What can I do to recover from a catastrophic injury?

Recovering from a catastrophic injury after a motor vehicle accident can be a long, difficult, and often painful process, both physically and mentally. Catastrophic injuries are serious and leave the patient with some permanent difficulty, such as losing the ability to walk or perform other tasks you used to be able to do.

As a result, many people with these injuries experience stress and frustration, and some may become depressed. However, just because an injury is permanent doesn’t mean you can’t take steps to make your life easier or resume some of your usual activities. Here are some ways patients may work on their recovery:

Physical Therapy

A physiotherapist will assess your needs, determine what functions you’ve lost, and put together a plan to help you regain as much function, strength, and mobility as possible. Ideally, they want you to get to as close to where you were before your accident as possible. They also work to reduce the risk of re-injury and prevent future difficulties.

The physiotherapist will perform different assessments based on the nature of your injuries. If you suffered a head injury or traumatic brain injury (TBI), they may do an assessment of your cognitive abilities, balance, and reflexes. If you lost a limb or suffered some level of paralysis, they may focus on your ability to do physical tasks. Often they start with simple tests, like asking you to sit down and stand up from a chair.

Remember that it’s okay if you can’t complete some or all of the tasks the physical therapist asks you to do. The purpose is to help them see where you’re at. They will then recommend exercises to help you gain strength in certain muscle groups, learn new ways to complete tasks, or re-learn things you were previously able to do.

Typically, you will have regular sessions with your physical therapist. They may have you do exercises on specific equipment, and may also help you with stretching to keep your muscles and joints flexible. Depending on your situation, this could include joint mobilizations, aquatic therapy, resistance exercises, manual therapy, and other strategies.

However, it’s important to understand that the work you do at your therapy sessions isn’t the only thing that will help you. Your physiotherapist will also give you a list of exercises to do at home. Patients who do their “homework” regularly tend to have better outcomes and progress faster than those who only make an effort at their therapy sessions.

You should follow your therapist’s instructions, and do home exercises as often as recommended. If you’re having pain or feel that the exercises are making your pain worse, be sure to tell your physical therapist. They may be able to modify your routine or alert your doctor if they think there may be an unaddressed problem.

Occupational Therapy

This type of therapy is designed to help people who have permanently lost function learn different ways to return to their daily life activities. This may involve learning to use mobility aids, like crutches, a cane, a wheelchair, “grabber” devices to help you reach things that are far away, etc. Often it takes time and practice to get used to a mobility device. Your occupational therapist may also work with your physical therapist if they think specific exercises can help you with this – for example, a person learning to use a wheelchair may need to work on their upper body strength so they can eventually get in and out of the chair on their own.

Often an occupational therapist will begin working with you while you’re still in the hospital. Your therapist will start by going through your typical day and making notes of the things you’re used to doing. They will then walk you through some of these activities, observing which tasks you can still do and which may require some support. Your therapist might show you alternative methods for doing certain tasks, or recommend an accommodation that could help, like adding a chair and accessible handholds to your shower. Their goal is to help you to live as independently as possible, and do as many of the activities you did before as you can. If there are some tasks you simply can’t do for yourself right now, or ever, your occupational therapist can also recommend services to help you, such as in-home care.

The occupational therapist may continue to help you if you’re transferred to a rehabilitation facility – where you will work with physical and other therapists – or if you are sent home. Sometimes the therapist will visit your home to observe your living situation and offer recommendations to make your life easier and help you with daily activities. Their work will go on until they’re confident you’re able to do typical tasks like eating, bathing, brushing your teeth, moving around in your home, getting in and out of a vehicle, etc. Your therapist can also provide guidance if you need help returning to work.

Cognitive Therapy

If you’ve suffered a head injury or another illness or injury with neurological effects, you may benefit from cognitive therapy. This is meant to address difficulties with memory, attention, socializing, judgment, problem-solving, communication, and managing long-term plans. Cognitive Rehabilitative Treatment (CRT) may be restorative or compensatory:

Restorative treatment is designed to help patients recover some functions they may have lost.
Compensatory treatment provides solutions for permanent problems or loss of function.
Many patients have a combination of restorative and compensatory treatment.

As with other types of therapy, a cognitive therapist will begin with an assessment to determine where you are currently, and what needs should be addressed. They may ask questions to determine how alert and aware you are, and if you are having any memory difficulties. Often different experts may be brought in to help you depending on your symptoms. For example, if you’re having trouble speaking or with other language-processing skills, you might be referred to a speech pathologist.

The therapists you work with will make recommendations to deal with the particular issues you’re experiencing. If you’re having trouble with memory or concentration, your therapist may help you figure out how to reduce or eliminate distractions. For memory issues, they may recommend carrying a notebook to write things down or helping you set alarms on your phone to remind you of things like taking medication, making lunch, etc.

Don’t Forget Your Mental Health

When dealing with a catastrophic physical injury, it can be easy to overlook your mental health. However, these kinds of injuries can be mentally and emotionally draining, too. They are often life-changing and it can be difficult to adjust. You may no longer be able to work in the job you’ve done for years. This can be devastating for someone who is very invested in their career – or for someone who just likes being able to pay their rent. You may not even be able to do the leisure activities you enjoy anymore, which can mean you lose an outlet to relieve stress. The accident itself may have been traumatic, and you may suffer from nightmares, panic attacks, flashbacks, or other symptoms of PTSD. All of these difficulties can lead to depression, anxiety, insomnia, and other mental health issues. If you’re experiencing stress or frequently feeling sad, angry, or anxious, make time to take care of your mental health. Ask your doctor or other healthcare workers if they can recommend a mental health specialist or support group. Many therapists now provide remote therapy if you have difficulty leaving your home due to your injuries.

Inpatient Vs. Outpatient Rehabilitation

Depending on your injuries, progress, and current level of ability, your doctors may recommend inpatient or outpatient rehabilitation after a catastrophic injury. With inpatient care, when you’re ready to be released from the hospital, you’ll be transferred to a rehabilitation facility. With outpatient care, you’ll go home, and your therapists will provide in-home care, or you’ll visit a rehabilitation facility several times a week to work with them. There are pros and cons to both situations:

With inpatient care, your needs will be taken care of by trained staff while you recover. If you’re still unable to do things like move from a bed to a wheelchair, bathe yourself, etc., you’ll have assistance with these tasks while your occupational therapist helps you work toward doing them on your own. This can be a good option for someone who lives alone and won’t have anyone to help them at home. It may also work well if you live with someone who isn’t physically strong enough to provide all the assistance you need, or if your home simply isn’t accessible to you right now – for example, if it lacks a wheelchair ramp, or you have no way of getting up the stairs in your current condition. In an inpatient facility, you’ll also have easy access to a full team of different specialists, who can work with you every day if necessary. For this reason, inpatient treatment can be better for patients who need a more intense level of care.
With outpatient care, you won’t have round-the-clock help from professionals, but you will get to be at home. Many people feel that this helps them mentally and speeds up their progress. If you live with family, spending time with them may also be beneficial. Additionally, some people find inpatient facilities uncomfortable, noisy, too hot or cold, or distracting because of other patients, and these issues can negatively impact your recovery. For example, it can be hard to apply yourself in physical therapy if you were up all night because the patient in the next room was listening to the TV at top volume. Outpatient care can be a good fit if you live with family or other people who can help you with anything you’re currently unable to do. You can continue your therapy with in-home care or by going to a rehab center several times a week.

Unfortunately, in many situations, it isn’t up to the patient – or their doctors and care team – to decide which kind of rehabilitation to have. Frequently the health insurance provider for the patient will decide they’re only going to pay for outpatient care, which is less expensive. We’ve met people whose doctors insisted they needed inpatient care, and even helped them appeal to the insurance company, but were not successful. Being sent home when your situation calls for inpatient care can be detrimental to your recovery. Sometimes patients have to spend time figuring out which neighbor they can call for help getting in and out of bed if they don’t live with someone who can help. This kind of stress can be exhausting and take energy away from working on your recovery.

If you and your doctor believe inpatient care is best for you but the insurance company won’t pay for it, call an attorney right away. They may be able to offer some advice on the situation.

Other Insurance Issues

Refusal to pay for inpatient care is not the only problem we see with catastrophically injured patients and their insurance companies. The insurance carrier may refuse to pay for any kind of treatment for any reason. Here are some other common scenarios:

The insurer won’t pay for cognitive therapy because the patient’s initial medical exam after the accident didn’t reveal any cognitive problems. Often these symptoms may appear later on, and the insurance company may claim they aren’t serious or don’t require treatment, or that they had nothing to do with the accident.
The insurer will only pay for 20 sessions of physical therapy, when the patient needs much more than that. We often meet clients who say something like this: “Just when I was starting to make real progress with my physical therapy, my insurance company says I’ve hit my limit and they won’t pay for any more sessions. I can’t pay out of pocket, so I had to quit!’ This is always disheartening to hear, because it means the patient may lose any progress they’ve made. Unfortunately, it’s common for insurers to limit payments for physiotherapy to 20 sessions a year.
The insurer says you’ve reached some other limit, or conversely, won’t pay because you haven’t met your deductible.
The insurer says they don’t cover a particular treatment you need or don’t cover it for your particular issue.

What To Do If You Need Therapy For A Catastrophic Injury And Can’t Afford It

The first thing you should do is speak with a North Carolina car accident lawyer. They can advise you about different options to receive compensation for your injuries. If your accident was caused by the negligence of another party, you may be able to make a claim against their insurance or sue them directly. Even if the other party was uninsured or underinsured, there may still be other options, such as your own insurance (depending on the kind of coverage you purchased), or in some situations, making a claim against a third party.

At Auger & Auger Accident and Injury Lawyers, we’re always happy to provide a free consultation if you need help after a catastrophic injury. We only get paid if you get paid — if we don’t win your case, you don’t pay anything. That’s our Zero Fee Guarantee. To learn more about how we can help you recover after a catastrophic car accident in North Carolina and beyond, contact us online or give us a call at 800-559-5741.