What Happens If My Chiropractor Says I Need More Treatment?

Question from AL, What Happens If My Chiropractor Says I Need More Treatment?

Answer from AI:

When you’re involved in an accident or suffer from an injury that leads to you seeking chiropractic care, one term you might hear is “maximum medical improvement” (MMI). MMI is a state where a patient has recovered as fully as possible, and any additional treatment is not expected to improve their condition further. However, what happens if your chiropractor suggests that you haven’t reached MMI and need several more months of treatment? Understanding your rights and the implications of this situation is crucial, especially in the context of insurance claims or legal cases in the United States.

Understanding Maximum Medical Improvement (MMI)

Maximum Medical Improvement is a critical concept in personal injury cases and workers’ compensation claims. It indicates that a patient’s condition has stabilized and is unlikely to improve significantly with further medical treatment. However, reaching MMI does not mean the patient is fully recovered or that they won’t need ongoing treatment to manage pain or other symptoms.

Implications of Needing More Treatment

If your chiropractor believes you need more treatment to reach MMI, this can have several implications:

1. Insurance Coverage: Insurance companies often use MMI to determine when to stop covering medical expenses. If your chiropractor suggests extending treatment, you may need to negotiate with your insurance provider or the responsible party’s insurer to cover these additional costs.
2. Legal Cases: In personal injury lawsuits, reaching MMI can significantly impact the settlement amount. If you haven’t reached MMI, it might be premature to settle your case since the full extent of your injuries and the cost of future medical care are not yet known.
3. Workers’ Compensation: For work-related injuries, reaching MMI can affect your benefits. If you require further treatment, it may extend the period you’re eligible for medical benefits and possibly affect disability ratings.

Steps to Take If More Treatment Is Needed

If your chiropractor recommends more treatment before reaching MMI, consider the following steps:

• Documentation: Ensure all recommendations for further treatment are well-documented. This includes detailed notes from your chiropractor explaining why additional treatment is necessary.
• Communication: Promptly inform your insurance company or attorney (if you have one) about the need for extended treatment. Providing updates and medical documentation can help support your claim for additional benefits or compensation.
• Review Your Policy: Understand the terms of your insurance policy, especially regarding coverage for extended medical treatment. This can help you advocate for yourself when discussing your needs with insurers.
• Legal Consultation: Consider consulting with a personal injury attorney if you’re involved in a legal case or if your insurance company disputes the need for further treatment. An attorney can provide advice tailored to your situation and help protect your rights.

Conclusion

Requiring additional chiropractic treatment to reach MMI can complicate insurance claims and legal cases. It’s important to stay informed about your rights and the potential impact on your case. Always ensure proper documentation of your treatment needs and communicate openly with your insurance provider or legal representative. If you’re unsure about your situation or how to proceed, seeking legal advice from a qualified professional is advisable.

For more information on MMI and its implications, you might find resources like the Nolo Legal Encyclopedia helpful. Remember, while general guidelines can provide a starting point, each situation is unique, and consulting with a legal professional is often the best course of action.