Frequently Asked: How Long Do I Need to Treat
Insurance companies are famously good at math – the entire industry thrives on a deep understanding of probability and statistics – so the show of innumeracy they often put on can be surprising if you aren’t used to it. A frequent example, which I have heard almost verbatim as an opening line from many adjusters: “We will not pay for any treatment after eight weeks, because the average patient with soft-tissue injuries only needs eight weeks of treatment.” They say they will gladly pay for all the medical bills reasonably related to the injury (so long as the charge for each service is less than the average) until the patient recovers from the injuries (so long as the patient’s recovery takes less than the average time). But for a patient who needs more treatment than the average? Nope. As if by magic, an “estimated recovery date” becomes a “guaranteed recovery date,” and any expenses incurred after that date become proof of overtreatment and the patient’s bad intentions.
That racket sounds just like the logic behind a slot machine or a roulette wheel in a casino – in both cases, basic math determines that the house wins more than it loses. At least casinos make an effort to show you a good time.
So, if you have soft-tissue injuries from a car wreck, how fast should you expect to get better? Believe it or not, we understand something that insurance companies pretend not to: That the answer to that question is completely different from person to person and from injury to injury!
First, we should address the term “soft-tissue injury,” because insurance companies like to pretend that “soft-tissue injury” means “minor” injury or even “imaginary” injury. As a practical matter, the term really just means “damage that you can’t see on an x-ray.” Well, x-rays are great, inexpensive diagnostic tools, but there’s a reason more expensive tests like CT scans and MRIs exist: Because sometimes they are the only way to detect injuries just as serious as, or even more serious than, those that show up on x-rays. A broken bone may stand out on an x-ray and it may take an MRI to diagnose a herniated disc, but I’d rather have a nasty break in my arm than a herniated disc in my back. I have seen both in a whole lot of cases, and I can tell you that the “soft-tissue” injury is likely to last longer, hurt more, cost more to treat, and have a bigger impact on your quality of life than the injury that just happens to be more photogenic.
We have many clients and former clients who took their “soft-tissue” injuries to the chiropractor, physical therapy, massage therapy – everything a reasonable person might do trying to fix a soft-tissue problem in the most conservative, economical way – only to find after a few months of treatment that the injury was just not getting better. Some still can’t sit for long periods of time, or they still can’t turn their neck one way or the other, or they still get shooting pains down their legs. Just as more advanced imaging exists for when x-rays can’t find the problem, when chiropractic and physical therapy can’t provide relief there are more advanced modes of treatment to turn to.
So, after trying the conservative approach these patients progress to the orthopedist or the neurologist, and sometimes the ensuing MRI shows an injury that can only be addressed with surgery. But despite the patient’s having done exactly the right thing – consistently pursuing conservative treatment and then moving up the medical food chain when the conservative treatment stops producing improvement – insurers regularly try to deny coverage because the patient took longer than the “average” to treat, or took too long (according to the insurer’s arbitrary standards) to take the problem to an expensive specialist.
That kind of nonsense is unfair and insulting. If you are grappling with an injury, it is critical that you keep pursuing treatment as long as it takes to get you better. It is important to be consistent, to keep your appointments, and to follow your doctor’s advice about what tests and treatments you need. Rushing to finish treatment because an insurance adjuster pushes an artificial timetable only serves to make potentially treatable injuries permanent.