Spinal Cord Injury From a Car Accident: How the Claim Works

Spinal cord injuries are described by the level of the spine at which the cord was damaged and by whether the injury is complete, with no function below the level, or incomplete, with some preserved sensation or movement. A cervical injury affects the arms, trunk and legs and may affect breathing; a thoracic or lumbar injury affects the trunk and legs. The level and completeness determine the degree of paralysis, the care required, and the complications the injured person will face.

The lifetime cost follows from that. Attendant care, which for a high cervical injury may be around the clock; wheelchairs and their replacement every few years; home modification for accessibility; an adapted vehicle; medical follow-up; and the treatment of complications such as pressure injuries, urinary infections, respiratory problems and autonomic dysreflexia, which are expected rather than possible. The first-year cost of a severe injury runs well into six figures and the lifetime cost into the millions, as published estimates from spinal cord injury research centers show.

The claim is valued by proving those costs with expert evidence. A life care planner projects the care; a vocational expert assesses what work remains possible; an economist converts both into present value. Pain, suffering and loss of enjoyment of life are claimed in addition, and in a paralysis case they are substantial, subject to any state cap.

The hospital record establishes the injury: the imaging showing the vertebral fracture or dislocation and the cord damage, the neurological examination that classifies the level and completeness, the surgery, and the course through acute care and rehabilitation. The treating neurosurgeon, physiatrist and rehabilitation team provide opinions on prognosis and permanency, and in a complete injury the prognosis is settled early.

The life care plan is the central document for future damages. A qualified planner reviews the records, consults the treating physicians, assesses the home and the injured person's circumstances, and produces an itemized projection of every category of care, equipment and service over life expectancy, with costs. The defense retains its own planner and the two are compared; the differences are usually in attendant care hours and life expectancy, and they are litigated.

Lost earning capacity is proven by a vocational expert, who assesses the injured person's education, work history and remaining capacity, and an economist, who projects the lost earnings to retirement and discounts them to present value. For a young person with a complete injury, this figure can exceed the past medical bills many times over.

Suppose you were driving home from work when a pickup crossed the center line and struck your car head-on. You suffered a fracture at the mid-thoracic spine with a complete injury, producing paraplegia. You spent five weeks in acute care and eight weeks in inpatient rehabilitation, and are now at home in a wheelchair, with your house partly modified and no return to your job as an electrician.

Medical bills in the first year were $610,000, paid by your health insurer, which holds a lien. A life care planner projected the lifetime cost of care, equipment, modifications and the management of complications at several million dollars over your life expectancy. A vocational expert concluded you could not return to electrical work and had limited options for sedentary employment; an economist calculated the lost earning capacity from your pre-injury income to retirement.

The pickup's driver carried a $50,000 policy, paid at once. Your own underinsured motorist coverage added its limit. The driver was found to have been on a work call for his employer, and the employer's commercial policy became the principal source. A road design question about the absence of a median barrier on that stretch was evaluated against the state's highway department, subject to its notice deadline and damage cap. The claim was litigated and resolved at mediation after the experts had been deposed. All figures are hypothetical; the structure is typical.

The injured person is in hospital for weeks; a family member handles the claim's first steps, and they decide what coverage can be found.

• Identify every possible source of coverage in the first week: the at-fault driver's policy, every household auto policy for underinsured motorist coverage, the driver's employer if they were working, the vehicle's safety performance, and the road's design.
• Obtain the police report and have preservation letters sent for the vehicles, camera footage and the at-fault driver's phone records.
• Keep the vehicles; a product claim about seat, restraint or roof performance depends on examining them, and insurers dispose of total-loss vehicles quickly.
• Do not sign any release or accept any early offer; the lifetime cost cannot be known for months.
• Keep a record of the injured person's course, complications and what the family does for them daily; it becomes the basis of the attendant care claim.
• Confirm the health insurer's lien position in writing and ask about Medicare or Medicaid eligibility, which affects how the settlement must be structured.
• Consider the authority question: a power of attorney or guardianship may be needed for the family to act.

Caps on non-economic damages exist in some states and shape paralysis claims. Several states cap non-economic damages in all injury claims at fixed amounts, with exceptions for catastrophic injury that paralysis usually meets, but the wording of the exception in the specific state decides it. Caps on claims against government bodies, which apply to road design claims, are low in many states and strictly enforced.

No-fault states change the early picture. In Michigan, the personal injury protection level selected on the policy, which can be unlimited or capped, decides whether lifetime care is funded by the injured person's own insurer; it is the first question in a Michigan paralysis claim. In Florida, New York and New Jersey, PIP pays a limited amount and the claim against the at-fault driver proceeds because the threshold is plainly met. Comparative negligence applies to any fault on the injured person's part, and the contributory negligence states, Alabama, Maryland, North Carolina and Virginia, bar recovery for any share.

Deadlines run from the crash: one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina. Claims against government bodies for road design require notice within months. Product claims against vehicle manufacturers follow the state's product liability deadline and, in some states, a statute of repose measured from the vehicle's sale.

A paralysis settlement is not simply paid as a check. The health insurer's lien, and any Medicare or Medicaid lien, is resolved first, usually at a negotiated reduction. If the injured person is or will be eligible for Medicaid or Supplemental Security Income, a special needs trust holds the settlement so that it funds care without ending eligibility, and the rules for these trusts are strict.

A structured settlement, in which part of the recovery is paid as a fixed income stream over life, is common because it funds care predictably and protects the money from mismanagement. Medicare's interest in future medical costs may require a set-aside arrangement. These decisions are made with the attorney, a settlement planner and often a financial advisor, and they affect the injured person for decades.

The attorney's contingency fee and the case costs, which in a litigated paralysis claim with multiple experts are substantial, are deducted from the gross. The net to the injured person and how it is structured are set out in a closing statement before anything is signed.

A spinal cord injury claim is a lifetime claim built on expert evidence against every available source of coverage, and it is litigated because insurers do not pay lifetime projections without testing them. The questions to answer early are who all the responsible parties and policies are, whether the vehicles and evidence have been preserved, and how the family will have authority to act. Serious injury cases are handled by attorneys with experience in them, on contingency.

Ask Legal Matters is a free claim-review request service, not a law firm. Requests may be shared with independent attorneys and legal services partners who handle inquiries in your state, and an attorney must evaluate the facts before anyone can say what the claim is worth. If a family member suffered a spinal cord injury in a crash caused by someone else, you can request a free claim review on their behalf.

• Car Accident Claims in the United States: The Complete Guide
• Truck Accident Claims: Liability, Federal Rules and Compensation
• Wrongful Death Claims: Who Can File, Deadlines and Damages
• Airbag Did Not Deploy in a Crash: Can You Sue, and Whom?
• At Fault in a Car Accident? Comparative Negligence Explained
• What Is the Average Car Accident Settlement? What Sets the Value
• Back and Neck Injury Settlement After a Car Accident: Factors
• Bicycle Accident Claim: Hit by a Car While Riding
• Broken Bone Car Accident Settlement: What Drives the Value

Need local rules? Choose your state from the injury law guides hub or read the statute of limitations by state.