Medicare Set-Aside applied to spinal cord injury litigation: methodology, deliverables, and case-specific considerations.
SCI plans address physiatry follow-up, urology and bowel programs with supplies, skin integrity and pressure-injury prevention, respiratory care in high cervical injury, spasticity management, physical and occupational therapy, manual and power wheelchairs with seating and replacement cycles, transfer and lift equipment, hospital beds and pressure-relief surfaces, home accessibility modifications, adapted vehicles, and personal care attendants at hours determined by functional level.
A written expert report, supporting data appendices, and, when retained, deposition and trial testimony.
Higher cervical injuries generally require ventilatory support, extensive attendant care, and power mobility; lower thoracic and lumbar injuries may permit independence in transfers and self-care with manual mobility. The plan states the level and completeness and ties each recommendation to them.
Wheelchairs, cushions, transfer equipment, shower and commode chairs, beds, pressure-relief mattresses, standing frames, and vehicle adaptations are typical. Replacement intervals follow manufacturer guidance and clinical practice and are stated in the plan for each item.
Yes. Ramps, doorway widening, accessible bathrooms, roll-in showers, lowered work surfaces, and lift systems are projected, usually with input from an occupational therapist or accessibility consultant, and one-time costs are separated from recurring costs.
By functional assessment and the treating team's recommendations, expressed in hours per day by level of service. The plan documents the rate source and addresses whether family-provided care is valued.
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