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Gaps in treatment: finding them early in an injury file

Long breaks between medical visits are one of the first things an insurer looks for. Finding them early lets counsel understand them and gather the explanation while it is fresh.

Legal support4 min readCorvane Ashmoor & Co.

In injury matters, the timeline of care matters. A delay before the first visit, or weeks without treatment in the middle, can raise questions about the injury or its cause. Often there is a simple reason: a scheduling backlog, a lost job, a family emergency, a referral that took time. Counsel decides how gaps are addressed. Litigation support makes sure they are found and documented.

Build the visit list

List every visit from every provider, by date, from the records themselves rather than from memory: emergency room, primary care, specialists, therapy, imaging and pharmacy where relevant.

Look for two kinds of gaps

  • The first gap: days from the incident to the first treatment.
  • Middle gaps: stretches between visits longer than the firm's threshold, often thirty days.

Gather the reason

For each gap, note what the client says happened, and look for records that support it: appointment requests, cancellations, referral dates or insurance approvals.

Our treatment gap finder lists the gaps from a set of visit dates.

Litigation support is performed at the direction of a licensed attorney. How gaps are addressed is counsel's decision.

This article is general information, not legal, tax or regulatory advice. Rules change; confirm current requirements with the responsible agency or a licensed professional.

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