What happens if there’s a delay in my therapy sessions—can I include that cost in my injury claim?: North Carolina personal injury

Woman looking tired next to bills

What happens if there’s a delay in my therapy sessions—can I include that cost in my injury claim? - North Carolina

Short Answer

Yes—under North Carolina law you can claim therapy costs that are reasonable, medically necessary, and caused by the accident. A gap in treatment does not automatically disqualify those bills, but insurers often scrutinize gaps. Document why the delay happened, keep your appointments once treatment resumes, and get your provider to connect the therapy to the injury.

Understanding the Problem

You want to know if you can include therapy costs in a North Carolina personal injury claim when there’s a gap between providers because appointments weren’t available. You’re the injured person seeking payment for medical care. The decision point is whether delayed or interrupted therapy can still count as recoverable damages in your claim.

Apply the Law

North Carolina allows recovery of medical expenses that are proximately caused by the at‑fault party and that are reasonable and necessary. In practice, insurers look closely at treatment “gaps” and provider switches to question causation and necessity. You help your claim by showing continuity of care, promptly resuming treatment when you can, and supplying provider notes linking therapy to the injury. Most personal injury lawsuits must be filed in the county’s state trial court (District or Superior Court, depending on amount) within three years of the injury.

Key Requirements

  • Causation: The therapy must be tied to injuries from the incident (not unrelated conditions).
  • Reasonableness and necessity: The type, duration, and cost of therapy should make medical sense for your diagnosis.
  • Mitigation and documentation: You should act reasonably to get care, explain any treatment gap, and keep thorough records (bills, notes, transfer-of-care).

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, you had a gap between core physical therapy and follow‑up total body therapy because appointments weren’t available, and you later switched therapists after dissatisfaction. Those costs can still be claimed if your providers document that the therapy was medically necessary for accident‑related injuries and you resumed care as soon as practical. Your attorney can explain the gap and provider switch to the insurer and supply records that maintain the causal link.

Process & Timing

  1. Who files: The injured person (through counsel). Where: Start with a demand to the at‑fault insurer; if unresolved, file a civil action in the appropriate North Carolina trial court (District or Superior Court). What: A demand package with medical records, bills, provider opinions, and an explanation of any treatment gap; if filing suit, a complaint and civil summons. When: File suit before the three‑year statute of limitations runs.
  2. The insurer typically reviews a complete demand within a few weeks; responses vary. If they question the gap, your attorney supplements with provider notes, scheduling records, and a transfer‑of‑care summary.
  3. If settled, expect a written release and payment; if not, litigation proceeds to discovery and, if necessary, trial for a damages determination.

Exceptions & Pitfalls

  • Long, unexplained gaps can lead insurers to argue your condition resolved or that later care wasn’t caused by the accident—get a provider note explaining the delay (e.g., no appointments available) and why therapy remained necessary.
  • Switching therapists is fine, but ask for a transfer‑of‑care summary to preserve continuity and causation.
  • Incomplete records or unpaid-bill confusion slows claims—keep itemized bills and proof of payments; obtain medical opinions tying therapy to the injury.
  • Insurers may raise contributory or intervening-cause arguments; clear, consistent medical documentation reduces those risks.
  • Deadlines and evidence rules matter; procedures can vary by county and case type.

Conclusion

In North Carolina, you can include therapy costs in your injury claim if they are accident‑related, reasonable, and medically necessary. A documented scheduling gap or provider switch does not automatically defeat recovery, but you must explain the delay and show continuity of care. The practical next step is to have your providers put in writing that therapy remains necessary for the injury and to include that with your demand—or, if needed, file suit within three years.

Talk to a Personal Injury Attorney

If you're dealing with a treatment gap and an insurer questioning your therapy costs, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

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.

Categories: 
close-link