Perhaps years of practicing insurance defense litigation has jaded me. I am ever more amazed that some of the doctors who routinely treat injured Plaintiffs involved in litigation do not seem to recognize that failing fail to follow a reasonable medical care management approach often leads to much closer scrutiny of the claim and a poor legal outcome for their patients. But even worse for the injured Plaintiff, these doctors set their patient’s on a path that leads to a failed medical outcome. It could be an unnecessary surgery. Or maybe an uncomplicated soft tissue injury that is followed by years of overtreatment and hundreds of therapy and doctor visits. While it is true that more medical damages can give the appearance of a more serious injury, in most of the cases we have defended on behalf of insurance companies, we have seen this approach by the Plaintiffs and their doctors backfire in terms of improvement of case value. A lack of credibility always seems to follow unreasonable and unnecessary treatment, and Texas juries are typically not sympathetic.
Since the goal of medical treatment is ostensibly to try to return the patient to their pre-injury status , or as close as possible to such status, a well-managed case will include decreased treatment frequency while occupational and daily activities are slowly reintroduced over time. In our experience as lawyers who defend against personal injury lawsuits, we have found that a constant treatment frequency maintained from the onset of care can lead to problems for the Plaintiff attorney and the plaintiff. This is because they are forced to explain this apparent inconsistency, and it is hard to do.
An unreasonable approach to treatment more often than not complicates settlement. When we ask, “how can an accurate prognosis of the patient’s future medical condition be measured if the treatment has remained basically the same?”, we are frequently met with a blank stare or an evasive answer when we cross examine the Plaintiff’s doctor. Also how can the patient reach their pre-injury status if the stresses of daily life and normal occupational effects were never reintroduced while under treatment?
The medical care rendered by the providers should be reasonable and fall within reasonable guidelines for treatment duration. Of course, an accurate diagnosis and prognosis are always fundamental to a determination of what the medical care needs are and will be in term of future care. The amount of settlement should be based on accurate medical information based on reasonable protocols and treatment guidelines.
Red flags that signal unreasonable medical management, overtreatment, or mismanaged care include: if the patient’s condition gets worse under the care rendered; when the patient’s subjective complaints reach a point where the treatment rendered only makes them feel better for a few days and then they are the same as before medical visit; or if the patient fails to make progress between visits over a lengthy time period, and the clinical potential for further significant healing or improvement is remote.
Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.