Detailed Answer
Can a gap in medical treatment stop me from getting compensation under Wisconsin law?
Short answer: usually no — a gap in treatment does not automatically bar you from recovering compensation for injuries in Wisconsin. But the gap can make it harder to prove that your injuries were caused by the incident and that your medical expenses were reasonable and related to that incident.
Key legal standards to understand
- Causation: You must show that the defendant’s actions more likely than not caused your injury. A gap gives the defense ammunition to argue the injury came from another event or that the injury isn’t as serious as claimed.
- Damages and reasonableness: You must show your medical care was reasonable and related to the injury. Courts and insurers look at timing, necessity, and cost of care when deciding what to pay.
- Mitigation of damages: Plaintiffs have a duty to take reasonable steps to limit losses (for example, seeking appropriate medical care). An unexplained refusal to pursue reasonable care can reduce recovery.
Time limits (statute of limitations)
In Wisconsin most personal-injury claims must be filed within three years of the injury. See Wis. Stat. § 893.54 for the general limitation on actions for injury to the person. If you wait too long to file a lawsuit, you could lose the right to sue even if you later resume treatment. Wis. Stat. § 893.54: https://docs.legis.wisconsin.gov/statutes/statutes/893/54.
How courts and insurers treat a treatment gap
Defendants often argue that a gap shows the injury was not serious, healed, or resulted from a later accident or normal aging. But courts and juries allow explanations. Valid reasons such as financial limits, lack of insurance, fear of medical procedures, gradual worsening of symptoms, or reliance on home remedies are commonly accepted if supported by documentation and testimony.
What you must prove after a gap
- When and how the injury first occurred (incident details, witness statements, accident reports).
- That the current symptoms and treatment are linked to the incident (medical records, treating provider notes, and expert opinions).
- That the treatment you resumed was reasonable and necessary (records showing treatment plans, referrals, test results, and bills).
Practical examples (hypotheticals)
Example A: You had a car crash and felt minor neck pain. You treated with ibuprofen and home stretches for six months. Pain later worsened and you saw a doctor who diagnosed a herniated disc and started physical therapy and injections. You can still seek damages if your medical witnesses link the herniation to the crash and explain the delay (initial mild symptoms, lack of insurance, delayed progression).
Example B: You injured your knee but waited two years and then injured it again playing sports. Without clear evidence connecting the later care to the original accident, recovery for the original incident will be weak.
How to rebuild a strong claim after a gap
- Gather all records: previous medical notes, new evaluations, imaging (MRI, X-ray), prescriptions, therapy notes, and billing statements.
- Document why you delayed care: financial statements, insurance denials, correspondence, or testimony from family and treating providers.
- Ask treating providers to explain causation in writing: a treating physician’s opinion tying symptoms and treatment to the accident strengthens your case.
- Consider a retained medical expert (if needed) to explain progression of injury and why delayed treatment was reasonable under the circumstances.
- Preserve other evidence: photos of the scene, your injuries, witness contact information, and employer records if you missed work.
When a gap can be deadly to a claim
A gap can be fatal if the plaintiff cannot connect the later medical condition to the incident, cannot explain the delay, or misses the statute of limitations. The stronger and earlier the medical documentation, the stronger your claim.
Do I need an attorney?
It helps to consult a personal injury attorney early. An attorney can evaluate whether your gap will likely harm proof, help gather missing evidence, preserve rights before the statute of limitations runs, and arrange medical opinions that explain causation despite the gap.
Disclaimer: This content is for general informational purposes only and is not legal advice. I am not a lawyer. For advice about your specific situation, consult a licensed Wisconsin attorney.
Helpful Hints
- Act quickly on the statute of limitations. Three years is common for personal injury in Wisconsin (see Wis. Stat. § 893.54: https://docs.legis.wisconsin.gov/statutes/statutes/893/54).
- Keep a clear timeline: date of incident, dates and types of every medical visit, and when symptoms changed or worsened.
- Save all medical bills, receipts, correspondence, and test results. Bills alone help prove the reasonableness of expenses.
- Get contemporaneous statements from treating providers explaining why immediate treatment was not sought or why symptoms worsened over time.
- Don’t post details of your injury or claim on social media—defense counsel will use public posts to attack credibility.
- Consider a medical-records review or independent evaluation before negotiating with insurers.
- If finances limited your treatment, document that fact—insurance denials, inability to pay, or waiting on approval can justify delay.
- Talk to a lawyer before signing any release or settlement offer from an insurer.