I've been talking to a lot of people who have been hit by cars and haven't met one--besides myself--who didn't fail to get the treatment they required and deserved. One girl who works in the shop where I bought the money order so I could get a copy of the accident report from the police station told me she received only $2,000 and no treatment, and that hasn't been able to do the aerobics she loved to do so much before being hit in the years since. She says she gained weight and now has no way to shed those pounds--and she is only about twenty years old.
Injured people usually miss out on treatment and benefits because they don't realize the need to take charge of the situation, to get an MRI on anything that's constantly painful and discuss it with a surgeon, or check with their Human Resources department to see if they're eligible for Disability benefits which are most likely part of their compensation package. They're worried about losing their jobs or that they'll have to fight to get paid and in the meantime lose everything--their job, their home, everything.
I can tell you that in my case, until I asked to get an MRI I wasn't told I needed one; and once I had the MRI I was told I needed surgery--then another MRI and another surgery, and I will have yet another MRI later on and likely another surgery. The moral is, you wont get anything that you don't ask for.
At the company where I am employed, they automatically include Short Term Disability insurance in every employee's benefits package--covered from day one. It pays up to 26 weeks, job protected, paid benefits. For the first 13 weeks they pay 100% of regular salary and thereafter 66.66%. If I had been with the company more than five years, it would pay 100% the entire 26 weeks (six months).
Additionally, employees have the option to purchase Long Term Disability at 50% of salary for cheap or 66.66% for about $19 a month.
I always buy the max--which I've never needed until now--because I'm a very active guy who enjoys cycling, hiking, and general outdoor head cracking activities. But even if I wasn't so adventurous, I'd say it's a good idea to purchase this additional insurance. I was hit in a crosswalk for instance, not during some glorious downhill, high speed adventure. I was moving maybe 3 mpg. This could have happened to anybody. Even if I slipped and fell in the shower, and required Disability benefits, I would be paid.
If you don't have Disability coverage, you have to pursue payment from the driver's insurance carrier, and as I wrote in an earlier post their whole goal is not to pay or to pay as little as possible.
So far I haven't had any lost income because of the coverage I have, but after 13 weeks the amount of money I receive from my employer will be reduced by a third, which in my case is a rather large sum of money. I would be stupid not to pursue payment from the driver's insurance for that lost income.
So in Week 5 I was required by the driver's insurance to see their doctor to determine just how disabled I am. I went yesterday.
It was obvious that this is the bulk of this particular orthopedic surgeon's business. People were packed in the waiting room to see the surgeon for five minutes.
I filled out a form which asked all too simple questions. I advised everyone around me, "If these forms do not ask you for information you feel should be included, then write that information on the form. And don't be the least bit shy about whining about how you feel, about every little ache and pain."
The insurer's doctor's entire goal is to make it seem like you're not really injured at all, that you will heal up just fine. There will likely be another person in the room who will record everything you say--so complain, complain, complain!
In my case, I complained about both knees and my right ankle, as well as my back, my hip, my shoulder--anything that ever ached after being hit. The doctor asked me to stand up, move side to side, raise my arms, reach for my toes, et cetera.
Near the end he said, "So the right knee isn't so bad." I wasn't going to let him get away with that! I immediately said, "The MRI revealed a torn ACL and other damage that requires surgery. I'd say any damage that requires surgery is very bad. Just because I can dance around for five minutes after sitting on my butt for a month doesn't mean I can resume normal activities." And sure enough, I saw the other person in the room writing down everything I just said.
Besides all that of course, I have my own surgeon, and MRIs, and physical therapists who can all attest to the fact that I require more surgery. So the insurance company can try, but they can't win.
One final bit of good news: I was just approved for an extension of the Short Term Disability benfits I receive from work, to the end of February. The doctor certified that I need to be out until July, but the benefits folks will only approve short intervals at a time. In any case, I can relax and recover until at least March at 100% of my normal salary.
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