Spinal Cord Injury Rehab Bills After a Crash in WV

Rehab bills after a spinal cord injury are usually paid from several sources at once. Start with your health coverage. Then check your auto policy, if it applies. Last, see whether a claim against the at-fault driver or company makes sense.

The question many families ask is how do I pay for rehab after a spinal cord injury from a crash? The answer depends on the facts of each case. Still, the sources below are the ones people usually look at first.

Why Rehabilitation After a Spinal Cord Injury Often Continues for Years

Rehabilitation after a spinal cord injury often lasts well beyond the hospital stay. MedlinePlus explains that car accidents can cause spinal cord injury. The injury may result in permanent paralysis, loss of function, or loss of sensation below the injury site.

Rehab usually includes inpatient care, physical and occupational therapy, equipment such as wheelchairs, and follow-up visits. Those needs can change over months and years. That means the question of who pays is usually ongoing, not a single bill. Researchers have studied recovery after traumatic spinal cord injury, and timing varies from person to person.

A common mistake is treating each bill as a separate problem. Track every payer, every denial and every deadline from the start. For an overview of these injuries, see our catastrophic injuries overview.

Start With the Health Coverage You Already Have

Health coverage is usually the first place rehab bills go. That includes employer plans, individual marketplace plans and other private health insurance. Public programs may also apply, and those are covered later on this page.

Ask two questions early. Which therapy, equipment and facility stays does the plan cover? What approval does it need before care starts? The hospital billing department and the insurer can answer both. Ask for the answers in writing when you can.

Keep every explanation of benefits statement, denial letter and appeal deadline in one folder. An explanation of benefits is the insurer’s summary of what it paid and what it did not pay. Many denials can be appealed. Appeal deadlines are short, so write them down the day a letter arrives.

Check Whether Your Auto Policy Covers Medical Bills

Your own auto policy may help pay some medical bills, depending on what it includes. Some policies carry medical payments coverage. Others carry personal injury protection. Your policy itself shows whether you have either one.

Read the limits, the exclusions and the claim rules closely. The policy states who may claim and how soon the insurer must be told about a crash. These benefits can apply whether or not another driver was at fault. That is a key difference from a claim against someone else.

Underinsured coverage is another piece. West Virginia’s motor vehicle insurance statute, W. Va. Code § 33-6-31, requires that auto policies include an uninsured motorist endorsement covering damages up to the state’s minimum liability limits, and it gives the insured an option, at adjusted premiums, to buy higher uninsured motorist limits and underinsured motorist coverage. W. Va. Code § 33-6-31 reads: “unless it contains an endorsement or provisions undertaking to pay the insured all sums which he or she is legally entitled to recover as damages from the owner or operator of an uninsured motor vehicle, within limits which shall be no less than the requirements of section two, article four, chapter seventeen-d of this code, as amended from time to time: Provided, That such policy or contract shall provide an option to the insured with appropriately adjusted premiums to pay the insured all sums which he or she shall be legally entitled to recover as damages from the owner or operator of an uninsured motor vehicle up to an amount of $100,000 because of bodily injury to or death of one person.” The statute defines an uninsured vehicle mainly as a vehicle with no liability insurance, a vehicle whose insurer has denied coverage, or a vehicle whose owner or operator is unknown. W. Va. Code § 33-6-31 reads: “The right of subrogation granted insurers under the provisions of subsection (f) of this section does not apply as against any person or persons who is or becomes an uninsured motorist for the reasons set forth in this subsection.” That limit on subrogation applies only to an at-fault driver whose liability policy is uncollectible because the insurer is insolvent or in receivership.

Claims Against the At-Fault Driver or Company

A claim against the at-fault driver or company is separate from any insurance you already carry. Losses from a crash can include rehab bills, lost income and care needs at home.

Deadlines matter. Under W. Va. Code § 55-2-12, a personal injury action must be brought within two years after the right to bring it accrued. Evidence fades, and the clock keeps running while you focus on therapy.

Fault is another piece. Under W. Va. Code § 55-7-13c, your own fault does not bar recovery unless it is greater than the combined fault of everyone else responsible. If it is less, your recovery is reduced in proportion to your fault.

Truck crashes add another layer. In Zirkle v. Winkler, a West Virginia Supreme Court decision, the court held that a master is answerable for the negligent act of an employee done within the scope of employment.

Early contact has limits too. Under W. Va. Code § 55-7-11a, within twenty days from the date of a personal injury, and only while the injured person is either an inpatient in any hospital or partially or totally unable to engage in his or her usual trade, profession or occupation, no person may negotiate or attempt to negotiate a settlement of the claim, seek a partial or general release of liability from the injured person, or obtain a statement from that person for use in a settlement, except that a person acting for the injured person may obtain a statement upon the express request of the injured person.

Social Security Disability, Medicare and Medicaid When Injuries Last

Federal and state programs may help when a spinal cord injury keeps you from working for a long time. Social Security Disability Insurance is one example. Eligibility depends on your work history and your medical records.

Medicare may become available to people who qualify for disability benefits. Medicaid is a state and federal program in West Virginia. It may cover rehab for people who meet its income and medical requirements.

Timing matters. Benefits that start later can leave a gap in the first year after injury. That is why it helps to ask early which programs may apply. Keep your paperwork organized so nothing slips through.

How Hospital Social Workers and Discharge Planners Can Help

Hospital social workers and discharge planners can help you sort out coverage before you leave the hospital. They often explain insurance paperwork, arrange transfers to rehab facilities and find programs for equipment and home care.

Ask for a social work or discharge planning meeting early in the hospital stay. Don’t wait until discharge day. Planners have more options when they start early. Bring your insurance cards and a written list of questions.

Changes to the home are often needed after a spinal cord injury. Our page on home modifications after a catastrophic injury explains how West Virginia families plan for them.

Health Plan Reimbursement Claims and Why They Matter in a Crash Case

Health plans and some public programs may seek repayment from a crash case. A reimbursement claim means a payer wants back what it paid for your care. Knowing who paid, and who has a right to be repaid, helps you understand what may be left.

Under W. Va. Code § 55-7b-9a, a defendant found liable for damages for medical care, rehabilitation services, lost earnings or other economic losses may present evidence of payments you received for the same injury from other sources. That happens after a verdict and before judgment. The court may not reduce the verdict for amounts a payer can recover back through subrogation, lien or reimbursement. Subrogation means an insurer steps into your place to recover what it paid.

Past medical expenses have their own rule. Under W. Va. Code § 55-7b-9d, a verdict for past medical expenses is limited to bills paid by or on your behalf. It also includes unpaid bills that you, or someone on your behalf, is obligated to pay.

Many people assume every bill is simply covered. Keep a running list of each payer, amount and date.

Talk With the Firm About Your Rehabilitation Costs

If you are in rehab after a spinal cord injury from a car or truck crash, you don’t have to sort out the coverage alone. You may be able to recover through your health or auto coverage, and a claim against the at-fault party may also be available.

Big Bubba Injury Law handles car accidents, truck accidents, commercial vehicle accidents, catastrophic injuries, traumatic brain injury, spinal cord injury and wrongful death. We serve injury victims across West Virginia, including people in Charleston, Huntington, Morgantown, Wheeling, Parkersburg, Beckley, Clarksburg, Fairmont and Weirton.

If you’re unsure which coverage applies after a crash, request a free case review with the firm. We’ll look at the crash, your injuries and your coverage questions with you.