Got a question. Ok….let me try to make this simple. Charlie sees a doctor for some dizzy spells about a month prior to his accident, but doesn’t go for further tests. He needs orthopedic surgery for broken bones after the accident. Would they do the surgery?
Jordyn: I don’t see this as a big reason NOT to do the surgery. Dizzy spells are pretty non-specific meaning LOTS of things benign (like I have extra fluid in one ear) to major (I have a brain tumor) can cause this. Most often times it is something very benign and transitory.
Holly: And if he hit his head when his truck rolled over, would he HAVE to have a head injury?
Jordyn: No, he wouldn’t have to have a head injury in the sense that he wouldn’t have to have concussion. He likely would have some bruising and pain at the site of impact but head injury is denoted more by global headache (my whole head hurts and not just the bump), loss of consciousness, nausea/vomiting, confusion, and perhaps amnesia progressing to more serious things if you choose.
Holly: I’m setting up a scenario where the insurance wants to deny coverage because of a pre-existing condition. (the dizzy spells maybe caused a stroke, or so they determine.)
Jordyn: I don’t think a complaint of dizzy spells would be enough for this. It’s not really a pre-existing condition. A pre-existing condition has to be an actual medical diagnosis and dizziness is a symptom—something only the patient can tell us they experience. A symptom is not something we can measure. So, if he had a diagnosis of TIAs or Transient Ischemic Attacks and one of his symptoms was dizziness then this might be more believable.
Holly: Which gives me a new question. Can you prove a stroke has happened? Or a mini stroke.
Jordyn: Yes, strokes (new and old) can appear on certain imaging tests. MRI is more specific for old and new brain injuries caused by stroke.