Questioni was involved in an auto accident in november 2010.
i busted the windshield with the right side of my head.
the hospital did not xray it.
what is the insurance company time limit for seeking treatment in indiana.
seemed alright but started getting headaches and are getting
worse.
i have not settled with insurance yet.
roger
31 july 2011
AnswerHi Roger,
This is Dr. Settlement's flight day—headed back to Washington this afternoon. But your case is so serious and you so much need some help that I am going to get this out for you right here at the airport. I can get maybe halfway done here, and will send this along before I leave.
Once in Seattle, I ride one of our great ferries to my area, and will be home around midnight. I promise to finish tonight so that you can have the balance first thing tomorrow.
There is no case as important to me right now as yours, Roger, so I am going to give you a lot of my time in hopes that you will follow my advice and get the kind of medical care I am recommending.
MY BOTTOM LINE FIRST:
You are well within time to have insurance cover your expenses. You have a most serious injury, which I will detail below. You must get care, and tonight I will tell you what kind of medical doctors and dentists to see and how to get an appointment.
I am dividing your answer into five topics, as follows:
#1. Introduction & statement of IMMEDIATE ACTION REQUIRED
#2. Background on head injuries and post-concussive injuries
#3. How to get medical and dental care
#4. How to pay for that care—insurance time limits
#5. Do-it-yourself versus attorney
#6. Assumptions I had to make in light of lack of information in your note.
So what I will do is try to get through at least the first two items on my list this afternoon, and follow-up tonight. Wait until you have the entire response before making your feedback.
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#1. Introduction & statement of IMMEDIATE ACTION REQUIRED
I am going to make some assumptions since your note is so brief. These assumptions will guide my answer, but I do not want you to get bogged down in reading them first, so I have put my assumptions at the end of my answer. This way, you will get the most important part first, which is: GET YOURSELF TO A NEUROPSYCHOLOGIST ASAP FOR EVALUATION AND TESTING.
Roger, you have a VERY SERIOUS MEDICAL CONDITION, and you MUST get medical help ASAP. Let me first get you to understand that if you did break a windshield, then the trauma suffered by your brain is very serious, and the consequences can AND WILL last for many years.
Let me also get you to understand that sometimes people wait to see if the symptoms they experience will go away. Sometimes they do. But in a case such as yours, where there is serious trauma to the brain, sometimes the symptoms linger and then get worse over time. This is what has happened to you, Roger, and there is nothing wrong whatsoever to going in now and seeing a doctor and letting her know that you have suffered these symptoms as a direct result of the accident.
Here is a bit of free auto accident information www.SettlementCentral.Com has insurance claim help on this delayed medical consultation topic. You put off seeing a doctor because you thought that your injuries would just "go away". That is common, but do NOT make the mistake of waiting too long. Do not hesitate to SEE A DOCTOR and ATTRIBUTE the PAINS TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A CAR ACCIDENT http://www.settlementcentral.com/page0104.htm
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#2. Background on head injuries and post-concussive injuries
How hard did you hit your head, Roger? It sounds like a pretty hard whack. So, let’s first address that topic of the most significant potential injury, your traumatic brain injury. Research that term, and especially post concussive syndrome and you will see some of the symptoms of that condition. My bet is that you DO HAVE A MODERATE BRAIN INJURY.
Let’s first examine what is a concussion and what is a loss of consciousness. You DID HAVE A CONCUSSION, that much is for sure, since you hit your head. So traumatic brain injury is in play in your claim since you suffered a brain concussion.
Post-concussion syndrome, also known as post concussive syndrome or PCS, is a set of symptoms that a person may experience for weeks, months, or even years after a concussion, a mild form of traumatic brain injury. As many as 50% of patients who have experienced concussion have PCS, and some sources say as many as 90% of patients experience post concussion symptoms. People who have had concussions may experience physical, mental, or emotional symptoms. Symptoms can appear immediately or weeks to months after the initial injury. In YOUR CASE—DELAYED ONSET is what you experienced. It is also common.
Physical symptoms can include:
• headache
• dizziness
• impaired balance
• nausea and/or vomiting
• fatigue or sleepiness
• inability to sleep
• decreased libido
• sensitivity to noise or light
• ringing in the ears
• double or blurred vision
• decreased sense of taste, smell, or hearing
Emotional symptoms may include:
• irritability
• anxiety
• restlessness
• depression
• lack of emotion
• emotional lability or mood swings
• lack of ability to tolerate stress or alcohol
• aggression
Cognitive or mental symptoms can include:
• amnesia or difficulty remembering things
• confusion or impaired cognition
• impaired judgment
• slowed cognitive processing
• difficulty with abstract thinking
• difficulty concentrating
• decrease in work performance
• decrease in social skills
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Roger, consider this for headaches: TMJ
TMJ—temporomandibular joint syndrome: possible source for any HEADACHES.
This is another term I want you to research. When an accident victim strikes his head, there is a good possibility that the disc in the condyle, or jaw joint disc, can be displaced. One of the consequences of jaw joint displacement is headaches. All too often in my practice, the doctors treated headaches as having originated from cervical problems, when in fact, they were due to a TMJ.
http://www.lectlaw.com/med/med04.htm
http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder
http://www.tmjdoctorofmaryland.com/
There are two at-home ways to see if your jaw joint is moving. First, find the spot in front of the little lobes on the middle of your ears. These are called “tragus”: http://www.infovisual.info/03/048_en.html
Now, put your fingers just in front of the tragus and over the jaw joint and open and close your mouth. If the disc is far out of place, you will feel a click. Better is for someone to stand behind you as you are seated and perform the same test. That person can feel the click if your jaw joint disc is far out of place.
That is it for now, Roger. More tonight,
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
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Hello again, Roger.
As promised, I am back to work now, from my home on a large island near Seattle. I want to get this out to you before I go to bed since tomorrow is a full day and I do not want you to wait another day. Let's take up where we left off, with #3 of the following topics:
#1. Introduction & statement of IMMEDIATE ACTION REQUIRED
#2. Background on head injuries and post-concussive injuries
#3. How to get medical and dental care
#4. How to pay for that care—insurance time limits
#5. Do-it-yourself versus attorney
#6. Assumptions I had to make in light of lack of information in your note.
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#3. How to get medical and dental care
WHAT TO DO ABOUT REFERRALS: I feel that you do have many of these symptoms and they are of some significance,, so I WOULD INSIST UPON TREATMENT for them ASAP. It is best to get your general practitioner doctor to refer you, but you can self-refer if you have to. Some general practitioners will make light of your headache complaints and try to find another reason for them, such as having too much stress in your life, etc.
BULL!! Do NOT stand for that. You ARE suffering as a direct result of the brain injury, and you are entitled to proper care. In my opinion, that is at the minimum, starting with a psychologist. But much better would be a neuropsychologist to test and to treat the brain injury. That is where the big mental help will come from, and of course that is where the BIG INSURANCE SETTLEMENT DOLLARS come from also.
The key part is to get the neuropsychologist to run the battery of tests. She can then treat you and also refer you to a medical doctor familiar with brain injuries for prescription of medicine. That is often a psychiatrist.
As for the TMJ, a dentist who specializes in that field would be a lot better than an ordinary dentist. The TMJ specialist is adept at diagnosis and treatment, and of course, at making records that will help in making a good insurance settlement.
Your own general practice dentist is not going to make much of this because he has no idea of the TMJ specialty. In my own personal case, would you believe I could not convince my own dentist that I had headaches from a TMJ caused by auto accident trauma?? I had to self-refer myself to a TMJ specialist, who promptly took 360 degree x-rays that documented the TMJ.
Call around and find someone who specializes in TMJ. The appliance that my specialist made for me helped to reduce the headaches. And of course, that also added considerable value to my auto accident insurance claim.
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#4. How to pay for that care—insurance time limits
See my assumptions, below. You need to make the payments via your own insurance. You likely have PIP or Med/Pay, which is first party coverage irrespective of fault. The question you asked is whether or not your claim would be timely. There are two aspects to your question, Roger.
The first is whether or not you have coverage this far after the accident. The answer is YES. The minimum for first party auto insurance medical payments is one year, so you are covered. In fact, most companies also offer longer periods, and you may have one of those. But in any event, you ARE legally within your rights as of now.
The second aspect is whether or not there could have been intervening causes that would make your claim questionable. For example, if you fell off a deck and hit your head in recent months, then there could be a question about what has caused the present headaches. But since you have not had any such injury, this aspect is also resolved in your favor.
The way to do this is you see the doctor and you MUST ATTRIBUTE THE SYMPTOMS TO THE AUTO ACCIDENT AT THE TIME OF YOUR FIRST CONSULTATION. You give the doctor's billing clerk your auto insurance information. Make them bill the insurer.
As an aside, it is also OK to use your health insurance, if you have any. It is less desireable to try to bill the third party tortfeasor's carrier for medical payments since those companies will try to put off paying in an attempt to force you to settle a claim early. We always like to use the victim's own insurance first. Personal Injury Insurance Claim http://www.settlementcentral.com/page0201.htm Insurance Company Payment of Medical Expenses as Incurred.
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#5. Do-it-yourself versus attorney
Yes, the very best help with auto accident insurance claims is www.SettlementCentral.Com with the self-help instructions and forms that guide you in making a good insurance injury claim settlement. BUT, in this case, I would recommend that you forego trying to settle your own claim. It is true that Doctor Settlement is the acknowledged expert on insurance settlement help, but I also know that sometimes we have to get professional help from good experienced personal injury attorneys.
There are two reasons for this recommendation, Roger. First, this is a case in which you will have to prove a connection between the injury and the symptoms, all these months later. And you are without the necessary experience to carry this forward. Only an experienced trial attorney can do that.
Secondly, this could be a case with SUBSTANTIAL VALUE if handled properly. Head injury claims do have a lot more value than soft tissue injuries. We are talking some hefty numbers if the injuries result in long-term impacts to your life. And again, we cannot recommend that a novice try to handle such a big claim, even with the excellent auto insurance claim instructions and forms www.SettlementCentral.Com membership offers. In this case, even a small error by the victim can cost him big money in settlement results, so an attorney is best to carry the load when the case is so significant.
But make sure to get ONLY an attorney who has ACTUAL TRIAL EXPERIENCE IN BRAIN INJURY CLAIMS. I will tell you that all attorneys advertise as if they have handled such cases, but in truth, only about ten percent have actually done so. Make certain that they give you the actual cases they have handled through trial, by name if need be. Do not let them bluff you, Roger. I will guarantee you that all attorneys will try to bluff you on this—so insist upon the experience proof BEFORE you agree to come into their office.
Finding a good attorney can be difficult, but here is one tip: make sure that the attorney is a member of her state trial lawyers association http://www.settlementcentral.com/links.php
AND you MUST HAVE an attorney who has EXPERIENCE on brain injury and TMJ cases. Insist upon that information being furnished over the phone before you EVER go in for an appointment.
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#6. Assumptions I had to make in light of lack of information in your note.
Your note does not tell me anything whatsoever about:
• Whether you or another party was at fault, and hence limiting your choices of insurance to claim against; or
• whether or not you have first party medical on your auto policy;
• or if you have health insurance;
• or if you are going to claim only versus the third party tortfeasor.
Sooooo, I am going to guess the following in setting up my answer, since the following are common reasonable assumptions in auto cases:
• Since you hit your head, I am going to assume that you did not cause the accident. Otherwise, you would have prepared yourself and avoided the windshield. Hence, I am going to guess that there is another party at fault and that they do have liability insurance you can claim against.
• Indiana is an at-fault state, so I am going to assume that you do have first party insurance, usually called "PIP" or Med/Pay or the like.
• I am not going to assume that you have health insurance.
Best wishes for a smooth and quick recovery from your many injuries.
I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
David,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
