Short Answer

In a North Carolina neck/shoulder and concussion-type injury claim, you should gather (1) complete medical records that show what you complained of, what providers found, and what treatment you received, and (2) billing documents that show what was charged and what was actually paid or still owed. Start with the ambulance and ER records (including imaging), then collect follow-up care records (like chiropractic), and keep a running list of every provider and date of service. Because you have Medicare, also keep your Medicare Summary Notices and any letters about reimbursement.

Understanding the Problem

If you were hurt in a North Carolina motor-vehicle crash and you have neck pain, pain in both shoulders, headaches, and concussion-like symptoms, the practical question is: what records and bills should you gather so an insurance adjuster (or a jury, if needed) can clearly see what happened medically and what it cost. In your situation, one key fact is that you were transported by ambulance to the ER, had imaging, and then followed up with chiropractic care.

Apply the Law

In a North Carolina injury claim, medical documentation usually serves two jobs: (1) proving the nature and extent of your injuries and treatment, and (2) supporting the medical-expense part of your damages. North Carolina law also has specific rules about medical-provider liens and about how medical charges can be shown in a civil case, which is why it helps to collect both the clinical records and the billing records (including what was paid versus what was charged). If your claim resolves by settlement, liens and reimbursement claims (including Medicare-related reimbursement issues) can affect how settlement funds are handled.

Key Requirements

• Complete treatment timeline: A clear list of every provider (ambulance, ER, radiology, primary care, chiropractic, physical therapy, neurology, etc.), with dates of service, so nothing is missed.
• Records that document symptoms and findings: Notes showing your neck/shoulder complaints, headache complaints, concussion screening, exam findings, and diagnoses.
• Imaging and test documentation: Radiology reports (and, when available, the actual images) for CT/X-ray/MRI and any other testing tied to head/neck/shoulder complaints.
• Proof of medical charges and satisfaction amounts: Itemized bills and statements showing what was charged and what was paid or is still owed (often different numbers).
• Proof connecting bills to the injury event: Records that tie treatment to the crash-related complaints (not just that treatment occurred).
• Lien/reimbursement paperwork: Any notices of liens or reimbursement claims (including Medicare-related correspondence), because these can impact settlement distribution.

What the Statutes Say

• N.C. Gen. Stat. § 8-58.1 (Medical charges evidence) - Allows an injured person to testify about amounts paid/required to be paid for medical charges if records accompany the testimony; creates presumptions about reasonableness in certain situations.
• N.C. Gen. Stat. § 44-49 (Medical provider lien; itemized statement within 60 days) - Creates liens for certain medical-related charges tied to an injury recovery and requires an itemized statement/record/report and notice to the attorney upon request within 60 days as a condition to a valid lien.
• N.C. Gen. Stat. § 44-50 (Duty to retain funds; lien cap) - Addresses how liens attach to settlement funds and requires retaining sufficient funds after notice of claims; limits the lien amount (exclusive of attorney’s fees) to 50% of damages recovered.
• N.C. Gen. Stat. § 44-50.1 (Accounting of disbursements) - Requires certain accounting/certification information when lienholders are paid less than claimed and addresses confidentiality/HIPAA considerations.

Analysis

Apply the Rule to the Facts: Because you had ambulance transport and an ER visit with imaging, the first records to gather are the ambulance run sheet, ER physician and nursing notes, and radiology reports for any head/neck/shoulder imaging. Since you then had follow-up chiropractic care, you will also want the initial chiropractic intake, treatment notes, and any re-exams/discharge summaries to show how your symptoms changed over time. Finally, because you have Medicare, you should collect Medicare Summary Notices and any reimbursement-related letters so the “what was charged” and “what was paid/owed” numbers are clear and so reimbursement issues do not surprise you later.

Process & Timing

1. Who gathers: You (and your attorney, if you hire one). Where: From each provider’s medical records/billing department (ambulance service, hospital/ER, radiology group, chiropractic office, and any other follow-up providers in North Carolina). What: Request (a) the complete medical chart for the date(s) of service and (b) an itemized bill and payment ledger showing charges, adjustments, payments, and balances. When: Start as soon as possible, because providers can take time to process requests and some records are easier to obtain while the visit is still recent.
2. Organize and cross-check: Put records in date order and compare them to your bills and to your Medicare Summary Notices so you can spot missing providers (common examples after an ER visit include separate bills from the hospital, the ER physician group, radiology, and ambulance).
3. Update as treatment continues: Keep collecting records and bills as you go, especially if you are still treating for headaches, dizziness, neck/shoulder pain, or other concussion-type symptoms. Your final “packet” usually includes a last visit note (or discharge note) and final billing statements.

Exceptions & Pitfalls

• Missing “separate bills” after the ER: A single ER visit often generates multiple bills (facility, ER physician, radiology, imaging interpretation, ambulance). If you only collect the hospital bill, your documentation may be incomplete.
• Only collecting bills (not records): Bills show cost, but they usually do not explain symptoms, exam findings, concussion screening, work restrictions, or why treatment was recommended.
• Only collecting records (not proof of what was paid/owed): In North Carolina, the amount paid or required to be paid (with records accompanying the testimony) can matter when medical charges are disputed, so keep documents that show satisfaction amounts, not just sticker prices.
• Gaps in treatment without explanation: Long gaps can invite arguments that symptoms resolved or were caused by something else. If there is a gap, make sure your providers’ notes accurately reflect why (for example, scheduling delays or waiting on referrals).
• Concussion-type symptoms not documented early: If headaches, dizziness, light sensitivity, nausea, sleep problems, or concentration issues are not recorded in early records, insurers may argue they started later. Tell providers your symptoms so they are documented.
• Medicare reimbursement surprises: Medicare-related reimbursement issues can affect net settlement. Keep Medicare Summary Notices and any reimbursement correspondence so it can be addressed early.

Talk to a Personal Injury Attorney

If you're dealing with a crash-related neck/shoulder injury and concussion-type symptoms, our firm has experienced attorneys who can help you understand what documentation matters, how to organize it, and what timelines can affect settlement and reimbursement. Reach out today by calling (click to call).

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.