Visitor Question

Whiplash aggravated a previous condition…

Submitted By: Michelle (Ohio)

My husband and I were rear ended by a dump truck driven by someone with a suspended license. My husband sustained neck and shoulder pain. I also sustained neck and shoulder injuries. Neither of us went to the ER that day, but we both went three days later. (The accident happened Friday evening, we went Monday morning.)

Because neither of us had ever been injured in a car accident before, we thought the soreness and pain was normal, and would subside. Neither of us thought the injuries were life threatening, but because the pain did not get better, we went to get checked out at the ER.

My diagnosis was whiplash, no x-rays were taken, and no tests were run – just the physical examination. I felt relieved that the Doctor told me time will heal it. Initially, I began to feel somewhat better. As I look back, I feel the muscle pain and inflammation subsided after a few weeks, but the underlying pain and discomfort was now apparent.

As time went on, I became more uncomfortable. I felt a previous condition was recurring as a result of this whiplash. I was previously treated for neck issues related to degenerative disease and arthritis. But I had not suffered any pain related to this disease for years.

Just three days prior to the accident, while in the doctor’s office for a regular physical, we discussed the neck issues. I told him there were no issues and that I have not had any pain in years.

Now, after this car accident, I am having neck and shoulder pain. So I went to the doctor and was sent for X-rays. (This is now several weeks after the accident.) The doctor recommended I get physical therapy. I went as he prescribed twice a week for six weeks and finally have relief.

The insurance company is questioning whether the injury is directly related to the accident, and have suspended payment until my medical records are released. I have nothing to hide and just want my medical expenses paid. I have released the information.

The car has been repaired, though when we went to see about purchasing a new car, we were told “the car has been in an accident and the value has decreased as a result.”

My doctor is convinced that the pain is directly related to the accident, aggravating a previous condition. Will this be a case of a “pain and suffering” settlement? Or can I expect only the repairs of the vehicle and my medical bills paid? Please let us know where we can go from here. Thank you.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Michelle,

Once the insurance company reviews your medical records they will decide whether your new injury is in fact a new and separate injury, or an exacerbation of your prior injury. If they decide your existing pain is an exacerbation of your prior injury, they may decide to permanently suspend payments, or at best, pay some, but not all of the rest of your medical and therapy bills.

To convince them to pay all of your recent medical and therapy bills will take a very strong medical narrative. That narrative will have to specifically state your recent pain and suffering is a direct and exclusive result of the recent collision. Without that narrative, the insurance company will likely pay little more than they already have.

Insurance companies closely scrutinize therapy bills. They are hesitant to pay them because they believe many victims take advantage of collisions by running up therapy bills. While you are not one of those people, you can expect to be treated the same way.

There is no doubt your car repair costs will be paid. Be sure to tell the insurance company and the body shop you want the replacement parts to be “Original Equipment Manufactured” (OEM) parts. Those parts are the same quality as your car had when you purchased it.

If you don’t demand OEM parts, the body shop may be directed by the insurance company to repair your car with secondary inferior parts made overseas.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,

Published: December 9, 2014

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