Rehabilitation
What is it?
In many claims for damages for personal injuries, the claimant's current medical situation, and/or the long-term prognosis, may be improved by appropriate medical treatment, including surgery, being given at the earliest practicable opportunity, rather than waiting until the claim has been settled. Similarly, claims may involve a need for non-medical treatment, such as physiotherapy, counselling, occupational therapy, speech therapy and so forth ("rehabilitation"): again, there is a benefit in these services being provided as early as practicable.
In cases of serious injury the claimant's quality of life can be immediately improved by undertaking some basic home adaptations and/or by the provision of aids and equipment and/or appropriate medical treatment as soon as these are needed ("early intervention"), rather than when the claim is finally settled. Later, when these medical or other issues have been dealt with, there may be employment issues that can be addressed for the claimant's benefit, to enable him or her to keep his or her existing job, to obtain alternative suitable employment with the same employer or to retrain for new employment. If these needs are addressed at the proper time, the claimant's quality of life and long-term prospects may be greatly improved.
We at Bolt Burdon Kemp understand that we can achieve more for our clients - by making rehabilitation available - than just the payment of compensation and we actively consider, with our clients and with the defendant's insurance company, the use of rehabilitation services and the benefits of an early assessment of our clients' needs. We consider that the possibility of improving our clients' quality of life and their present and long-term physical and mental well-being are just as important as the payment of just, full and proper compensation.
How does it work?
We focus on an early assessment of our clients' needs in terms of treatment and/or rehabilitation and we consider in consultation with our client and/or the family, whether it is likely or possible that early intervention, rehabilitation or medical treatment would improve his or her present and/or long-term physical or mental well-being. This is of most importance in the early stages of the case but continues throughout the life of the case. We consider whether there is an immediate need for aids, adaptations or other matters that would seek to alleviate problems caused by disability and then communicate with the insurer as soon as practicable about any rehabilitation needs, with a view to making resources available.
Unless the need for intervention, rehabilitation or treatment has already been identified by medical reports the need for intervention, rehabilitation or treatment will be considered by an independent assessment. This assessment can be carried out by one or more of the treating physicians/surgeons, or by a suitably qualified agency which is financially and managerially independent of Bolt Burdon Kemp and the insurers dealing with the claim.
We make sure that the process of assessment and recommendation is carried out by those who have an appropriate qualification (to include physiotherapists, occupational therapists, psychologists, psychotherapists and so forth) and who have experience in treating the type of disability from which each individual client suffers.
We agree the agency to be instructed with the insurer. We send a letter of instruction to the agency and a copy of the letter to the insurer. We ask the agency to interview our client at home (or in hospital, if he or she is still in hospital, with a subsequent visit to our client's home) and ask the agency to produce a report, which covers the following headings:
- The injuries sustained by our client
- Our client's present medical condition (medical conditions that do not arise from the accident should also be noted where relevant to the overall picture of our client's needs)
- Our client's domestic circumstances (including mobility, accommodation and employment), where relevant
- The injuries/disability in respect of which early intervention or early rehabilitation is suggested
- The type of intervention or treatment envisaged
- The likely cost
- The likely short/medium-term benefit to our client
The agency sends a copy of the report to us and to the insurer at the same time. We can ask the agency questions about the report, as can the insurer, sending copies of correspondence to the other party.
The report is prepared and used wholly outside the litigation process. The report, any correspondence relating to it and any notes created by the assessing agency will not under any circumstances be disclosed in any legal proceedings and any person involved in the preparation of the report or involved in the assessment process cannot be a compellable witness at court.
Once the parties have agreed, following an assessment report, that a particular regime of rehabilitation or treatment should be put in place, the case management of that regime and any notes and reports created during the subsequent case management will be governed by the usual principles of disclosure of documents and medical records.
The insurer will pay for the report within 28 days of receipt. If any further or subsequent assessment is needed we agree this with the insurer.
The insurer will consider the recommendations made in the report and the extent to which funds will be made available to implement all or some of the recommendations. The insurer will not be required to pay for intervention or treatment that is unreasonable in nature, content or cost. Our clients are not obliged to undergo intervention, medical investigation or treatment that is unreasonable.
Money paid by the insurer for the rehabilitation is treated as an interim payment on account of damages. If money is provided for specific intervention, rehabilitation or treatment, the insurers may not dispute the reasonableness of that treatment nor the agreed cost, provided of course that our client has had the recommended treatment.