Why Insurers Label Car Accident Injuries as Degenerative
When you're recovering from a car accident, the last thing you want to hear is that your injuries are being dismissed as "degenerative" by an insurance company. This tactic can drastically affect your compensation claim, leaving you to shoulder the burden of medical expenses and ongoing treatment costs. Here's a detailed and comprehensive article explaining why insurance companies often claim that car accident injuries are degenerative, complete with illustrative examples.
Understanding Degenerative Conditions
What Are Degenerative Conditions?
Degenerative conditions refer to health issues that gradually worsen over time. Common examples include osteoarthritis, degenerative disc disease, and chronic back pain. These conditions are typically associated with aging but can also result from wear and tear, repetitive stress, or prior injuries.
Why Insurance Companies Label Injuries as Degenerative
1. Reducing Liability and Payouts
One of the primary reasons insurance companies label injuries as degenerative is to reduce their liability and minimize payouts. By attributing your pain and suffering to pre-existing conditions, insurers can argue that your injuries are not solely caused by the accident.
Example: Sarah was involved in a car accident and suffered significant lower back pain. The insurance company claims her pain is due to degenerative disc disease rather than the accident. This assertion allows the insurer to limit her compensation, arguing that the accident merely exacerbated an existing condition.
2. Questioning Causation
Insurance companies often question the causation between the accident and your injuries. By labeling your injuries as degenerative, they can claim that the accident was not the primary cause, thereby reducing their responsibility.
Example: John experiences chronic knee pain after a car crash. The insurance company argues that his pain is due to pre-existing osteoarthritis, not the accident. This stance allows them to contest the direct link between the crash and his current condition, potentially lowering the settlement amount.
3. Leveraging Medical Records
Insurance adjusters meticulously review medical records to identify any pre-existing conditions or previous injuries. If they find any indication of a degenerative condition, they use this information to challenge the extent of your injury claims.
Example: Lisa has a history of mild back pain documented in her medical records. After a rear-end collision, her back pain worsens significantly. The insurance company seizes on her prior medical history to argue that her current pain is due to pre-existing degenerative changes rather than the accident, thus attempting to minimize her compensation.
4. Exploiting Ambiguities in Medical Diagnoses
Medical diagnoses can sometimes be ambiguous, especially when it comes to conditions like back pain or joint issues. Insurance companies exploit these ambiguities to suggest that your symptoms are part of a natural degenerative process rather than the result of a traumatic event.
Example: Tom sustains a neck injury in a car accident, leading to severe pain and limited mobility. His medical diagnosis mentions degenerative changes in the cervical spine. The insurance company uses this ambiguity to claim that his symptoms are primarily due to these degenerative changes, not the accident, thereby reducing his compensation.
Combating the Degenerative Injury Argument
Understanding why insurance companies claim car accident injuries are degenerative is crucial, but knowing how to combat this tactic is equally important. Here are some strategies to effectively counter their claims:
1. Seek Immediate Medical Attention
Prompt medical attention is vital for documenting your injuries and establishing a direct link between the accident and your condition. Detailed medical records from the time of the accident can help counter claims that your injuries are purely degenerative.
Example: After her accident, Maria visits the emergency room immediately and undergoes comprehensive diagnostic tests. Her medical records clearly indicate that her injuries were sustained during the collision, providing strong evidence to refute any claims of degenerative conditions.
2. Obtain Expert Medical Opinions
Securing a medical opinion from a specialist can be instrumental in differentiating between accident-related injuries and pre-existing degenerative conditions. Experts can provide detailed reports that clarify the primary cause of your symptoms.
Example: John consults with an orthopedic specialist who thoroughly examines his knee injury and provides a detailed report. The report concludes that the car accident significantly aggravated his pre-existing osteoarthritis, with the trauma being the main cause of his current symptoms. This expert opinion strengthens John's claim.
3. Maintain Detailed Medical Records
Keep meticulous records of all medical treatments, diagnostic tests, and doctor visits related to your injury. Detailed documentation can help demonstrate the progression and impact of the injuries caused by the accident.
Example: Lisa maintains a comprehensive file of all her medical appointments, treatments, and diagnostic tests following her car accident. Her detailed records show a clear timeline of her injury progression, making it difficult for the insurance company to attribute her pain solely to degenerative changes.
4. Challenge the Insurance Company's Medical Assessment
Insurance companies often have their own medical experts review your case. If their assessment contradicts your treating physician's diagnosis, challenge their findings with additional medical evidence and expert opinions.
Example: Tom's insurance company uses their medical expert to argue that his neck pain is due to degenerative changes. Tom's attorney arranges for an independent medical examination, which confirms that the accident was the primary cause of his injury. This additional evidence helps counter the insurance company's argument.
5. Hire an Experienced Personal Injury Attorney
An experienced personal injury attorney can help you navigate the complexities of your case, gather compelling evidence, and counter the insurance company's tactics. They can advocate on your behalf to ensure you receive fair compensation.
Example: Maria hires a personal injury attorney who specializes in car accident cases. The attorney works with medical experts, compiles detailed evidence, and negotiates with the insurance company to secure a fair settlement that reflects the true extent of Maria's injuries.
Conclusion
Insurance companies often claim that car accident injuries are degenerative to reduce liability and minimize payouts. By questioning causation, leveraging medical records, and exploiting ambiguities in medical diagnoses, they aim to undermine your claim. Understanding these tactics and knowing how to counter them with prompt medical attention, expert opinions, detailed records, and legal representation can help you secure the compensation you deserve.