If you or a loved one has suffered a traumatic brain injury (TBI) in an accident, you may assume your health insurance has everything covered. After all, TBIs are serious injuries that can impact memory and mental health, coordination, communication, and more – and it’s true that your health insurance will likely cover most of the basic rehabilitative care for this condition. However, caring for someone with a TBI requires more than just medical treatment, and that’s where other funding concerns enter the picture.
In order to finance other types of post-injury care and support, you’ll need deep pockets or, more likely, to win your lawsuit against whoever caused the injury. You have a lot to gain and, with the right lawyer, little to lose by going down this road.
Cover Your Losses
TBIs cover a wide spectrum, from mild cases in which the affected individual recovers nearly full function to those that leave the victim in a vegetative state or comatose. Those with less serious injuries can typically return to work, if with some modifications, but others may not be able to work as much or at all after their injury.
One advantage of filing a personal injury lawsuit is that you can sue for lost wages to help support yourself and your family in the years to come. Your lawyer will work with medical professionals to evaluate your ability to work. Then, based on your age and career trajectory, will determine your estimated losses in this area.
One possible outcome of a TBI is that it may lead to seizures, vertigo, or poor coordination, all of which can make safely navigating the home difficult and potentially dangerous. Unfortunately, most health insurance plans don’t provide any coverage for home modifications, even when a change in medical status makes them necessary.
Funds from a personal injury lawsuit can be critical to adapting the home environment, such as if you need to install stair lifts, ramps, or if you need to purchase a special bed to prevent falls. Some individuals with TBIs also benefit from smaller, but still expensive adjustments, such as larger writing, larger eating utensils, special grips, alarms and emergency alert systems, or grab rails and benches.
It’s a frustrating fact that, though we understand TBIs much better now than we did even a decade or two ago, these injuries come with a great number of unknowns, regardless of an individual’s health and function immediately after the injury. For example, there’s strong evidence that those who have suffered a TBI are more likely to develop Alzheimer’s or another form of dementia later in life. This can significantly impact end-of-life costs, as Medicare only covers medical treatment, not care that is considered “residential” in nature. This can leave families with a big bill.
In response to all of this uncertainty, some UK courts have come to rely on what’s termed a Periodic Payment Order (PPO). These orders account for a potentially shortened lifespan, as well as for inflation. This approach has not been tried in US courts, with victims expected to pay for long-term care out of their original award, however there is a distinct possibility that a PPO could save defendants money in some cases.
It’s hard to think about the long-term immediately after you or your loved one has suffered a TBI, but because of the statute of limitations on many such injuries, it’s important to address those needs quickly. Consult a lawyer and find out what your options are. Having some extra money in the bank can only make your life easier if unexpected care needs arise in the future, and this may be your only chance to make such a claim.