Symptom Checklists – Good or Bad?

A brief PI case review as to whether Symptom Checklists are good or bad.
By Jeffrey A. States
Personal Injury Training Institute

September 26

A 26-year-old male was involved in a motor vehicle collision (MVC). He was injured following being rear-ended (Type I) in April of 2026. The following day he reported to the emergency department (ED). His chief complaints were “foot pain & motor vehicle collision, low back pain, “low back / side soreness radiation down right leg, difficulty walking & lifting, intermittent numbness resolved after sleep”. Symptoms improved by 800 mg of IB “sometimes 2 at a time”. Otherwise pain is a 10/10.” It was noted that the patient took 1600 mg of over-the-counter IB right before his ED visit.

The next day the patient reported to a chiropractic physician’s office. The symptoms were noted in the records with the following actual symptom checklist:

1. Upper back pain
2. Lower back pain
3. Neck pain

Other records show:
4. Immediate head and stomach pain

The automobile insurance adjuster is offering a very limited value to settle the claim.

“Upon a re-review of the documentation, there some inconsistencies in the claim that we should discuss… he (patient) has significantly changed his
story, not only from his initial ER visit, but also from his registration to the motor vehicle collision questionnaire (filled out on the same day the same provider within the same hour). Further, the Motor Vehicle Collision Questionnaire seems to be leading the answers, and he increases his injuries and story of what happened the accident” Further stating, “Given the information provided in the demand, I am unable at this time to assess the claim higher than my original finding. I do want to continue to work with you toward settlement but can’t assess injuries that pop up from moment to moment, we can only assess injuries that have causation based on the impact and are supported by facts.” Of course, this is a very limited view of the entire case.

Keep in mind that the automobile claims adjuster is taking a few limited facts to support their low offer. A low offer is their job. Is the onset of MVCOI within 48 hours best described as injuries that “pop up from moment to moment”.

A few questions are crucial to evaluate this adjuster’s point of view:
1. Are only the first symptoms listed in a MVC case the only ones to consider?
2. Can additional symptoms show up later in MVC cases?
3. Can pain medications cover up MVC occupant injuries?
4. Will more symptoms show up when not taking pain reducing drugs?
5. If more symptoms show up, does that mean a patient is malingering? Symptom magnifying? Biopsychosocial challenged?

In this case the plaintiff attorney requested help from the treating DC in this matter. In Personal injury ONLINE Trainings we stress to never use symptom checklists. Quality physicians, properly work-up each symptom in an efficient and organized fashion. This will serve the patient in many positive ways. It will also prevent this adjuster’s distraction tool used to limit settlements. Quality work is critical in PI work. See PersonalInjuryTrainingInstitute.com for more
information.