Disclaimer: The materials on this website (a) have been prepared by Express Legal Funding LLC (Express Legal Funding) for informational purposes only, (b) do not constitute legal advice, and (c) are not guaranteed to be complete, up-to-date, or accurate in all respects as laws are constantly changing.
Following an injury, your primary focus is to get the medical attention you need to recover from any damage sustained in your accident. There are all kinds of treatments for pain management, ranging from traditional to holistic. However, in the case of a personal injury claim, some types of treatment are viewed poorly by the powers that dictate your compensation and the treatment you pursue.
In particular, a holistic treatment known as acupuncture can occasionally raise a few eyebrows with the insurance adjusters tasked with reviewing your claims. Such incredulity might have you wondering whether using acupuncture as a treatment option will cost you the coverage you are owed.
With this article, we hope to enlighten you on whether or not your acupuncture costs will be honored along with your other medical bills. We’ll also discuss any resistance you might encounter with the insurance claims adjuster in charge of handling your case and what can potentially affect those odds.
Let’s dig in!
What is Acupuncture?
If you’re suffering from a personal injury, you likely want to use any methods at your disposal to ensure your pain is mitigated. If you have never made use of acupuncture treatments before or have only heard secondhand accounts, you might be wondering exactly how it can help you with pain management.
Initially developed in China back around 100 B.C., acupuncture involves the insertion of sterilized needles into crucial parts of the body to stimulate the central nervous system. This stimulation prompts the release of chemicals into your muscles, brain, and spinal cord that trigger your natural capacity to recover from injury. Some acupuncture variants forgo needles in favor of other tools like heat, pressure, suction, or even electromagnetic energy to produce similar results.
As for how acupuncture can affect the body’s recovery from an injury and manage pain, you might be surprised. Some research and scientific study has found acupuncture to be a valuable treatment for physical ailments such as back pain, cramps, neck pain, and other varieties of muscle aches.
The effect of acupuncture on muscles and nerves makes them particularly effective for car accident victims with nerve damage or whiplash. It may even help with significant conditions like arthritis and sciatica.
The use of acupuncture as a substitute for treatment from medical providers and facilities is generally not advisable. Still, its use as a supplementary treatment for your pain symptoms can prove to be beneficial to your overall recovery. Unfortunately, this has not helped acupuncture’s public image much.
Due to acupuncture being rooted in Chinese medicine and dating back thousands of years, it is occasionally viewed as little more than a holistic hoax and not often taken as a legitimate form of medical treatment in response to a personal injury.
This bias is also affected because practitioners are not obligated to attend medical school to acquire accreditation. This situation means using it might negatively impact your claim unless you do it in a way that shows its necessity to your recovery that even the adjuster cannot refute.
Insurance Companies and Holistic Treatment
As unfortunate as it might sound, insurance agencies are commonly more focused on protecting their bottom line than helping out. This focus means they will pounce on any justification to avoid paying out what they owe despite how badly you might need the funds.
With holistic medicine being viewed as pseudoscience by some practitioners, the insurance adjuster may view the costs incurred by your acupuncture treatment as frivolity and waste to justify not covering the cost in the settlement. Acupuncture is not even the sole victim of this bias that insurance adjusters aim to exploit.
Treatment avenues like chiropractors, psychological care, acupuncture sessions, or even physical therapy alternatives like yoga are occasionally viewed as lesser avenues that they may attempt to belittle to avoid paying out.
This issue arose because every insurance agency has personal biases about what constitutes “real treatment” that they justify by discrediting its validity.
It’s challenging to dispute injuries treated at a hospital or healthcare provider but much easier to challenge treatment that a doctor didn’t perform. An insurance adjuster’s job is to minimize expenses and risk, and they do so by attempting to question things – and sometimes, it works.
Doing so has allowed agencies to sidestep paying out on specific treatments to keep their bottom line inflated. The simple fact is that the only way to get the insurance adjusters to authorize coverage on these alternative treatment types is to render their use irrefutable. However, this particular fight will always be challenging since most agencies have successfully argued around these treatments for years.
To M.D. or Not to M.D.
One of the main things an adjuster will look at when verifying the treatment you took following your injury is the qualifications of the one who treated you. One of the golden rules an adjuster has when authorizing treatment for compensation is that they have to have a medical degree to be considered “valid.”
However, this bias is not reinforced by the law and can be successfully fought if your attorney can legitimize the provider’s treatments in the adjuster’s eyes.
This tactic has a double-pronged effect. Suppose the treatment is conducted by an M.D. and is extremely expensive. In that case, the adjuster will almost always recognize it as a legitimate treatment so long as you did not seek it out when your doctor did not explicitly recommend it.
Alternatively, if the treatment was provided by a professional who lacks a degree, the adjuster may dismiss it as illegitimate. Even if these non-physician treatments are declared legitimate, they may be given low multipliers when the overall settlement amount is calculated.
Unfortunately, this bias is an unspoken tolerance that insurance companies have been getting away with for some time.
The adjusters will always give providers with an M.D. higher priority and respect, meaning any treatment from a provider without one will need to be proven as necessary. How you can legitimize such therapies will vary depending on the case and the intensity of the treatment you were forced to seek out.
How to Legitimize Holistic Treatment
Your insurance company may not want to pay for your holistic care at all and could attempt to delegitimize it in the eyes of those involved. However, just because the insurance adjuster wants to undermine acupuncture as a treatment does not mean they have any power to do so.
Insurance companies have no right to dictate the type of treatment you pursue, and it is entirely up to you and your care physicians what treatment you employ. Using acupuncture as a treatment avenue for your injury claim can be validated if it was not an excessive decision.
Your physicians dictate your treatment plan following your needs and advise you to get what they feel is in your best interest.
For example, suppose your doctor advises you to seek acupuncture or chiropractic care to help with your pain from your auto accident. In that case, the adjusters will have little choice but to honor what the medical professionals have advised.
Even still, taking advantage of holistic treatments in addition to mainstream medical treatment will maintain their legitimacy in the eyes of adjusters. This change is because you are seeking individualized treatment while also pursuing commonly-accepted treatment options in the interest of improving your odds of recovery.
With that in mind, you should never make decisions solely based on the potential effects it might have on your legal proceedings and should always do so based on the medical benefits the options have to offer.
Even when acupuncture or other holistic treatment options are being considered due to being prescribed by a physician, they will still be rated lower on the scale than other, more recognized treatments.
Ultimately, the legitimacy of any treatment is not up to the adjuster and is determined strictly by how well it alleviates your pain and allows you to return to everyday function. Yet, you must take care to avoid treating beyond what you need since overtreating – with even holistic treatments – can leave you worse off.
You might be wondering how the type of treatment you use affects the settlement coverage of your treatment. The answer is simple. The amount of money you receive from your settlement to pay off your medical expenses, holistic or otherwise, is primarily determined by the overall costs of your treatments and pain relief.
This situation is why insurance adjusters will be looking to find any costs they can write off as unnecessary to minimize the overall settlement amount they will be obligated to provide.
The Legal Proceedings
Regardless of the medical treatment used to recover from your injuries, you will have minimal luck independently negotiating your stance against the adjusters.
To that end, retaining the services of a law firm will radically improve your odds of seeing the adjusters concede the point that your acupuncture treatment was just as crucial to your recovery as the mainstream treatments that led to it.
The medical treatment stage is where your actions also need to be closely monitored since overtreating will give the adjusters more ammunition to deny your claim.
Your attorney’s job is to compile the evidence of your treatment and present the costs to the adjuster. If the treatment amount is excessive, the adjusters will analyze the treatment frequency with a fine-tooth comb to discount the necessity of each appointment that they might view as extreme.
This step can lead to accusations of you attempting to overtreat to maximize the settlement amount rather than with the intent to recover from the injury. However, these medical records and the input from your attorney can help justify the use of acupuncture in addition to other treatments.
The legal aspect of a personal injury case is just as crucial to verifying treatment compensation as the actual medical benefits you receive from it. With the aid of your attorney, insurance adjusters will have a much harder time refuting the validity of the treatments you sought and will be more likely to pay the proper amount to your settlement.
A combination of reasonable frequency of therapy and a well-versed attorney can make your case go much smoother.
Acupuncture is not a widely appreciated form of treatment for pain management, especially in the eyes of insurance adjusters who will do anything and everything to avoid paying. Again, this phenomenon is common because it is a “holistic” treatment option administered by an individual who isn’t a licensed physician.
This situation can happen despite acupuncturists requiring extensive education and accreditation to do their job. However, you still can recover acupuncture costs during your personal injury claim proceedings despite this unfortunate bias.
A combination of being smart about your treatment and retaining a skilled attorney will make it near impossible for an insurance adjuster to refute the claims that your acupuncture was an essential part of your healing process.
Even when acupuncture is approved as a recoverable treatment medium for your wounds, you are still saddled with the responsibility of being a functioning member of society, even as your injuries associated with your personal injury case drain your resources. When pursuing a legal case of any sort, you are still obligated to fulfill your financial obligations.
Fortunately, there is a measure you can take to keep yourself afloat financially while a personal injury attorney is handling your case. Legal funding is a specialty service in which a company advances you an amount of money you can use to pay for essential costs such as housing and other everyday bills in exchange for a portion of your settlement or trial award once your case resolves.
The best part of legal funding is that they have zero risk to the plaintiff since you are not obligated to repay the money funded to you if you do not win the case. So, if you need cash now, consider using legal funding to your advantage while the insurance adjusters argue about your acupuncture treatment. Please feel free to contact us today for a free consultation and see how you can qualify.