Catastrophic Injury Compensation Claims

In simple terms, suffering catastrophic injuries usually enables an injured victim to claim significant treatment expenses and lump sum compensation.

If you have suffered a catastrophic injury you may be able to seek compensation for various types of damages including general damages, financial loss, treatment expenses and other miscellaneous costs.

 

The Catastrophic Injuries Support Scheme, for motor vehicle accidents in particular, was introduced in West Australia on 1 July 2016. The Scheme involved the Motor Vehicle (Catastrophic Injuries) Act 2016 and the Motor Vehicle (Catastrophic Injuries) Regulations 2016 being enacted into West Australian legislation.

The Catastrophic Injuries Support Scheme is administered by the Insurance Commission of Western Australia.

Eligibility requirements for the Catastrophic Injuries Support Scheme are strict and applications are made to and assessed by, the Insurance Commission of Western Australia. The following factors must be satisfied to be eligible:

• The catastrophic injury must have occurred due to a motor vehicle accident on or after 1 July 2016;
• The road accident must have occurred in West Australia;
• The catastrophic injuries can result from a crash involving an unregistered (but registrable) motor vehicle as long as the accident did not occur on private property;
• The catastrophic injury must be either a spinal cord injury, a traumatic brain injury, severe burns, multiple amputations or permanent traumatic blindness as detailed in the Motor Vehicle (Catastrophic Injuries) Act 2016;
• The catastrophic injuries must be caused by a road accident involving two vehicles, a road accident involving a pedestrian or cyclist, a vehicle running out of control or a collision or action taken to avoid a collision with another vehicle; and
• You must be unable to prove that a negligent driver caused the accident (if the accident was caused by a negligent driver you may be able to make a claim in the Compulsory Third Party compensation scheme).

If an injured victim is eligible for participation in the Catastrophic Injuries Support Scheme they are initially accepted for a minimum period of two years. Through this period the Insurance Commission of Western Australia will pay for the reasonable treatment and care they may require.

If at the end of the initial two year period the catastrophically injured person again meets eligibility requirements, they will be eligible for lifetime participation in the Catastrophic Injuries Support Scheme.

The Catastrophic Injuries Support Scheme will not provide assistance in the following circumstances:
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• Where the catastrophic injuries were sustained in an organised motor sport event or practice session;
• Where the catastrophic injuries were caused by an act of terrorism;
• Where the catastrophic injuries were caused by a crash only involving unregistrable vehicles like motorbikes, quad bikes, off-road or racing vehicles; and
• Where the catastrophic injuries were caused by an accident only involving unregistered (but registrable) vehicles on private property.

The Catastrophic Injuries Support Scheme provides benefits as long as they relate to the injuries sustained in the road accident. The benefits must be reasonable and aim to maximise the injured victim’s chances of being independent, returning to work and participating in society. The benefits can include:

• Ambulance transport;
• Medical treatment;
• Rehabilitation;
• Dental treatment;
• Domestic assistance;
• Home and transport modifications;
• Education and vocational training;
• Aids and appliances;
• Respite care services;
• Attendant care services; and
• Prostheses.

The Catastrophic Injuries Support Scheme will not pay for the following expenses:
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• Any expense not related to the motor vehicle crash;
• Compensation for economic loss or pain and suffering;
• Any costs associated with property damage;
• Services provided to the injured victim on a gratuitous basis;
• Day to day living expenses;
• Costs relating to raising children;
• Any service or product supplied by a provider not approved by the Catastrophic Injuries Support Scheme; and
• Any expense that does not meet the requirements of the Motor Vehicle (Catastrophic Injuries) Act 2016.

The Insurance Commission of Western Australia has an experienced team of Care Service Coordinators who are allocated to injured people eligible for the Catastrophic Injuries Support Scheme. The role of a Care Service Coordinator is quite broad but is explained in detail in the client care plan that is developed and implemented at the start of their appointment. The Care Service Coordinator is able to meet with the injured person at their home, in the community or at medical appointments. Generally they will:
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• Provide information about the treatment, care and support the injured person may receive or be eligible to receive;
• Assist with the application for lifelong participation in the Catastrophic Injuries Support Scheme if required;
• Assist the injured road victim in making a car crash compensation claim;
• Obtain and manage information, make needs assessments and implement treatment, care and support plans;
• Help plan and coordinate discharge from hospital;
• Manage community based treatment, care and support services; and
• Review, monitor and report on the catastrophically injured person’s day to day needs.

Globally, traumatic brain injuries are the injury type that most frequently causes death and disability. It is generally accepted within the medical profession, that brain injuries suffered after birth are referred to as acquired brain injuries. Where the acquired brain injury occurs due to a traumatic event like an accident, the injury is technically referred to as a traumatic brain injury.

Traumatic brain injuries are commonly sustained in car crashes, work accidents, criminal assaults and public liability accidents. A world leader in research on serious brain and head injuries, the Mayo Clinic explains that traumatic brain injuries occur, due to a violent blow or jolt to the head or body. Traumatic brain injury can also occur where an object, like a glass shard or a shattered piece of skull penetrates the brain tissue. A traumatic brain injury involves the brain being torn, penetrated, stretched, swollen or bruised.

Traumatic brain injuries typically include subdural haematoma’s, epidural haematoma’s and intracerebral haematoma’s which can result in a range of cognitive and / or physical symptoms. Here, the University of Queensland’s, Brain Institute provides a comprehensive list of symptoms which include:

Cognitive Symptoms-

• Problems with memory and information processing;
• General fatigue, slowed responses and reactions;
• Inability to concentrate and pay attention;
• Irritability, general insensitivity, increased expression of anger and greater vulnerability to stressors;
• Inappropriate behaviour, general awkwardness and poor social skills;
• Self-centredness, heightened dependency on others and decreased ability to understand others;
• Lack of motivation and initiative and an inability to solve problems;
• Depressive behaviour, confusion and lack of emotional control; and
• Impulsive and erratic behaviour.

Physical Symptoms-

• Sensory impairment and loss of taste, touch and smell;
• Dizziness and balance problems;
• Epilepsy and seizures;
• Weakness, fatigue and tremors;
• Headaches and chronic pain;
• Blurred vision;
• Insomnia, tiredness and sleepiness; and
• Slurred speech, paralysis or movement disorders.

Successful early diagnosis and careful treatment of traumatic brain injuries is critical to how the injured victim may recover. Historically, how long the injured person stayed in a coma and / or how long they suffered post-accident memory loss were used as general indicators to assess the severity of the traumatic brain injury. More recently, the severity of traumatic brain injuries have been assessed by using the Glasgow Coma Scale which measures an injured person’s level of consciousness based on verbal, motor and eye-opening reactions to specific stimuli.

The brain’s ability to heal is limited and it is very difficult know whether an injured person will enjoy enough of a recovery to enable them to lead a relatively normal post-accident life. Academic research in this area confirms that the provision of expert rehabilitation programs is a key component in improving recovery from traumatic brain injuries. It critical that anyone suffering traumatic brain injuries is diagnosed, treated and provided with rehabilitation services as soon after the accident as possible. Delays in the provision of these services can often be avoided through the early appointment and intervention of an expert plaintiff injury lawyer.

Spinal Cord Injuries Australia defines a spinal cord injury as damage to the spinal cord that results in a loss of functional mobility or feeling. In these injuries the spinal cord does not have to be partially or fully severed for symptoms, or particularly, a loss of functioning to occur.

Spinal cord injuries can result from injuries to other body parts, like vertebrae, ligaments or the spinal column, that are in close proximity to the spinal cord. Often traumatic spinal cord injuries occur due to a sudden, high impact blow to the spine or piercing type wounds that penetrate and cut the spinal cord. Spinal cord injuries involve damage to the nerve fibres that pass through the area of impact and which can then affect part or all of the muscles and nerves below the injury zone. Here, more specifically, quadriplegia which is also known as tetraplegia, results in a loss of function below the victims neck. Paraplegia, however, is a loss of function below the chest.

Spinal Life Australia, a helpful support group for victims of spinal cord injuries, explains that damage to the spinal cord can be described as being ‘complete’ or ‘incomplete’. Here, the description used depends on the level of injury to the nerve fibres in the spinal cord. A ‘complete’ spinal cord injury refers to complete loss of movement and sensation below the site of the injury. An ‘incomplete’ spinal cord injury refers to a situation where the victim can experience some feeling, movement or function below the site of the injury.

Common symptoms experienced by people suffering from a catastrophic spinal cord injury include:

• Extreme pain, swelling or pressure in the neck, head or back;
• Paralysis, weakness or a lack of coordination in any part of the body;
• Loss of sensation, numbness or tingling in the hands, fingers, feet or toes;
• Inability to walk, balance or maintain a particular posture;
• Problems with breathing, coughing or clearing the throat;
• Contortion of the neck or back; and
• Loss of bladder or bowel control.

Unfortunately, in most cases a spinal cord injury is permanent, irreversible and is not able to be treated by surgical intervention.

An amputation is commonly defined as the removal of the whole or part of an arm, hand, leg or foot. Unfortunately, amputations are relatively common where catastrophic injuries have been sustained.

Workplace accidents and car crashes can involve injuries where limbs or parts of limbs are smashed, crushed, burnt or ripped off. In some cases, a traumatic injury to a limb may be suffered and an attempt to save the affected limb is made. Sometimes these efforts are in vain and the affected limb or part of the limb cannot be saved and must be surgically amputated. These situations often involve diagnoses where swelling around the injury site is too intense and must be relieved, where blood flow to the affected limb has been too severely restricted or where infection has set in and cannot be treated.

The loss of a limb is a highly traumatic injury to sustain and one that alters the course of the victim’s life forever. Amputations often have a significant impact on the injured victim’s mobility, self-image, ability to care for themselves, complete domestic duties, enjoy leisure activities and return to work.

Extensive treatment and rehabilitation of amputation injuries is critical if the injured person is to return to the highest possible level of function and independence. Johns Hopkins University is a world leader in research into rehabilitation for amputees and argues that, rehabilitation programs should include:

• Treatments to improve wound healing and stump care;
• Activities to help improve motor skills, balance, coping with day to day activities and to allow the patient to be as independent as possible;
• Exercise that promotes muscle strength, endurance, general fitness and control;
• Fitting and use of artificial limbs or prostheses;
• Pain management and psychological care for postoperative and phantom pain;
• Specialist counselling to help the patient deal with the trauma event and their new body image;
• Training in the use of devices that may assist domestic and vocational tasks;
• Counselling in nutrition and general health and well-being;
• Counselling regarding issues attached to returning to work and the challenges that may arise;
• Making the home environment safe, accessible and easy to negotiate; and
• Counselling regarding integration back into society and coping with relationships.

In recent years, treatment and rehabilitation outcomes for amputees has benefited from significant improvements in prostheses and the ability of the amputee to operate these devices.

Catastrophic or severe burns can occur as a result of industrial or workplace accidents and road accidents where spilt fuel, oil or other flammable material is ignited as a result of the vehicle collision. Burns are commonly defined as being tissue damage that is caused by heat, exposure to radiation, chemicals or electrical currents. The severity of a burn injury can vary significantly and can depend on how deep the tissue damage is, how extensive the area of the burns are and what parts of the body are burnt.

Second degree burns are burns that affect both the epidermis and the dermis or second layer of skin. These burns can cause swelling and skin discoloration. Second degree burns can cause extreme pain which is often intensified by significant blistering of the skin. Second degree burns often cause scarring.

Third degree burns penetrate through to the fat layer beneath the skin and can leave affected areas looking black, brown or white in appearance. The affected area may also look leathery. Third degree burns often destroy nerves and can cause numbness.

Catastrophic burns can sometimes cause a range of complications including bacterial infection, respiratory problems and bone and joint problems where scar tissue causes shortening, tightening or contraction of the skin, muscles or tendons.