What Is a Gap in Treatment?
A gap in treatment refers to a period of time during which an injured person stopped receiving or seeking medical care for their injuries. This can be a gap between the accident and first treatment, or a gap between follow-up appointments during recovery.
Why Insurance Companies Focus on Gaps
Insurance adjusters use treatment gaps to argue that injuries were not serious, that the claimant has already recovered, or that the current complaints are unrelated to the original accident. Even a gap of a few weeks can be used to reduce the perceived value of a claim.
Legitimate Reasons for Gaps
Gaps in treatment often have legitimate explanations that can be documented and addressed. Common reasons include lack of health insurance or difficulty affording treatment, inability to get an appointment with a specialist, family or work obligations, temporary improvement followed by a setback, or a mistaken belief that injuries would resolve on their own.
How Attorneys Address Gaps
When a treatment gap exists, attorneys work to document the reasons for it. A brief explanation in medical records — "patient delayed follow-up due to lack of insurance" — can address the gap in context. Attorneys also work with medical experts who can explain why certain symptoms might be delayed in their presentation or severity.
Going Forward After a Gap
If you have had a gap in treatment, the most important step is to resume care. Resume treating with your physician and be transparent about why care was interrupted. Consistent treatment going forward demonstrates ongoing injury impact and medical need.
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InjuryClaimSource is an educational resource. We are not a law firm and do not provide legal advice. Consult a qualified personal injury attorney for advice about your specific situation.