Client Stopped Going to Physical Therapy? Here’s What to Do

When a personal injury client stops going to physical therapy, you have a narrow window to prevent permanent case damage. The first 48-72 hours after a missed PT appointment are critical — waiting longer allows treatment gaps to widen and gives insurance adjusters more leverage to reduce settlements. This guide provides step-by-step actions to take when a client misses one appointment, multiple appointments, or has completely abandoned PT.

What to Do When Your PI Client Missed One Physical Therapy Appointment

Within 2-4 Hours of the Missed Appointment

Step 1: Confirm the miss with the PT provider

Don’t assume the client missed just because they didn’t mention going. Call the PT office:

“Hi, this is [Name] from [Law Firm]. I’m calling to confirm whether [Client Name] attended their appointment today at [time].”

Why this matters: Sometimes clients go to appointments but forget to tell you. Sometimes they reschedule directly with the provider. Confirm before you reach out.

Step 2: Contact the client immediately (same day)

Call or text within 2-4 hours of the missed appointment. Don’t wait until tomorrow.

Text message template:

“Hi [Name], I checked in with [PT Office] and saw you weren’t able to make it to your appointment today. Everything okay? Let me know when you can — I want to make sure we get you rescheduled ASAP.”

Why text works better than calling:

• Less intimidating than a voicemail
• Easier for the client to respond quickly
• Creates a paper trail

Step 3: Get the real reason (ask about barriers, not blame)

When the client responds, don’t start with “Why didn’t you go?”

Ask: “What made it hard to get there today?”

Common responses and what they mean:

Client SaysWhat They Really MeanYour Next Action"I forgot"Overwhelmed, need remindersSet up appointment reminder system"I couldn't get a ride"Transportation barrierHelp arrange medical transport or adjust schedule"I was in too much pain"Fear of PT hurting moreConnect with PT about pain management"Work came up"Schedule conflictHelp reschedule to non-work hours"I'm feeling better"Doesn't understand treatment importanceEducate on how gaps hurt case value

Step 4: Reschedule immediately (not “next week”)

Don’t end the conversation with “Try to get back on schedule.”

Say: “Let’s get you rescheduled right now. I’m going to call [PT Office] and find a time that works for you this week. What days are best?”

Critical timing rule:

If they missed Monday’s appointment, get them rescheduled for Thursday or Friday same week. Don’t let it slide to next week — that turns a 3-day gap into a 10-day gap.

Step 5: Solve the barrier before the next appointment

If the client said:

• “I forgot” → Set up automated reminders or have your office call 24 hours before
• “No transportation” → Arrange medical transport, rideshare reimbursement, or schedule adjustment
• “Too much pain” → Have them call PT to discuss pain management before next visit
• “Work conflict” → Find morning, evening, or Saturday PT slots

Don’t just document the problem. Fix it.

Step 6: Document everything in your case file

Record in your CRM:

• Date and time of missed appointment
• Reason client gave
• Barrier identified
• Solution implemented
• New appointment date/time
• Follow-up plan

Why this matters: If this becomes a pattern, you need documentation. And if insurance questions the gap later, you can show you intervened immediately.

24 Hours Before Next Appointment: Confirm Again

Call or text: “Hey [Name], just confirming you’re all set for PT tomorrow at [time]. Do you have transportation sorted out?”

This second touchpoint catches problems before they cause another miss.

What to Do When Your Client Has Missed Multiple PT Appointments

Multiple misses mean there’s a systemic problem, not just a one-time issue.

Immediate Actions (Within 24 Hours of Discovery)

Step 1: Assess the damage

How many appointments has the client missed?

• 2-3 appointments (1-2 weeks): Recoverable with immediate intervention
• 4-6 appointments (2-3 weeks): Serious gap forming, needs urgent attention
• 7+ appointments (4+ weeks): Case damage likely, may need attorney involvement

Calculate the actual gap in days between last PT visit and today.

Step 2: Call, don’t text

Multiple misses require a phone conversation, not a text.

Opening script:

“Hi [Name], I wanted to check in with you. I noticed you’ve missed a few PT appointments over the past couple weeks, and I’m concerned. I’m not calling to lecture you — I just want to understand what’s going on and see how we can help.”

Why this works:

• Acknowledges the pattern without judgment
• Expresses genuine concern
• Offers help instead of criticism
• Opens the door for honest conversation

Step 3: Ask the hard question directly

“Can you tell me what’s been making it hard to get to physical therapy?”

Then stop talking and listen.

What you’re listening for:

• Transportation problems (car issues, no rides, can’t drive)
• Pain avoidance (PT hurts too much, afraid of making injury worse)
• Financial stress (worried about copays or bills)
• Life chaos (work, kids, overwhelming schedule)
• Emotional shutdown (depression, anxiety, feeling hopeless)
• Lack of understanding (doesn’t know gaps hurt case value)

The real reason is usually not the first thing they say. Keep asking gentle follow-up questions.

Step 4: Educate on the stakes (without threatening)

Most clients don’t understand how treatment gaps affect settlement value.

What to say:

“I want to make sure you know that when there are gaps in your treatment, insurance uses that to argue your injury wasn’t serious and reduces the settlement offer — sometimes by $10,000 or more. I don’t want that to happen to you, which is why I’m trying to help you get back on track now.”

What NOT to say:

❌ “If you don’t go to PT, your case is worthless.” ❌ “Insurance is going to destroy your case because of these gaps.” ❌ “You’re going to lose thousands of dollars.”

Education works. Fear and blame don’t.

Step 5: Create a recovery plan together

Work with the client to solve the barriers and get back on schedule.

Sample recovery plan:

1. Reschedule all missed appointments for this week and next week
2. Solve the barrier (arrange transportation, adjust schedule, address pain concerns)
3. Set up accountability (paralegal checks in 24 hours before each appointment)
4. Confirm attendance (paralegal follows up 2 hours after each appointment)
5. Weekly touchpoint (how’s it going? any new issues?)

Write this down and send it to the client via text or email so they have it in writing.

Step 6: Escalate to the attorney if needed

If the client:

• Refuses to go back to PT
• Says they’re “done with treatment”
• Won’t commit to rescheduling
• Has a barrier you can’t solve (like financial issues)

→ Loop in the attorney immediately.

The attorney may need to:

• Have a direct conversation about case implications
• Adjust the treatment plan with the provider
• Explore alternative treatment options
• Discuss whether the case can settle now

Step 7: Get documentation from PT provider

If the client does return to PT after a gap, ask the PT provider to document in their notes:

“Patient returned to treatment after [X]-day gap due to [reason: transportation issues/work conflict/etc.]. Patient reports symptoms remain consistent with initial injury. No indication of recovery during gap period.”

This helps you counter insurance arguments later.

What to Do When Your Client Has Completely Stopped Going to Physical Therapy

If a client has abandoned PT entirely (30+ days since last visit, no plans to return), you’re dealing with serious case damage.

Step 1: Determine why they stopped

Call the client and ask directly:

“I see it’s been over a month since your last PT appointment, and you don’t have anything scheduled. Can you help me understand what’s going on? Are you planning to continue treatment, or have you decided you’re done?”

Possible responses:

1. “I’m feeling better / I don’t think I need it anymore”
   • Client doesn’t understand PT isn’t optional if they want full case value
2. “PT isn’t helping / it’s making me worse”
   • Legitimate concern that needs addressing with provider
3. “I can’t afford it / I’m worried about bills”
   • Financial barrier that may require attorney involvement
4. “I’ve been too busy / overwhelmed”
   • Life chaos, needs support to re-engage
5. “I just don’t want to go”
   • Treatment fatigue or avoidance, hardest to overcome

Step 2: Determine if treatment should resume

Not every abandoned PT plan needs to restart. Ask:

Is the client truly done recovering?

• Are they still experiencing pain?
• Do they have ongoing symptoms?
• Did the PT provider discharge them, or did the client just stop going?

If the client is legitimately recovered:

• Get a discharge summary from the last treating provider
• Document that treatment concluded naturally
• Prepare to settle

If the client is NOT recovered but stopped anyway:

• Explain the case value impact
• Try to get them back into treatment
• Consider whether the case can settle with the existing records

Step 3: Have the attorney call the client

When a client has completely abandoned treatment, a paralegal call isn’t enough.

The attorney needs to have a direct conversation:

“[Client Name], I want to talk to you about where your case stands. You stopped going to PT about 5 weeks ago, and that creates a significant problem for settlement negotiations. Insurance is going to argue that you recovered and don’t need treatment anymore. That could reduce your settlement by $15,000 to $30,000 or more. I need to understand: are you done with treatment, or do you want to restart?”

Why the attorney should make this call:

• Clients take attorneys more seriously than staff
• Demonstrates the firm cares about the case
• Creates documented attempt to address the issue
• Helps the attorney decide next steps

Step 4: Explore alternative treatment options

If the client says: “PT isn’t helping” or “PT makes it worse”

Don’t force them back into the same PT program.

Instead:

• Ask if they’d be willing to try a different PT provider
• Explore alternative treatment (chiropractic, acupuncture, pain management)
• Suggest a follow-up with their treating physician to adjust the treatment plan

Sometimes the issue isn’t treatment avoidance — it’s that the current treatment isn’t working.

Step 5: Document everything and assess case strategy

If the client refuses to return to treatment, you need to decide:

Can you settle the case with existing records?

• If the client completed most of their treatment plan and has strong medical documentation → Yes, possibly
• If the client barely started treatment and has minimal records → Case value is severely compromised

Attorney decision points:

• Proceed to settlement with reduced value expectations
• Continue negotiating despite the gap (harder, but possible)
• Consider withdrawal if the client won’t cooperate (last resort)

Scripts for Common PT Drop-Off Scenarios

Scenario 1: Client Says “I Feel Better, I Don’t Need PT Anymore”

Your response:

“I’m really glad you’re feeling better — that’s great. But here’s what I need you to understand: even if you feel better now, insurance is going to argue that you didn’t need all the treatment you’re claiming damages for. If you stop PT before you’re discharged by the provider, they’ll say you recovered early and reduce your settlement by thousands of dollars. Can we at least get you back in to see the PT and have them do a final evaluation and proper discharge? That protects your case.”

Scenario 2: Client Says “PT Hurts Too Much”

Your response:

“I totally understand — PT is painful, and I hear that from a lot of clients. But here’s the thing: some discomfort during PT is normal as your body heals. What’s not normal is if it’s making your pain significantly worse. Let’s do this: I’m going to have you call [PT Provider] and tell them the PT is too painful. They can adjust your treatment plan or modify the exercises. If they can’t make it more manageable, we’ll talk to your doctor about other options. But we can’t just stop treatment without exploring alternatives, because that’s going to hurt your settlement.”

Scenario 3: Client Says “I Don’t Have Transportation”

Your response:

“Okay, let’s solve that right now. Have you looked into medical transportation services? A lot of insurance plans cover rides to medical appointments. If yours doesn’t, let’s figure out other options — can a family member or friend drive you? Can we adjust your PT schedule so it’s easier to get there? What about rideshare reimbursement? I want to help you get there because missing these appointments is going to cost you way more in your settlement than any ride would cost.”

Scenario 4: Client Says “I Can’t Afford the Copays”

Your response:

“I understand — medical bills add up fast. Here’s what I recommend: talk to the PT office about whether they can bill your treatment under a letter of protection so you don’t have to pay upfront. Some providers will wait until your case settles. If that’s not an option, let me connect you with [Attorney Name] because there might be other ways to handle this. What I don’t want is for you to stop treatment because of cost and then lose $20,000 in settlement value because of the gap.”

Scenario 5: Client Says “I’m Just Too Busy / Overwhelmed”

Your response:

“I completely get it — life doesn’t stop just because you’re recovering from an accident. But here’s the reality: if you stop going to PT, insurance is going to use that against you and reduce your settlement by $10,000 to $30,000. I want to help you figure out a way to make this work. Can we find a PT office with evening or weekend hours? Can we space out the appointments so it’s less overwhelming? What would make this easier for you?”

How to Prevent PT Drop-Off Before It Happens

1. Set expectations at intake

Tell clients from day one:

“Physical therapy is going to be a big part of your case. I need you to know that if you miss appointments or stop going before you’re discharged, insurance will use that to reduce your settlement — sometimes by tens of thousands of dollars. We’re going to check in with you regularly to make sure you’re getting to your appointments and to help if anything comes up that makes it hard.”

2. Check in before every PT appointment

Don’t wait for clients to tell you they’re struggling.

24 hours before each PT appointment, send a text:

“Hey [Name], just confirming you’re all set for PT tomorrow at [time]. Let me know if anything comes up.”

This simple touchpoint catches problems before they turn into no-shows.

3. Follow up after every PT appointment

2-6 hours after each PT appointment:

“How’d PT go today? Any issues?”

If the client doesn’t respond, call them. Non-response often means they didn’t go.

4. Ask about barriers proactively

Don’t wait for clients to volunteer that they’re struggling.

Every 1-2 weeks, ask:

“How’s PT going? Is anything making it hard to get there — transportation, scheduling, pain, anything like that?”

When clients know you’re actively trying to help, they’re more likely to ask for help before they just stop going.

5. Educate clients on why treatment consistency matters

Most clients don’t understand the financial impact of gaps.

Mid-treatment check-in script:

“I just want to remind you how important it is to stick with PT through the full treatment plan. I’ve seen cases where clients miss a few appointments and it costs them $15,000 to $30,000 in settlement value because insurance argues they didn’t really need the treatment. I don’t want that to happen to you.”

How FileFlow Prevents PT Drop-Off Automatically

FileFlow’s AI case assistant, Samantha, prevents clients from stopping PT by:

• Calling clients 24 hours before every PT appointment to confirm attendance
• Following up within hours after appointments to verify they went
• Asking about barriers proactively (transportation, pain, scheduling) before they cause misses
• Rescheduling immediately if a client misses an appointment
• Detecting patterns (delayed responses, multiple misses) and alerting your team
• Providing consistent accountability without feeling like nagging
• Documenting everything so you always know the client’s status

The result:

Clients don’t stop going to PT because problems get caught and solved before they turn into abandonment. And when issues do arise, your team knows within 24 hours — not 3 weeks later.

Common Questions About Clients Stopping Physical Therapy

What should I do if my PI client missed a physical therapy appointment?

Contact the client within 2-4 hours of the missed appointment. Text or call and ask what made it hard to get there (focus on barriers, not blame). Reschedule immediately for later the same week. Solve the barrier (transportation, pain, scheduling) before the next appointment. Document everything in your case file.

How do I get a client back to PT after they’ve stopped going?

Call the client and ask directly what’s been making it hard to attend PT (listen for transportation, pain, financial, or overwhelm issues). Educate them on how treatment gaps reduce settlement value by $10,000-$30,000+. Create a recovery plan that solves their barriers. Schedule multiple appointments this week. Follow up before and after each appointment to ensure attendance.

Can I still settle a PI case if the client stopped going to physical therapy?

Yes, but the settlement value will be significantly reduced. Insurance will argue the client recovered or didn’t need treatment, which reduces pain and suffering damages and eliminates future medical coverage. If the client completed most of their treatment plan, you can still negotiate. If they barely started, the case value is severely compromised.

What do I tell a client who says they feel better and don’t need PT anymore?

Explain that even if they feel better, stopping PT early gives insurance leverage to argue they recovered and reduces the settlement by thousands. Recommend they return to PT for a proper discharge evaluation from the provider. This protects case value by showing treatment concluded medically, not because the client quit.

Why do personal injury clients stop going to physical therapy?

Clients stop going to PT because it’s painful, time-consuming, and they don’t understand how compliance affects case value. Common barriers include transportation issues, work schedule conflicts, financial stress about copays, emotional overwhelm, and treatment fatigue. Most don’t realize missing appointments reduces settlements by $10,000-$30,000+.

How many missed PT appointments is too many?

One missed appointment is recoverable with immediate intervention. Two to three missed appointments (1-2 week gap) requires urgent attention. Four or more missed appointments (2-3+ week gap) causes serious case damage. Any gap over 14 days gives insurance leverage to reduce settlement offers.

What should I say to a client who says PT hurts too much?

Acknowledge their pain and explain that some discomfort during PT is normal, but significant worsening isn’t. Have them contact the PT provider to discuss pain management and treatment plan adjustments. If PT can’t be modified, talk to their doctor about alternative treatments. Emphasize that stopping treatment without exploring options will reduce their settlement.

How do I prevent clients from missing physical therapy appointments?

Prevent PT misses by checking in 24 hours before every appointment, following up within hours after appointments to confirm attendance, asking proactively about barriers (transportation, pain, scheduling), solving problems immediately when they arise, and educating clients on how treatment gaps reduce settlement value.

Should the attorney call a client who has stopped going to PT?

Yes, if the client has abandoned PT entirely (30+ days with no plans to return) or has missed multiple appointments despite staff intervention. The attorney should explain the case value impact directly and determine whether the client will resume treatment or if the case should proceed to settlement with reduced expectations.

The Bottom Line on PT Drop-Off

When a personal injury client stops going to physical therapy, you have 48-72 hours to intervene before serious case damage occurs. The longer you wait, the wider the treatment gap becomes, and the more leverage insurance has to reduce the settlement.

The solution isn’t waiting until the client has abandoned treatment entirely — it’s catching problems early, solving barriers immediately, and maintaining consistent check-ins throughout the treatment timeline.

Firms that prevent PT drop-off are the ones that treat client follow-up as case protection, not administrative busywork.

Want to see how FileFlow prevents PT drop-off before it damages case value?
Book a 10-minute demo: [Link to demo]

Read next:
→ Why Personal Injury Clients Miss Medical Appointments (And How to Prevent Treatment Gaps)
→ How Insurance Adjusters Use Treatment Gaps to Reduce PI Settlements
→ Why Personal Injury Clients Ghost Their Attorneys (And How to Get Them Back)