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.
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