Our job as your attorneys is to make sure you get the medical treatment you need and to maximize the amount of compensation due to you for your injuries.
There are, however, several things you can do to help us in this task. Insurance companies, corporations, governments and employers have teams of individuals working diligently on their side to try and decrease the value of your claim and to limit the amount of benefits payable to you. We need to work together to do everything we can to increase your overall recovery.
The following is a list of pointers put together by The Babcock Law Firm, LLC, for our clients about how they can help maximize their claim, or at least avoid destroying it. These pointers are based in part on our experience representing individuals and families. More importantly, however, these pointers are based significantly on the many years spent representing insurance companies, corporations, governments, and employers. We understand very well why the organizations and individuals on the other side of the table do the things they do because we used to represent them.
Please review these pointers and incorporate our recommendations into how you approach your case.
DOCUMENTATION, DOCUMENTATION, DOCUMENTATION...
The individuals on the other side of the table, i.e. insurance companies, corporations, governments, employers, etc., have very few and limited opportunities to communicate directly with you and/or with your medical providers. Consequently, the other side relies heavily on records, and predominately on medical records, for information when determining what benefits and compensation you are owed. What this means for you is that it is extremely important that the information contained in your records is complete and accurate. In order to influence the information included in your records, please keep the following in mind:
- Every injury and/or medical problem/condition you suffer in connection with your case must be documented in your medical records. If a condition is not documented in your medical records, the other side will question whether you really have the condition and whether it is really related to your claim. Make sure you report all problems to every medical provider at every visit. Communicate each problem clearly describing in detail what body part is affected and what your symptoms are.
- The other side will only pay for treatment that is related to your claim, and therefore, wants to see that the treatment they are being asked to pay for was recommended by a medical provider in connection with your case. Every treatment that is recommended and performed in connection with your case must be documented in the medical records. This is an easy task when the treatment recommendation is for surgery. This is not such an easy task, however, when we ask the other side to pay for over the counter medications, slings, bandages, a gym membership in connection with an exercise program, massage therapy, acupuncture, etc. Your records must reflect ALL treatment recommended and completed.
- The other side is responsible for compensating you for wages or income lost as a result of your injuries, but only for wages or income lost as a result of your injuries. If you miss work because of your injuries, it must be documented in the records of the medical provider who removed you from work or imposed restrictions that prevented you from performing your job, and it must be documented in your employer's records.
- The amount of compensation you are due will be influenced by the impact your injuries have on your life. You need to report to your medical providers how your injuries affect your activities of daily living. This includes how your injuries affect your ability to work, sleep, perform daily chores at home (bathing, doing dishes, taking care of children, etc.), perform recreational activities and how your injuries impact your relationships with friends, co-workers, and family (including sexual relationships with spouses, partners, or significant others). There is a big difference between a medical record that states “neck pain” versus a medical record that states “neck pain present 100% of the time that is causing difficulty with sleep, concentrating at work and prevents the patient from playing with her children.”
- Few things are more deadly to a case than gaps in medical treatment and/or indications that a client failed to follow treatment recommendations. Without other information, the other side will interpret these situations to mean either that the claim related injury resolved and that the client re-injured himself or herself during the gap in treatment or that the client is not as injured as he or she suggests and that the client is just trying to “work the system.” All gaps in medical treatment or failure to follow treatment recommendations must be documented in your medical records as authorized by your medical providers.
WAS IT SOMETHING I SAID?
We have all seen enough episodes of NYPD Blue, Law and Order, and/or Cops to know that if the unfortunate happens and we are arrested by the police, we have “the right to remain silent and that anything you say can and will be held against you in a court of law.” What clients fail to realize, however, is that the same holds true in civil, non-criminal matters. The other side can provide judges and juries anything you say about your case, your medical treatment, your injuries, or a potential settlement regardless of where it was said or your motivations for saying it. More importantly, things you say can and will sabotage your case. All too often we have seen insurance adjusters or employers who refuse to be reasonable on cases or walk away from settlement discussions because they heard that our client was bragging to their co-workers about the large settlement they were about to get. Please keep the following in mind when you consider who you should talk to about your claim:
- Do not talk to anyone from any insurance company ever! Insurance adjusters and investigators are trained to build a rapport with clients and to gain their trust in order to achieve a minimal value settlement down the road and/or to get the client to provide them with detrimental information that allows them to challenge all or part of a claim. No matter how nice or cooperative a person from the insurance company sounds, always remember that their job in the end is to pay you as little as possible. This same advice holds true for employer representatives in workers' compensation cases.
- Do not talk to your medical providers about non-medical aspects of the case. Nothing looks worse to a judge or jury then a statement in a medical record that “patient is stressed that she will not get a large settlement for her injuries.” More importantly, your medical providers' perception of your injuries/conditions, and therefore your medical treatment, can be negatively impacted if your medical providers believe your ultimate goal is a large financial recovery.
- Do not talk to anyone about our conversations or disclose our written correspondence to anyone. Communications between you and The Babcock Law Firm are protected by the attorney-client privilege and are confidential. Our communications, however, lose this protection if you disclose our conversations or correspondence to someone else.
- Always be aware of where you are and who is around when you are discussing your case, your injuries or your medical treatment because you never know who is listening. It is human nature for clients to want to discuss something that is having such a dramatic impact on their lives. We advise clients, however, to limit conversations regarding the intimate details of their case, injuries, or treatment to close family members and friends and within the privacy of their home.
- Do not brag about your case or a settlement to anyone. If you are getting a large settlement or award, it is because the large amount is justified due to your injuries and the losses you have suffered in the case. When the other side finds out that a client is bragging about their case, it causes the other side to question the legitimacy of the client's complaints and whether they are as severe as represented. A judge or jury will also question your motivations if they are provided with these types of statements.
I HAVE MY EYE ON YOU!
One of the number one tools the defense industry uses to decrease the value of a claim is surveillance. We would estimate that surveillance was at least attempted on approximately 90% of our cases during our years on the defense side. Don't be fooled, the other side will be watching you!
Almost any medical provider out there will tell you that most conditions will be worse on some days and better on others. As a result, some days a client may feel fine mowing the lawn, playing football with the kids, or shopping for three hours with the husband or wife regardless of their low back, neck, head, shoulder, knee, hip, or other injuries. If the other side gets surveillance video of you performing these activities on one of these “good” days, however, they will ask your doctor, a judge, or a jury to compare your presentation on that day to the complaints in your medical records about your “bad” days. No matter how much you explain that it was a “good” day, the damage will already be done.
Also keep in mind that surveillance can take many forms. In addition to professional investigators hired by the other side, your co-workers, neighbors, doctors (or the staff in their office), and even friends can all be asked to testify regarding your activities and their observations of your behavior and physical capabilities.
It is best to take the approach that the other side is always watching you and to limit your behavior accordingly no matter how good you feel.
THANKS FOR THE SETTLEMENT, BUT WHAT ABOUT...
You are entitled to compensation for the losses that are caused by your injury. This may vary somewhat depending on the nature of your case, i.e. motor vehicle accident versus workers' compensation. One rule holds true, however. We cannot seek compensation for a loss if we don't know about it. You are the only person who can inform us of the losses you have sustained, and therefore, we must rely on you to keep us informed about your case and to provide us with information. It is difficult, if not impossible, to go back once several months or maybe even a couple of years have passed and try and remember what losses you incurred. It is important that you gather and retain information as your case proceeds. Please keep the following pointers in mind regarding what records and information we need to get you all of the compensation you are entitled to:
- The other side must provide you with the medical treatment you need to treat your injuries. In order to seek recovery of these costs, we need to know who you treated with so that we can obtain treatment and billing records. Please keep us updated regarding all medical providers you are referred to for treatment.
- You may be forced to pay some costs associated with your medical treatment out of pocket. These costs typically include co-pays, deductibles, co-insurance or payment for treatment not covered by your health insurance. You may, however, also have to pay for things like over the counter medications, slings, crutches, canes, bandages, etc. Please keep copies of bills and receipts for all costs you are forced to pay out of pocket.
- You will likely be forced to incur mileage expenses to attend your medical appointments and you are entitled to compensation for this expense. In our initial meeting you were provided with forms to assist you in keeping track of this mileage.
- You are entitled to compensation for the time you miss from work as a result of your accident regardless of whether the time is missed to attend appointments or because you cannot work due to your injuries. You can also record the time you miss from work on the forms that were provided to you in our initial meeting.
- There are other ancillary expenses you may incur as a result of your injuries. For example, the single parent who is restricted to bed rest following a surgery will need someone to assist with caring for the children. Another example is the home owner who is restricted to no lifting due to a neck injury and has to hire the neighbor's teenager to shovel snow. It is extremely important that records of these types of costs be kept as documentation since the other side always looks at them with skepticism.
Talk with Us Today – a Free, No-Risk Consultation
We invite you to discuss the details of your personal injury, insurance dispute, or workers' compensation claim with a lawyer at The Babcock Firm, whether you're in Denver, Boulder, Aurora, Broomfield, Louisville, Lafayette, Golden, Thornton, Westminster or another Colorado city. If your case falls within our practice area and we feel our representation can benefit you, an attorney will meet with you for an in-depth consultation, at no charge. We are here to help you secure a successful outcome. Learn more about how representation works and then contact us today.
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