Where to Start for a Brain Injured Loved One

by John Bair

Tragedy can upend a family in many ways. For those dealing with brain injuries, for example, each comes with unique challenges.
The initial focus for most families is healing; can I get my loved one back like they were before the injury? Under miraculous circumstances, there is nothing more blessing than a complete recovery.

However, many people only make a partial recovery, and thus face varying degrees of challenges associated with their brain injury for the rest of their life. These challenges can range from aggression, mood disorder, speech impairment, motor function, hearing and visual degradation, and overall impaired cognitive function.

As with all catastrophic injury, the healing process typically consumes the time and resources of a family completely. The first profound financial step is to realize that you are going to want assistance, and from someone you trust.

Healthcare costs, rehab, and the maze of complexities that come with current health care treatment in America are challenging enough for most families. In most instances, out-of-pocket expenses are often not even realized for years. You will want someone to help you navigate the financials of these situations that you are likely encountering for the first time.

Circle of Advocacy
It’s important to put a legal and financial team in place early on. When constructing your support team, a few good places to start are with a lawyer if there is negligence, a settlement expert if there is an ongoing lawsuit, a financial planner, and a health care expert. The Brain Injury Association of America (www.biausa.org) has a wealth of resources.

Legal Considerations
Depending on the depth and complexity of the brain injury, the following are real potential solutions for a family long term:

Domestic Asset Protection Trusts can provide a legal framework that empowers a family to be in charge of the legal and financial mechanics. These trusts are typically established in South Dakota; however, many states offer similar asset protection.

Special Needs Trusts are an equally prevalent legal trust that will protect the client’s assets and keep them eligible for government benefits, such as Medicaid. These trusts come with some tough decisions, however; if Medicaid is the only source of health care coverage, and you need either long-term rehabilitation or in-home attendant care, these costs can erode a family’s finances quickly. A special needs trust protects the assets of the brain-injured family member.

Limited and durable Powers of Attorney may be considered, giving a spouse or sibling powers of decision-making for financial considerations and health care. Deciding who should have these powers is a standard family decision, but certainly not an easy one.

Financial Impact
Most families face significant financial strain during these times. It is vital to have a few financial experts that you may rely upon for life. If you are in litigation over how the accident or injury happened, it will also be important to have an expert settlement planner on your financial team to consider structured settlements, health care trusts, and evaluate lifetime budgeting.

A key ingredient to lifelong management is having a support system that you trust. The financial consultants you rely on should have experience not just in managing money for the long term, but in coordinating all of your financial needs.

In providing advice to families about building a financial and legal framework around their family and insured loved ones, the primary caregiver, spouse, child, or sibling can still stay in charge. He or she will always be the best advocate for the injured party; hiring experts, trustees, tax professionals, and/or settlement planners does not mean giving up authority. This type of complete planning allows the family to focus most of their energy on recovery and quality of life, while leveraging the expertise of people experienced to provide the type of advice they may need.