Following a serious or life-changing injury, medical treatment is often only the beginning of the recovery process.
An injured person may need physiotherapy, occupational therapy, psychological support, specialist equipment, adaptations to their home or help from a professional case manager. In the most serious cases, rehabilitation and support may be required for many years.
This can leave injured people and their families with an important question: who pays for rehabilitation after a serious injury?
Depending on the circumstances, rehabilitation may be available through the NHS or funded as part of a personal injury claim. Crucially, an injured person does not necessarily have to wait until their compensation claim has concluded before accessing privately funded rehabilitation.
Why is rehabilitation important after a serious injury?
The aim of rehabilitation is to help an injured person achieve the best possible recovery and regain as much independence as possible.
What this involves will be different for every person.
Someone who has suffered a head or brain injury may need neurorehabilitation, cognitive therapy and psychological support. A person who has undergone an amputation may require specialist physiotherapy, prosthetics and help adapting their home. Someone with a spinal cord injury may need a much broader package of ongoing care, equipment and support.
Depending on the injury, rehabilitation might include:
• physiotherapy;
• occupational therapy;
• psychological or neuropsychological support;
• speech and language therapy;
• specialist neurological rehabilitation;
• prosthetics and orthotics;
• pain management;
• specialist equipment and mobility aids;
• home adaptations;
• vocational rehabilitation and support returning to work; and
• professional care or support at home.
For people with particularly complex injuries, a case manager may also be appointed to coordinate the different professionals and services involved in their rehabilitation.
Do I have to wait for my compensation claim to settle?
No.
A major trauma claim can take time to conclude, particularly where the full long-term effects of an injury are not yet known.
Waiting until the final settlement before beginning necessary rehabilitation could mean losing valuable months or even years of recovery time.
For this reason, rehabilitation needs should be considered at an early stage of a serious injury claim.
Where appropriate, a specialist serious injury solicitor can work with the defendant’s insurer to try to secure funding for rehabilitation while the compensation claim itself continues.
What is the Rehabilitation Code?
The Rehabilitation Code 2015 provides a framework for claimant solicitors and insurers to work together to identify an injured person’s rehabilitation needs as early as possible.
The focus is on the injured person’s recovery, independence, quality of life and ability to return to work where possible, rather than simply waiting for the legal claim to reach its conclusion.
Importantly, rehabilitation can be considered separately from the question of compensation.
Even where liability for an accident has not yet been agreed, the parties can still work together under the Rehabilitation Code where appropriate.
This can be particularly important following catastrophic or life-changing injuries, where early access to specialist treatment and support may have a significant impact on recovery.
How are rehabilitation needs assessed?
In serious injury cases, an Immediate Needs Assessment, sometimes referred to as an INA, may be arranged.
This is an assessment of the injured person’s current circumstances and rehabilitation needs. It can consider issues such as:
• physical treatment and therapy;
• psychological support;
• care needs;
• mobility;
• equipment;
• accommodation;
• returning to work or education; and
• support for the injured person’s family.
Following the assessment, recommendations can be made for the treatment, equipment and other support that may assist the person’s recovery.
Where appropriate, the defendant’s insurer can then be asked to fund those recommendations.
Will the defendant’s insurer pay for rehabilitation?
In many serious injury claims, funding for rehabilitation can be sought from the defendant’s insurer.
This might include the cost of private physiotherapy, psychological treatment, specialist rehabilitation, equipment or professional case management.
Funding is not automatic. The appropriate arrangements will depend upon the circumstances of the claim, the injured person’s needs and the position taken by the insurer.
However, the Rehabilitation Code encourages both sides to consider rehabilitation at an early stage and, where possible, to work collaboratively to ensure that an injured person’s recovery is not unnecessarily delayed by the legal process.
What if liability for the accident is disputed?
A dispute about who was responsible for an accident does not necessarily mean rehabilitation has to stop while the legal arguments are resolved.
The Rehabilitation Code encourages the parties to consider rehabilitation at an early stage, including in appropriate cases where liability has not yet been agreed.
We have seen the importance of this in our own cases.
In one Major Trauma Lawyers amputation case, liability remained contested following a serious road traffic accident. Despite this, an amputee specialist case manager was jointly instructed shortly after the claim began and an Immediate Needs Assessment was completed. Rehabilitation was able to progress while the legal claim continued, with interim payments also secured before the eventual £1.5 million settlement.
Every case is different, but it demonstrates why rehabilitation and the wider litigation do not always have to move at the same pace.
Can an interim payment help pay for rehabilitation?
Another important source of funding in serious injury claims can be an interim payment.
An interim payment is an advance payment of part of the compensation a claimant is expected to receive, paid before the final claim has been settled.
Depending on the circumstances, interim payments can be used to meet immediate needs arising from the injury, including:
• rehabilitation and therapy;
• private medical treatment;
• professional care and support;
• specialist equipment;
• accommodation or home adaptations; and
• financial pressures caused by being unable to work.
An insurer may agree to make an interim payment voluntarily. Where a voluntary interim payment cannot be agreed, it may be possible in certain circumstances to apply to the court for an interim payment.
Whether an interim payment can be obtained, and the amount available, will depend upon the individual claim.
Interim payments can be particularly valuable in serious injury claims because it may take some time before medical experts can properly assess the injured person’s long-term prognosis and future needs.
What does a case manager do?
For somebody recovering from a life-changing injury, the number of professionals involved can quickly become overwhelming.
A specialist case manager can help assess, organise and coordinate the rehabilitation package.
Depending on the person’s injuries, this might involve bringing together physiotherapists, occupational therapists, psychologists, medical specialists, carers, prosthetists and equipment providers.
The case manager can also monitor progress and identify how the person’s needs change throughout their recovery.
For the injured person and their family, this means there is somebody overseeing the practical rehabilitation process rather than leaving them to coordinate multiple services themselves.
Can rehabilitation costs be included in my compensation claim?
A serious injury compensation claim considers much more than the injury itself.
Where reasonable rehabilitation, treatment and support costs arise as a result of the accident, these may form part of the overall assessment of the claim.
Depending on the person’s circumstances and long-term needs, a claim may include provision for future:
• rehabilitation and treatment;
• professional care and support;
• therapies;
• specialist equipment;
• prosthetics;
• case management;
• adapted accommodation; and
• other costs arising from the injury.
This is why it is important not to settle a serious injury claim before the injured person’s long-term prognosis and future needs have been properly investigated.
How Major Trauma Lawyers can help with rehabilitation
At Major Trauma Lawyers, our role is not simply to pursue a compensation payment at the end of a claim.
Our specialist solicitors deal with complex and life-changing injury claims where rehabilitation, care and long-term support can be just as important as the eventual settlement.
Where appropriate, we work with defendant insurers under the Rehabilitation Code to seek early funding for treatment and support. We can also seek interim payments during the claim to help meet immediate and ongoing needs.
Our case results demonstrate what this can mean in practice. In one below-knee amputation claim, early interim payments helped fund a private case manager, multidisciplinary rehabilitation, specialist prosthetics and intensive private physiotherapy before the claim ultimately settled for £1.5 million.
If you or a member of your family has suffered a serious injury, you can speak directly to one of our specialist solicitors about your circumstances and the rehabilitation and financial support that may be available.
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