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9 Most Common Questions About Medical Malpractice

Questions About Medical MalpracticePeople have a lot of questions about medical malpractice. If you have been a victim of medical malpractice and if you have watched a loved one suffer, you deserve to understand the essentials. To help you out, here’s a look at some of the most common questions about medical malpractice.

1. What Does Medical Malpractice Mean?

Medical malpractice occurs when a healthcare provider does not meet their duty to the patient. This may happen when a doctor, nurse, or other healthcare provider fails to diagnose a condition properly, doesn’t advise the patient about risks, makes a grave mistake during a medical procedure, or ignores the patients’ needs.

As a general rule of thumb, if the healthcare provider behaved in a way that is different from how most other responsible healthcare providers would have acted in the same situation and if the patient was harmed or suffered damages as a result, medical malpractice may have occurred.

2. What Causes Medical Malpractice?

Medical malpractice can be caused by a variety of issues including the following:

  • Inadequate training
  • Ignorance about the condition
  • Distraction
  • Lack of communication
  • Dangerous procedures or systems in hospital settings
  • Failure to read medical records correctly
  • Misdiagnosis
  • Giving the wrong dosages or types of medication
  • Administering anesthesia incorrectly
  • Surgical errors
  • Failure to maintain equipment properly
  • Dirty environments leading to infections

3. How Are Medical Malpractice Settlements Calculated?

In medical malpractice cases, settlements are based on the damages you suffered as a result of the medical malpractice. Typically, damages include medical expenses, lost earnings, and other costs directly related to the incident. However, many people suffer long-term injuries that can affect the rest of their lives, and as a result, their settlement may include lost future income and estimated future medical expenses.

On top of that, the settlement may also include money for pain and suffering. Putting a number on pain and suffering is a delicate process. Often, the courts assign a multiplier between one and five, and they multiply your other damages by that number to determine the amount related to your pain and suffering. In other situations, they may take your daily wage and multiply that by the number of days you experienced pain. You may also receive some monetary compensation for emotional distress or loss of consortium.

4. What Are Medical Malpractice Caps?

Medical malpractice caps limit the amount of the settlement you can receive from these cases. In Massachusetts, the law caps compensation for pain and suffering, loss of companionship, embarrassment, and other items of general damage to $500,000. But there are exceptions. If you suffered substantial impairment or permanent loss of a bodily function or substantial disfigurement, the caps do not apply. Additionally, the caps don’t apply if they prevent you from getting fair compensation.

As you can see, the Massachusetts guidelines are very subjective. To ensure you get the fairest settlement possible, you need a skilled medical malpractice attorney who can help to establish that your injuries are substantial and that a low settlement wouldn’t be fair. For example, the lawyers at Mazow | McCullough, PC helped a client win $535,000 for a medical malpractice injury, and they also got her health insurance lien waived.

5. Can Medical Malpractice Be Criminal?

Generally, medical malpractice cases are civil. That means that the healthcare providers, hospitals, medical clinics, or other defendants in the case are held financially responsible, but they do not face criminal charges. However, in extreme cases, medical malpractice may constitute criminal medical negligence, and the defendant may be subject to criminal penalties including prison or fines.

6. What Are Medical Malpractice Lawyers?

Medical malpractice lawyers are generally lawyers who focus on personal injury law. They help clients who have suffered damages due to the negligence of another party, and in addition to serving clients who have been injured in car accidents, by dog bites, or in a variety of other situations, they also help clients who have been injured due to the actions of a medical professional or institution.

7. How Does a Medical Malpractice Lawsuit Work?

Medical malpractice suits usually start with a consultation with a medical malpractice attorney. They help you decide if your case is viable. If you decide to move forward with the lawsuit, the lawyer may do some investigating and researching to prepare for the case and estimate how much your settlement should be. Then, your lawyer sends a demand letter to the defendant, letting them know what damages you have suffered and explaining why they are at fault.

At that point, the defendant may accept or reject the demand or make a counteroffer. If the demand is rejected or a counter offer is made, your lawyer may urge you to handle the issue in mediation or through arbitration. If that’s not possible, the case may go to trial. At the conclusion of the trial, the judge decides if you deserve a settlement and the amount of the settlement.

8. Are Medical Malpractice Awards Taxable?

Normally, medical malpractice settlements are not subject to income tax. However, if you claimed a tax deduction for medical expenses related to the claim and the settlement reimbursed you for those expenses, you may have to deal with some tax issues related to reversing that deduction.

9. Can I File a Medical Malpractice Claim Myself?

Legally, you can always represent yourself in a court of law, but from the demand letter through the trial, medical malpractice cases are complicated. Physicians, hospitals, and insurance companies spend a lot on their lawyers, and going in on your own is usually a mistake.

Instead, you should get help from a medical malpractice attorney. At Mazow | McCullough, PC, we have helped many clients get the justice they deserve. To learn more and to set up a free case evaluation, contact us today.

Do You Have to File a Personal Injury Lawsuit?

Personal Injury ClaimDealing with an injury is physically painful, but it can also be emotionally draining and time consuming. When you have so much on your plate, you may not want to add anything else. You may be wondering if it’s even worth it to file a personal injury lawsuit. If your injuries are minor and the responsible party is willing to cover your costs, you may not need to file.

But, filing a lawsuit is usually the best option when you have incurred serious injuries, can’t work, and/or are experiencing pain and suffering due to an injury caused by another party.

Take a look at a few key situations where you should contact an attorney or consider filing a claim.

An Insurer Has Given You a Lowball Offer

Sometimes, you can avoid a personal injury lawsuit by filing a personal injury insurance claim. For instance, if you are in a car accident and suffer minor injuries, the at-fault driver’s insurer may offer you a settlement. If the settlement truly covers all of your injuries and expenses, that can work. But, in a lot of cases, insurers offer lowball settlements.

Sometimes, these companies offer small settlements due to policy limits. If you’re worried that a settlement doesn’t cover all the damages you have incurred as a result of the injury, you should consult with an attorney about filing a personal injury lawsuit.

You Want Help Negotiating with the Insurer

Keep in mind that personal injury attorneys don’t necessarily have to take your case to court. These lawyers can also negotiate with the insurance company on your behalf. To get a fair settlement, you have to convince the insurance company that their client was responsible for your injuries, that you suffered damages as a result of the injuries, and that the amount of the damages you are requesting is appropriate for the situation.

You may also have to prove that the injuries prevented you from working or caused intense pain and suffering. That can be hard to do on your own, but an attorney knows how to handle that process effectively.

You Have Suffered Serious Injuries

Often, the extent of your injuries dictates whether or not you should file a personal injury lawsuit. If you are dealing with any of the following issues, you should contact a personal injury attorney:

  • A loved one’s death
  • Dismemberment
  • Disfigurement
  • Intense scarring
  • Loss of a bodily organ or a bodily function
  • Issue, such as a herniated disc, which requires extensive surgery
  • Injuries which prevent you from working or performing daily activities
  • Significant or constant pain

The Other Party Can’t Come to an Agreement in Mediation

Often, before going to trial, many people start with mediation. This is an informal proceeding that usually involves you, your attorney, the defendant, their attorney, and a professional mediator. The mediator tries to help everyone agree on a fair settlement.

If you can’t come to a satisfactory agreement in mediation, you may need to move forward with a lawsuit. However, mediation tends to be less expensive and easier than a lawsuit. To get the best results, you should work with a lawyer who has experience with mediation. At Mazow | McCullough, PC, we helped a client win $500,000 for premise liability negligence in mediation and we secured a  $150,000 medical malpractice settlement in mediation.

A Lawyer Suggests Filing a Personal Injury Lawsuit

Deciding if you should file a personal injury lawsuit on your own can be difficult. To help you decide, most attorneys offer free case evaluations. During the evaluation, the attorney listens to your story, helps you assess your damages, and gives you an overview of how your case is likely to go. Generally, if a personal injury attorney believes that you have a solid case, they agree to handle your concerns on a contingency basis. Mazow | McCullough, PC only gets paid if we win you a recovery.

However, some personal injury lawyers will agree to work on a fee-for-service basis. Usually, attorneys only structure their fees in this way if they aren’t sure that you can win the case. Ideally, you should not work with a personal injury lawyer who charges upfront fees. You should only work with a lawyer on a contingency basis. If you meet with a quality personal injury attorney and they advise you to bring forward a personal injury lawsuit, that’s a strong indication that you should probably move forward with the case.

You Want Fair Compensation for Your Injuries

The number one reason to file a personal injury lawsuit is so that you get fairly compensated for your injuries. At Mazow ❘ McCullough, PC, we help our clients get financial justice for their injuries. To set up a free case evaluation, contact us today.

The Risk of Infection from Dog Bites

Of the 4.7 million dog bites that occur every year in the U.S., 18% — nearly 1 in 5 – become infected after not getting treated. Some dog bite infections are minor and can be treated at home, but others are more serious and may require immediate medical attention.

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Minor Infections from Dog Bites

Dog bites are likely to become infected due to the amount of bacteria that live in a dog’s mouth. While most of this bacteria is harmless to humans, it only takes one of the few dangerous strains that pose a threat to you to make you sick.

Relatively minor dog bite infections can be caused by several types of bacteria. For example, Capnocytophaga spp. is a weak bacteria that rarely harms people; you could be infected with it and never feel sick. However, it can present more risk to people with compromised immune systems or preexisting medical conditions.

Another potential infector is the Pasteurella bacterium, which is found in 50% of all infected dog bites. Usually, Pasteurella simply causes a painful but local infection around the bite wound. In some circumstances, however, it can cause more dangerous symptoms such as swollen glands, painful joints, and difficulty moving. Any of these symptoms should be examined and treated by a medical professional as soon as possible.

Major Infections from Dog Bites

Dog bites can also cause life-threatening diseases, the most well-known and terrifying of which is the rabies virus. Affecting the brain and causing a wide array of dangerous symptoms, rabies is fatal if left untreated. Thankfully, efforts over the past century have reduced the number of domestic animals with rabies to around 7%, and only 1 to 3 cases of human rabies are reported annually. However, statistics are not a safeguard. If you have been bitten by a dog, you should bring the animal in for testing if possible. If the animal tests negative, you will not need rabies treatment. However, if the animal tests positive or you are unable to bring in the animal and determine its rabies status, it’s critical to begin treatment for rabies immediately.

Less prominent but no less dangerous potential infections include MRSA, a powerful strain of Staph bacteria that is unaffected by ordinary antibiotics. MRSA requires extensive medical attention and a battery of unique antibiotics, as it can be as life-threatening as rabies. Dog bites can also transmit tetanus, which can cause paralysis.

Signs of Infection

When a dog bite punctures the skin, you are at an increased risk for the wound to become infected. The signs of infection include pain or soreness around the injury site, redness, swelling, drainage of pus or fluid, or the development of a fever.

Additionally, loss of sensation around the wound, red streaks emanating from the wound, night sweats, fatigue, swollen lymph nodes, and the limited use of limbs near the wound are signs of a potentially life-threatening infection.

Preventing Infection from a Dog Bite

To care for a minor bite at home, wash the wound carefully with warm, soapy water, then apply antibiotic cream and cover with a bandage or wrap. Try and keep the injury elevated. If the wound becomes inflamed at any time or you develop a fever, seek immediate medical attention. For deeper wounds, apply firm pressure with a clean cloth to stop the bleeding, and it is recommended you call 911 or visit your local emergency room right away. Dog bites are often deeper than they appear, and it is better to exercise caution when faced with such injuries.

If you were bitten by a dog that you do not know or may appear to have rabies, or if it has been more than 5 years since your last tetanus shot, it is essential to seek immediate medical attention.

If you were attacked by an unfamiliar dog and the owner is present, obtain the owner’s information, even if the attack seems minor. You should also notify animal control or the police to ensure that the owner has taken steps to prevent the dog from attacking someone again.

If you’ve been injured by a dog bite, you may be eligible for compensation. The experienced dog bite attorneys at Mazow | McCullough, P.C. can inform you of your legal options and assist you in pursuing your claim for maximum financial restitution. Call today for a free consultation.

Guide To Dog Bite Law E-Book

Justice and Compensation Go Hand in Hand

In the aftermath of a sudden death of a loved one, it can be a confusing and depressing time. Learning that your loved one’s death was caused by negligence can be even more devastating. You may wonder why you should add to the understandable stress of the situation by pursuing a wrongful death claim or why you should reopen those wounds by reliving the loss again. However, bringing forward a claim for compensation isn’t just about money – it can help you achieve justice for your loved one’s passing and prevent the same from happening to another family. This can make the healing process easier over time.

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Compensation Can Soften the Financial Blow of a Loved One’s Passing

The sudden loss of a loved one often involves exorbitant charges, including medical bills, funeral fees, and lost wages. These costs can be overwhelming—medical expenses alone can easily be hundreds of thousands of dollars, even over a relatively short period of time. Incurring these costs yourself can put you and your family in a dire financial situation that may last for years.

Seeking compensation for these costs can help ease the financial burden of a death, and can relieve some of the stress that comes from a loss. You can spend more time healing and less time worrying about finances.

Compensation Can Help with the Coping Process

A portion of the financial restitution obtained from a wrongful death claim is meant to compensate survivors for emotional distress. This can include pain and suffering, loss of consortium, and loss of companionship. Even though money cannot bring back your loved one, this kind of compensation can provide some comfort as you deal with the grief of losing a loved one.

Further, non-economic damages act as a penalty on the people liable for your loved one’s death. It charges them for more than just the physical costs, but also for your family’s loss and devastation.

Punitive Damages Can Prevent Future Deaths

In cases of gross negligence—where the reckless action or inaction was far beyond the line of reasonable behavior—the court may also award punitive damages to the plaintiff(s) in a wrongful death claim. Punitive damages are determined by the judge and jury based on available evidence and the degree of negligence the defendant(s) exhibited. This can result in damages worth hundreds of thousands, or even millions, of dollars.

Punitive damages serve two purposes. First, they provide a compelling incentive to the defendant to correct the behavior or actions that caused the death—whether that be ignoring a safety concern, driving recklessly, or misdiagnosing a patient. Second, they create an incentive for others not to attempt similar action for fear they will incur punishment for their negligence.

Seeking compensation from those liable for your loved one’s wrongful death can feel like a staggering and terrifying prospect, but it can help you and your family find some solace in a chaotic and frustrating time. The lawyers at Mazow | McCullough, PC, are experienced in wrongful death suits and can help you sort through the difficult legal process as you file and follow through with your claim. They can represent you in court and help you negotiate the highest compensation award possible. If you’ve lost a loved one due to wrongful death, contact us today for a free consultation at (978)-744-8000.

How the Statute of Limitations May Affect Your Wrongful Death Claim

How the Statute of Limitations May Affect Your Wrongful Death Claim

Our legal system can seem daunting, especially to inexperienced plaintiffs, due to the legal technicalities and rules involved in filing a claim for compensation. Coupled with the emotional burden of dealing with the sudden and devastating loss of a loved one, that confusion often feels insurmountable.  One concept in particular that tends to complicate is the statute of limitations. Here are answers to some common questions about statutes of limitations.

What are Statutes of Limitations?

Statutes of limitations are rules that essentially set a time limit after something happens—an injury, an accident, a threat, a death, etc.—for filing civil or criminal claims. If a claim is filed after the statute of limitations is up, the courts may not allow it to be heard. Even if a late claim is brought to court, the defense could successfully argue that the claim should be thrown out because the statute of limitations has expired. In both examples, filing a claim exceeding the statute of limitations often means that the case is never heard and no damages are awarded.

Are the Statutes of Limitations the Same Everywhere?

No. The statute of limitations depends on what law is in question and in what state the claim is being filed. In Massachusetts, the statute of limitations for most civil cases, including wrongful death, is 3 years. The same 3 year limit to wrongful death cases applies in New Hampshire according to state law.

Do the Statutes of Limitations Allow for Flexibility?

It depends on the state and the claim in question. In certain circumstances, the courts may count the statute of limitations differently or allow for exceptions.

In Massachusetts, the statute of limitations for a wrongful death case typically starts from the date of the death. However, if the death is not obviously wrongful and the estate administrator discovers evidence in the course of their duties indicating wrongful death, then the statute of limitations applies from that moment of discovery. The time limit of 3 years does not change but how it is counted does.

The same law also establishes that in cases in which the wrongfulness of a death is not immediately clear, the statute of limitations applies from the moment the estate administrator should have reasonably discovered the evidence.

If The Statute is 3 Years for Wrongful Death Claims, Why Should I File a Claim Quickly?

For filing a wrongful death claim, 3 years might seem like plenty of time. However, it is important to file as soon as possible after the loss of a loved one or after the discovery of crucial evidence.  Evidence can degrade or be misplaced. Witnesses may become difficult to locate or their memories of the events might fade. Those who might be liable may not be reached for trial.

Filing a wrongful death claim promptly and correctly is often difficult. At Mazow | McCullough, P.C., we can help you file a claim within the statute of limitations and help you find justice for your loved one. Contact us today for a free consultation at 978-744-8000.

Preventing Dog on Dog Attacks

Dog Barking

It is a mistake to assume that your dog will not fight with other dogs. Dog on Dog attacks can occur no matter how well behaved the animals are. The fact is that dogs will act out against people or other animals if they feel any of the following:

  • Afraid.
  • Stressed due to lack of space.
  • Dogs are pack animals, meaning they may feel the need to dominate.
  • They may be protective of you.
  • Curiosity.
  • Or they may simply be over excited.

Below are a couple tips on how to help your dog cope and act in the presence of other canines in order to prevent a confrontation.

Be Calm and Decisive

One of the most common mistakes made by people when encountering another dog is to tense up and become fearful of what your dog may do. If you become afraid when encountering another dog, you will subsequently tense up, leading your dog to pick up on your energy which will likely trigger an aggressive reaction from your dog. Remain calm throughout the encounter, while still reading your dog’s expressions. If you feel the encounter is becoming too stressful, intervene and cut the meet and greet short. You may also want to redirect your dog’s attention back to you from time to time during the interaction with another dog to remind him that you are there and he is safe.

Ignore

From my experience with dogs, I have found this technique to be most effective when started at an early age. Not to say that it is impossible if not started at an early age, just a lot more challenging to imply. When going out for a walk with your furry friend and passing by another dog, you should make it a point to ignore the other dog and its owner. This will teach your dog that when you see other dogs it is best to ignore them instead of confronting them. Be careful not to crowd the dog when walking past another dog. Since we now know dogs love space and aren’t too keen on it being invaded, this might send the wrong message to your dog causing him to lash out. If rather than ignoring the dog, your dog decides to confront the dog and starts barking and showing aggressive behavior. As a substitute to standing while tugging at the dog, try walking away and tugging at the dog. This will help create space while at the same time hopefully creating comfort.

Remember that German shepherd I spoke about, the one that enjoys chasing after flying bugs? Well she also enjoys staring at dogs intensely as they stroll by for their walks.  This is not good behavior. Just because they are in a down position and not barking or growling, doesn’t mean they aren’t thinking about acting. It may actually mean that they are just waiting for the right moment. When she does this it usually leads to a “go inside” command.  Teaching your dog how to ignore the presence of other dogs will be one of your best defenses against your dog’s aggressiveness to other dogs.

Socializing

Generally most dogs are sociable creatures meant to live in groups and packs. However, since they are man’s best friend, and are not living wildly in the streets this is not always the case. Dogs are not always properly socialized with other dogs enough for them to feel comfort around them. This often times causes aggression when meeting a new dog. According to the ASPCA, it is best to introduce your dog to new experiences between the age of 3 and 12 weeks. After that time period your dog will become less prone to accepting new experiences without becoming wary and uncomfortable. When it comes to introducing adult dogs to new experiences you will find that you need a lot of patience, vigilance, and a couple treats never hurt anyone.

To wrap it all up, when your dog meets a new dog for the first time, it is best to remain vigilant and observant of your dog’s mannerisms and behavior. Remember nobody knows your own dog’s tell-tale signs like you do. If you see him/her becoming anxious or uncomfortable step in and interrupt the situation before it escalates.

Photo credit: dgoomany / Foter / CC BY-SA

Roof Snow Removal Safety Tips

snow covering rooftop and chimneyThe heavy snow and extremely cold temperatures have not only made any form of transportation in the Northeast a nightmare, but it has also contributed to additional worries at homes, businesses and schools. Along with having trouble with the snow removal on the roads, a lot of people are founding common ground in the woes of snow removal and accumulation on roofs.

There have been about 71 building collapses in Massachusetts over the last week or so. Some schools have been forced to dismiss students before the anticipated February vacation week due to unsafe conditions. “We cannot safely have students, staff and community members in our schools without roofs being cleared,” Somerville officials said in a statement. This early release for students only adds on to the already accumulated school closing days that have been caused by the latest snow storms and blizzards.

In Newburyport, Massachusetts, 70-80 residents were displaced from their residence after a condo’s roof partially collapsed. The condo was occupied at the time but no injuries were reported. With the already record breaking amount of snow in New England and more to come, residents need to take preventative measures and stay proactive when it comes to taking care of the snow removal on roofs.

Safety Measures Roof Snow Removal

  • Try not to do it alone. Always have someone below the roof to keep foot traffic away from locations where falling snow or ice could cause injuries.
  • Don’t try to clear the roof during period of high winds.
  • Do not use mechanical snow removal equipment or sharp tools while removing the snow.
  • Avoid garage roofs and outbuildings. Chances are these structures were built with more lenient standards and therefore are more prone to collapsing.
  • The safest tool to use to try and remove snow on roofs is a roof rake. This will allow you to safely remove the snow while still being on the ground.

For more safety tips and instructions on removing snow from roofs visit the Massachusetts Emergency Management Agency website. It is imperative that safety be the number one priority on everyone’s mind as we deal with the less than perfect conditions that we are currently facing. After all, we are expecting to get another batch of snow and ice through the weekend, which of course will only make conditions worse – not only for the roads, but also for the accumulated snow on the roofs. If you hadn’t heard, we’re sorry to the messengers; snow at this point should be considered a bad word, perhaps a four-letter word one should not speak of.

Medical Providers Being Forced To “Jump through Hoops”

medical bills with change jarIn my previous job working at a chiropractor’s office, I would get a sort of disappointed feeling every time I answered the phone and a new personal injury patient was at the end of the other line to schedule an appointment. Not because we didn’t want to treat the patient, but more because of the back and forth that was to materialize throughout the coming days with the patient’s insurance carrier.

Recently the State District Court rendered a decision in VIP Physical Therapy, Inc. v. Government Insurance Company.  Government Insurance Company was sued by VIP Physical Therapy, Inc. under the personal injury protection statue, for refusing to pay for treatment that VIP Physical Therapy, Inc had rendered to the injured policyholders.  The defendant Government Insurance Company argued that the Massachusetts Standard Automobile Policy states that “anyone covered under [a] policy” and “any person seeking payment” must cooperate with the insurer, including submitting themselves to a EUO (Examination Under Oath) at a place designated by the insurer.  Subsequently, Government Insurance Company argued, that by refusing to submit to a EUO VIP Physical Therapy, Inc. was being uncooperative which justified their refusal to pay for rendered services.

Judge William P. Hadley disagreed with the defendant Government Insurance Company. Hadley pointed out that that the terminology in the standard automobile policy conflicts with the terminology in the PIP statue itself. Under the PIP statue it states that non-cooperation defense is limited to the non-cooperation by the “injured party.” Therefore, Hadley granted the plaintiff VIP Physical Therapy, Inc. their motion for partial summary judgment.

Many times, I have found that auto insurers make it somewhat difficult for injured parties in car accidents to obtain payment for their medical bills. In my personal experience, while working at a chiropractor’s office, this discourages medical providers to render services to the people in need of these services. This ruling gives medical providers a sense of security knowing that they can provide care to the injured parties without the concern of having to ensue in a battle with insurers over payment.

While not involved in VIP Physical Therapy, Inc. v. Government Insurance Company, Attorney Robert Mazow of Mazow & McCullough was contacted by Massachusetts Lawyers Weekly to provide insight into the opinion. “Requiring that medical providers jump through hoops and attended what are essentially depositions without boundaries puts an unfair burden on providers and their patients and stretches the PIP statue beyond the breaking point.” Mazow said. “Moreover, the PIP statue simply cannot be logically construed so as to extend the duty to provide a EUO beyond insureds and claimants.”

Insurance Company Can’t Force “Examination Under Oath”

taking-oathCar insurance companies in Massachusetts constantly search for new and unique ways to deny or reduce medical bills related to treatment for people hurt in car accidents. Part of the Massachusetts Automobile Insurance Policy requires insureds and their injured passengers to cooperate with insurance companies in their investigations of car accidents. While “cooperation” isn’t defined in the insurance policy, insurance companies can require their insureds and injured people in the insured vehicle to attend an “Examination Under Oath.” An Examination Under Oath, or EUO, is essentially a deposition or inquiry conducted by an attorney hired by the insurance company to investigate the circumstances of the accident and the medical treatment. Historically, if an insured or the injured passenger didn’t show up for the EUO, the insurance company would deny the claim as a result of “non-cooperation.”

Over the last few years, insurance companies have stretched the boundaries of the demand for cooperation. They have requested that medical professionals who are providing treatment to the insured or their passengers appear for these EUO’s. Some medical professionals have done so, others have refused. Certain Massachusetts insurance companies have used that refusal on the part of the medical professional to appear for an EUO as a reason to deny payment of medical bills.

In a recent decision out of one of the Massachusetts District Courts, VIP Physical Therapy, Inc. v. GEICO, Judge William Hadley disagreed with GEICO in its denial of medical bills owed to an insured. GEICO used the fact that the physical therapist didn’t attend an EUO as a reason to deny bills.

Robert E. Mazow of Mazow & McCullough, PC in Salem represents medical providers in PIP cases. While not involved in VIP Physical Therapy, he called the ruling an “important reminder” to auto insurers that the primary purpose of the PIP statute is to provide those injured in car accidents with a quick and efficient method for payment of related medical bills.

“Requiring that medical providers jump through hoops and attend what are essentially depositions without boundaries puts an unfair burden on providers and their patients and stretches the PIP statute beyond the breaking point,” Mazow said. “Moreover, the PIP statute simply cannot be logically construed so as to extend the duty to provide an EUO beyond insureds and claimants.”

Because Judge Hadley determined that the insurance company has no authority under the law to demand that medical providers attend EUO’s, he ordered that the patient’s medical bills be paid.

While this decision is non-binding on other courts, it certainly sends a strong message to the insurance industry that “cooperation” has its boundaries in the Massachusetts automobile insurance context.

Medical Treatment

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Receive Treatment for All Injuries After a Car Accident

The most important aspect of a personal injury case is your medical treatment. You need to ensure that you are getting the best and most appropriate treatment for your injury. It is critical that you document your injuries and your complaints of pain – even if they feel minor or are “not a big deal.” Often what seems like a small injury or complaint can turn into something much more significant. If the complaint is not documented in the medical records, you can be assured that the insurance company will question whether it is related to the accident. When you go to the hospital, doctor, or any medical treatment provider, it is imperative that you make sure that your complaints are being articulated to the medical professionals and documented in the medical record. You will have a very difficult time arguing to the insurance company that you want to be compensated for pain and suffering if there is no medical evidence of that treatment.

Avoid Gaps in Medical Treatment

Insurance companies are quick to point out gaps in treatment or long delays before you seek medical attention. Therefore, if you are referred to a medical provider by your primary care doctor, you should go at the earliest opportunity. If you are instructed to get an X-ray, an MRI, or some other diagnostic testing, you should not delay. Again, the insurance company will use any delay in seeking treatment to argue that you “aren’t hurt enough to seek treatment.” Do not fall into this trap.

Your primary care physician is there to be the quarterback of your medical treatment. While it’s perfectly acceptable to go to a chiropractor, physical therapist, or any medical provider you prefer, your primary care physician will know the best course of treatment for you. If you have a complaint, contact your primary care physician for advice.

Once you start a course of treatment, be it physical therapy, chiropractic care, massage therapy, or any other treatment, be sure to complete the treatment or discuss with the medical provider whether you are progressing or not. Do not simply stop going. The insurance company will want to know why you stopped going and will assume that it was only because you “got better.”

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