One of the first questions a new client usually asks is, “How long will this whole process take?” Unfortunately, there is no exact answer for that question. Some people respond quickly to medical treatment, while others take longer to heal. Some insurance companies settle their claims speedily, others drag their claims out in effort to hold on to their money as long as they possibly can. The average case that I handle with soft tissue injuries generally settles somewhere between 4 and 8 months from the date of the injury unless of course the client gets caught up in overtreatment.
Most doctors, whether chiropractors or physical therapists, will treat a patient for approximately 3-4 weeks. If in that amount of time, the pain level has not gone down, diagnostic testing such as MRI’s, x-rays, nerve tests or other things are usually ordered. If the pain level is decreasing, then another 3-4 weeks of treatment usually does the job. Depending on the results of the diagnostic tests, continued therapy may be prescribed, or in the event there is a bigger underlying problem such as a herniated disc, the patient is then referred on to an orthopedic or pain doctor. At this point, the patient/client can undergo pain injections or even surgical procedures to try to eliminate their pain. Sometimes, that person is referred back to the chiropractor or physical therapist for additional treatment. At the point where a medical doctor is prescribing additional therapy, those extra weeks of treatment are very easily justified even in the eyes of an insurance company. However, when a chiropractor or physical therapist keeps a patient in treatment, several times per week, for a period of time of more than 6-7 weeks, with minimal decrease in pain level and without referring that person out for diagnostic testing, overtreatment occurs.
Many doctors do not understand how difficult it is to settle a claim with an insurance company when there is more than 2 months of the same treatment without any other type of referral. Some doctors are hesitant to refer patients out because they are afraid that if that patient is referred out that he or she might not come back. This practice is very detrimental to the patient’s well-being as well as the outcome of their personal injury settlement. By referring patients out, the doctors are better able to know exactly what is going on and better able to treat the underlying problems. Also, if a doctor does order an MRI and there are positive findings, these are things that can significantly increase the value of the person’s injury claim as well as giving that person a clearer picture as to what kind of treatment is needed to resolve their problem. Any time an insurance company sees a huge therapy bill without any diagnostic testing on a claim, this raises a red flag and the insurance company will usually not be willing to pay for the entire bill. In certain cases where there is a significant injury, treatment beyond 2 months is completely justified. However, in these cases, there will always be some kind of referral made and diagnostic testing done which will support the additional treatment needed to get the patient/client better.