Tbilaw.com has been at the cornerstone of the web advocacy of the Brain Injury Law Group since it went online in 1996.For a full treatment of the topic of brain injury, and recovering adequate compensation for those who have survived such injury, please visit our other pages.
Waiting.com, a page designed to assist those with issues regarding coma, especially in the acute phase when the doctors are saying "I just don't know."
Vestibulardisorder.com addresses vertigo and dizziness resulting from trauma as well as information and resources for vestibular disorders.
Subtlebraininjury.com focuses on all aspects of concussion and non-coma injuries.

Our first advice is not to worry about it too much.

If your loved one is in a coma, at least in the United States, they will not be denied care, at least not until the acute stage is over. While that doesn't mean you won't have financial hardship ahead, at this point, care will continue, regardless of how the bills get paid. At least in the United States, people with severe brain injuries are not denied acute care. In fact, the people who set hospital and insurance rates understand that and all of the rest of us pay a little more, on the chance that this kind of care is needed for someone who doesn't have the ability to pay.

If you are getting hassled about medical bills while someone is still in a coma, basically tell them not to bother you, that you have more important things to worry about.

Now that having been said, getting medical bills paid may become a priority. If the person is in a coma has a family or spouse to support, then finding a source to pay these bills will help to reduce the financial hardship caused.

The first place to have medical bills paid in most cases, is your own medical insurance policy.

While there will typically be deductibles associated with this policy, after the deductible, $250 to $1000, and the copay (20% up to $5,000 typically) they should cover all acute care costs. Unfortunately, with the advent of HMOs and managed care, getting the proper care from your medical insurance company may require you to be an "advocate." The term advocate is used to mean you may have to push them, argue with them, persuade, cajole and perhaps threaten them. While every insurance policy is different, the medical insurance company's obligation to pay for necessary care is much broader than they will typically admit.

One suggestion from an insurance professional, who is now a caregiver, is to try to get a case manager appointed. A case manager has the authority to make decisions that make sense both for the patient, and also to lessen the long term burden on the insurance company. For example, providing some in-home care, may not be authorized by the policy, but may be much cheaper than the alternative of a nursing home, which is covered.

Med Pay Coverage

If the survivor was injured in an accident, there is a significant probability that what we will refer to as "Med Pay Coverage," is also available. Med Pay coverage is additional insurance to cover medical bills related to the accident. Such a policy may be on the car that the survivor was riding in, any other car owned by the survivor or a member of his or her household, or on the place where the person was injured, such as in a fall. In some states, where there is no-fault or personal injury protection laws ("PIP") the Med Pay coverage may pay all the bills, but this differs from state to state.

It is a good idea to have an attorney review all insurance policies held by any member of the injured person's household, including umbrella policies, disability policies, homeowner's and even all policies on credit cards owned by the person. It may be that medical pay coverage is included in such policies.

Medical Assistance

With children, not covered by insurance, and adults who do not have substantial assets, medical assistance may be available. Medical assistance is available to someone who qualifies for SSI benefits from the social security administration. SSI, as opposed to SSDI, is available to people who do not have a substantial work history (have not paid into social security taxes in enough quarters) but who need assistance because their income and resources are below the minimum level. To understand more about qualifying for social security, go to the social security page herein.

Click Here to go to Social Security

If the survivor is eligible, medical assistance should pay all acute care costs, and substantial amounts toward long term care and rehabilitation. Medical assistance waivers, which are becoming more widely available, can sometimes be utilized to get medical assistance to cover things not typically covered by the program.

Workers Compensation

In most states, if the injury occurred at work, workers compensation is obligated to pay all related medical bills, especially for acute care costs. But as workers comp benefits are being trimmed to make states more competitive to recruit industry, an attorney may be required to force the insurance company pay all that is necessary for long term care and rehabilitation.

Personal Injury Actions

One final way to get medical bills paid is through a lawsuit, against someone who is legally responsible for the injury. And if you have a viable action, the survivor may recover many times the medical bills in lost wages as well. To recover in a personal injury action, the survivor must prove that someone else wrongfully caused the injury.

Click Here for Information on Legal Actions

The critical mistake in too many personal injury cases is that an insurance adjuster convinces the survivor or his family to settle for a relatively modest sum, before the full extent of injury or entitlement is clear.

If an insurance adjuster is there early in the process, seemingly generously offering to pay all medical bills, don't sign anything. When faced with the pressure of catastrophic medical bills, the promise to pay all the bills may sound wonderful. Regardless of how much they try to endear themselves to you, the insurance adjuster is not your friend. He is not offering to pay medical bills out of the goodness of his heart, but to avoid paying substantially more. The insurance adjuster's job is to pay as little as he can. An early offer to pay bills is tantamount to an admission that they realize they are responsible to pay far more.

Don't sign anything until you have at least consulted with an attorney. Most personal injury attorneys will not charge for the initial consultation.

• Getting Medical Bills Paid
• Understanding Why You Hurt
• Non-Obstacles to Recovery
• Choice of Lawyer
• About Insurance
• Car Insurance
• Independent Medical Exam

NEXT: UNDERSTANDING WHY YOU HURT?

"No head injury is too severe to despair of, nor too trivial to ignore."- Hippocrates

 

Understanding Subtle Brain Injury

View our video series on concussion.

The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.

 

Contact the
Brain Injury
Law Group
1- 800-992-9447

This site is brought to you by the advocates of the Brain Injury Law Group, a community of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI.

The Brain Injury Law Group is involved with a network of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI, so we may be of better service to the survivors of brain injury. This network of lawyers are not part of a national law firm. We have separate law practices and are licensed to practice only in our home states.

The Brain Injury Law Group is here to listen and for that reason we maintain an 800 number and a staff willing to discuss your case and legal information where appropriate. There is no charge to call. We only represent people on a contingent fee basis and charge a fee only when we recover for the client. For more on Attorney Gordon Johnson, click here.