The steps to determine causation are
the same regardless of the type of doctor rendering care. Once causation is
determined then other aspects of the claim can be evaluated. If the traumatic
event did not caused or materially contributed to symptoms and diagnosed
conditions then the claim has no basis.
1. Symptoms
Following a MVC
Pain affects more Americans than
diabetes, heart disease and cancer combined.
Symptoms
related to the back and spine is among the most common everyday complaints.
Pain
– 76.2 million people, National Centers for Health Statistics
Diabetes – 20.8 million people (diagnosed and estimated undiagnosed), American Diabetes Association
Coronary Heart Disease (including heart attack and chest pain) and Stroke – 18.7 million people, American Heart Association
Cancer – 1.4 million people, American Cancer Society
Diabetes – 20.8 million people (diagnosed and estimated undiagnosed), American Diabetes Association
Coronary Heart Disease (including heart attack and chest pain) and Stroke – 18.7 million people, American Heart Association
Cancer – 1.4 million people, American Cancer Society
“Whereas PAIN is generally associated with most forms of disease it does
NOT stand alone as a diagnosis to establish causation or the necessity of
on-going or prolonged treatment.”
Back pain is one of the most common medical problems in the United States .
It affects up to 90% of Americans at some point in their lifetime, with more
than half of those experiencing multiple episodes.
This is a very common reason why a claim is denied or why care is reduced
for insufficient documentation.
From a recent
review:
The reporting
of "pain" or “symptoms” alone is not sufficient to establish the
medical necessity of the treatment rendered related to the car accident.
Whereas pain and symptoms are generally associated with most forms of disease
it does NOT stand alone as a diagnosis to establish causation or the necessity
of on-going or prolonged treatment. Symptoms related to the back and the spine
is among the most common of adults' everyday complaints.
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