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Health Insurers Often Don’t Pay For Brain Injury Rehab

  • On Behalf Of Colton Holm
  • Published: August 21, 2013

Brain injuries are an all-too common result of automobile accidents in Montana. And they are common throughout the country: one estimate says 1.7 million people annually suffer a traumatic brain injury in the United States. Of these, about 90,000 result in a long-term or permanent disability.

Doctors often prescribe cognitive therapy for traumatic brain injuries. Cognitive therapy is a combination of physical, occupational and speech therapies designed to help injured portions of the brain become active again, or to cause uninjured portions of the brain to take over.

Unfortunately, many health insurers refuse to pay for all therapy that is necessary for a full recovery. Most insurers cut off payments after an arbitrary amount of time, or when a review of medical records by an insurance adjuster shows that the patient’s rehab has plateaued. Some require a physical disability in addition to the cognitive injury before they will pay for long-term care.

Tragically, many families find that their benefits are cut off just as their loved one is beginning to recover. And the damage caused by these insurers can be irreparable: most recovery from a brain injury happens in the first 18 to 24 months after the accident that caused it. Even if a family is successful in getting benefits reinstated through an appeal process, by the time therapy begins again it may be too late.

This is why, when a brain injury is caused by the negligence of another person, it is critical to bring a personal injury lawsuit against that person. When a serious head injury results from an automobile or other type of accident, the law allows the injured victim to recover monetary damages from one whose negligence caused the accident. In a case involving a brain injury, those damages can help fund therapy and rehabilitation that health insurance won’t cover.

Source: StarTribune, “Brain injury patient Ellie Cizek fights for time and money,” Jeremy Olson, Aug. 13, 2013

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