At least one million Americans are treated and released from hospital emergency departments as a result of traumatic brain injuries. About 230,000 are hospitalized and survive, about 50,000 die from their brain injuries, and about 80,000 people are discharged from the hospital with a TBI-related disability. Traumatic brain injuries are devastating to the patient as well as to his or her family members.
Serious traumatic brain injuries can lead to severe and permanent disabilities. Some brain injuries are considered primary, meaning the damage is immediate, while others are secondary, meaning they can occur gradually over the next hours, days, or weeks. Traumatic brain injuries can take a very long time to recover from, although some patients never fully recover. Some victims of TBI may never be the same, either physically, or emotionally.
After enduring the challenges of a traumatic brain injury, receiving a denial from your insurance company for the rehab facility your doctor recommends for your recovery can be devastating. This is the time to contact an experienced attorney who will fight for your rights and your recovery. Attorney Scott Glovsky is ready to help you through this difficult time in your life in the best way possible.
What Type of Care Is Considered TBI Rehabilitation?
TBI rehabilitation is an important part of recovery. Rehab for TBI victims can take many forms that may include physical, occupational, and speech therapy, along with social support and psychiatric care. TBI rehabilitation can improve your ability to function at home and in your community while treating mental and physical problems resulting from traumatic brain injuries. TBI rehabilitation can help you adapt to changes as they occur during your recovery and can help prevent TBI complications like:
- Bowel and bladder problems
- Pain
- Muscle weakness and muscle spasms
- Breathing problems
- Pneumonia
- Pressure ulcers
- Reproductive and sexual function problems
- Drops in blood pressure when you stand or sit
How Do Traumatic Brain Injuries Occur?
Traumatic brain injuries usually result from a violent blow or jolt to the body or head. In some cases, an object can penetrate the brain tissue, shattering pieces of the skull. A closed brain injury occurs when there is no penetration to the brain and no break in the skull. It is often caused by rapid forward or backward movement or shaking of the brain inside the bony skull. Car accidents and sports injuries are often causes of closed-brain injuries. A penetrating brain injury occurs when an object – like a bullet – pierces the brain.
Why Could TBI Rehabilitation Treatment Be Denied?
The average cost of TBI rehabilitation is about $125 per session, and treatments generally last at least six months but can last much longer. Ongoing rehabilitation for TBI can include physical therapy, occupational therapy, and speech therapy. An insurer may say an insurance denial is because the treatment is not medically necessary, or it could be a simple issue like missing information on the paperwork.
In reality, insurance denials are often due to cost. Insurance companies want to pay as little out as possible, so they may issue a traumatic brain injury rehabilitation denial, believing most people will either be unaware they can appeal a denial or may not understand the appeal process. While only about half of all denials are appealed, at least half of those will be overturned, and the insurance company will be forced to pay for TBI rehabilitation.
Which Insurers Might Deny TBI Rehabilitation Treatment
Any insurance company can deny TBI rehabilitation treatment, usually by claiming the treatment is not medically necessary. All insurance denials can be appealed, first with an internal appeal, then with an external appeal by a neutral third party. Some California insurers that may deny TBI rehabilitation treatment include:
How the Law Offices of Scott Glovsky Can Help with a Traumatic Brain Injury Rehab Denial
Many of attorney Scott Glovsky’s cases are referred by other attorneys, thanks to his reputation and expertise in forcing insurance companies to pay for denied treatments. Because Scott worked on the other side early on in his career, he knows the tactics used by insurers to deny payment.
When you choose the Law Offices of Scott Glovsky, Scott and his legal team will devote a tremendous amount of time and care to your traumatic brain injury rehab case. This is not an “assembly-line” law firm that processes clients through as quickly as possible; rather, we are a client-centered, highly experienced firm that will fight for you, your health, and your future. Contact the Law Offices of Scott Glovsky today.