could faint! Or, grinding anxiety may make it almost impossible for some people to function at home or work AND make the perception of the pain and outlook for the future seem MUCH WORSE! And your insurance adjuster is very aware of that!

FILING A PERSONAL INJURY CLAIM AND NEGOTIATING A SETTLEMENT

THE INSURANCE ADJUSTER AND YOUR PHYSICAL/PSYCHOLOGICAL ANGUISH: Don’t kid yourself that the adjuster can’t get a handle on, nor understand, the pain, anxiety and discomfort you’ve experienced. He can, but even so, he’ll try to act as though what you’ve been experiencing is no big deal. Why? Because he knows your claim will cost a lot more money if you get the idea he does understand the impact the accident had on your body and mind. S/he is well aware of where you’ve been and where you’re coming from because s/he negotiates with injured people day in and day out (all of them struggling with similar problems) as s/he goes about the business of settling "pain and suffering" cases. S/He handles identical issues every hour of the work day. S/he knows what you’re going through but (never forget) his/her job is to make you believe you’re exaggerating your complaints.

S/he’s fully aware of all there is to know about post-traumatic-stress disorder (PTSD), other psychological injuries vs. hard physical injuries vs. soft tissue injuries. The adjuster is constantly in contact with the twisted, bruised, battered, pulled and snapped problems of pain, stress, doubt and worry that people must endure because of injured tendons and ligaments, muscle strain and/or spinal cord injuries. Each and every day your adjuster is exposed to the wide range of problems that injured people must endure. These also include stress, anxiety and/or deleterious emotional reactions. The adjuster is no dummy when it comes to comprehending the legal concept of “pain and suffering“. His/her paycheck depends upon how well s/he understands these factors because they’re dramatically involved in the amount of money that’s paid out by his/her corporate employer. So s/he makes much of his/her living by stonewalling. So, you may ask, in the final analysis, how does the insurance adjuster make his/her living? The answer to that one is very simple, s/he’s most often paid to manipulate injured people into ridiculously low settlements.

THE ADJUSTER AND YOUR MEDICAL BILLS: After you file your injury claim, the adjuster may try to con you by telling you that many of your medical expenses don't qualify as "medical" in nature. S/he'll attempt to divide your medical costs into two areas - - one part "diagnostic" and the other "treatment". In "diagnostic" s/he'll include ambulance and emergency room costs, the cost of X-rays, plus any psychological testing and visits to other specialists. The rest of your bills, usually the money paid out to the hospital emergency room, pharmacy and regular office visits to your doctor, psychologist, physical therapist, s/he'll term "treatment". Those items s/he incorrectly identifies as "diagnostic" are bills that many adjusters will try to disallow - - telling you that they're not "medical" in nature.

S/he knows, if s/he can get away with doing this, the value of your claim will be drastically reduced, because the bottom-line amount of your "special damages" has been dramatically downgraded. The adjuster may likely contend that only the "treatment" portion of your bills are "directly related" to the severity of your injury, therefore that's what truly reflects the value of your "pain and suffering.”

Don't let him/her get away with that ! Demand full inclusion of ALL medical bills, otherwise your personal injury claim will be drastically reduced.

Tell the adjuster, conjuring up all the authority you can muster: “Legally speaking you can't separate medical expenses into two categories. Each bill I have goes hand-in-hand with all the others. It would be impossible for me to get properly treated without being thoroughly diagnosed and, even more important than that, I can’t place a value on my personal injury claim until all my Special Damages have been correctly assessed”.

When the adjuster hears that s/he will blanch and then gulp! Why? Because s/he knows that what you're saying is true. S/he’ll suddenly become aware that you know how to place a value on your “pain and suffering” and that should put an end to his/her nonsense.

DISCLAIMER: The only purpose of this article is to help people understand the motor vehicle accident claims process. No guarantee of any kind is warranted; NOR does this article purport to engage in rendering any legal service; NOR to substitute for a lawyer, an insurance adjuster, or claims consultant.

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To make an appointment,call 1-847-275-8236, or schedule yourself in our online appointment book now; Click:  Make appointment for Cary Office: Therapy and Counseling

 

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Copyright (c) 2006 Dr M Shery

About The Author

 

Dr. Mike Shery is the director of ACRS and is a licensed clinical psychologist. He has practiced clinical psychology for approximately 24 years and is affiliated with almost all health plans, including: ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First Health, Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana, most union local plans, most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental Health Network, Managed Health Network, United Behavioral Health, most auto and workers' compensation carriers and Beech Street.

  

He is board certified as a specialist in professional counseling by the International Academy of Behavioral Medicine, Counseling and Psychotherapy. He a member of the American Counseling Association. The office is located in Cary, IL, near Crystal Lake, in southern McHenry County and, in select cases, phone consultations are available for those who don’t live locally>Telephone Counseling.

 

To make an appointment, schedule yourself now; Click here:  Make appointment for Cary Office: Therapy and Counseling  

 

Or, if you prefer, call Dr. Shery at 1-847-275-8236 and he'll schedule one for you on the spot. .

 

 

To make an appointment, schedule yourself now; Click:  Make appointment for Cary Office: Therapy and Counseling

 

                                                                         To return to:  Motor Vehicle Accidents, Job Injuries and PTSD

 

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