In New Jersey, with the advent of the verbal threshold, the small soft tissue cases – and what I mean by that is injuries to the muscles as opposed to something more serious like a bone fracture, herniation of the disc, nerve injuries, head injuries, or something else like that – don’t have a lot of value any longer. In some situations, there may still be some value, but it’s rather small. Generally, I tell people that if they need medical care, then go get it. There is usually coverage for that. Once they’ve completed their medical care, we’ll figure out if there is enough to go forward with that case.
The ones that are easiest to understand can take no more than a year. The ones that need to go into litigation can take up to three years depending on how quickly they wind through the courts. There are some counties that have a two- to three-year wait from the day you file that case just to get a jury.
That’s a great question. I have a simple rule. If it’s your child, take them to the pediatrician and document everything, even if there are no complaints. That way, the doctor may elicit something that you were unable to get from the child. You don’t want to take any chances with your children, so have your child examined by the pediatrician.
If it was yourself and you have no pain at all, then you could consider getting yourself checked out by your general physician just to make sure you’re not missing anything. Generally, after a few days or a week, if you’re going to have any problems, you’ll know about it. If you want to be cautious, there is nothing wrong with getting examined by your regular doctor, documenting that an accident occurred, and letting them see if they find something that you may have missed or simply downplayed.
It can make it quite tricky because there is no putting it past an insurance company to say that the injury you’re now complaining of didn’t occur during the accident. If weeks or even months go by and you don’t get any care, they are going to be looking for every little thing that might show that this occurred somewhere else, somehow else, or that it even occurred prior to the accident and has been longstanding or old or chronic. So it’s always a good idea to be seen by the emergency room to fully document what occurred, even if you delay additional care hoping that it will go away. Let’s say you’ve gone to the emergency room and they have documented everything that you feel and any bruises that you might have and they have given you a full exam and then you go home and you’re willing to see if these symptoms pass, as many of us are wont to do. If, a week or two later, the pain doesn’t go away, then you’d truly need to see a doctor.
In general, I don’t give any medical records to the other side’s insurance company until my client is completely done with treatment. That’s one of the main reasons why I will ordinarily wait until my client is done with the treatment to even get those records or consider filing suit. That way, neither me nor the insurance company nor any lawyers on the insurance company’s behalf are bothering your doctors and medical providers to get your medical records. That’s why I much prefer to allow someone to be treated in private by their own doctor and to not have the involvement of lawyers and insurance companies during those stages. That is the major reason why I will usually wait, and I certainly won’t give any medical records to the insurance company before you’re done.
When we’re talking about New Jersey and we’re talking about what would be considered a claim for personal injury protection benefits, the standard policy contains $250,000 in coverage. That is a lot of money, but it gets used up very quickly in catastrophic situations. I had a situation where a woman standing as a pedestrian was struck by an auto, and over the first weekend, my client had several surgeries to try to save her leg, and within three days, they had burned through that $250,000. Fortunately for her, she did have health insurance, which kicks in after the PIP is exhausted or stops paying. In that situation, even though she had used up the $250,000 in coverage, her major medical or health coverage continued to pay the balance of the bills.
Every situation is different, though. It helps to have health coverage as a backup. Again, though, there are these smaller policies that sometimes don’t offer that type of protection. By the way, if you happen to be working when the automobile accident occurs, then your workers’ comp pays all your authorized medical bills and is pretty much unlimited.
Yes, I do that all the time. That largely occurs at the end of a case when you know what everything is. You know what the settlement offer is, you know what the unpaid medical bills are after the insurance is paid, and you know what any limitations on coverage might be, meaning that there may not be enough coverage to take care of everything. That’s the time when you get in there and negotiate on any remaining balances.
That is a complicated question. When you’re working and an automobile accident occurs that isn’t your fault, you actually have two claims. You have a workers’ comp claim and then you have a direct claim, which is sometimes called a third-party claim, where you’re the first party, your employer is the second party, and anyone else who might be responsible to you would be the third party. Now, I don’t do workers’ comp cases any longer. Generally, I prefer the client to see a specialist or someone who only does workers’ comp handling that, because then the people tend to get the best money. In those cases, I can assist with making sure they are placed properly.
Third-party cases are something that I routinely handle, though. When you complete a third-party case, you’re required to reimburse the workers’ comp carrier for a good portion of what they have paid out on your behalf. Now, while the case is going on, you get three things from the workers’ comp carrier: authorized medical bills, temporary wages while you’re not working, and, at some point in time, something for permanent disability. The problem with workers’ comp is that the amounts for permanent disability are rather low, and that’s because everybody who is injured gets something. In at-fault accidents, we’re not limited the way we are in a workers’ compensation situation, and we can recover the money that the client is due up to the full amount that the personal injury warrants. So every situation is going to be slightly different.
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