Litigation

Traumatic brain injury needs to be redefined as a chronic medical condition

By Michael Kaplen

Traumatic brain injury needs to be redefined as a chronic disease to ensure that patients receive proper medical care and that this care is reimbursed by health insurance plans according to an article in the Journal of Neurotraumac co authored by Doctors Brent Masel and Douglas DeWitt.

Insurance carriers now consider brain injury to be a singular event instead of  the beginning of an ongoing process that impacts multiple organ systems and may cause or accelerate other diseases and disorders that can reduce life expectancy.

The authors conclude that traumatic brain injury should be re-defined and managed as a chronic disease to ensure that patients receive appropriate care.

For too long medical insurance carriers have been permitted to treat long term brain injury care under the category of rehabilitation services and then limit this care to arbitrary periods of time, such as 30 or 60 days under the rehab provisions of their policies.   

Brain injury and brain damage cannot be treated in the same manner as a fractured hip.  The brain is a vital organ and the necessary care that individuals suffering from brain damage require cannot be considered rehabilitation, but needs to be re-categorized as necessary on-going medical treatment. 

Similarly, insurance carriers cannot be permitted to limit care to arbitrary time periods and then discontinue further care on the grounds that there has been no substantial improvement.  Brain injury recovery simply cannot be measured in days or weeks and it is improper for an insurance carrier to use this standard to judge the  benefit of further brain injury rehabilitation. 

Full post as published by Brain Injury News and Information on September 15, 2010 (boomark / email).