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Chiropractors


 
We have mentioned our belief that chiropractors are more likely to support the claimant in both the physical recovery and financial recovery. Obviously, in a severe medical injury case, use of a chiropractor is inappropriate. If a person has severe bodily injury and broken bones, etc., an orthopedic surgeon is required and a neurologist will attend to nerve damage. There will be no referral or use of a chiropractor or alternative medicine.
 
On the other hand, for the vast majority of soft tissue injury cases, the most appropriate place to start is often a chiropractor or a general practitioner who is supportive of your treating with a chiropractor while he oversees your recovery.
 
In this latter situation, you have the best of both worlds: a medical doctor who can fend off the insurance attacks from other medical doctors and a chiropractor that can treat you and care for your recovery.
 
Chiropractors are highly trained doctors who are fully competent to take a complete history and perform a chiropractic examination. They are adept at writing reports and they are more likely than not going to make the effort to learn the background of your claim and support your financial recovery by making a thorough report in their records.
 
Find out whether your doctor has a plan and timetable for your recovery. Find out what his charges are. Take a look at what he proposes spending. This is one place that you can bend the rule about following your doctor's orders. Obviously, it is to his best interest that you are treated three or four times a week but you may need to negotiate that down. You will see elsewhere that you may get stuck with some chiropractor bills if treatment is too expensive or goes on for too long. If you'd rather not mention costs in negotiating down from his treatment plan, you can always mention inconvenience, time away from work, etc. Have him give you some exercises or something to do at home. Take the number of treatments you decide are appropriate after letting the doctor explain his position.
 
Find out what kind of notes he makes. The writing of medical doctors is notoriously poor and the chart notes of chiropractors bear some of the same problems. Little scribbles with codes on them by date of treatment mean little to an insurance adjuster. Therefore, the chiropractor may have to prepare a letter or written narrative report. Ask him to show you some records and ask him how the insurance adjuster is going to interpret these without a written report. Have him tell you what the costs of a narrative report will be.
 
Some doctors and chiropractors dictate their notes for transcription or prepare their own notes on a computer. If you find a doctor who does this, you are getting free narrative reports - and everything is typed up and legible.
 
Find out what a chiropractor's policy is for referring you to a medical doctor. Many chiropractors will treat for a while and then make a referral to medical doctors with whom they have worked in the past. These medical doctors understand the benefits of chiropractic treatment and will examine and oversee a general treatment plan for an injured person. Examples of appropriate referrals can be to neurologists, occupational health specialists or sports medicine specialists. In these referrals, the medical doctor will allow the patient to continue chiropractic care while he receives medical attention.
 
Can you have a doctor who is too supportive and favorable? The answer is yes. You may run into doctors who make a living treating injured people. That may sound excellent, because it is someone who will take the time to understand your claim and has worked with lots of other injured people and writes excellent reports. The problem is, many of his reports have probably landed on the desks of insurance adjusters in your area. Insurance companies keep track of the quality and quantity of reports they receive. If they receive too many reports that sound the same, they will take the time to compare the language. When they find a boilerplate report that the doctor churns out in quantity, they will not honor much of what that doctor has to say.
 
Some healthcare practitioners have lost their effectiveness - at least in terms of your financial recovery - without even knowing it. For example, in one region, there are at least four major insurance companies who will not accept a TMJ report from a particular dentist. They think he turns out TMJs and finds they are due to trauma when they may be due to many other factors in life. Whether you are a first party claimant or a third party claimant, if you present a TMJ report from that doctor to any of those companies, you can expect that the company will order an IME immediately.
 
Of course, you know better than to get involved with some doctor who is churning claims. Those can border on fraud and you do not want any part of that. But if your doctor is highly proactive in pushing your claim, ask yourself how his work is likely received by the insurance industry. Better yet, call your insurance adjuster and ask him if he has ever heard of this doctor. He will let you know what he thinks of the doctor. Obviously, we do not want to let insurance adjusters choose our doctors. Still, if you have selected someone whose work has been noted as unreliable by the insurance industry, why would you want to continue that uphill battle?

As discussed elsewhere, medical specialists such as orthopedic surgeons often are not as active in their support of your financial recovery as are general practitioners or chiropractors. Should they be? Aren't they committed to practice medicine and get you better? Those are questions you will have to resolve.

You will use your own auto insurance PIP or MEDPAY, your HMO or medical plan, the tortfeasor's insurance or some other means to pay. If you do not have any medical insurance available and you do not have the means to pay, go to the doctor(s) and discuss medical liens (see Effect of Medical LiensMembers onlyMembers only). Historically, chiropractors have been very sympathetic to those without insurance and, having an understanding of the claims system, they have been able to work out agreements for care with the use of medical liens. Acceptance of a lien for ongoing treatment may depend on the strength of your liability case, so be prepared to discuss the facts of the accident with your chiropractor in order to convince her to give you service based upon a medical lien. The lien is filed with the insurance company to ensure your doctor gets paid off the top of your settlement award.