Accessing Rehabilitation for Brain and Spinal Injuries
If you have been seriously injured as a result of an accident, one of your main priorities will be accessing the right treatment and therapy to ensure you have the best chance of reaching your optimal recovery.
Solicitors who are members of APIL subscribe to the Rehabilitation Code of Best Practice. The most up to date code came into force on 1 December 2015.
What is the Rehabilitation Code and how can it help?
The Rehabilitation Code sets out a legal framework for early intervention to address the needs of the injured person. It imposes a duty on your solicitor and the compensator to work together to address your needs.
In the first instance, the personal injury solicitor should at an early stage advise the insurance company of your claim and notify them of the need for rehabilitation.
In terms of the code, the insurer is required to respond within 21 days.
What if liability for the accident is in dispute?
Where there is no agreement on liability, the insurer and your solicitor may still agree to use the code. The benefits of proceeding with rehab at an early stage may be especially strong in brain and spinal cases.
Compensators are required to consider from the outset whether there is a possibility or likelihood of at least partial admission of liability later in the process so as not to compromise the prospects of rehabilitation.
Immediate Needs Assessment (INA)
The code provides that an Immediate Needs Assessment be carried out at the earliest opportunity in order to identify your short-term rehabilitation needs.
The Immediate Needs Assessment should be carried out by a professional person with the appropriate skills and experience to identify your rehabilitation needs.
There are timescales set down in the code to ensure the immediate needs Assessment is instructed and produced within specific timescales.
Rehabilitation can include the following:-
- Appointment of a case manager who will oversee and implement all of the needs identified in the immediate needs assessment;
- Adaptations to your home or sourcing suitable alternative accommodation;
- A specially adapted vehicle that you can drive or access easily;
- private therapy, including physiotherapy, occupational therapy, psychological therapy or indeed any other therapy to ensure that you get the best possible treatment with the minimum of delay;
- Equipment and aids to help maximise your independence;
- Employment of support workers or carers to assist you with activities of daily life;
- Providing respite for family carers;
Appointing the Case Manager
A key stage in the process is the appointment of a case manager. It is important to select someone with the right experience to ensure you get a rehabilitation programme that suits your individual needs and a personal injury solicitor can also help in this process.
It is recognised in the code that you are likely to be receiving on-going treatment with the NHS and therefore there is a duty on case managers to co-operate and work with NHS clinicians.
Will all insurers follow the Rehabilitation Code of Practice?
The code is a guide to best practice and is adopted voluntarily by parties. It is not possible to force insurers to comply with the code, however many insurers will agree to abide by the code.
Who pays for the rehabilitation?
If an immediate needs assessment and the recommendations made in the INA are instructed jointly with the insurers then this is paid for in full by the insurer. There will be no dispute at a later stage regarding the costs of the rehabilitation and there will be no attempt to recover any of the costs of the rehabilitation from the injured party, even if liability is later disputed or partially disputed.
If the insurers are not willing to instruct rehabilitation jointly then it may be possible to obtain advance payments (known as interim payments) to fund the cost of a case manager and rehabilitation programme where the insurer accepts that their insured is at least partly to blame for the accident. Sometimes, it is preferable for the rehabilitation to be provided in this way, particularly if someone is very severely injured.
Case in point: Rehabilitation Code is the key to early resolution after brain injury
This case involved Tom, a 16 year old who sustained a traumatic brain injury as a result of a road traffic accident.
With Digby Brown's experience in serious injury, we were able to identify that an Immediate Needs Assessment under the Rehabilitation Code would pinpoint what needs required to be met as a consequence of the accident.
A case manager was appointed for Tom and with the co-operation of the insurer and a period of residential rehabilitation in Glasgow was arranged.
It cost over £50,000 for case management and rehabilitation and this was paid by the defender’s insurer. The final compensation was agreed at £400,000.
Head Injury Information Days
Every year, Digby Brown hold Head Injury Information Days (HIID) which are free information events for people with a head or brain injury, including their families and carers as well as professionals in the field. Learn more about upcoming Head Injury Information Days or contact us on 0333 200 5925 for more information.