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Home > Blog > Questions & Answers > What is a Catastrophic Personal Injury Claim?

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What is a Catastrophic Personal Injury Claim?

Contributor: Enjuris Editor How can I contribute?

catastrophic injury

Any kind of accident can lead to serious injuries.

But what makes an accident catastrophic?

Someone once said that even a minor medical procedure is a major one if you’re the patient — which makes a lot of sense. An injury that changes your life, even temporarily, can feel catastrophic to you.

But when it comes to your insurance company or a claim for damages, there are specific circumstances that lead to a catastrophic injury classification.

What makes an injury “catastrophic”?

A catastrophic injury is one that’s so severe that it results in long-term disability or debilitation. It can also be defined as an injury that permanently prevents a person from performing any gainful work.

In many cases, a catastrophic injury involves a deformity or loss of capacity, whether physical or mental, that could be the result of a traumatic brain injury, loss of limb (amputation), brain damage, or spinal cord injury (paralysis).

Whether you’ve suffered a catastrophic injury or you’re caring for someone who’s facing a severe injury, you’re likely overwhelmed by the information that you now need to understand. Your medical treatment, itself, could be daunting. And, you’re probably worrying about how you’re going to pay for all of it, along with your regular living expenses if you’re no longer able to work.

Common causes and types of catastrophic injuries

There are infinite ways a catastrophic injury could occur — and many are unusual, “freak” accidents. But statistically, there are some common causes of catastrophic injuries:

  • Motor vehicle accidents (including motorcycle accidents and truck accidents)
  • Construction or hazardous worksite accidents (see also: Workers’ Compensation claims)
  • Swimming pool accidents
  • Product defects and defective pharmaceuticals
  • Sports injuries
  • Slip and fall accidents
  • Medical malpractice
Facing facts
  • Approximately 54 people per million in the U.S. suffer a spinal cord injury each year (about 17,000).1 A spinal cord injury (SCI) could result in limited movement or total paralysis.
  • Nearly 2 million people in the U.S. live with limb loss, and approximately 185,000 amputations occur each year nationwide.2
  • Nearly 500,000 people on average are treated in hospitals each year for burn injuries.3 A severe burn injury could cause permanent disfigurement and many are catastrophic injuries.
  • The U.S. saw 2.87 million traumatic brain injury (TBI) hospitalizations in 2014, according to the most recent statistics by the Centers for Disease Control and Prevention.4 A TBI could cause cognition, memory, movement, behavior, and speech issues.

Regardless of how your injury happened, your priority afterward is working toward at least partial recovery and reclaiming costs so you can move forward.

What expenses are related to my catastrophic injury?

If you’ve suffered a recent catastrophic injury, you might still be trying to figure out what your financial future looks like.

If you’re pursuing a personal injury legal claim, you can recover expenses that include:

  • Medical treatment
  • Lost wages and future earning capacity
  • Assistive devices (wheelchair, walker, etc.)
  • Prosthetics
  • Loss of enjoyment of life
  • Loss of consortium
  • Counseling for emotional distress
  • Ongoing physical/occupational or other therapies
  • Assistance from home health aides or caregivers
 

The person who suffered a catastrophic injury isn’t the only one affected. The lives of their families are often also forever changed. It’s emotionally draining and physically exhausting to provide care for a family member with a mobility or cognitive limitation, especially when the change happens very suddenly and there’s little time to prepare.

In addition, a spouse or caregiver often must leave their own employment to provide 24-hour care, which means a household can lose more than just the injured person’s income. The spouse or partner might be put in the difficult position of determining whether it’s more cost-effective to leave their own job and provide care at home or to hire a home health aide or caretaker, which is also a tremendous expense. Even if the injured person didn’t have an outside income, they could’ve been the person tasked with caring for children and managing the home, both of which have economic value.

Calculating damages after a catastrophic injury

In addition to each of the expenses listed above, you can often receive damages for pain and suffering after a catastrophic injury.

Pain and suffering is compensation for the overall loss of comfort, happiness, and opportunity that you might experience after an accident or severe injury.

One of the first steps in calculating damages for a catastrophic injury is to have your lawyer work with accountants, actuaries, and other financial experts to determine how much your expenses will be, not just today, but estimated for the rest of your life.

These are your economic damages.

You likely already have medical bills piling up, and calculating those is the easy part. The trickier part of the process is figuring out how much your future treatments, therapies, devices, and costs of life will be.

In addition, they’ll calculate how much income you’ll lose over the course of your life if you’re not able to work. There could also be calculations based on the potential for future medical complications that could arise as a result of your injuries, and for which you might need additional surgeries or treatments.

Your non-economic damages include pain and suffering, loss of consortium, and other losses that don’t have a specific money value.

Enjuris tip:

Pain and suffering is often calculated using a multiplier method. The lawyers would negotiate a multiplier between 1 and 5, based on the severity of the injury. A minor injury that has temporary effects and for which there’s expected to be a near-full recovery might be a 1. A catastrophic injury that will leave the plaintiff with life-long, serious and debilitating issues might be a 4 or 5.

The court would multiply that number by the amount of medical costs to arrive at a figure for pain and suffering. For example, if your medical bills are anticipated to be $600,000 and your multiplier is 4, you’d multiply 4 x $600,000 for a total of $2,400,000 in pain and suffering damages.

What to do after a catastrophic injury

First, focus on your immediate recovery.

Second, if your injury was caused by an accident or someone’s negligence, you can explore your legal options with the help of a personal injury lawyer.

A catastrophic injury might involve extensive medical costs and financial losses. You might find that even if it’s covered by insurance, a severe injury will cost more than a policy’s limits. When that happens, the only other way to recover the funds you need to move forward is to pursue legal action against the person or entity that caused your injury.

Enjuris tip: The 8 Basic Steps to Every Personal Injury Lawsuit

Here’s how to begin the process of financial recovery:

1. Find a personal injury lawyer

If the stakes are high, it’s especially important to find a lawyer near you who’s a good fit for you and your case.

Here are some resources that can help you through this step:

  • Tips for Hiring a Personal Injury Lawyer
  • What You Should Look For in an Attorney
  • What to Bring When Meeting an Accident Lawyer for the First Time (download in PDF)

2. Maintain records

If you’re unable to maintain records, ask a trusted friend or family member for help. It’s going to be important to have documentation of those aspects to your recovery that probably aren’t documented by doctors or hospitals.

This Enjuris Post-Accident Journal (download in PDF) provides a fill-in guide where you can note the symptoms you’re experiencing, side-effects of any medications or therapies, communications with doctors or insurance companies, how your activities are affected on a given day/week, and more. It’s a useful tool to track your experience and develop evidence of your pain and suffering and what resources might be necessary in the future.

It’s also helpful for you to keep track of every expense you incur related to the accident. This worksheet is a start and guides you through listing each provider, date of service, amount billed, amount paid, and what insurance reimbursed. These records will be very important and useful to provide to your lawyer for calculating damages.

3. Gather evidence

You can’t be expected to investigate your own accident, especially following a severe injury. That’s your lawyer’s role. But there are things you can do to assist in the process.

Enjuris offers these free downloadable forms that can help:

  • Documents & Evidence Checklist
  • Accident Report Form
  • Personal Injury Attorney Interview Sheet
  • Medication Log Sheet
  • Damages/expenses worksheet
 

The Enjuris Personal Injury Law Firm Directory is a great place to begin to find the best lawyer who can help you recover financially from your catastrophic injury. Working together is the best way to find your path to recovery.

Sources:
1 National Spinal Cord Injury Statistical Center, Spinal Cord Injury Facts and Figures at a Glance
2 Amputee Coalition, Limb Loss Statistics
3 American Burn Association, Burn Incidence Fact Sheet
4 Centers for Disease Control and Prevention, Traumatic Brain Injury & Concussion

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