Catastrophic Injuries

By the years ahead, meaning care, rehabilitation, adapted housing and lost earning capacity, established with medical evidence, not by the bills so far.

Yes. Someone unable to manage their own affairs can be represented by a family member, and the deadlines can be different in that situation.

Two years is the general limit in California, but the exceptions matter more here: a later diagnosis, a person unable to manage their affairs, a minor.

A life care plan is a written projection of everything the injury will need for the rest of a life: care, equipment, therapy, medication, housing and vehicle changes, and the cost of each, year by year. In a California catastrophic injury case it is prepared by a qualified planner working from the treating doctors’ opinions, and it is the foundation of the claim, because the largest part of the loss is ahead, not behind. Without it, the insurer prices the injury by the bills so far.

Yes. California allows recovery for lost earning capacity: the difference between what you were reasonably likely to earn over your working life and what you can earn now, even if you return to some work. It is proved with your work history, medical restrictions and, where needed, a vocational and economic analysis. It is separate from the wages already lost.

Every other source is looked for before the limits are accepted. Your own underinsured motorist coverage, a second driver or owner, an employer if the driver was working, a public entity if the road or a public vehicle was involved, a product maker if something failed, and any umbrella or commercial policy. California requires only low minimum limits, so in a catastrophic case this search is most of the work.

Yes to the first, and it depends on the benefit for the second. California State Disability Insurance pays partial wages while you cannot work and is not repaid from a settlement; workers’ compensation, Medi-Cal and many health plans do have repayment rights against a recovery. Applying for SDI or Social Security disability does not hurt the injury claim. Each benefit is handled in the settlement so that nothing is owed twice.

It is built to allow for it. A catastrophic claim is not settled until the doctors can say what is permanent, because a settlement is final and cannot be reopened when the prognosis changes. Where recovery is uncertain, the life care plan states the range and the claim is valued on the medical evidence, not on hope or on the insurer’s preference. That is one reason these cases take longer than others.