As a personal injury lawyer, I am frequently asked by injured clients which doctor they should see for their injuries. This question often arises because physicians, like many personal injury attorneys, solicit business from individuals involved in car wrecks. Police reports from these car crashes are public records that can be reviewed by businesses seeking to solicit business.
The Wall Street Journal recently wrote an article about doctors who treat car accident victims. The article pointed out that some doctors will provide services on a contingent fee basis, meaning that the doctor gets paid only when the patient recovers from the personal injury lawsuit. The physician’s fees are not subject to a usual customary and reasonable (UCR) adjustment that occurs when medical expenses are paid by private health insurance, Medicare, Medicaid, the VA or Workers’ Compensation. The benefit to the physician is that they receive a significantly higher fee when their bill is not subject to a UCR adjustment. Injury victims benefit if they do not have insurance to seek care elsewhere and, presumably, by having a physician on their side during the litigation process.
It is important to determine whether the physician’s fees are contingent upon a successful recovery. If not, the injured person will be on the hook for the inflated medical expenses going forward, whether or not they successfully recover compensation from the at-fault party’s insurance company. Likewise, the inflated medical expenses can cut into settlement proceeds, leaving little or no net recovery for the injured party. In some instances, the physician will negotiate his/her bill, but not always.
It is usually preferable to seek medical treatment from your own primary care provider, who will make referrals to appropriate specialists, and bill all of the care to your health insurer who will obtain a UCR adjustment in the bill. Using your own medical providers is wise because they carry greater credibility than a hired gun, and they typically have experience with the litigation process from past patients. There are, however, some physicians who refuse to participate in the litigation process. Even worse, there are some major hospital systems that discourage all of their physicians from participating in personal injury and wrongful death litigation. In those cases, your personal injury or wrongful death lawyer may have to retain an independent medical examiner to review your medical records and prepare a medical report detailing your injuries, the extent of disability and prognosis. One important factor is whether a personal injury or disability is permanent, since future damages are dependent upon a determination that the disability will continue into the foreseeable future.
Ideally, your medical expenses will be paid by private health insurance, Medicare, Medicaid, the VA or Workers’ Compensation. These insurers will obtain a usual customary and reasonable discount on your behalf, thereby significantly reducing your medical expenses. However, it is important to note that these insurers will require reimbursement for any expenses that they have paid on your behalf. This is called subrogation. Overall, however, the total burden of medical expenses is reduced. This increases your net settlement recovery.
If you have questions about medical expenses related to a personal injury claim, you should contact an experienced wrongful death law firm in Cleveland, OH early in the course of the claims process.
Thanks to Mishkind & Kulwicki for their insight into personal injury claims and what doctor you should see for your personal injury claim.