Chiropractors play a vital role in helping patients recover from car accidents, slip and fall incidents, and workplace injuries. However, in the realm of personal injury claims, insurance companies often scrutinize chiropractic care, looking for reasons to minimize or deny compensation. Understanding common tactics used to discredit treatment allows chiropractors to better protect their patients and ensure proper documentation supports their claims.
Questioning the Necessity of Treatment
One of the most common tactics is challenging whether chiropractic care is medically necessary. Adjusters may claim that injuries are minor, self-limiting, or would have healed without care. They may also argue that treatment is excessive or not supported by objective evidence.
Chiropractors can counter this by providing thorough documentation, including:
- Objective findings such as range of motion limitations, muscle spasms, and positive orthopedic tests.
- Detailed treatment plans explaining the rationale for each session.
- Progress notes demonstrating improvement or ongoing need for care.
Clear, consistent records help establish that care is reasonable, necessary, and directly related to the accident.
Highlighting Gaps in Care or Missed Appointments
Insurance companies often point to missed visits or gaps in treatment as evidence that injuries are not severe or that the patient’s condition is unrelated to the accident. Even short delays can be used to question causation. Chiropractors should:
- Document all missed or rescheduled appointments and the reasons provided by the patient.
- Note patient education and home care instructions to show proactive management.
- Maintain a timeline of treatment, symptoms, and improvements.
These steps help attorneys demonstrate that care was consistent and necessary, even if occasional gaps occurred.
Challenging the Credibility of Chiropractors
Some adjusters may attempt to undermine a claim by questioning the credibility of chiropractic treatment compared to medical doctors. This tactic often includes claims that chiropractic care is “alternative” or “unproven.” You can protect your patients by:
- Providing clear explanations of your clinical findings and treatment rationale.
- Using objective measurements and documentation to support your clinical decisions.
- Ensuring treatment notes follow industry standards and best practices.
A well-documented, evidence-based approach makes it difficult for insurance companies to dismiss your care.
Suggesting Pre-Existing Conditions Are the Cause
Insurance adjusters frequently claim that a patient’s symptoms are due to pre-existing conditions, rather than the accident. This tactic can reduce settlement value or lead to denial of claims. Chiropractors can help differentiate accident-related injuries from pre-existing issues by:
- Conducting thorough patient histories.
- Comparing pre- and post-accident function.
- Using diagnostic imaging or objective testing when appropriate.
- Documenting symptom onset and progression.
Clear differentiation strengthens the link between the accident and the injury.
Downplaying Subjective Complaints
Insurance companies often discount patient-reported pain, fatigue, or functional limitations as subjective or exaggerated. Without objective documentation, adjusters may argue that symptoms are not credible. Chiropractors should:
- Pair subjective reports with objective findings.
- Track improvements or setbacks over time.
- Record examples of functional limitations in daily life.
By combining objective and subjective documentation, you create a compelling record that supports the patient’s experience.
Insurance companies have many tactics to challenge chiropractic treatment in personal injury claims. The best defense is thorough, consistent, and objective documentation, combined with clear communication with both patients and attorneys.
