by Guest » Sat May 23, 2009 09:49 pm
Hi
I am a disabled VET who has had low back problems before this last accident. My L5-S1 region has disk thinning and calcium build up and has caused pain from time to time. It was ok before the accident. I have a disability rating at 30%. Well I was picking up my kids from high school and stopped at a red light behind a slow moving bus.
So I slowly crept up to the intersection to make a right hand turn and had to wait for school children in the cross walk. A young driver slammed into my back of my vehicle he must have been doing 30MPH. I thought I was fine right after the collision but within 30 seconds lightning pain went up my legs to my back and it seemed to have hang time were my past injury was. Then it went up to my neck.
I had sprang ankle and back pain as well as whiplash. I decided to seek my chiropractor vs MD because I did not feel the need for MRI or xray was needed I was trying to keep cost down for both sides. My car did not look that bad but bumper went into the UNI body and cost was around $9100 to fix it. I told my chiropractor to be in line with what my expenses I thought I would be reasonable. He estimated each visit to be $120. I went 30 times in close to 4 months as my pain did not decrease. I started to take Vicaden for the pain. At the 33 visit I ended treatment as not to spend too much. He said billing was ok and reasonable “I could go more” that I owed somewhere around $4300. I ended then and there. I was soon billed $5020. I still have pain but live with it. I can get free med from here on out from the VA. I got the insurance to pay the damage, and finally turned my sons whiplash bill and mine in. His bill was only $860 he was offered a total of $1500 for medical and pain and suffering. Less than 1X Pain and suffering! Then it came to my bill they said it was unreasonable for soft tissue? And they offered me $5180 total Medical and pain and suffering. Now I know it not cut and dry but I was re-injured and he hit me and screwed my life up again! I would like to get a lawyer but it could cost too much! What do you suggest?
I am a disabled VET who has had low back problems before this last accident. My L5-S1 region has disk thinning and calcium build up and has caused pain from time to time. It was ok before the accident. I have a disability rating at 30%. Well I was picking up my kids from high school and stopped at a red light behind a slow moving bus.
So I slowly crept up to the intersection to make a right hand turn and had to wait for school children in the cross walk. A young driver slammed into my back of my vehicle he must have been doing 30MPH. I thought I was fine right after the collision but within 30 seconds lightning pain went up my legs to my back and it seemed to have hang time were my past injury was. Then it went up to my neck.
I had sprang ankle and back pain as well as whiplash. I decided to seek my chiropractor vs MD because I did not feel the need for MRI or xray was needed I was trying to keep cost down for both sides. My car did not look that bad but bumper went into the UNI body and cost was around $9100 to fix it. I told my chiropractor to be in line with what my expenses I thought I would be reasonable. He estimated each visit to be $120. I went 30 times in close to 4 months as my pain did not decrease. I started to take Vicaden for the pain. At the 33 visit I ended treatment as not to spend too much. He said billing was ok and reasonable “I could go more” that I owed somewhere around $4300. I ended then and there. I was soon billed $5020. I still have pain but live with it. I can get free med from here on out from the VA. I got the insurance to pay the damage, and finally turned my sons whiplash bill and mine in. His bill was only $860 he was offered a total of $1500 for medical and pain and suffering. Less than 1X Pain and suffering! Then it came to my bill they said it was unreasonable for soft tissue? And they offered me $5180 total Medical and pain and suffering. Now I know it not cut and dry but I was re-injured and he hit me and screwed my life up again! I would like to get a lawyer but it could cost too much! What do you suggest?
Posted: Mon May 25, 2009 11:16 am Post Subject:
Jerry, I hope you understand...that we totally 'get' what you're saying...we're just trying to help you understand where the adjuster is coming from (cause we both are one :wink: )... in an attempt to help you make better decisions about how you proceed in your claim...we aren't trying to argue how much pain you do or don't have...only you know that...and why....(just needed to get that out there)..
Brother, there's just no other way to say this other than to say you've got a big hill to climb (IMO)...this adjuster is looking at this like, well, gotta a guy with a bad back... two prior injuries, yes, we hit him hard in the back end...but we didn't cause any of these injuries...we only aggravated what was already there...so we'll pay for your treatment, and 180...(which I agree is absurd)...he didn't have x-ray one...cannot prove any injury at all from any diagnostic...says he had a spained ankle, but can't prove that either...that's it were done here.....sorry but that's how (i think) they are seeing it....
In your case Jerry, you hurt rather than helped yourself with the course of treatment (and lack of diagnositc) .... I'm not so sure seeing an attorney isn't the best way for you to go...You could try to explain your situation again...and all that you have gone thru etc...if you feel there is no movement on the adjusters part then you might want to rethink the attorney...One thing on your side however is the amount of damage to your vehicle, that is significant and shows a hard impact....
Let me ask you this...what do you think this claim is worth? That might help us determine if you'd better run rather than walk to an attorney.. :wink: I don't understand their not atleast offering your mileage to and from the doc...could be a CA thing...but most adjusters would just pay that...
(alittle side/personal information so you don't think I'm some hard a** adjuster that doesn't understand back issues...I personal have deg. disc disease, ostopro. three herniated discs, four compression, two impact fractures, 20 indentified bone spurs in my spine, cervical spondilosis (sorry can't remember how to spell that one :roll:), basically i have little to no discs left..and have suffered thru more needles/hopeful cures than you can shake a stick at...so "I" know where you're coming from, and do have great empathy.. :wink: )
Posted: Mon May 25, 2009 01:22 pm Post Subject: insurance
JERRYSKI........sorry I can't respond by a PM, or something like that. So..I'll tell ya what I wanna say. You said you had an injury while you were in the Military ( Navy)..right? From talking to people, that served in ANY Branch of Service ( back then), they said the Military din't really get as 'intense' as they do today, on investgating injuries. I know someone who wants to re-join into the Military. He can't because of an injury ( the Military claimed it never happened while he was on Active Duty) the FIRST time around.
Posted: Mon May 25, 2009 11:21 pm Post Subject:
sdchargersfan The military was the one who informed me that my injury was a disability and that it would get worse. Th VA has been great. they can't cure me I believe no one can. You deal with it no big deal. But as each accident happens to me it increases pain and the degeneration. Is the driver at fault to cure me. The answer is no. But they should have to pay to treat me to the point before the accident! Health I appreciate every ones help. It is I who needs to better convey my pain and treatment was warranted. I was under the assumption they they had access to all my medical records and they would simply read my priors in there defense.
If I was to argue that this accident was life altering I could see the argument they would have. But if there low offer was just standard negotiation practice then so be it. I will argue and hopefully be satisfied and if we do not come to term, well I guess we both spend more money.
Tick for Tack is not how I role and usually hope to come to a conclusion with one conversation and workout a deal, this was the first time it had not.
Well Tanks Again! (Army Joke!)
Jerry
Posted: Tue May 26, 2009 03:34 am Post Subject: insurance
I agree........they should pay you SOMETHING. You said you were "under the assumption.." Don't assume anything. Sounds like you're 'fighting' this. I don't blame you.........I would, too. ( By the way, I'm a Truck Driver in the Military, so...good joke!!) LOL
Posted: Tue May 26, 2009 10:09 am Post Subject:
Well Jerryski, there are a few things I'd like you to clarify. For 33 visits I could count an estimate worth $3,960. Then how did you reach up to $4,300?
Did they mention the cause of their assuming the $5,020-worth bill to be so unreasonable?
Steven
Posted: Thu May 28, 2009 06:07 pm Post Subject: More
I never reached $4300. that is the amount the chiropractor had said that I was at after my last treatment. But when I got the bill it was for $5020. I dont' trust DC or MD anymore when it comes to billing. I wanted to know what was being spent for what and I did not these bills to get to high just in case I had to pay them! I could not get anything more then "your bills are with in reason! Well he still is arguing that today. "Please be advises that this was a minor impact loss" ($9100) "wherein you and your son sustained soft tissue injuries. No emergency treatment was needed at the scene of the accident or later at a hospital. This indicates that the injuries were mild in severity. These types of injuries tend to heal with or without treatment within the first few weeks. Your chiropractor billed over $5000. We find that amount to be excessive and unusual for a minor accident. Please understand that we only owe reasonable and necessary medical treatment, we do not just pay any inflated bill a chiropractor presents for payment."
Posted: Thu May 28, 2009 09:15 pm Post Subject:
I could not get anything more then "your bills are with in reason!
Non-sense...he HAS to provide you with an itemized bill if you request one...(which I would do)...Honestly the one thing you should be able to dispute without question with the carrier, (and I would in writing)..Ask them their definition of "minor impact" I can guarantee it's NOT $9100.00
Posted: Thu May 28, 2009 11:21 pm Post Subject: last
Well I got the final bill that was itemized! but nothing in between when I asked for it mid way through. It was as if the numbers did not matter, "stay beyond the curtain" says the wizard of OZ. Regardless I feel I needed the 33 treatments for the pain. At what cost that I guess I could call around to see if he was to high. This same Chiropractor called my adjuster twice already to ask for direct payment which was not agreed upon by me.
I negotiated a little up today. They still insist on placing pain and suffering with medical payment and leaving me no room to argue to keep my med pay from my insurance. They offered $6000- $4020 of which goes to Chiropractor, $1000 back to my Med Pay account leaves me $980 for my four months of pain and suffering and 38 hours of lost for treatment and close to 280 miles wear and tear on my car to get to treatment.
Posted: Fri May 29, 2009 10:05 am Post Subject:
This same Chiropractor called my adjuster twice already to ask for direct payment which was not agreed upon by me.
I can't believe this guy didn't send a lein to the adjuster...quite surprising...and stupid on his part...great for you....dumb (lack of) move for him.......They have to have a release signed for the 'total' amount...they can't do it separately....sounds to me like...regardless of their payment per your understanding of the medpay subro right...any amount above the chiro bill would have to go back to your med pay carrier right? How else could they not demand it? What about health ins? Do you have any? Have you filed this with them? Also I don't think you gave us 'their' explaination for not paying mileage to and from the doc...'what say they' about that? Personally I would still try and get them to respond in writing their definition of low impact...
Posted: Fri May 29, 2009 01:59 pm Post Subject:
I suppose it's occurred to ya'll that, assuming OP's son is a minor, that claim can't be resolved, short of a court-approved settlement, with finality. Given the psychology in play here, I wouldn't feel comfortable with trying to settle it on a Parents and Guardians Release,
Has OP presented the adjuster with a specific dollar demand for the release of all claims? He will never "bid against himself."
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