How to get the chiropractor bills paid

Personal Injury attorneys in the Quad Cities, throughout Illinois, and probably most of the nation struggle with this conundrum quite often: Client gets into an accident. Client goes to the chiropractor. Insurance companies/juries don’t pay for the chiropractic bills.

 Believe it or not, this is a large issue here in the QC… even though part of the QC is Davenport, home of Palmer College of Chiropractic (the first ever chiropractic college), and most of the potential jury pool will usually have been to a chiro at some point in their lives.

So how do you fix this at trial?

1. Establish why the client went to the chiropractor in the first place.

Most of the time, a client will go to the ER before he sees any other doctor. The ER discharge instructions usually say two or three things: (A) if symptoms persist or get worse, see your family doctor, (B) if symptoms persist or get worse, go back to the ER, and (C) if you do not have a family doctor, call ###-####. These instructions are often held against your client.

By nature, your client failed to do at least one thing on the list. If he followed up with his family doctor, then he can didn’t go back to the ER. If he went back to the ER, he didn’t follow up with his family doctor. The instructions are inconsistent. Unfortunately, if he went to the chiropractor, then he did none of the three things above.

So you have to establish why your client chose to go to the chiro. Had he been to him/her before? How did he hear about them? Did he know him/her from somewhere else? Did he have a family doctor? Did he not just think about a chiropractor as a doctor who specializes in the back and neck? If the client’s reasons for going to the chiro rather than following the discharge instructions are good, it will go a long way towards getting the bills paid.

2. Have the client explain the course of treatment and how he felt after each visit.

One of the primary knocks on chiropractors is that it seems like their patients constantly have to go back… often three times a week or more for several years or even life. Many people feel like this is unnecessary and excessive.

To combat this, try to establish that your client made his appointments with the chiro as needed, not by any set schedule. (This, of course, only works if it’s true). Also, bring out the fact that, after each visit, your client felt a little better, and that gradually he improved (if that is the case). I think jurors are more likely to include damages for treatment that helped the client feel better.

3. Keep the chiro’s testimony to a minimum.

Some chiropractors belive that spinal manipulation can solve nearly everything… headaches, impotence, acne, depression, basically any disease or disorder you can name.

People don’t buy it.

What people do buy, however, is that conservative chiropractic treatment, in small doses, can help the back and neck. If that’s all that’s at issue, keep the chiro on topic. If you get one who believes that spinal manipulation can help your eyesight, cure your ingrown toenails, and help you remember your 11th grade French class, politely instruct him or her to keep that to him/herself.

4. Explain subluxations

Chiropractors love subluxations. The whole practice is devoted to fixing them.

However, doctors define “subluxation” differently than chiropractors. The physician definition is more narrow, which leads many defense attorneys to try to argue that chiros look for something that isn’t there.

It’s important for the chiropractor to explain that it’s not just a broader definition, it’s a different language altogether. This way when the ER doc testifies that there were no subluxations, and the chiropractor testifies that there were several, the jury will understand that they are simply talking about a different thing.

Can I prevent this from ever becoming an issue?

That’s a thorny one. If a client comes into your office, shortly after an accident, how much can you influence their choice of medical treatment.

I’m not exactly sure. You don’t want to practice medicine, and any advice you give them would not only get in the way of a personal choice, but would arguably be medical advice. You don’t want to go down that road. (It’s kind of like when certain professionals tell injury clients that their case should settle for “X” or that they should hold out for trial… it happens all the time, and it’s probably practicing law).

On the other hand, it is probably ok to explain to your client, before any non-ER treatment has begun, that juries and insurance companies often do not pay for certain treatment (chiropractic, massage therapy, acupuncture, holistic medicine, etc), and that they are free to make whatever treatment decisions they want, but that they need to be aware of the potential consequences.

I sure don’t have all the answers, but hopefully this helps someone in future cases. Does anyone else have tips in getting insurance companies and/or juries to pay for a client’s chiropractic treatment?