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Editor's Note: The author has a unique and personal perspective on this issue. He is a C6, C7 quadriplegic who has been paralyzed from his chest down since 1989, and went from a seemingly hopeless situation in a hospital bed, to intense therapy, to the courtroom.
When you take a catastrophic injury case involving paralysis, it is important to have a thorough understanding of the problems and pitfalls. In this two-part article, I will explore, from personal experience, the different types of future expenses the client can expect to incur.
Experts
Use your experts as a tool, but don't use them blindly. Certainly, life-care planners and medical professionals are helpful and necessary, but do you really want to turn over all the thinking about things of such great value to another person? As you negotiate and advocate, you'll need to be confident about the facts. A lack of understanding will create a lack of accountability when dealing with experts and a lack of persuasion should the matter go to court.
The client has given you his future to look out for, and that responsibility encompasses hiring the best experts and making sure they do their best. With knowledge of your client's possible future problems and conditions, you can help get every cent that is coming to him or her.
Looming Issues in Disguise
The best predictor of prognosis for your injured client comes from the level of impairment as defined by American Spinal Injury Association (ASIA) scale. Fortunately, survival rates have improved since the 1980s. However, short-term survivability leads to increased incidents of long-term medical issues that are problematic and often fatal.
Causes of morbidity in a paralyzed patient are unique in that they are a magnified subset of problems that face the general population. They are, so to speak, an extra factor in the equation of determining life span that got added when the injury occurred.
Frequent causes of morbidity of spinal-injured patients include deep vein thrombosis; pulmonary embolism; pressure sores; urinary tract infections, and upper urinary tract dilation (overfilling, which can trigger potentially life-threatening autonomic dysreflexia); urinary calculi (from demineralization of bones due to immobility); contracture of muscles, which can lead to fixed deformities; limitations of range of motion in the paralyzed joints; constipation and hemorrhoids; osteoporosis and fractures of the long bones; syringomyelia (a progressive disease of the spinal cord, which in the case of a cervical injury could further damage the respiratory system); cardiovascular-problems; respiratory problems (pneumonia and influenza); suicide from depression; septicemia; pulmonary embolism; and accidents that occur due to the disability.
It is the attorney's job to assist the client in obtaining the financial means of dealing with causes of morbidity, and the difficulties and discomforts of life. Those things that are foreseeable translate into potential dollars for the client.
For the Future
The devil remains in the details. It is important that you avoid thinking of spinal cord injury cases as you would every other case. Simple things can kill your client, or create a life problem. As far as day-to-day living, simple things cease to be simple. Know this, and incorporate it into you case and approach. Next month, we will look at some of the ways this can be accomplished.
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Mitch Warnock is a lawyer in Dublin, GA, who represents injured parties and their families.
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