When you have an injury such as a fracture caused by a car accident, as the most general way to handle the situation, you will have routine doctor visits or stay in a hospital to seek medical treatment provided by a doctor. After receiving treatment from a medial institution for a while, you will gradually recover from your injury as time passes. The course of medical treatment for such injuries can be described as the following figure.
As shown in the above figure, the line describes how the condition of an injury gets better after the highest point where the accident happened. Any injury, however, eventually reaches the stage where “no further recovery can be expected” at some point. Let’s say you have a scratch caused by an accident. The stage where your injury cannot expect any further recovery is when the wound is closed and your skin looks how it used to look like before the accident.
However, as described in the above figure, the condition of an injury often ends up reaching the stage where any further recovery cannot be expected after certain treatment procedures. The point the condition of an injury reaches this stage is called “the Date of Agreed Medical Examination” (Sho-Jyo-Kotei in Japanese) in the sense that the condition of the injury will not either get worse or better.
“The Date of Agreed Medical Examination” often becomes a big issue in claims for damage caused by a car accident. Let’s discuss what the impacts of the Date of Agreed Medical Examination are in detail below.
What are the impacts of the Date of Agreed Medical Examination?
Determining the Date of Agreed Medical Examination is very crucial as the amount of compensation will be adjusted depending on this date. What affects you the most is that medical fees will not be reimbursed after this date is determined. As further treatment is considered ineffective, the reimbursement for medical expenses will be discontinued.
The following coverage will be affected depending on if a claim is made before or after the Date of Medical Examination.
(1) Before the Date of Agreed Medical Examination
- Medical expenses
- Compensation for loss of earnings
- Compensation for inpatient and outpatient treatments
(2) After the Date of Agreed Medical Examination
- Compensation for after-effects
- Lost earnings
How is the Date of Agreed Medical Examination Determined?
An Agreed Medical Examination is usually conducted by a primary doctor as it’s designed to offer an indication that any further treatment will not be effective. However, since whether you declare symptoms or not will matter a great deal when injuries are not visible such as whiplash, the recovery period should be carefully determined after a detailed consultation with a doctor.
Additionally, if you have whiplash symptoms, insurance companies are likely to lead you to an Agreed Medical Examination in the early stages. If you need further medical treatment, you might as well not to accept what they suggest without any careful consideration
When you are not satisfied with how an insurance company handles claims or what they offer, please contact our office.