After a serious injury, a need for long-term rehabilitation is common for victims. Medical care, physical therapy, mental health care, lost wages, and home care are some of the most common costs victims face after a life-altering accident. In order to fully recover compensation for a serious injury, victims must first meet the serious injury threshold in New York. But even if your injuries qualify as serious under New York law, valuing your case accurately–and having a legal team in place that can help–is essential to your recovery. I’ll tell you more about how rehabilitation costs are valued after a serious accident and how a New York car accident attorney may be able to help. At Buttafuoco & Associates, we have decades of experience fighting for victims’ rights. To find out more about how your case could be valued, get in touch for a free consultation at 1-800-NOW-HURT.
What Qualifies as Serious Injury in New York?
New York Insurance Law § 5102(d) defines a serious injury as an injury that results in:
- Death
- Loss of a fetus
- Dismemberment
- Disfigurement
- Fracture
- Permanent inability to use a body organ, member, function, or system
- Permanent severe limitation of a body organ or member
- Significant inability to use a body function or system
In order to qualify as a serious injury, victims must supply medical evidence to prove that their injury meets these requirements and significantly impacts their lives, usually in a permanent or significant way. Working with a qualified car accident attorney serving New York can help you ensure that you have sufficient evidence to prove your injuries.
What Types of Injuries Cause Long-Term Rehabilitation?
When an injury is serious, it often qualifies for long-term rehabilitation claims, but this is largely dependent on providing solid evidence in the form of medical records.
Some injuries that often require long-term rehabilitation include:
- Traumatic brain injuries
- Spinal cord injuries that result in partial or full paralysis
- Complex fractures
- Amputations
- Some severe soft-tissue injuries, if they produce a permanent or significant limitation
Just because your injury is life-changing, however, is not a guarantee that it will qualify under New York’s serious injury threshold or will be eligible for long-term rehabilitation payments. In part, this is because these claims are highly likely to be disputed by insurers who are eager to meet the bottom line. If you are struggling with an insurer who won’t pay, a New York car accident attorney can often help you negotiate.
What Long-Term Rehabilitation Expenses are Covered?
If your injuries qualify as serious under New York law, your own insurance will be relied on for the first $50,000 of rehabilitation costs. This is because New York is a no-fault state, where regardless of who caused the accident, payments first come from your personal insurance. It is important to note that lost wage benefits and home health care are also deducted from the first $50,000, so it is possible that if your injuries are severe, you may quickly deplete your own insurance.
If you utilize all $50,000, the victim of a serious injury can pursue a lawsuit against the at-fault driver for any reasonable and necessary treatment that costs beyond $50,000. This can include:
- Hospitalization
- Doctor visits
- Physical therapy
- Speech therapy
- Occupational therapy
- Medications
- Medical equipment
- Home health care
- Mental health therapy
Again, you must have medical bills and treatment records, as well as other evidence showing the need for these treatments, in order to recover compensation. Some costs are easier to recover than others. For example, you will need extensive documentation to show that home and assisted living care are not simply helpful, but that they are medically necessary. In order to be compensated, costs also must be determined to be reasonable. In this case, it could be argued that a member of your family could provide the care just as well as a professional, in which case this request could be denied.
For lost work compensation, attorneys often call on vocational experts to determine how your injury limits your ability to work, as well as a forensic economist to determine the value this impairment will have over future years. A good New York accident attorney will have access to experts who can help accurately value your case.
What Factors are Part of Valuing Long-Term Rehabilitation?
Every case is different, so a wide range of factors can impact how long-term rehabilitation after a serious injury is valued. How serious your injuries are, how long you will require rehabilitation, and the degree to which the injury impacts your normal daily activities are all factors. Other questions that may be relevant include:
- Whether any injuries were pre-existing
- The victim’s age
- Whether the accident caused temporary or permanent disability
- How likely it is that further treatment will be needed in the future, and for how long
- The victim’s form of employment
- The victim’s income
- Whether the victim was in any way responsible for the accident
- Whether the victim appears believable to the jury
How long a victim will need treatment and what type of treatment is required (as determined by experts) will also have a significant impact on your case value. Does the victim require home nursing care, assistance with housework, or mental health care? Are they permanently disabled and in need of home modifications? Do they have family available to provide care, or is professional care needed? The answers to all of these questions will affect your compensation.
Under New York’s comparative fault rules, if the victim is found partly responsible for the accident, the recoverable compensation will be reduced by the percentage to which it is determined they were responsible for the accident. That said, if you suffer serious injuries, even if you were partly responsible, you can still hold the other responsible party accountable in court.
How are Future Care Costs Determined?
After a serious or catastrophic injury, victims often face years of rehabilitation. With the rising costs of healthcare, general inflation, and other unknown factors at play, it can seem impossible to value such a case. Under New York law, future costs must be projected by experts.
One key type of expert in these cases is a life care planner. This person, who is often a nurse or a rehabilitation specialist, will be brought on to carefully review your medical condition and build a future life care plan. This will include an incredibly detailed evaluation of:
- How long you may need medical equipment as well as how often equipment like wheelchairs or prosthetics will need to be replaced
- How many hours of home health care you will require on a daily basis and whether this can be expected to change over time
- Whether your home will need to be modified due to your injuries
- The cost of long-term medication
- The physician’s prognosis
- And more, depending on your case
The other key expert involved in valuing these cases is known as a forensic economist. They will review the life care plan and convert it into a dollar figure, accounting for inflation, projected medical cost increases, and how current wages would likely have changed over time. As you can imagine, this amount could be incredibly high, but working with an attorney is among the best ways to ensure that you recover the damages you are entitled to under the law.
How to File a Claim for Long-Term Rehabilitation
The steps for recovering compensation for long-term rehabilitation resemble the usual steps victims should follow after any accident to some degree. Getting medical treatment, reporting the accident to the care provider, and retaining all documentation are essential, as is notifying your insurance carrier immediately. (In New York, you must usually submit your application within 30 days of the accident.) If your injury meets the serious injury threshold, working with an attorney to file a lawsuit is important. An attorney can help prove that you are eligible for compensation for pain and suffering and future compensation for care and lost earnings. Vet your attorney, asking about their access to life care planners, forensic economists, vocational experts, and how they have worked with physicians in the past to value cases like yours. Finally, keep in mind that you must file a lawsuit within three years for a typical accident, and even faster for a claim against a city or other municipality.
If you have been in a serious accident and are concerned about your long-term wellbeing, get in touch with Buttafuoco & Associates for a free consultation today.
Call 1-800-NOW-HURT to determine whether you have a case and how to move forward.
