Wednesday, February 22, 2012

No Fault And Doctor's Appointments: Some Basics You Should Know

If you were hit by a car in a No Fault state the first thing you need to know is that you can, and should go to any provider of care that accepts No Fault.  In New York this includes orthopedists, chiropractors, and acupuncturists.  You do not need prior approval, a referral, or have to choose from a list of pre-approved doctors as you would with an HMO or Workers Comp.  You do not need to contact the insurance company--in fact you should never speak to them directly unless your lawyer says you have to.

This is important not only so that you can get the proper care as soon as possible, but because it also supports your case against the driver's insurer and possibly the driver if you cannot receive an acceptable settlement from the insurer.  Remember, the auto insurer has claims people whose job is to reduce the amount of money they need to pay for your injuries.  The insurer would really love it if you didn't go to the doctor, they had their Independent Medical Examiner look at you, and then they could cut you off from receiving any medical care AND reduce the amount of liability money you would have received otherwise.

So in my case for instance, I was told at the Emergency Room the day I was hit that I should go to my regular doctor a week later for a follow-up.  Instead, I went straight to the orthopedist.  I went to the front desk and simply asked, "Do you take No Fault Insurance?"  They said yes, and I made an appointment.  If I had gone to my regular, general physician he probably would not have realized how badly injured I was, or referred me surgeons--and even if he did, for lack of a specialty his diagnosis would not have carried as much weight.

If that doesn't convince you, consider this.  When the insurer sent me to an Independent Medical Examiner, they sent me to an orthopedic surgeon; he was a quack who just denies claims all day, but he was a surgeon.  If the insurer feels they need a surgeon to deny your claim or cut you off from care, then certainly you need a surgeon on your side.  And it's paid for by No Fault, so you really have no reason not to see a surgeon.

The other main thing you need to know is that you can go to as many doctors as you like, but you can't go to two of them in the same day.  This includes Physical Therapy.  So in my case I can't go to a chiropractor or go to a follow-up with the surgeon and go to Physical Therapy on the same day.  So if you are receiving care from multiple sources, make sure to schedule them out.

Also don't let a lapse of time go between getting care and simply resting.  If you're not receiving treatment for a time, this indicates to the insurers--including Disability or Workers Comp--that you no longer need care.  As hard as it is to keep going, as much as you would love to take a month off from getting electrocuted, stabbed with needles, going to Physical Therapy, and getting your bones manipulated, you can't stop until you are 100% and ready to go back to your normal life.

Monday, February 13, 2012

Having a Strategy: Plan Ahead for the End of Your Disability Period

If you get a load of money, a major windfall either from the settlement with the driver's insurance or in court, there are generally two things you can do with it in my opinion.  If you have the discipline to save it or some significant portion of it, and you don't have any dire need to spend it, then by all means sock it away for retirement or a big purchase such as the down payment on a home.  If you have been constantly behind the eight ball though with high credit card balances and bills piling up, and particularly if you're prone to squandering money, then if you are going to blow it then blow it on debt relief.

Personally, I was somewhere in between.  I had student loans I could never seem to catch up on, and in the past year I had bought my first car, which was financed with fairly outrageous terms.  So day one I killed off two student loans completely--gone, a tremendous weight off my shoulders.  Day two, I paid off that car loan in cash.  Between the student loan and car payments I would no longer be making I reduced the amount that I would be paying out monthly by over $700.  That's over $700 more cash, in my pocket, every month--or well over $8,400 per year.  It's like giving myself a raise.  By paying off the auto financing only six months after I bought the car, I also saved myself over $8,000 over the next four years--so now we are up to well over $10,000 a year that I get to keep in my pocket over the next four years.  No more worrying about missing a payment or two on my car due to a period of belt tightening, or not having a car to get to better job opportunities and places to live (and enjoy cycling of course), the car is mine.  And no more student loan officers chasing after me.

Of course I had a decent amount of money left after that, and decided that it would be best to buy things which I was going to need to buy eventually anyway.  I had some broken down old furniture which I bought used and never intended to be permanent to my life which I replaced.  I finally bought my wife a decent bookcase, and I bought some electronics which were very reasonably priced.  I also was able to buy my wife a trip to visit her family and friends back home--in a foreign country--without it being a real belt tightener.

But then there are the unexpected expenses of Disability that you should set aside some money for, and when you think you have enough to tide you over, think again.

In my case, once I was approved for Social Security Disability I received a lump payment back to June--when my Long Term Disability insurer started paying on my claim.  That meant that there were thousands of dollars in overpayments to me as the Social Security Disability payments reduced the amount of my benefits from MetLife.  Since I didn't want this to drag out so that I just ended up under the gun with them for years to come, I told them to keep the money they would have otherwise paid me until the overpayment was settled.  That was two and a half hard months and at the end of it I didn't have much left other than what I invested--but it was worth it.

And it seems as soon as you have some money, people are coming at you from all sides to take it.  I can't go into the details, but you might literally need a bit of a war chest for the messy period between the end of your Disability period and being employed again.  You cannot count on your employer fulfilling their legal responsibilities to rehire you or even to not literally penalize you for being disabled; they may act illegally counting on the fact that you do not have the money to hire a lawyer and fight for your rights, or that you may be ignorant of what your rights are.  In any case, you should assume that at the end of your Disability period, you will most likely need to find another job.  Even global mega-corporations can get very petty, making it seem like you went AWOL even though they have been made well aware of the physical impossibility of you doing your job for some time.

Bottom Line, on the positive side: Look at the long view.  This is probably a once in a lifetime event for you, you will get past it, and ultimately you will have the benefit of having used that windfall you received in Liability money to your maximum long term benefit and having your injuries treated as best they could be.

My goal at the end of all this is that my knees and spine will be even better than they were before I was hit.  After all, I just had a major overhaul done, not only physically, but financially as well.  So long as you're smart about how you manage your Disability period, your physical treatment and recovery, and your financial stability, ultimately everything is going to be as good or better than it was before.