Resuming Medical Care After a Gap: Can You Still Seek Compensation in West Virginia?

This FAQ explains, in plain language, what happens if you stop medical treatment for a time after an injury and later resume care. It covers how West Virginia law treats gaps in treatment, what impact a gap can have on your claim for compensation, and practical steps to protect your rights. This is educational information only and not legal advice.

Detailed Answer

Basic legal principles that matter in West Virginia

When you pursue money for an injury (for example after a car crash, slip-and-fall, or medical malpractice), three core issues often determine whether you can recover and how much:

• Causation: Did the defendant’s conduct cause your injuries?
• Damages: What medical care and other losses did the injury cause?
• Mitigation and credibility: Did you reasonably seek treatment and otherwise avoid making your injury worse?

A gap in treatment does not automatically prevent you from recovering compensation in West Virginia. However, a long or unexplained gap gives the other side ammunition to argue either that your injuries weren’t as serious as claimed, that something else caused the worsening condition, or that you failed to mitigate (reduce) your damages.

Duty to mitigate losses

West Virginia law expects injured people to take reasonable steps to limit their losses. If you unreasonably delay or stop treatment and that delay makes your condition worse, a court or jury can reduce your recovery for losses caused by the delay. A documented, reasonable explanation for the gap (for example, no insurance, transportation problems, or being advised by a treating clinician to wait) will weaken the defense’s argument that you failed to mitigate.

Statute of limitations and timing

All claims have a time limit for bringing a lawsuit. For most personal-injury claims in West Virginia the general limitation is two years from the date of injury. See West Virginia Code § 55-2-12 for the basic rule: https://code.wvlegislature.gov/55-2-12/

Medical professional liability claims have their own statutory rules and sometimes special discovery rules; check Title 55 provisions that govern medical professional liability and consult an attorney if you think a different limit applies: https://code.wvlegislature.gov/55-7B-8/

Medical records, experts, and proving causation

If you resume care after a gap, the key to preserving your claim is clear documentation linking the injury to the care you received and to your current condition:

• Collect all medical records before, during, and after the gap.
• Get a treating clinician to explain the relationship between the original injury and your current symptoms (causation and need for additional treatment).
• If the defense claims an intervening cause, use expert opinion (medical or other) to tie your present condition to the original injurious event.

What the defense will likely argue

Common defense arguments when there is a treatment gap include:

• Your injuries improved and later arose from a new event.
• You failed to mitigate damages by not getting timely care.
• Your claimed future medical needs are speculative because you delayed care.

These arguments are strongest when the plaintiff cannot reasonably explain the gap or lacks medical proof connecting the original event to the later symptoms.

Practical effect: gap does not automatically defeat a claim

Resuming medical care can preserve and even strengthen your claim if you:

• Promptly document the resumption and reasons for the earlier gap.
• Obtain clear treating-provider opinions about how the original injury caused continuing need for treatment.
• Keep bills, prescriptions, and records of lost work tied to the injury.

Hypothetical examples

Example 1 — Reasonable gap: Jane injures her neck in a minor crash. She treats briefly, loses insurance, and cannot afford care for 8 months. When insurance is restored she resumes treatment and her doctors confirm the symptoms are the same injury. A jury may accept her explanation and award damages, although the defense might argue mitigation depending on facts.

Example 2 — Unexplained gap: Tom has a claimed back injury but stops all treatment for two years without explanation, then seeks extensive surgery. The defense argues the gap shows the condition wasn’t severe or that a new event caused the problem. Without good medical records or an expert tying the surgery to the original injury, Tom’s recovery could be reduced or denied.

When to get an attorney

Talk to an attorney early if you intend to claim compensation and you have had a treatment gap. An attorney can help:

• Preserve medical evidence and obtain retrospective medical opinions about causation.
• Address statute of limitations issues so you do not miss filing deadlines.
• Negotiate with insurers who will exploit a treatment gap.

Helpful Hints

• Resume medical care as soon as reasonably possible. Even a short visit that documents continuing symptoms helps your claim.
• Write and date your own symptom journal describing pain, limitations, and why you stopped treatment (for example, cost or travel). Courts and juries find contemporaneous notes persuasive.
• Request and keep full copies of all medical records and bills. Get them from every provider who treated you before and after the gap.
• Ask your current treating provider to explain in their records how your current condition relates to the original injury.
• Keep proof of reasons for any treatment gap (insurance denial letters, employer notes, travel records, or medical advice to delay treatment).
• Count time carefully. Determine which statute of limitations applies to your type of claim and calendar the filing deadline immediately. See WV Code § 55-2-12: https://code.wvlegislature.gov/55-2-12/
• If you cannot afford care, ask providers about payment plans or community resources rather than stopping care entirely; a record of trying to get reasonable care helps later.
• Consult a West Virginia attorney experienced in personal injury or medical liability as soon as possible to preserve evidence and legal options.

Disclaimer

This article is educational only. It does not create an attorney-client relationship and is not legal advice. For advice specific to your situation, contact a licensed West Virginia attorney.