Rehabilitation is seen by clinicians as critical to the wellbeing of patients after a spinal injury. NHS medical rehabilitation is often provided to seriously injured patients, often in specialist centres. However, rehabilitation resources are finite.
Some patients receive excellent rehabilitation over the full period of their recovery or for the rest of their lives. For some the rehabilitation journey is less certain.
In all spinal cord injury claims, access to long term private funding of rehabilitation is dependent on establishing liability. If we at Thompsons Solicitors are able to show that the accident was caused by someone else, who is insured, then the solicitor should be able to obtain funds to pay for rehabilitation.
If the insurer will not make a voluntary payment then we may be able to start court proceedings and request that a judge should make a court order for an interim payment.
However, a difficulty often arises in circumstances where it is not immediately or easily possible to establish fault for the accident. In these cases, the 2007 Rehabilitation Code can offer help.
The Rehabilitation Code 2007 was developed following research showing that in many cases early intervention with appropriate rehabilitation can help people who have serious injuries make a quicker and better recovery.
The Rehabilitation Code recognises the difficulty faced by someone who has had a spinal injury. So the Code moves the focus away from the question of liability or fault and encourages a spirit of cooperation between injured parties and insurers. The Code is not compulsory but over time has been used more and more often by solicitors and insurers.
The move away from the focus on fault to a focus on rehabilitation puts the injured person’s need at the centre of the process. When rehabilitation needs are identified we tell the insurer, who then has a duty to consider if early intervention would be beneficial, and an assessment takes place.
The Code states that the assessment should be prepared by “an appropriately qualified person.” Thompsons Solicitors and the insurer should attempt to agree on the choice of assessor. The assessment may be prepared by one of the treating clinicians or may be carried out by an independent person.
If the assessment is carried out early enough it may take place while the person with the spinal cord injury is in hospital, which should mean that the knowledge of the treating clinicians and therapists will be brought into the process. This will allow those professionals who have had responsibility for the immediate care of the patient to have a significant input to the assessment.
The assessment report will identify what rehabilitation is needed, at what cost and the anticipated outcome of the care. The insurer pays for the assessment report and must consider whether they agree with the findings.
Where the insurer provides funding under the Code, they do so on the basis that they will not subsequently in the personal injury claim argue that the rehabilitation or its cost were not necessary.
In addition, when insurers pay for the assessment and rehabilitation, they cannot later request this is paid back to them by the injured person.