Approximately 17,000 people suffer spinal cord injuries in the United States each year. These injuries usually require extensive medical treatment. They also have permanent impacts on the lives of the individuals living with them.
These injuries can cause death or paralysis. They can affect almost every body system. Even if an individual retains function, that function will often be extremely limited.
Unfortunately, many spinal cord injuries happen on the job. These work injuries may happen from a car wreck, a fall from height, or a falling item among other things. Work-related spinal cord injuries usually lead to workers’ compensation claims.
How are spinal cord injuries different than other workers’ compensation injuries?
One major difference with spinal cord injuries comes from the potential for catastrophic designation. Georgia workers’ compensation law places a limit on almost every benefit. With a catastrophic designation, many of those limits do not apply.
Spinal cord injuries can qualify as catastrophic injuries at least two different ways.
- O.C.G.A. 34-9-200.1(g)(1) – anyone who suffers a “spinal cord injury involving severe paralysis of an arm, a leg, or the trunk” should qualify for a catastrophic designation. The key question is what is “severe” paralysis. Many cases will be clear. But, insurance companies may try to fight a catastrophic designation if the paralysis is limited.
- O.C.G.A. 34-9-200.1(g)(6) – this section is known as the “catch-all” section for catastrophic designation. Someone with a spinal cord injury who does not have “severe paralysis” can still qualify for catastrophic designation. They just need to prove that the injury prevents them from being able to perform their prior work and any work available in substantial numbers in the national economy for which they are otherwise qualified.
A catastrophic designation allows injured workers to continue receiving workers’ compensation benefits without many of the artificial limits placed on temporary total disability and medical benefits by Georgia law. However, injured workers still need to know that deadlines like the change in condition statute of limitations still apply.
Spinal cord injuries often require home and vehicle modifications and other complex medical assistance
Many spinal cord injuries cause total or partial paralysis. Quadriplegics and paraplegics usually will need some form of assistance getting around. Often, this will be a wheelchair or scooter.
Wheelchairs and scooters often require specialized vehicles to transport. The use of this medical equipment inside a home requires doorways to be a certain width. The insurance company may have to pay to renovate bathrooms and kitchens to accommodate the equipment. Entrances and exits from the house may require ramps or other modifications.
When a workers’ compensation case is designated catastrophic, the Georgia State Board of Workers’ Compensation should assign a catastrophic rehabilitation supplier. This person often helps coordinate medical treatment and rehabilitation including housing and vehicle modifications.
Even if a case is not designated catastrophic, the workers’ compensation insurance company should be responsible for the necessary medical equipment when it is ordered by the authorized treating physician.
Spinal cord injuries often necessitate specialized care in or outside the home. Nurses may need to come into the home to provide treatment. People may need to stay with injured workers to cook, clean, and assure their safety.
The workers’ compensation insurance company should pay for this care if the authorized treating physician orders it. Georgia laws covers both medical and nonmedical attendant care.
One quirk that currently does exist under Georgia law is whether spouses and other family members must be paid for attendant care. An older Georgia case held that they do not have to be in some situation. The Georgia courts might very well decide this case differently today. But it is important to consider this old case in making decisions about who will provide attendant care for a spinal cord injury.
Settlement of spinal cord injuries
Spinal cord injuries are complex. Their medical treatment is as well. The one thing you do not want to do is rush into settlement if you have a spinal cord injury.
You can settle your case, but you also need to know that you do not have to settle your case. Some people rush into settlement. You do not want to rush because you need to have a really good understanding of your future medical treatment to settle your case.
You may need a life care plan done to get a good estimate of medical treatment. Good life care plans can make you aware of medical treatment you will need that you had not considered. Also, you will probably need some opinions from medical experts about your future condition.
Spinal cord injuries are complex. You may have questions this article does not answer.
The workers’ compensation attorneys at our office are available if you have questions about your case. You can get answers to your questions through a free consultation with one of us. Before setting one up, you can read this article to find out more about how a free consultation works, what you will learn from it, and how to set one up.
Jason Perkins is an attorney who specializes in representing injured workers. He regularly blogs about Georgia’s workers’ compensation system and issues that are important to injured workers and their families.
You can subscribe to his Georgia Workers Compensation channel on YouTube.