Why does the insurance company say my MRI wasn't necessary?
PIP pays for treatment that is reasonable, related to the crash, and medically necessary. Each of those is a determination the insurer makes, and each can be disputed.
Common reasons given. The imaging was ordered too early. Conservative treatment should have been tried first. The findings are degenerative rather than traumatic. The scan wasn't indicated by the clinical presentation.
Where it comes from. Frequently a records review by a physician who never examined you, or a report from the examination described above.
What answers it. Your treating physician's documentation of why the imaging was ordered — the specific findings, the symptoms, the clinical reasoning. A well-documented order is considerably harder to dispute than one that appears routine.
The degenerative argument specifically. Most adults have some degenerative changes on imaging. That doesn't mean the crash didn't cause an acute injury, and it doesn't mean an aggravation isn't compensable. The response is comparing function before and after, not arguing about the scan.
Ask your doctor to document why the imaging was ordered. That note answers this. ---
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