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Phases of Medical Treatment In FloridaImmediately following an accident I always recommend that you seek immediate medical treatment at the Emergency Room. This is the first phase of your medical treatment. Even if you don’t feel pain right of way it’s always best for your body and your piece of mind to be x-rayed and examined by an emergency room doctor.

Initial Visit

After you’ve been released from the emergency room you’ll be instructed to follow-up with a specialist. This is the second phase of your treatment.
I recommend that accident victims follow-up with a medical doctor, rather than a chiropractor. You want to see a medical doctor who has experience in personal injury cases. I recommend avoiding primary care physicians because they have been known to sand-bag cases. This is likely becasue of inexperience and/or wanting to avoid the hastle of personal injury litigation. Also, you want to make sure your treating physician is board-certified.

During your initial visit you’ll spend time filing out lots of paperwork. You’ll be asked questions about your medical history, the accident, and your injuries. Be sure to be 100% truthful when completing initial intake forms. What you write and say could be used against you in Court. You don’t want to deny a prior accident, when you’ve had several in the past. Be sure if you aren’t truthful the defense will find out! Credibility is the most important thing in any accident case.
When you finally meet the doctor during your initial visit, expect a full and complete examination. The doctor may order x-rays. If so, he or she will discuss the findings and prescribed a treatment plan. Almost all treatment plans involve a normal course of physical therapy.

Physical Therapy

The third phase of treatment is a normal course of physical therapy. Some doctor offer in-house physial therapy while others will refer you to a chiropractor or other facility. Physical therapy usually consists of 4 to 12 weeks of treatment, depending on your injuries. If you’ve been treating longer than 12 weeks, you should find out why. You’ll want to be careful becasue some doctors, will continue to treat you until all your insurance benefits are exhausted. This could be a red-flag for the insurance company signaling that your treatment was not reasonable, necessary, or related.
In the beginning you may be prescribed daily physical therapy, followed by a gradual tapering down to 1-2 times per week. Again, everyone is different, so your own personal physical therapy needs may be different.
Treatment during the physical therapy phase usually involves 3 to 4 modes of treatment. The most common modalities for soft tissue injuries are electrical stimulation, hot/cold packs, ultrasound, and chiropractic adjustments.

MRI Scans

The third phase is the MRI scan phase. After an accident your pain might not immediately go away. Often it may get worse. When this happens your treating physician will refer you for an MRI to determine the exact nature of your injuries. A common injury after an accident is a bulging or herniated disc. These painful disc injuries can only be seen on an MRI scan.
The sooner you have an MRI after the accident the better. That way it’s less likely the defense can argue that the objective findings on the MRI scan were caused by something else. For example, if you wait 6-months to have an MRI scan, the injuries shown on the films could have been from anything. It’s less likely something other than the accident caused your herniated discs if taken within 30 days of the accident.

Surgical Evaluation

If the MRI reveals a disc injury, especially common in car accident and slip and fall cases, you will be referred to an orthopedic surgeon or a neurosurgeon for work-up and evaluation. This is the fourth stage of medical treatment. If you’re already treating with an orthopedic surgeon, then you’re ahead of the game.
An orthopedic surgeon would examine you and your diagnostic tests to determine if you’re a surgical candidate. Usually before surgery you may be referred to a pain management specialist for a series of epidural steriod injections.
Epidural steroid injections are given in a series of 2 to 4 injections, usually 30 days apart. Injections can be diagnostic as well as therapeutic. They can give an injured person partial to complete short term relief, and also can be used to tell the complete extent of the disc injury, including its exact location.
If you don’t get relief form epidural steroid injections your most likely option is the dreded “surgery.” Most people who are recommended for surgery never follow though. Keep in mind that the insurance company usually won’t pay you as if you’re going to have the surgery, unless you follow through. In other words, it’s not good enough to submit a medical record from an orthopedic surgeon recommending you have surgery. You must actually have the surgery.

Final Evaluation

The final phase is the final evaluation Once you’ve reached maximum medical improvement your treating physician will schedule a final evalation. After the final evaluation the doctor will write a final report. This is the most important medical record in your case. The final report will summarize your treatment, show that you’ve reached maximum medical improvment, and in most cases state you have a permanent injury caused by the accident.
The final piece of the puzzle is the heralded impairment rating. This rating is a percentage rating based on the AMA guidelines. For example, your doctor may state you have a 10% whole person impairment. Without a doctor stating your have a permanent injury, you’re not entitled to damages for your pain and suffering in Florida; only your past medical expenses. This only applies in car accident cases; you do not have to prove permanancy in any other injury cases (i.e. slip and fall, products liability, etc.) So, the final evaluation and impairment rating are critical to your accident case.
By:  Micah J. Longo, Managing Attorney, The Longo Firm P.A. (Davie, FL)
Tel:  (954) 862-3608