Navigating Finances After a Catastrophic Injury

The aftermath of a catastrophic injury is often a whirlwind of chaos as you grapple with the life-changing impacts of the incident. Expenses, from medical costs to home and vehicle modification needs, begin to pile up, creating a stressful financial mess. At Shamieh Law, we’re well-versed in catastrophic injury cases and can help you financially recover by pursuing compensation and justice for your injuries.

Catastrophic injuries can cause immense financial strain due to numerous factors, from lost wages and future earning capacity to staggering medical bills and home or vehicle modification needs.

These injuries occur suddenly, resulting in severe physical damage to the body. They can result from several occurrences, such as motor vehicle accidents, car accidents, semi-truck accidents, and even boat accidents. These can all leave victims with severe injuries and medical bills. Workplace accidents can also be extremely dangerous, such as in the construction industry, where workers operate heavy machinery, usually on job sites with dangerous working conditions. Even slip-and-fall accidents can have severe outcomes. Regardless of what caused your injury, navigating your finances after such an injury can be intimidating, but the right information and resources can help you sort things out.

Understanding Insurance

Many people carry health insurance as a safety blanket to offer support during unexpected medical emergencies. An insurance policy is a contract between you and your provider, ensuring you receive coverage for qualified scenarios.

The type of coverage you choose will determine how and when you’ll receive reimbursement for covered expenses. Common types of insurance include the following:

Health: This type of coverage is the basic policy many people carry. It extends to a limited range of specific expenses, such as routine checkups, tests, urgent and emergency care, and prescription drugs.
Disability: This insurance partially replaces your income when you cannot work due to a short- or long-term disability. While it won’t cover the full amount of your earnings, it covers a percentage.
Personal accident: These plans extend to covered accidents and will pay a benefit directly to you or your beneficiaries in the case of death. Emergency treatments, medical exams, hospital stays, and final expenses are common inclusions. It can complement other insurance policies, such as disability or health, to bridge the gap on costs your other insurance policies don’t cover.
Critical illness: These policies offer benefits for individuals diagnosed with specific critical illnesses or conditions, including heart attacks, strokes, and major organ transplants. It provides a direct lump-sum benefit that you can use for expenses your other insurance doesn’t cover.

However, it’s important to understand the parameters of these plans. Insurance providers often impose stringent requirements to be eligible for coverage.

These requirements vary based on the provider and plan, so familiarizing yourself with the specifics of your coverage is crucial. As you read through your policy, you may find a few key terms, including the following:

Deductible: The amount you must pay for covered health care services before your insurance policy begins to pay
Premium: The monthly amount you pay for your health insurance policy
Coinsurance: Your share of the cost of the covered health care service after you pay your deductible, which is generally calculated as a percentage of the total amount for the service
Copayment: The amount you pay, often a flat fee, as your share of the cost for a medical service or item
Network: The group of health care providers, including doctors and hospitals, that the insurance company contracts with to offer services at a discounted rate.
Benefit: The amount the insurance company will pay to a plan member for medical expenses
Benefit level: The maximum amount the health insurance company will pay for a covered benefit
Rider: Coverage add-ons, such as a maternity rider, which can be used to expand your basic insurance plan for an additional cost

Managing Medical Expenses

Management of medical expenses is a critical part of handling a catastrophic injury. Setting up a payment plan, using a Flexible Spending Account or Health Savings Account, and sorting your bills by the due date can help manage your expenses.

In addition, you should negotiate your medical bills to ensure correctness and inquire about financial assistance. Here are a few tips to help you negotiate your medical bills:

Request an itemized bill: Review the statement for errors, including services or medication you didn’t receive or duplicate charges. Sometimes, the hospital will make mistakes and overcharge you.
Review the explanation of benefits: Your insurance company may send you an explanation of benefits after receiving medical care. While this documentation isn’t a bill, you can use it to compare your itemized hospital bill for discrepancies. If you find inconsistencies, report them to your insurance provider.
Ask about financial assistance: Many health care providers offer financial assistance for low-income patients. Ask your health care provider if any waivers, discounts, or hardship or relief programs are available.

However, despite valiant efforts to manage medical expenses, they can quickly spiral out of control. Here are a few programs designed to help with medical expenses:

Medicare
Extra Help, an extension of Medicare
Supplemental Security Income, a Social Security program
Healthcare Insurance Marketplace under the Affordable Care Act or Obamacare
Medicaid
Children’s Health Insurance Program, or CHIP

Aside from management techniques and medical programs, looking into tax deductions available for medical expenses is advisable.

The Internal Revenue Service states certain individuals may be eligible for a tax deduction on medical and dental expenses for the year. You may deduct the total medical expenses exceeding 7.5 percent of your adjusted gross income. Discuss this opportunity with your certified personal accountant for options specific to your situation.

Social Security Disability Benefits

You might be eligible for Social Security Disability benefits, which can make a world of difference while recovering from a catastrophic injury.
To qualify for benefits, you must meet the following criteria:

Be unable to work due to a medical condition that is expected to last at least one year or result in death
Worked long enough and recently enough to have paid a sufficient amount into the system through payroll taxes
Not have a partial or short-term disability
Meet the Social Security Administration’s definition of a disability
Be younger than your full retirement age

To apply for disability benefits through Social Security, follow these steps:

Review the Adult Disability Checklist to help you gather the information you need for the application process.
Fill out the Disability Benefit Application.
Complete the Medical Release Form.

After you apply, the Social Security Administration will begin the review process. The administration will do the following:

Supply confirmation of your application via email or mail
Review the application to ensure you meet the requirements for benefits
Contact you as necessary to gather additional information or documentation
Notify whether your family members may be eligible for benefits on your record or if you might be eligible to receive benefits on another individual’s record, such as a parent’s or spouse’s
Process your application
Inform you of the final decision via mail

The process usually takes three to six months to reach an initial decision. Once you’re approved for Social Security Disability benefits, you’ll begin receiving monthly paid benefits. The amount you receive each month depends on your lifetime average earnings before the disability. Use the Social Security Administration’s online benefits calculator to estimate your monthly benefits.

Seeking Legal Recourse

If your injuries resulted from the negligence or actions of another individual or entity, seeking legal recourse is wise. The process often requires help from a skilled lawyer specializing in your particular type of case, whether it involves personal injury, medical malpractice, product liability, or something else.

First, you’ll discuss the specifics of your situation with your lawyer in the initial consultation. Your lawyer will launch a thorough investigation to gather evidence and build a formidable case in the following days and weeks. They will help you by undertaking settlement negotiations and representing you in court if necessary.

Through this process, your lawyer can help you recover multiple types of compensation, although it varies based on the circumstances surrounding the incident.

Medical Care Costs

Medical expenses following a catastrophic injury are often overwhelmingly high. Your lawyer can help you recover compensation for past and future medical care costs associated with your injury, which can make a major difference in financially recovering from the incident.

Lost Wages and Benefits

Losing your job after an injury can lead to various losses, including wages and benefits you received from your job. You can claim this type of compensation when your injury prevented you from going to work, thus resulting in lost wages and work benefits.

Future Earnings Capacity

Your injury may leave you unable to continue working, diminishing your future earning capacity. This compensation is much the same as lost wages but applies to future earnings instead of previous salaries.

Pain, Suffering, and
Mental Anguish

Pain, suffering, and mental anguish resulting from the incident are non-economic damages that can be difficult to quantify. An experienced lawyer can help you determine a fair reimbursement amount that covers these things. You may be eligible for this type of compensation if you have experienced any of the following due to your injury:

Pain and suffering
Emotional distress
Loss of enjoyment of life
Humiliation
Anxiety
Fear
Anger
Shock

Home or Vehicle Modifications

Home and vehicle modifications may be necessary after a catastrophic injury to ensure you can safely navigate them. For example, after a spinal cord injury, the victim’s home and vehicle may require extensive modifications to ensure they are wheelchair-friendly.

Remodeling your home or upgrading your vehicle for this purpose can be expensive. However, you might be eligible for compensation for the renovations and modifications necessary to accommodate your restrictions.

Loss of Services and Companionship

Non-economic compensation for loss of services and companionship is available in certain circumstances.

Loss of services is when an injured individual can no longer contribute to household tasks, such as cleaning, lawn maintenance, or pet care. Loss of companionship focuses on the damage to the relationship between the injured or deceased individual and their family members.

Emotional and Mental Health Support

Psychological stress is common following injuries, especially catastrophic or extreme incidents. These injuries can have ripple effects throughout various aspects of your life, from physical health to emotional and mental health.

It’s difficult to adjust to a new way of life, especially if your accident resulted in major changes, such as a spinal cord injury leading to full or partial paralysis or a traumatic brain injury affecting behavior and mood. Many individuals who have experienced extreme injuries grapple with various mental injuries, including depression, anxiety, and post-traumatic stress disorder, or PTSD.

It’s important to recognize the signs of emotional and mental trauma, as addressing it will help you on your road to recovery. Signs and symptoms may include the following:

Anxiety or panic attacks
Fear
Anger
Irritability
Mood swings
Emotional numbing and detachment
Depression
Shame and guilt

Shock or disbelief
Changes in sleeping and eating patterns
Nightmares
Edginess or extreme alertness
Overwhelming fatigue and exhaustion
Loss of memory and concentration abilities
Disorientation or confusion

If you’re experiencing symptoms of psychological distress after your injury, you’re not alone. Support from loved ones can make a significant difference, but if you don’t feel comfortable talking to family or friends about your feelings, consider seeking third-party assistance.

Help from a licensed therapist or psychologist can be valuable in learning to cope and adjust to your situation. Many therapists and psychologists offer in-person and online services, so you can select the option that best accommodates your needs. Look online for opportunities in your area if you prefer in-person services.

Numerous support groups nationwide aim to help victims recover from injuries. Check your local hospital or government site for support groups in your area.

Additionally, learning more about emotional and mental health can be useful in traversing the recovery phases. Here are some resources for you:

Long-term Care

Long-term care is a reality for many individuals recovering from a debilitating injury. Those with chronic pain or chronic medical conditions may require routine, long-term care, whereas those with permanent disabilities due to the accident may require full-time long-term care.

Selecting a long-term care option can be overwhelming, particularly amid post-injury chaos. The easiest way to find long-term care options in your area is to ask a knowledgeable person, such as your doctor or nurse. Alternatively, many states have a government site with information on long-term care services.

Here are a few tips to help you select the best option for your situation:

Proximity: Choosing a nearby option is essential, as many people want to be near friends and family as they traverse the difficulties following a catastrophic injury. Search for options in your city or filter by state.
Staffing: The staff at a long-term care facility tremendously impacts the quality of care and patient advocacy. Look for well-staffed facilities with friendly, helpful teams. Ask pertinent questions about the staffing levels, such as the number of staff on duty at night, the patient-to-staff ratio, and how many patients each nurse or staff member is responsible for.
Visitor rules: Some facilities have specific visitor policies. Ask about these policies at each facility you visit.
Cost: Consider the cost of attending routine appointments or living in the facility. Does your insurance offer coverage? Does the facility take your insurance?
Transportation: This ties into proximity, as you’ll need a facility close enough to make your appointments. Talk to friends and family about transportation to appointments to ensure you can be there when needed. If that isn’t an option, look into local bus routes and other transportation services.

Finding Employment and Income Opportunities

As you move toward recovery, you may decide to look for employment and income opportunities. While the opportunities available to you will vary based on the circumstances of your injury, reentering the workforce may be a reality.

Vocational rehabilitation can help you navigate the complexities often accompanying reentering the workforce, especially with an injury or disability. These rehabilitation courses typically include the following components:

Vocational assessment and evaluation
Training
Updating of skills
Refreshers
Career counseling
Aid with employment searches
On-the-job training
Consultations with employers regarding job accommodations and modifications

Many states have a division or program dedicated to vocational rehabilitation, so consult your state’s website to determine options available in your area. The inclusions in the program may vary from state to state, but the general purpose remains the same.

In addition, various stay-at-work and return-to-work programs are available to ease the transition back into working routines. Many companies offer return-to-work programs to encourage those with employment gaps to apply, so keep an eye out for those employers.

A disability or injury doesn’t necessarily mean you cannot reenter the workforce. Individuals recovering from injuries and adjusting to disabilities may have numerous employment opportunities, although options will vary based on the circumstances of the injury or disability.

Talk to potential employers about work-from-home opportunities or adaptive work arrangements to accommodate your needs. Don’t be afraid to communicate your needs, as clear expectations and understanding go a long way in creating a healthy, adaptive environment where everyone thrives.

Seek Support From Friends, Family, and Professionals

Remember to lean on your friends and family as you traverse the tumultuous waters of post-injury life. These times are often difficult, confusing, and stress-riddled. Thus, a support network will go a long way in your recovery.

Additionally, speaking to a lawyer to determine your legal options is highly recommended, especially if your injuries result from another’s actions or negligence. Our experienced lawyers at Shamieh Law are always ready to lend a helping hand and help you get the justice and compensation you deserve, so don’t hesitate to reach out.