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Surprise! New law started on 1/1 to cut thousands of dollars in medical bills

After someone is injured in a car accident, they must be treated immediately. They naturally assume their medical bills will be paid quickly -- by someone else. But unfortunately, this doesn't often happen. We strive to get our clients the maximum in-pocket recoveries of money. We also stay on top of all new laws and court decisions that can help them. So we are excited to announce some great news for the victims of car accidents in the Dallas-Fort Worth area. The "No Surprises Act" took effect on January 1st. So what does that mean and how can that help you?

An injured passenger has the right to be compensated for his or her medical bills and other damages. But the legal process can be difficult and confusing, especially if you try to handle your case yourself. The insurance company adjuster and lawyer will not want to pay you what your claim is worth. Don't fall for these insurance company tricks. In the meantime, your medical expenses, lost wages, and other damages will pile up. What should you do? As a personal injury lawyer, I have handled countless injured passenger cases. Here are answers to questions that my clients have asked me over the past 41 years that should help you.

1. What should I do after the collision?

How much money can you receive for your injured finger or hand?

The hand is a very complex and fragile structure. It has many small parts that can easily be hurt including 27 bones, 34 muscles, 27 joints, and over 100 tendons and ligaments. After a car accident, people often suffer an injured finger or hand. The pain can be crippling and must be dealt with -- along with a lot of financial and legal concerns -- as soon as possible. If you are suffering from an injured finger or hand, you may be wondering

What should you do about your shoulder injury?

No one ever expects to be in a car or truck collision but their brute force and high speed can easily hurt different parts of your body. You may have just suffered a shoulder injury. Your pain can be excruciating. And your financial damage can be serious if not handled properly. You can be left with huge medical bills, substantial lost wages, and other adverse effects. Fortunately, medical treatment and the passage of time often resolve someone's injury. We thought to write about this topic because we just resolved a case for a man who underwent an arthroscopic shoulder surgery and a man on a motorcycle was diagnosed yesterday with shoulder tears that will require surgery. We only represent people injured in collisions so we have seen countless people who have suffered a shoulder injury over the last 41 years.

A car crash can cause someone's life to change in the blink of an eye, especially when a devastating spinal cord injury occurs. Fortunately very few people experience this, but for those who do, life for them and their families will never be the same. Motor vehicle collisions are the leading cause of a spinal cord injury. That is understandable given the size and speed of vehicles involved in a crash. Other variables like the angle of impact, body position, seatbelts, and airbags affect the severity. The injured victim will need to take immediate action so that they can get the medical treatment they need and have sufficient financial resources in the future. We strongly discourage someone with any case, let alone a catastrophic injury like this, from relying on the generosity of the other driver's insurance company.  A spinal cord injury is life-changing. Medical and other expenses will be extremely expensive. A lawsuit will need to be filed and a personal injury lawyer needs to lay the proper groundwork to prove your damages. The sooner you consult with an experienced car accident lawyer, the better.

An injured person must prove their case at trial. They must introduce pertinent evidence including proof of medical bills that are reasonably priced. The defendant can attack this evidence. The judge rules on the admissibility of the medical bills and other damages and the jury decides how much compensation the injured party receives. To make trials more efficient and fair, Texas law has allowed the parties to prove and disprove medical bills and records with affidavits since 1979.

The New In Re Allstate opinion

The Texas Supreme Court issued an opinion on Friday that will dramatically curb the use of these affidavits and require doctors to testify in person. The justices directed a Corpus Christi trial court to vacate its order that struck a counter-affidavit filed by the plaintiff's car insurance company.

What can you do when you have constant pain in your neck and back after a car wreck? After numerous trips to your doctor and anti-inflammatory and pain-relieving medications don't work, he or she may recommend that you have an epidural steroid injection. This happens frequently after you have been diagnosed with a bulging for herniated disc. Should you get these controversial injections? This post will answer questions about these shots.

What is an epidural steroid injection?

A corticosteroid and anesthetic are injected into the outside section of the spinal column. That is where inflamed nerve roots are located in the space between the bone and the sac that protects spinal nerves. At other times, the injection goes into the transforaminal space where the spinal roots exit (a "nerve block") or into the sacral hiatus in the tailbone area. Cortisone is one of many hormones made in the body. Adrenaline is released by the adrenal gland that curbs the inflammation from the immune the system and reduces the mind's ability to perceive pain. It is part of the “fight or flight” reflex.

How is the injection done?

It is usually performed by an interventional pain physician in their office or at a surgery center. X-ray guidance called fluoroscopy is used. Local anesthesia is used, although occasionally the patient is sedated. The procedure takes less than 15 minutes. Side effects are usually limited.

What is the success rate for an epidural steroid injection?

Studies show that up to one-half of patients report improvement in their pain level, but that depends on various factors including the
  • Type of steroid - some like dexamethasone are considered safer but are shorter-lasting; others, like methylprednisolone, are stronger and carry greater risks;
  • Size and location of any bulging or herniated disc;
  • Number - they are often administered in a series of three, so just having one will not be as beneficial; and
  • Diagnosis - a bulging disc or herniated disc may not be affected but they may help other problems.

What are the advantages of having one?

Getting an epidural steroid injection is a simple, minimally invasive procedure. It can relieve an injured person’s pain for one to three months and sometimes longer. Most seriously injured people would quickly sign up for that, especially if the other options are to undergo a surgery or live with the pain forever. We just blogged about how to deal with a bulging disc and getting these injections is sometimes the next step in that treatment: Bulging discs tips

What are the disadvantages?

Like any medical procedure, its success is not guaranteed. Some people only get a few days of pain relief. Each person will have different results. But getting an injection is never a permanent solution. Furthermore, there are potential risks. The injection is not approved by the Food and Drug Administration (FDA), which has warned it can cause rare but serious neurological problems. That alone would stop many people from getting one. Sometimes a different procedure like a percutaneous disc decompression or surgery is a better alternative.

How does this affect my injury case?

Your need for this extended pain management affects your prognosis and the value of your claim or lawsuit. But first, you and your doctor need to decide what your best medical options are. Then you and your injury attorney can craft the best strategy for moving forward with your case. Over the past 40 years, our law firm has represented thousands of car and truck wreck victims. Please contact us if you have questions.

It is common to feel pain in your neck and back after a car or truck crash. As you were hurled around your vehicle, your head and body may have slammed into the steering wheel, door, dashboard, and seat. Unfortunately, you may now have a bulging disc in your neck or back - or both. This article provides information about what this diagnosis means, the medical treatment that you need, and its effect on your injury claim or lawsuit.

What is a bulging disc?

The spinal column consists of seven neck (cervical), 12 mid back (thoracic), five low back (lumbar) and two other bones. These vertebrae, ligaments, and facet joints form the skeleton. The central nervous system transmits messages through the spinal cord which is protected by the spinal column. These 26 vertebrae are separated by spongy discs made of cartilage. They are filled with a soft material (pulposis). Think of the jelly inside of a donut. The function of the intervertebral discs is to keep the bones from rubbing against each other. They act like the shocks on your vehicle. The sharp forces during the car collision can cause the soft outer material (fibrosis) to bulge out. This can put pressure on the vertebrae, nerve roots, and other sensitive parts of the spinal column and cause you substantial pain as they rub together.

What often happens at the ER

You should seek immediate medical treatment after a crash. But the only test usually performed at an emergency room is an x-ray. It only shows broken bones, which very few people have after a wreck -- and almost no one has them in their neck and back. Further, a bulging disc rarely is apparent immediately after a car or truck collision. Sometimes -- especially if you have a gold health insurance plan -- expensive computed tomographs (also called CTs or "cat scans") will be performed. Again, these are not sophisticated enough to show if you have a bulging disc. You are discharged from the hospital with tests that show you have a minor injury. But you are in shock and scared. Your vehicle may have been destroyed and is out of commission and you have no transportation. You are wondering how you can work and just move without pain. And wait until you see the medical bill that might be secured by a hospital lien that you have to pay from your settlement or verdict if the crash was caused by another driver's negligence.

How do you know if you have a bulging disc in your neck or back?

In the next few days or weeks (if you did not feel them immediately), you may start feeling these symptoms:
  • headaches;
  • pain and tenderness in the neck, between the shoulder blades, and in the upper and especially lower back;
  • loss of range of motion;
  • dizziness;
  • altered vision;
  • ringing in ears;
  • pain in jaw;
  • nausea;
  • inability to sleep;
  • fatigue;
  • difficulty concentrating; and
  • irritability
These may be caused because you strained or sprained your neck and/or back. Your muscles, ligaments, tendons, joints, fascia, and connective tissue are torn. This "whiplash" can be very painful. Fortunately, strains and sprains usually go away within a few months. For more info: Soft tissue injury after a car accident

You need medical treatment ASAP

The only way to know whether you have a strain/sprain, a bulging disc, or another injury is to see a doctor. When you delay your medical treatment, this causes your medical problems to worsen. It also allows the insurance company and its lawyers to argue that your injury was minor and they you few medical bills to support a large jury verdict, so it will offer you far less money in a settlement. For more info: Neck and back injury: what is average paid for a car wreck? However you may not know which doctor to see. Many primary care physicians do not know how to diagnose and treat injuries that happen after a car accident -- or choose not to even get involved in them. They may write a prescription for an opioid medication (that can quickly become habit-forming). A Fort Worth personal injury lawyer can help you find the best medical professionals in our area to treat you, often under a delayed payment schedule. We work with many doctors in North Texas. The doctor will use different ways to resolve your injuries depending on his or her area of practice. Physical therapy, chiropractic treatment, anti-inflammatories and muscle relaxers, and other treatment can often help. If your pain continues, there are other more advanced methods that will be used to diagnose and treat your injury. The doctor can refer you to a specialist like a neurologist or an orthopedic or neurosurgeon if additional diagnostic tests like magnetic resonance images (MRIs) are needed or refer you for testing themselves. More aggressive treatment including steroid injections and nerve and facet joint blocks may be considered. Tests may show that the pulposis ruptured the outer layer, has leaked, and is pressing on nerve roots. Depending on the test results, the specialist may determine that you have a herniated disc, pinched nerve, or other more serious problem that may require surgery to correct. Herniated and bulging discs: what should you do?

You may be entitled to compensation

Depending on how your crash happened and other factors, you may be able to recover your damages from another driver or company. Berenson Injury Law has specialized in car, truck, and 18-wheeler crash cases for over 40 years. We have handled hundreds of bulging and herniated disc cases over the years and understand the medical and legal issues involved. Contact us with your questions at 1-885-801-8585 or chat with us online. The first consultation is free. Related injuries we have blogged about:
  1. Head
  2. Neck and back
  3. Spinal cord
  4. Shoulder
  5. Broken bones

When you are rushed to a hospital after a car crash, the cost for treatment and testing often exceeds $10,000. But instead of filing on limited insurance policies, the hospital can file a hospital lien to guarantee that it will be paid in full from your settlement or verdict. This is unfair and can wreck settlements. A major national newspaper just reported about the abuses with hospital liens. It noted that one hospital makes a shocking $10 million a year this way. How rich hospitals profit from patients in car crashes However, sometimes the hospital does not follow Texas law and its lien is not enforceable.

What are the requirements for a hospital lien to be valid?

The statute lists various requirements that must be strictly followed. These are some of the common errors made:
  • The required information is omitted;
  • The patient is admitted after the allowable time;
  • The facility does not file the hospital lien with the correct county clerk or at all;
  • The hospital charges too much;
  • The medical treatment is for too long of a period of time; and/or
  • The hospital accepts partial payment.

Is there a limit to the amount covered by the lien?

Yes, the amount must be reasonable for necessary services to treat a serious medical problem. However, proving these criteria can be difficult. Fortunately, thanks to a new law that took effect on January 1st, a personal injury lawyer can use cost estimates that the hospital is required to post on its website. For example, a hospital charged $3,400 for each of the four CT scans performed, but its site says that the test should only cost $675, so this saved our client a large amount of money. The attorney can also research what other local hospitals charge for the same services. Further, the total medical bill cannot exceed more than 50% of all amounts received by the injured person. For example, if the victim receives the negligent driver's total insurance policy of $30,000 and the hospital bill is $20,000, it must reduce the amount below $15,000. However, that is still an enormous amount, so the cap is often ineffective at making sure the patient is fairly compensated. In addition, the hospital is required to bill the patient's health insurance company, Medicare, or Medicaid plans within (1) the date on any applicable contract or (2) at the latest, by the first day of the 11th month after the injury. If the hospital partially collects on the patient's health insurance policy, it is barred from further payment from the patient. A new law will prevent surprise bills.

How do you know if a hospital lien was filed?

Further, the lien must be filed before the patient deposits the check that they receive from their attorney. The hospital is not required to write or call the patient or their lawyer. But the minute the lien is filed, all parties have automatic notice. They can be held legally accountable if they do not pay the hospital. In other words, you can not claim ignorance as an excuse for nonpayment. Therefore, a careful last-minute search is necessary. Here is a list of all the county clerks in Texas to contact to verify filing. Some courts have held that even if the person's name is misspelled or information is missing, the lien is still valid, so check other spellings if it does not appear the first time.

Can only the first hospital file a lien?

No, a lien can also be filed by providers including the
  • ambulance company in smaller counties with populations less than 800,000;
  • emergency room physicians if the reasonable cost of the services is less than $1,000; and
  • if the victim is transferred to another hospital, the lien also protects the second facility.

Are all insurance policies covered?

No, the lien does not attach to the victim's own insurance policies including personal injury protection and uninsured/underinsured motorists benefits. In other words, if the other driver who causes the collision did not have a valid liability policy, did not have enough insurance coverage, or the patient was paid by a benefit available under his own auto policy or by workers compensation, the hospital cannot assert the lien.

How can the hospital lien be removed or reduced?

It is usually necessary to have a personal injury attorney resolve this expensive issue. That is because until the lien is released, insurance companies will insist that the name of the hospital appear on the settlement check so it gets paid in full.

After you are in a car, truck, or 18-wheeler wreck, you will need medical treatment so you can heal. But it is expensive and you may not know how to get your medical bills paid. You naturally assume that the other driver and their insurance company are going to pay them quickly. But it can take some time for the possible payers -- the other driver's automobile insurance, your health insurance, your car insurance, and others -- to decide if they are going to pay you. Then they have to look at the medical records and medical bills and decide how much they want to pay. This is often a slow, complicated, and unfair process that affects every car and truck collision. Unfortunately injured people need to wait to negotiate a settlement or obtain a jury verdict until the possible payers obtain this information:
  • what their injuries are,
  • whether he or she needs surgery,
  • how much their medical bills and lost wages are,
  • how much pain they have and will experience, and
  • if they have suffered other damages.
This can take months to determine. But in the meantime, medical bills and then threatening FINAL NOTICE letters arrive. There is often a conflict between the injured person physically recovering from their injuries and not being harassed by bill collectors. What is the solution? In our last post we discussed some ways you can have your hospital, doctor, and other expenses paid after you were injured in a car or truck crash in Texas. This is such an important topic that we wanted to give you more useful ideas.

More resources to get your medical bills paid or deferred

You need to know up-front that this process is not easy. There is no one-size-fits-all solution and more than one source of funds is usually needed. You will have access to some of the following resources but not others.

Start with your job benefits: 

1. Short and long-term disability plans

Some companies offer to pay their employees two-thirds of their weekly wages and many of their medical bills if they cannot perform their job duties.

2. Unemployment benefits

If you lose your job, you should file for compensation through the Texas Workforce Commission.

3. Workers compensation or in-house plans

If the car or truck crash happened while you were driving while performing a job duty, for example while making a delivery, your company often has an insurance policy or similar program that will pay some of your medical bills and lost wages.

See if you qualify for any government programs:


5. Medicaid

Depending on your age and income status, these federal and state reimbursement programs can help get your medical bills paid. Note: repayment is often required
Note that the above programs and plans have liens which means that their payments must be repaid. But here's some good news: the amounts they pay are greatly discounted. For example, if a hospital bill with X-rays and CT scans totals $5,000, they might pay $500 to $1,500 and the balance is written off. And our office is often successful in reducing the remaining amount which can save thousands of dollars.

Use other solutions:

6. Letters of protection

Your accident lawyer can arrange delayed payments with certain medical providers. The advantage is that you do not have to pay your doctors out of your own funds until the settlement check arrives. At that time, they can often reduce those medical bills, again saving you a lot of money.

7. Installment agreements

Almost every hospital or doctor will allow the patient to make small payments while their case is pending. We always recommend that our clients pay even $10 a month so the provider know that it will get paid later. That way you can continue to receive treatment and your credit is not hurt.

8. Hardship arrangements

Some facilities will allow the patient to pay a reduced cash amount and they will write off the balance.

9.  Loans

We strongly advise our clients not to apply for the super high interest loans you see advertised on television and on the internet. In emergency cases, our office will make zero percent (0%) interest loans to our clients to pay medical or living expenses.

10. Complaints about medical billing

Calling or writing the medical provider if you believe that you have been overcharged or the services were inadequate may assist you. The Texas Department of Insurance has some useful resources including The Texas Department of State Health and the Texas Medical Board also investigate complaints against hospital and doctor for over billing. A good car accident lawyer will help you put together the pieces of your jigsaw puzzle. Mr. Berenson is one of the top-rated personal injury attorneys in North Texas. He only represents people who have been injured in car, truck, and 18-wheeler collisions. Contact him if you have any questions about your injury claim.
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