Protecting Your Financial Future After a Spinal Cord Injury: Understanding Settlements and Long-Term Care

Protecting Your Financial Future After a Spinal Cord Injury: Understanding Settlements and Long-Term Care

A spinal cord injury (SCI) can be a life-altering event, not only physically and emotionally but also financially. The costs associated with medical treatment, rehabilitation, and long-term care can be overwhelming. In the first year alone, expenses for spinal cord injury survivors with high tetraplegia average $1.1 million. Securing a fair settlement is crucial to protecting your financial future and ensuring access to the care and support you’ll need for the rest of your life.

The Financial Impact of a Spinal Cord Injury

Spinal cord injuries often result from falls or car accidents, creating serious challenges, especially financial ones. The lifetime cost of care can be staggering, potentially reaching millions of dollars. As of 2021, the cost of living with a spinal cord injury may range from about $1.2 million to $5.1 million. These figures emphasize the critical need for financial planning and securing adequate compensation.

Here’s a breakdown of the typical costs associated with SCI:

  • Immediate Medical Care: Emergency treatment, surgery, hospitalization, and initial rehabilitation are crucial but expensive. The first year of treatment can range from $347,484 to over $1 million, depending on the injury’s severity.
  • Ongoing Medical Treatments: Regular specialist visits, physical therapy, pain management, and medications are ongoing expenses.
  • Rehabilitation: Intensive rehabilitation is often necessary to regain as much function as possible.
  • Medications: Many SCI patients require medications for pain, spasticity, and other related conditions.
  • Home and Vehicle Modifications: Ramps, lifts, widened doorways, accessible bathrooms, and adapted vehicles can be necessary. The cost of adapting a car after a spine injury ranges from $20,000 to $80,000, depending on the types of modifications required.
  • Assistive Devices: Wheelchairs, walkers, and other mobility aids can be costly and may need to be replaced over time.
  • Long-Term Care: Many individuals with SCI require ongoing care, which may include in-home assistance or care in a specialized facility.
  • Loss of Income: An SCI can limit a person’s ability to work, leading to a significant loss of income. The average employment rate among people with spinal cord injuries is only 38 percent.

Understanding Spinal Cord Injury Settlements

If your spinal cord injury was caused by someone else’s negligence, you have the right to pursue compensation through a personal injury claim. A settlement is an agreement between you and the responsible party (or their insurance company) that resolves your case without going to trial.

Types of Compensation You Can Seek

A comprehensive settlement should cover all the expenses and losses related to your spinal cord injury, including:

  • Medical Expenses: Past and future medical bills, including hospital stays, surgeries, medications, therapy, and medical equipment.
  • Lost Wages: Past and future lost earnings due to your inability to work.
  • Pain and Suffering: Compensation for the physical pain, emotional distress, and mental anguish you have experienced.
  • Rehabilitation Costs: Expenses for physical therapy, occupational therapy, and other rehabilitation services.
  • Long-Term Care Costs: The cost of ongoing care, whether in-home or in a facility.
  • Home and Vehicle Modifications: Expenses for adapting your home and vehicle to accommodate your disability.
  • Assistive Devices: The cost of wheelchairs, walkers, and other assistive devices.
  • Loss of Enjoyment of Life: Compensation for the activities and experiences you can no longer enjoy due to your injury.

Factors Affecting Settlement Value

The value of your spinal cord injury settlement will depend on several factors, including:

  • Severity of the Injury: More severe injuries, such as complete paralysis, typically result in higher settlements.
  • Medical Expenses: The higher your medical expenses, the more your settlement will be worth.
  • Lost Wages: The more income you have lost, the higher your settlement will be.
  • Pain and Suffering: The more pain and suffering you have experienced, the more your settlement will be worth.
  • Negligence: The clearer it is that the other party was at fault, the higher your settlement will be.
  • Insurance Coverage: The amount of insurance coverage available will affect the maximum amount you can recover.

The Role of a Spinal Cord Injury Lawyer

Navigating the legal process and negotiating a fair settlement can be challenging, especially while dealing with the physical and emotional challenges of a spinal cord injury. An experienced spinal cord injury lawyer can help you:

  • Evaluate Your Case: A lawyer can assess the circumstances of your injury, determine the liable parties, and identify all sources of compensation.
  • Gather Evidence: From accident reports to medical records, your lawyer will collect and preserve crucial evidence to support your claim.
  • Negotiate with Insurance Companies: Insurance companies may try to minimize payouts. Your attorney will negotiate aggressively and fairly on your behalf.
  • Litigate Your Case: If a fair settlement cannot be reached, your lawyer will take your case to court, advocating for your rights and fighting for the maximum compensation.
  • Calculate Damages: Attorneys work with medical and financial experts to accurately calculate the full extent of your damages, including medical expenses, future care costs, lost wages, and pain and suffering.

Planning for Long-Term Care

Even with a fair settlement, it’s essential to plan for your long-term care needs. This may involve:

Life Care Planning

A life care plan is a comprehensive assessment of your current and future medical, rehabilitation, and long-term care needs. It includes a detailed breakdown of the costs associated with these needs, which can be used to support your settlement claim and guide your financial planning. A life care plan can mean the difference between obtaining the necessary care and equipment or not.

Special Needs Trusts

If you are receiving government benefits such as Medicaid or Supplemental Security Income (SSI), a personal injury settlement could jeopardize your eligibility. A special needs trust (SNT) allows you to receive the funds from your settlement without losing these important benefits.

  • First-Party Special Needs Trust: This type of trust is funded with your own assets, such as a personal injury settlement or inheritance. It allows you to protect your settlement funds while remaining eligible for government benefits.
  • Third-Party Special Needs Trust: This type of trust is funded by someone other than the beneficiary, such as a parent or grandparent. It can be used to supplement the beneficiary’s needs without affecting their eligibility for government benefits.

A trustee manages the SNT and can use the funds to pay for supplemental needs not covered by government benefits, such as:

  • Medical and dental expenses not covered by insurance
  • Special equipment, like powered wheelchairs or hospital beds
  • Home modifications
  • Transportation
  • Recreation and leisure activities
  • Education and training

ABLE Accounts

ABLE (Achieving a Better Life Experience) accounts are tax-advantaged savings accounts for individuals with disabilities. They allow you to save money without affecting your eligibility for government benefits. Savings can be used for qualified disability expenses such as housing, transportation, employment training, assistive technology, and healthcare.

Government Assistance Programs

Several government programs can provide financial assistance to individuals with spinal cord injuries, including:

  • Social Security Disability Insurance (SSDI): Provides a monthly income to those unable to work due to their injury.
  • Supplemental Security Income (SSI): A needs-based program that provides monthly payments to individuals with limited income and resources.
  • Medicare: A federal health insurance program for people 65 or older and those with certain disabilities.
  • Medicaid: A joint federal and state program that provides health coverage to low-income individuals and families.

Other Resources

  • Non-Profit Organizations: Many non-profits are dedicated to helping people with SCI and may offer grants, equipment, or other forms of aid.
  • HelpHopeLive: A nonprofit that offers a step-by-step framework to raise funds locally.
  • The Christopher & Dana Reeve Foundation: Provides financial planning assistance and resources for people with spinal cord injuries.

Taking Control of Your Financial Future

Protecting your financial future after a spinal cord injury requires a proactive approach. By understanding your legal rights, seeking expert legal and financial advice, and planning for your long-term care needs, you can secure the resources and support you need to live a fulfilling and independent life.