Medical Expenses for a Traumatic Brain Injury

Each year over a million people in the United States suffer a traumatic brain injury. The CDC estimates that in 2000 the medical costs and indirect costs (lost productivity) of TBI in United States totaled $60 billion. The medical costs to the individual can be overwhelming.

An average hospital stay for a moderate TBI is over 9 days. TBI patients may need a lengthy stay in a rehabilitation center; some patients stay for three months. When the injury is severe, the intensive rehabilitation needed may average over $1,000 a day.

Expenses for a TBI include: initial hospitalization, rehabilitation and possible continuing need for medical care and a caregiver.  When medical and non-medical costs are combined, the Brain Association of Missouri reports that the cost of care for the average TBI patient is around $151,000 in the first year after the injury.   The medical costs of people who do not survive the injury are typically higher than those who do survive, since in cases of severe TBI, ventilators and other expensive treatments are used in an attempt to give the brain a chance to heal; these costs may then fall on the family of the deceased.

Insurance which may cover Traumatic Brain Injury

If you or a family member has sustained a traumatic brain injury, your insurance or the insurance of the party responsible for the accident which caused your injury may pay part of your medical bills. The exact coverage depends both on the policy and the circumstances of the accident. Frequently, the insurance company of the party responsible for the injury is unwilling to pay a sufficient amount of damages for the injury; this makes it imperative to consult an experienced brain injury attorney. Attorneys experienced in dealing with TBI claims understand how to get you the compensation which you deserve.

Health and Accident Insurance

These policies vary considerably. Some only cover catastrophic events, while others offer more complete coverage, including annual physicals, and routine doctor visits, as well as coverage for accidents and hospitalization. You may not understand all the details of your policy, so it is a good idea to check with your insurance company as soon as possible after an accident occurs. If your TBI was caused by a fall or other accident at home, you homeowner’s insurance may provide some coverage; these policies may also provide coverage if someone else was injured in your home or if you were hurt in someone else’s home.

Automobile Insurance

Many brain injuries are caused by vehicle accidents. If you were injured in an automobile accident your policy or the policy of the driver who caused the collision will pay some damages. The amount of this coverage varies according to the policies owned by those involved in the crash and to state regulations. 

Most states require that you have a minimum amount of liability coverage and personal injury protection (PIP). Liability covers injury to another party and PIP provides coverage for medical expenses and lost wages to the party carrying the policy. These amounts are limited.

If you have been injured by a driver not carrying personal injury and liability insurance, you will receive some additional compensation from your auto insurance carrier if you were carrying underinsured/noninsured driver coverage. Call your agent or check your policy to see if you have this coverage.

Worker’s Compensation

If you were injured at work, you will most likely be covered by Worker’s Compensation. Not all employers are required to carry this coverage on their workers, but most are. Worker’s Compensation provides income to make up for lost wages, covers medical expenses, and may pay for vocational rehabilitation. You may receive two-thirds of your average salary. You may also be eligible for a lump sum benefit.  To avoid delays or needless hassles, the employer should be notified of the brain injury as soon as possible.

Short-and Long-Term Disability

Although not required by law, a growing number of employers are offer short- and long-term disability policies to their workers. Contact the survivor’s employer as soon as possible after the accident to see if this benefit applies.

Insurance policies are complicated and it can be difficult to understand them during the stressful time immediately after a brain injury. If you or a family member has recently suffered a brain injury and you are wondering what legal rights you have with regard to insurance policies, an attorney experienced in dealing with traumatic brain injury cases can give you helpful advice and help you cut through the red-tape.