I had mva approx 6 mnths ago, have had to have urgent spinal cord surgery since then but insurance say its pre existing cond.

Asked over 1 year ago - New York, NY

My car was rear ended whilst I was stationary about 6 months ago, I went to Drs 3-4 days later as I had back, neck and shoulder soreness, dx as bruising from mva. Approx 3 wks later, was cleaning and reached under a bed and got electric shock sort of pain down back of arm and fingers went dead, went of to Drs again and was referred for an urgent CT. CT showed a large mass between and around C2/3, C3/4 & C5/6. Sent for MRI which showed a badly herniated disc and 2 smaller bulges which was causing severe spinal cord compression, Specialist said it was an impressive injury caused by impact and was suprised my symptoms so few. Said ok to work etc but to take it very easy and if symptoms worsened to go immediately to A&E as I could end up paralized. Symptoms got worse and signed off for 5mth

Additional information

I was advised to do nothing, no lifting, cleaning, driving, exercising etc due to the risk of becoming paralized, my symptoms got worse particularly the electric shock pains in my arms which were bad when I walked. My Neurosurgeon booked me in for surgery 3 months after accident but insurance company refused to fund op so it then got delayed another 2 months and still insurance company saying it was a pre existing condition that caused the problem and not the accident. I am so frustrated as I knew nothing of the condition (osteo arthritis) I have had a problem with my shoulder in the past but it has been dx as tendernitis and I had no reason to believe otherwise, my faith was in my Dr as they know what they are talking about. They say it has been there for a long long time but have not said how long. What should I do?

Attorney answers (10)

  1. Gregory Scott Gennarelli

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    Contributor Level 14

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    Answered . You should consult with a personal injury attorney immediately who may be able to help. If the doctor relates your disk problem and the surgery to the accident, you would have a viable claim against the owner and operator if te vehicle that struck you in the rear. No Fault companies are notorious for denying medical claims and treatment as "not causally related" or "pre existing" even if you never had a problem before. As long as they have a doctor to justify the denial, they do. It Is possible to file an appeal of the denial, or you could commence a lawsuit to seek payment of the bills and for your injury, pain and suffering.

    New York Plaintiff's Personal Injury Attorney Serving NYC, Long Island, Westchester and the surrounding areas.... more
  2. Chris Matthew Limberopoulos

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    Contributor Level 16

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    Answered . You can have a pre-exisitng condition that is aggravated by trauma. It sounds like the insurance company is playing insurance company games. You need to retain a lawyer NOW!

  3. Jeffrey Mark Adams

    Contributor Level 20

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    Answered . You have t asked a question which strongly suggests you ate looking for direction. The wisest decision you can make is to speak with a qualified personal injury litigation attorney asap. Do t be foolish. Good luck.

    Personal injury cases only; I'm good at it; you be the Judge! All information provided is for informational and... more
  4. Steven Miller

    Contributor Level 10

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    Answered . If you don't have an attorney, get one now. Even if you had a pre existing condition the law protects you if the condition was activated/aggregated causing the need for surgery. What insurer is refusing to pay for the surgery, no fault? A lawyer should be able to clear this up quickly.

    This answer is not intended as legal advice, nor as a substitute for legal advice received from an attorney during... more
  5. Eric Edward Rothstein

    Contributor Level 20

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    Answered . You need a personal injury lawyer. You have several options including trying to get the surgery on a lien or filing for no-fault arbitration against the insurance company. Hopefully the car that hit you has a large insurance policy or you have a large SUM policy.

    I am a former federal and State prosecutor and now handle criminal defense and personal injury/civil rights cases.... more
  6. Yefim Rubinov

    Contributor Level 17

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    Answered . What's your question? Do you have a lawyer? If not, then get one right away!

  7. Dean P Murray

    Contributor Level 18

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    Answered . You owe it to yourself to contact a lawyer, whether myself or one of my colleagues. If you appreciate the time spent preparing this answer, kindly consider marking it BEST ANSWER or HELPFUL. Also, please be sure to read my disclaimer below. Good luck to you.

    Dean P. Murray
    The Murray Law Firm
    560 Sylvan Avenue
    Englewood Cliffs, NJ 07632
    T: (201)875-2600
    F: (201)549-8700

    Mr. Murray's response is NOT legal advice and does NOT create an attorney-client relationship. You should NOT rely... more
  8. Michael J Palumbo

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    Contributor Level 19

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    Answered . You need to retain personal injury counsel ASAP. Call my law partner Mark Kosofsky toll free 1-877-996-6849. All he does is personal injury cases.

  9. James D. Kiley

    Contributor Level 13

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    Answered . Your dilimena is not unique. Most people with spinal injuries from car accidents have degenerative spinal conditions. I'll take that one step further..., most people have degenerative spinal conditions. This the same game that all the insurance companies play. They send you to some Dr. who graduated last in his class for a three minute medical exam. Unless you walk in missing a limb, they either find nothing wrong with you or determine your condition to be pre-existing. Your options are 1) contest the no fault insurance company's finding ( through arbitration) ; 2) if you have private insurance, forget no fault and put it through your own insurance or 3) see if you can find a reputable surgeon who will perhaps take a lien against your personal injury case. Possibly a fourth option would be to borrow money against the case to have the surgery. What are the limits of insurance coverage on the vehicle that struck you? You have two of the four elements to make a strong case: 1) good liability; 2) significant damages. If you have 3) a defendant with a large insurance policy then the insurance company will most likely make a substantial offer on your case rather than go to trial on issue 4) which is proximate cause ( that the accident was a substantial contributing cause of your damages). My office handles such cases. Good luck to you.

    This communication does not create an attorney/client relationship. My firm is a second generation family firm... more
  10. Christian K. Lassen II

    Pro

    Contributor Level 20

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    Answered . A personal injury lawyer will argue aggravation of previous injury. Retain a personal injury lawyer with a low contingency fee, less than 30%, so you are left with the lion's share of the settlement, not your lawyer. Good luck.

    Only 29% Contingency Fee! Phone: 215-510-6755 www.InjuryLawyerPhiladelphia.com
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