A spinal cord injury is one of the most devastating, debilitating and life-altering injuries a person can sustain. Depending on the severity and location of the injury, a person may lose the use of their legs (paraplegia) or may even lose the use of their arms as well (quadriplegia). Paralysis and loss of function from spinal cord injury can be partial or complete. Regardless of the degree of injury, people who have lost function due to an insult to their spinal cord will require comprehensive and ongoing medical care, as well as a variety of equipment and other supplies in order to maximize their ability to function and prevent medical complications down the road. This article is intended to address the bare minimum of compensation categories that must be considered when assessing the needs of a person with a spinal cord injury. [1]
When we represent a client with a spinal cord injury, we make sure our client is carefully evaluated by medical experts who can determine and appropriately assess all of the client’s current and future needs so that we can, in turn, determine the amount of compensation that will be necessary to meet those needs throughout the remainder of our client’s life. Compensation for spinal cord injuries generally involves at least five distinct categories of compensation that can be summarized as (1) Ongoing medical care; (2) Equipment and medications; (3) Hospitalizations/surgical procedures; (4) Long-term assisted living/skilled nursing care; and (5) Home and vehicle modifications. Each category will be discussed in turn.
Ongoing Medical Care
In the immediate aftermath of a spinal cord injury, most people undergo an extensive period of “rehabilitation” where they undergo intense physical and occupational therapies to try to regain as much function as possible. During this time frame, they also learn how to adapt to their paralysis, be it partial or complete and, if they are able to participate and assist in their own transfers, they learn how to make transfers safely and efficiently. Following the rehab period, the client will require a medical team of physicians in different specialties to follow them and help them maintain their health as typical problems surrounding spinal cord injuries begin to emerge. Generally speaking, people with spinal cord injuries are followed and managed by a physiatrist or physical medicine rehabilitation physician who oversees their medical care and, where appropriate, refers them to the specialists they will need to see for various complications that arise for people with paralysis, including orthopedic surgeons (for releases should contractures develop); urologists (for self-cathing instruction, as well as ongoing bladder and urinary tract infections); pain specialists (for ongoing and newly developing pain, as spasticity and contractures develop), vocational rehabilitation (to determine if the client can be retrained in a different vocation should they lose their job as a result of their paralysis); physical and occupational therapists (to retain as much mobility as possible and to try to keep the muscles and joints from contracting and becoming spastic); psychologists (to assist with mental health and personal adjustments to limitations); and home health nurses (where there is a need for medical assistance in the home). In addition to the ongoing care listed above, there may also be other forms of ongoing medical care that is required, again depending on the severity of the injury and the level of disability.
Equipment and Medications
In addition to ongoing medical care, individuals with spinal cord injuries require a variety of equipment and medications to help maintain their health and provide mobility. Some of their equipment needs includes wheelchair accessible van/automobile; wheelchairs, standers, orthotics, shower chairs, canes, walkers, service animals, catheters and, occasionally, parenteral nutrition with its attendant g-tube/port. Spinal cord injuries also lead to a life-long need of a variety of medications including medications for pain, muscle spasms, spasticity, constipation, and various infections. These medications can be both prescription and over the counter and will generally be needed throughout the person’s life.
Hospitalizations/surgical procedures
Spinal cord injuries make those suffering from them particularly susceptible to pneumonia. They also lead to contractures of the wrists, ankles, knees, hips and other joints. When contractures occur, surgical intervention is often required to release or correct the contracture. Oftentimes people with spinal cord injuries have surgical procedures to install baclofen pumps that aid with pain and spasticity. People with spinal cord injuries are also often hospitalized for pneumonia or urinary tract infections. These hospitalizations can last a few days or many weeks depending on the severity of the condition and the patient’s response to the treatment that is given.
Long-term assisted living/skilled nursing care
People with spinal cord injuries who are dependent upon others for their everyday needs often require the assistance of a skilled nursing facility for the kind of round the clock observation, assistance and medical care that they need. Even people with spinal cord injuries who are relatively independent and can take care of themselves will usually require skilled nursing care and long-term assisted living after they reach a certain age and lose their ability to care for themselves independently. The cost of such facilities can be staggering. This is a category of compensation that should not be overlooked due to the financial implications to a paralyzed individual should they require these services in the future.
Home and vehicle modifications
For those individuals with spinal cord injuries who are relatively independent, it is important to include in the compensation calculations an amount necessary to modify their home and vehicle so they can be an independent as possible. With a few modifications to lower counter tops, widen hallways, remove impediments to entryways into showers and other rooms, a paraplegic can become quite functional in his/her own home. There are also devices that can be fitted to a vehicle that will allow a person with a spinal cord injury to drive independently, thus greatly enhancing the person’s overall level of independence and the quality of his/her life.
The foregoing categories of compensation for people with spinal cord injuries is not intended to be exhaustive or comprehensive. The author fully realizes that many paralyzed individuals require far greater and more comprehensive care than is anticipated within the categories of compensation discussed in this article. Nevertheless, these 5 categories of compensation can be considered the bare minimum that should be considered and provided for when determining the current and future needs of clients with spinal cord injuries.
If you have any questions regarding any of this information, please send me an email or give me a call at (801) 901-3470, and I will be happy to speak with you.
[1] This is not intended to be an exhaustive list of all categories of compensation for spinal cord injuries. The needs of each person with a spinal cord injury are different and individualized depending on the severity of the injury and the degree of disability. This list is intended only to provide a general overview of the main categories of compensation that apply to the majority of patients with spinal cord injuries.