Negotiating With the Insurance Company After Injection Therapy

Injections are one of the many types of treatment that your doctor might recommend after an auto accident.  Usually, they are offered after the failure of a course of conservative care.  If an auto accident victim has been through eight to twelve weeks of physical therapy or chiropractic care without much relief and the patient is not a surgical candidate, injections are offered as a pain management measure.

Injections – which can be in the form of trigger point injections, epidural steroid injections, or facet joint injections – are a medical procedure designed to “calm down” the nerves in your spine.  They usually combine a local anesthetic with a corticosteroid anti-inflammatory medication which helps to reduce pain and inflammation in the injected area.  We’ve heard doctors and patients refer to these injections as “band-aids” in that they mask the pain, they don’t usually cure it.

How Do Auto Insurance Companies Value Injection Cases?

The difficulty in evaluating and settling injection cases is that the condition that is being treated is typically a degenerative condition which has been aggravated or exacerbated by the car crash.  Injections are not usually used to treat “acute” injuries like herniations or disc tears.  The fight with the insurance company comes over whether the condition being treated would have required treatment anyway, regardless of the crash.

Auto insurance adjusters love to blame degenerative conditions for your treatment – even if you have never been to see a doctor for neck or back pain before the crash.  In our experience, injection cases almost always require a lawyer for this reason.  And it is important to be completely open and honest with your auto accident attorney about your prior medical history, because it impacts the value of your case.  Simply put, an injection case with a client who has never been to a doctor before for spine pain is going to have a higher value than a case with a client who has consistently seen an orthopedist, neurosurgeon, pain management doctor, or chiropractor prior to the crash.

Settling Your Neck Injection Case with the Insurance Company

Injection cases are difficult to evaluate for another reason: because the injection is a band-aid which masks current pain, but doesn’t cure it, injection cases often have some degree of permanency.  Meaning that it is important to obtain from your treating doctor, in writing:

1. The opinion that your current medical condition is related to the auto accident;
2. The prognosis that your condition is likely to be permanent;
3. An estimate for the annual cost of future care, which will often include the cost of injections, physical therapy, and MRIs to monitor the condition of your spine

While there is no formula for settling an auto accident case, the insurance company is responsible to you for your past medical bills; past lost wages; pain, suffering and inconvenience; and any future medical costs that you are likely to incur as a result of the crash.

Do I Need a Lawyer to Settle a Cervical Spine Injection Case?

In our opinion, yes.  These cases are complicated from a medical perspective and from a legal perspective.  It is often difficult to establish that the treatment is related to the crash because the MRI report in an injection case will almost always use the word “degenerative,” and it can be difficult for a person who doesn’t know how to navigate the legal system to obtain the proper narrative report from their doctor in order to get maximum settlement value from the insurance company.  You will also have to consider whether any health insurance lien will attach to your future medical care.  Injection treatment is usually expensive and making a mistake in underestimating the cost of your future medical care or failing to protect a health insurance subrogation claim can be expensive as well.