A treatment gap is one of the fastest ways an insurer slashes the value of a construction injury claim in New Hampshire.

And with a skull fracture, that's brutal.

If you fell on a Manchester job site, got checked out, then missed weeks or months of follow-up care, the insurance company will use that gap like a weapon. Their argument is usually dressed up as "failure to mitigate damages." What they mean is simpler: if you were really hurt, you would have kept treating.

That argument can wreck a case value even when the injury itself was serious.

What "failure to mitigate" really means here

In plain English, they're saying you didn't do your part to get better.

Not because they actually care about your recovery.

Because it gives them a clean storyline.

You're a restaurant server, not a union ironworker with a safety office and a company nurse. If you just moved to Manchester three months ago, maybe you don't know the system, don't know where to go after the ER, don't know whether to use workers' comp, health insurance, or both, and don't know who the hell is supposed to approve follow-up care.

The adjuster doesn't give a damn.

They'll still say the same thing: Elliot Hospital saw you, the records show a skull fracture or head injury concerns, and then there's a hole in the chart. No neurology follow-up. No rehab. No repeat imaging. No documented complaints for six weeks, two months, whatever it was. So now they say your symptoms must have resolved.

That's the game.

Why treatment gaps are extra ugly with head injuries

A skull fracture is not like a cut finger.

People with head injuries miss appointments. They get confused. They sleep at odd hours. They can't tolerate screens. They lose track of paperwork. They think they're "basically okay" until the headaches, dizziness, light sensitivity, balance problems, or mood changes keep screwing up work shifts.

That happens all the time.

Especially if you're trying to get back on your feet in a new city, working restaurant hours near Elm Street or South Willow, relying on rides, and trying not to get fired because spring mud season and frost-heaved roads already make everything harder.

But the insurer loves the gap because it creates doubt about causation and severity at the same time.

They'll say maybe you healed.

Or maybe something else caused the later symptoms.

Or maybe you're exaggerating now because the bills piled up.

The reasons people stop treatment that sound completely reasonable - and still hurt the claim

Here's what most people don't realize: legitimate reasons for a gap are still a problem unless they're documented.

• You couldn't afford co-pays
• You didn't have transportation
• You were waiting for approval
• You thought rest was enough
• You were scared to lose shifts at the restaurant
• You just moved here and had no primary care doctor in Manchester

All of that sounds human because it is human.

But if it's not in the records, the insurer acts like it never happened.

A phone note saying you canceled because you couldn't get a ride from the West Side to an appointment near Catholic Medical Center is better than silence. A chart note showing you reported worsening headaches but delayed care because of work is better than silence. Silence is where adjusters make their money.

Why this tanks case value so fast

Insurance money in an injury claim is tied to proof.

Not your private reality.

Proof.

When there's a gap, they reduce what they think they owe for pain, future treatment, lost earning ability, and sometimes even whether the current symptoms are related to the fall at all. With a skull fracture, that can mean they try to shrink a major claim into "brief treatment, recovered, minimal residual complaints."

That's insane, but it's common.

And on construction sites in New Hampshire, where safety corners get cut and enforcement is weak enough to make people roll their eyes, insurers already start from the position that somebody else is to blame. A treatment gap gives them another excuse.

What actually helps after the gap already happened

You can't erase the gap.

You can explain it with evidence.

The best repair work usually comes from records created now that clearly tie your current symptoms back to the fall and explain why treatment stopped. If your headaches, dizziness, memory issues, anxiety, neck pain, or sensitivity to noise never fully went away, that needs to be spelled out in the medical chart, not just said over the phone to a claims rep.

The denial language matters too. If they specifically used "failure to mitigate damages," they are not necessarily saying the fall didn't happen. They are saying your choices after the fall reduced or broke the value of the claim. That distinction matters because it tells you where the fight is.

Not over whether you hit your head.

Over whether the gap lets them pretend the damage wasn't real.

In Manchester, after a construction fall with a skull fracture, that's often the whole case.