Why Medical Treatment Gaps May Hurt Your Personal Injury Claim in Nevada

After an accident, seeing a doctor and following up on care can feel overwhelming. Many people end up missing medical appointments or putting off treatment. Maybe you felt better for a bit or thought you could handle your recovery alone. Sometimes, insurance paperwork and bills pile up, and you just want a break from everything. This is real life and completely normal.

But, insurance companies like to point to delays or gaps in treatment as evidence that someone was either not injured by an accident or not as injured as they claim to be. This can make some cases harder to win and/or decrease how much an insurance company is willing to pay.

What are “treatment gaps” in a personal injury case?

Treatment gaps in personal injury cases occur when the injured person delays or stops their treatment. It can also include times when they don’t properly follow their doctor’s treatment plan after an accident, like a motor vehicle crash or a slip and fall. Insurance companies and defense attorneys look closely at these gaps when deciding whether a claim is legitimate. Examples include:

Delay in initial medical evaluation

Some people don’t seek medical attention immediately after an accident. Maybe you didn’t feel hurt at first because adrenaline masked the pain, or you hoped your symptoms would improve on their own. If days or weeks pass before seeing a doctor, insurance adjusters might argue that your injuries aren’t as severe as you claim or didn’t result from the accident.

Long breaks between treatment sessions

Treatment doesn’t end after that first visit. Following up with your doctor, attending every physical therapy session, and keeping scheduled appointments show that your injuries are affecting your life. If you go long stretches without these follow-ups, insurers may say your injuries weren’t serious.

Ending treatment or skipping appointments

Some people stop physical therapy or quit scheduled doctor visits before the medical professional says it’s okay. Others might miss multiple appointments. Finishing care early or routinely skipping sessions can create the impression that you didn’t follow instructions because you weren’t that injured. Insurance carriers and defense attorneys look closely at your treatment records.

Even brief breaks in your care can lead to questions and skepticism about your claims.

How insurance companies view treatment gaps

Insurance companies review your medical history very closely after you are hurt in an accident. A common thing they focus on is gaps in treatment. Here are two common arguments insurers make in these cases:

“If you were really hurt, you would have seen a doctor right away.”

Insurers argue that people who are actually hurt go to the doctor as soon as possible. They expect accident victims to seek prompt medical attention, even if their injuries initially seem minor. If you waited before ever seeing a doctor, the insurance company may claim your injuries must not have been serious or that something else might be to blame.

“Your injuries must have improved if you stopped treatment.”

When you pause or quit treatment, the insurance company might argue that your symptoms went away. This means they’ll argue that you shouldn’t be entitled to compensation for future treatment or losses you claim are related to the accident.

Being aware of how insurers see and argue about treatment gaps makes it easier for you to protect yourself. Seeing health care providers regularly and keeping records helps substantiate that your injury is related to your accident. In many cases, medical expert opinion is required to establish causation.

Common reasons for gaps in treatment and how to address them

It’s not unusual to have breaks in your medical treatment after an injury. Life gets in the way sometimes. Insurance companies may try to use these gaps against you, but having honest reasons and sharing them is important. Here are some common reasons people stop or delay treatment, with ways to protect yourself if it happens.

Financial issues or lack of insurance

Many people do not have enough insurance to pay for the care they need. The cost can be overwhelming, even with coverage. Medical bills add up fast, especially after car accidents and other incidents that lead to severe injuries.

How to handle it: Keep copies of any bills you cannot pay or letters stating your coverage is denied. Let your doctor and your lawyer know about your financial situation. Some clinics offer sliding scale fees based on your income or set up payment plans, so ask about those options as soon as possible. Many medical providers also treat injured persons through medical liens, which means the provider gets paid once the case settles from the settlement proceeds.

Transportation or scheduling problems

Making every single appointment is hard when you don’t have reliable transportation. Sometimes the provider’s hours do not fit well with yours, especially if you work the same hours doctors see patients. 

How to handle it: Make note of the times transportation or schedule issues come up. If your case goes to trial, having this timeline will show you tried your best.

Work or family responsibilities

Sometimes you must care for children, support elderly family members, or work several jobs. Committing time for weekly therapy or non-stop testing isn’t always possible. The balance between daily life and medical care can become overwhelming.

How to handle it: Tell your medical provider and your lawyer right away if your home or work life stands in the way. These pressures can be written into your medical chart or put in personal notes. This helps support your story later on.

Pain improves, then comes back

It’s easy to stop going to medical appointments when you start to feel better. Relapses aren’t always predictable – they can occur weeks or months after stopping treatment. Taking a break sometimes comes from a genuine feeling of improvement.

How to handle it: Return to your doctor as soon as possible if the pain or issues return. Tell them why you stopped showing up and make sure they note it in your file. Be clear about what symptoms have come back and how they’re affecting your life. Share all of this with your lawyer as well.

Facing a treatment gap does not make your symptoms or injuries less real. Tracking your reasons and telling your provider and attorney what caused the gaps can help improve your chances of getting the compensation you need to focus on your recovery.

If you have questions about getting appropriate treatment or need help with a claim, our team is here for you. We’ve handled all types of injury claims and have recovered billions of dollars for injured clients over the years. Contact Claggett & Sykes Trial Lawyers to schedule a free consultation with one of our personal injury lawyers.