A Case Study in:
Medical File Review
AdvancedRM was contacted regarding Alex K., who was badly injured in a tractor trailer versus tree accident. Alex was an off duty driver of a tractor trailer traveling cross country when he encountered black ice during the night and slid off the road into a tree. The insurance companies involved were arguing due to confusion regarding workers compensation insurance versus motor vehicle insurance. While this arguing was going on, Alex was not receiving proper care. His attorney requested our assistance in reviewing the medical information and developing an overview of future costs to help him move the case along.
Client History
Alex was an off duty truck driver who was sleeping in the truck while his counterpart was driving cross country on a haul for a large trucking agency. While in the Midwest, the driver encountered severe weather conditions during the night. The driver hit a patch of black ice at a high rate of speed and his truck slid off the road and into a tree. Both the driver and Alex were ejected from the cab through the windshield. Alex sustained severe facial lacerations, orbital fractures, a cracked skull, a traumatic brain injury, a fractured clavicle, and dislocated right shoulder.
Alex was airlifted to the closest trauma center where he remained in a coma for seven days. Upon his release from the hospital, Alex returned to his home state but was unable to continue medical treatment due to the issue with his insurance coverage.
Process
- We met with Alex for an in person interview to ascertain information regarding his accident, his treatment to date, his medical history, and his status prior to the accident.
- We evaluated Alex’s home to determine if his environment was safe, determine whether home modifications were required, and assess what type of assistance and treatment he requires, and determine what he will need in the future.
- Alex signed a consent form to allow us to request his medical records to complete a thorough file review.
- We interviewed Alex’s treating physicians to obtain projects for recovery and future needs.
- We researched providers in Alex’s area including an orthopedic surgeon, a plastic surgeon, a PM&R physician, a pain management specialist, and a TBI program.
Analysis
We calculated costs for current and future care, equipment, medications, and treatment Alex will require. We completed a report with a projected total dollar amount that will be required to sustain Alex for the remainder of his life based on his life expectancy.
Outcome
We provided the attorney with our Settlement Projection. He was able to use the amount we calculated to prepare his settlement demand from the insurance company responsible for payment. Alex was provided with the money needed to obtain proper treatment, as well as with the information on the providers and programs that would be essential in his recovery thanks to the information provided in our report.