Tag Archives for " claim worth "

Part 4: How much is my claim worth? – Pain & Suffering

Emily Billiau

Principal

It is a significant part of a compensation claim.


Particularly for those who cannot claim wage losses, such as young people, retirees or the unemployed, pain and suffering often comprises the most considerable part of a compensation claim

We are back again with the final part of our four-part series on quantum or how much is your claim worth.

As discussed in Part 1, Part 2 and Part 3, many factors influence the amount of compensation a person can receive.

In this article, we learn about the final factor (or head of damage in legal-speak), known as pain and suffering.

For the injured person, the suffering post-incident can feel like it has the most significant impact on their life.

The hardest part is quantifying that intangible pain left after an injury. While difficult, it shouldn’t be overlooked.

What are pain and suffering damages?

Pain and suffering damages (aka general damages) refer to an award given by the court to the plaintiff for physical and emotional pain due to injury, illness, or loss. 

These damages are not the same as economic damages, which reimburse the injured person financially but are meant to assist them with the pain inflicted after an incident.


What are some examples?

Typically, claims for pain and suffering are for such things as:

  • Actual pain and suffering experienced
  • The pain and suffering you will encounter in the future
  • Loss of enjoyment of life
  • The inability to participate in your pre-injury sports, hobbies, education and recreational activities
  • The shortening of your life
  • Grief over the death of a loved one

Unfortunately, just because you may have experienced pain and suffering does not mean you will necessarily be entitled to compensation for it.


Why would you not be entitled to it?

The awards for pain and suffering depends very much on the circumstances surrounding the incident in which you were injured.

For example, being injured at work can result in different compensation entitlements to being injured in a car accident or a fall in a shopping centre. 

This difference is because there are different laws apply to each type of accident.


How is pain and suffering proven?

The pain and suffering of an individual can be subjective and very difficult to prove.

Medical experts are typical witnesses in these cases and often pivotal to a cases success. 

This is because they can determine the impact the injuries may have had on the injured person's livelihood. They can do this based on an Injury Scale Value (ISV) scale (see below).

However, the court takes into consideration other factors in its analysis, including:

  • The extent of the injury, as well as the medical diagnosis and prognosis.
  • Length of time that the symptoms have been presenting.
  • Physical or mental limitations in the plaintiff’s daily life (e.g., work, school, everyday tasks).
  • Accounts of other individuals with similar injuries, and the extent of their reported pain and suffering.

How much can you claim?

More on the ISV Scale…

Without getting too complex, the ISV scale is used to calculate pain and suffering damages in Queensland.

The scale regulates the award given for the areas of compensation based on the individual's level of injury.

Each injury has a corresponding ISV range. For example, a minor injury such as whiplash might have an ISV range of 5 – 10. Whereas, a severe injury such as quadriplegia may be at the top of the scale at 100.

Medical experts can help determine where a person might sit on this range.

Once the ISV range is known, then that range corresponds to a monetary amount on the scale.

For bicycle injury claims, your ISV range can be determined from the civil liabilities act Schedule 4.

These can be very subjective and confusing, so we recommend seeking expert advice before lodging any claim.

Tips for maximising your settlement amount.

When filing a claim that involves pain and suffering damages, you may wish to follow these guidelines:

  • Try to be as specific as possible when presenting your condition- vague conditions that can’t be proven will not result in an award of compensation
  • Make a log of your injuries before and after the incident - this will help to determine how your pain and suffering is related to the event, whether it be a car accident, slip and fall case, or another type of personal injury
  • Keep all written legal documents, such as police reports, medical receipts and bills, pay slips, and other records that can be used as evidence

Finally…

Be sure to read up on the other areas of compensation available to you to maximise your overall settlement amount. Click the links below to read them all.

Part 1: How much is my claim worth? – Future Economic Loss
Emily Billiau Principal ​Most people have heard of personal injury claims but very few would understand what quantum is. …and[...]
Part 2: How much is my claim worth? – Care Costs
Emily Billiau Principal Care costs can be the single most significant component of a claim.  Particularly when the injured party[...]
Part 3: How much is my claim worth? – Medical Expenses
Emily Billiau Principal Medical Expenses are a crucial part of all claims for compensation. Why? Well apart from the obvious[...]

Written by Emily Billiau | Principal

SHARE THE POST

Part 3: How much is my claim worth? – Medical Expenses

Emily Billiau

Principal

Medical Expenses are a crucial part of all claims for compensation. 


Why? Well apart from the obvious fact they pay for the cost of any medical treatment...


... compensation for medical expenses allows you to recover to your fullest extent as it removes the stress of working how you are going to afford it. 


It also gives you access to the tools needed to get back on with life, if you are unlikely to make a full recovery. 

We are continuing our four-part series on discovering the areas that your can claim under. 

Understanding these areas, will allow you to estimate how much your claim is worth. 

In this article, we unpack what medical expenses you can claim for, some example claims and the evidence you will need when approaching the insurers.

Don't forget to read  Part 1 on future economic loss and Part 2 on care costs

What are medical expenses?

Without stating the obvious too much, medical expenses relate to the costs of rehabilitation following an injury.

The expenses include both past fees that were already paid for, as well as future medical costs.


How much can you claim?

As is the case in every other area of compensation, the amount that can be recovered will vary depending on the individual’s treatment plan and care needs.

Some real-life case examples have been provided.

Example 1 - Slip & fall, permanent brain injury

Adam was cycling home from work one afternoon when a car failed to see him ahead and collided into the rear of Adam's bicycle.  Adam was throvn over his handlebars and landed heavily on his right shoulder. The force of the fall smashed his head into the ground. Despite the fact he was wearing a helmet, Adam suffered a brain injury. He was kept in hospital for a week to monitor his head and other injuries.

Adam has substantial memory deficiencies now. He finds it difficult to concentrate and had to relearn basic skills including walking and talking. 

Beyond that, he has significant post-traumatic stress disorder after the accident and cannot be in a car, let alone a bicycle. 

To facillitate his recovery, Adam requires comprehensive rehabilitation including physiothereapy, pyschology and others. He also needs the help of various assistive technologies to aid his walking.  

Because his life was irrevocably changed at such a young age and he requires significant ongoing treatment and assistive technology, Adam was awarded $409,000 toward his medical expenses.

Example 2 – pedestrian accident, ongoing hard damage

John was cycling along Moggill Road when a driver suddenly exited their driveway onto the road, taking John out with them. 

John flew over the back of the car. He landed heavily on the road, breaking his left ankle in the process.

The significant impact also caused nerve damage to his right arm. After much rehabilitation, John's nerve damage still causes him constant pain. He now requires regular doses of pain killers to manage his ongoing injury. 

John was awarded as part of his compensation a total of $32,496 for the cost of his past and future medical expenses (including medical appointments, medications and rehabilitation treatment).


What can you claim?

Some typical medical expenses that are included in a compensation claim include:

  • Hospital bills
  • check
    Diagnostic testing expenses (laboratory fees)
  • check
    Surgery costs
  • check
    Therapy and rehabilitation costs (including physio, massage, psychology and much more)
  • Cost of prescription medicines
  • check
    Cost of future home modification
  • Cost of any assistive technology required (crutches, wheelchairs, modified cars etc.)
  • check
    Pain management

For this reason, it's essential to be very thorough when documenting injuries in your claim file so that it is possible to calculate damages to account for future problems.

It is also important to attend all medical appointments or therapy sessions.


What evidence will you need?

Proving these expenses may require the help of an expert medical professional. Usually, thorough documentation is needed to calculate the total costs of medical treatment. These may include the presentation of various items of evidence in court, such as:

  • Hospital bills;
  • Chiropractor or medical therapy costs;
  • Medical treatment receipts;
  • Pharmaceutical bills; or
  • Any other documents showing the costs of the medical expenses

Keeping a clear record of items related to your injury is paramount to maximising your compensation amount.

As the old bible saying goes – Ask, and you shall receive.


There are many cases we have seen where critical medical expenses have been left out of a person’s compensation because of inadequate documentation, or they just forgot to include it.


It is crucial to gain expert advice from occupational therapists and doctors on likely requirements you will need in the future.


Small expenses such as assistive technology and home modifications are often overlooked but can be so important to an injured person’s quality of life.

Emily Billiau

Principal

Keeping a record of the medical expenses (treatment costs, medications, assistive technology) you had due to your injuries is very important, as it can mean the difference between having a claim for care and assistance, or not having a claim at all.

Keep a spreadsheet that details the following:

  • Type of service or item
  • Service or item provider (doctor surgery or pharmacy)
  • Date of service/purchase
  • Cost of service/item
  • Will the service/item be required in the future and how often

To help ensure that you maximise your damages, keep in mind the following helpful tips:

  • Buy all of your prescriptions/dressings/painkillers etc. from the one pharmacy and ask your pharmacist to record all of your purchases.  When it comes time to claim your damages, you can simply obtain a printout from the pharmacy;
  • Keep receipts for any purchases that you have made;
  • Photocopy or scan those receipts, in case they get lost or destroyed;
  • Consistently fill out the table as each service is provided.

Next Steps...

Don't miss out on other aspects of your claims...

...read the other blogs in the series below.

Part 1: How much is my claim worth? – Future Economic Loss
Emily Billiau Principal ​Most people have heard of personal injury claims but very few would understand what quantum is. …and[...]
Part 2: How much is my claim worth? – Care Costs
Emily Billiau Principal Care costs can be the single most significant component of a claim.  Particularly when the injured party[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal

SHARE THE POST

Part 2: How much is my claim worth? – Care Costs

Emily Billiau

Principal

Care costs can be the single most significant component of a claim. 


Particularly when the injured party doesn’t work (therefore doesn’t have significant income loss) but is seriously injured.

How much is my claim worth?

It's a big question.

And one that is asked by every claimant we see.

Unfortunately, the answer is never straightforward – mostly because there are many factors that significantly influence the overall amount awarded. 

The amount of compensation that a person receives is known as quantum.

As we learn through this four-part series, there are a number of areas under which you can determine what your quantum is and in turn, discover how much your claim is worth.

The second topic we will be covering is care costs.

Be sure to read our first article on future economic loss first.

What are care costs?

Care costs relate to an injured party inability to complete daily living tasks.

The idea is the amount of money received under this head of damage will pay for another person to assist with daily living and maintenance task.

The care can be provided to you by friends, neighbours or relatives, or you may have engaged paid services to undertake the tasks you could not perform yourself due to your injury.

Legislation in Queensland imposes threshold care requirements in cases of motor accident injury or public liability claims, and there are increased restrictions on care claims when claiming for a work injury.


How much can you get for it?

Again, this is dependent on the level of care that is required based on your unique circumstance.


What factors influence it?

  • check
    The extent of injuries and their lasting impact on your ability to complete daily tasks
  • check
    What daily tasks you completed before the accident
  • check
    The ability to PROVE the above two factors

Example 1 – Bicycle Car Accident 

Jack was an 25-year-old, training for the cycle leg of an upcoming triathlon. He was riding in the streets close to Mt Cootha and as he crossed an intersection with a green light, a car sped through a red light and straight into Jack. 

Jack was left quadriplegic. For the rest of his life, will require assistance with feeding, toileting and bathing. All movement around his house, getting in and out of bed, and any daily errands will need help from another person.

His claim for compensation included daily care to assist him in completing tasks as well as home maintenance, garden care and driving services. His care cost totalled $2.5 million.

Example 2 – Inferior Infrastructure Accident

Angie was cycling along a bike path on her way to work. Angie slowed as she approached a stretch of the path that she knew was slippery due to the surface material. She had heard of other cyclists having accidents at that same spot before.    

Despite her efforts to stay safe, Angie's wheels had slipped on the surface. Angie instinctively held her arms out to catch herself. By doing so, Angie fractured both her wrists. She required surgery to correct her fractures and her surgeon indicated that recovery would likely be slow. Because of her injuries, Angie could not longer complete household and personal care tasks. She relied on her husband and as well as some commercial help in the form of a cleaner for around 8 months. 

Angie’s claim for care totalled $35,000. The money covered the cost of her cleaner and compensated her husband for his time assisting Angie. 

What care is covered?

  • check
    Domestic tasks – such as general household chores such as cooking, cleaning, mopping, vacuuming, taking out rubbish, changing bed sheets, laundry, ironing, cleaning windows or mirrors, dusting, scrubbing out bathroom areas, grocery shopping etc.;
  • check
    Personal care tasks - such as helping you out of a chair or bed, or helping you to the toilet, helping you bathe, helping you dress, changing bandages or cleaning wounds, helping with hair care, obtaining your medications or medical aids for you, cutting your toenails or shaving, even providing you with massages to relieve pain etc;
  • check
    Travel tasks – such as driving you to appointments or helping you run personal errands. Even taxi services can be considered paid care where you are unable to drive due to your injuries.
  • check
    Vehicle maintenance tasks - such as cleaning your car, or undertaking your car repairs or maintenance that you did yourself before the accident;
  • check
    Home maintenance - such as cleaning down gutters or eves, washing down walls or outside windows and screens, house repairs and general maintenance to your home such as fixing gates or even changing light bulbs etc, as well as yard maintenance such as mowing the lawn, undertaking the gardening, weeding, whipper snipping, lopping back trees, pruning bushes etc.

Did you know you can also claim for the help your friends and family provide?

It’s known as gratuitous care.

Confusing title aside, it relates to any voluntary work of third parties (like your friends, family (including your partner), neighbours, and very kind strangers) who assist you in any of the above tasks.

IMPORTANT: Under legislation in Queensland, a person can only claim for gratuitous care if:

  • The care is different from any help previously provided
  • The care was/is provided for at least 6 hours a week and for at least 6 months.

Take for example....


If your mum helped look after your children one day a week while you work, and she continued to assist while you were off work recovering, that assistance could not be claimed for after the accident.

 

However, if she helped out an additional day (over 6 hrs of unpaid work) after the accident and that help continued for six months or more that care can be claimed for.

Emily Billiau

Principal


What evidence will you need?

You will need to prove that you completed the tasks before the accident.

For personal care tasks (such as showering, cleaning your teeth), it’s assumed you would have completed tasks those tasks yourself.

For jobs such as cooking, cleaning, garden care and child care, evidence is needed to show that you were responsible for some or all of these tasks within your household.

Equally so, you will need to put a monetary value on the work that you do. 

Some examples of evidence might include:

  • Testimony from partner, or someone living with you of the jobs you usually do around the house
  • Tax invoices and receipts for commercial care post accident
  • Quote for commercial care (such as a gardener, cleaner, nanny etc.)
  • Record of help provided by friends and time allocated
  • A medical note from a medical professional on your ability to complete daily tasks
  • Written testimony from friends and family of the hours worked and tasks that were undertaken.

Keeping a record of care provided since the accident is crucial

Keeping a record of the care and assistance provided to you due to your injuries is very important, as it can mean the difference between having a claim for care and assistance, or not having such a claim at all.

Keep a spreadsheet that details the following:

  • Type of care (paid or unpaid)
  • The service provider (company or person's name if unpaid)
  • Kind of service provided (i.e. mowing, laundry, cleaning)
  • Date and duration of service
  • Cost of service (if paid)
  • Will the service be required in the future and how often

To help ensure that you keep an accurate record, keep in mind the following helpful tips

  • Keep receipts for any services that you have paid for;
  • Photocopy or scan those receipts, in case they get lost or destroyed;
  • Consistently fill out the table as each service is provided;
  • Ask the service provider to give you an "Itemised Account" that details the dates and costs of each service when they are performed

No good compensation claim is without Future Economic Loss.

Like the saying – don’t put all your eggs in one basket - don’t forget to read the rest of the articles in this series on the other areas of compensation available to you.


Part 1: How much is my claim worth? – Future Economic Loss
Emily Billiau Principal ​Most people have heard of personal injury claims but very few would understand what quantum is. …and[...]
Part 3: How much is my claim worth? – Medical Expenses
Emily Billiau Principal Medical Expenses are a crucial part of all claims for compensation. Why? Well apart from the obvious[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal

SHARE THE POST

Part 1: How much is my claim worth? – Future Economic Loss

Emily Billiau

Principal

Most people have heard of personal injury claims but very few would understand what quantum is.


…and they really should – behind liability, it's the second most significant determinant of a successful claim.​


You’d be forgiven for thinking quantum has something to do with physics. But it nowhere near as difficult to wrap your head around.


Simply put, quantum means an amount. So, it refers to the amount of compensation a person will receive for a personal injury.

As we learn through this four-part series, there are a number of areas under which you can determine what your quantum is and in turn discover how much your claim is worth.

The first topic we will be covering is a person's future economic loss. This area often makes up the most significant percentage of your quantum.

[RELATED: Calculate your Future Economic Loss using our worksheet here)


What is Future Economic Loss?

Future Economic Loss relates to an injured person’s ability (or inability) to work after an accident.

Simply, it covers a person's reduced income.

For example, this area of compensation might cover a person’s:

  • Total inability to return to work
  • Fewer hours or a move to part-time work
  • Change in duties or job
  • Inability to progress career through promotions or job changes

..up until they retire.


How much can you get for it?

The amount awarded for future economic loss varies considerably.

It depends on five major factors including:

  • The extent of injuries and their lasting impact on the ability to continue working
  • Pre-employment history
  • Likely career trajectory
  • The ability to prove the above three factors; and
  • Age at trial or settlement (how far you are away from retirement).

Example 1 – Bicycle-car accident, long-term soft tissue injury

Olly was on a bike when a car switches lanes and pulls in front of him. Olly runs into the back of the car, falls off his bike and hits the ground.  

Hospital X-rays show ligament damage to his injured ankle and a cracked left wrist, which is put in a cast. Despite having worn a helmet, Olly has a concussion and is kept in hospital overnight. Olly is advised to begin a physical therapy on his ankle and wrist once its removed from its cast. 

He misses out on a week of work. 

Two months of physical therapy has had little impact on his ankle.  He found he had continuing pain for many months but was mostly able to work through it.

At age 29, he has most of his working career as a Teacher ahead of him. While he never lost the ability work (beyond his week off), Olly felt he lost work opportunities because of his continual pain meant he couldn't go the extra mile in his job. This reduced the likelihood he would be picked for new job or promotions. As it's difficult to quantify missed job opportunities, Olly's lost future earning capacity couldn't be calculated mathematically.

As a result, the judge awarded a small estimated figure to compensate his loss. Olly was awarded $40,000 in lost future economic loss. This is largely due to his young age. Otherwise, his injury has had only minor impact on his future economic loss. 

Example 2 – T-Bone collision, permanent hard injury

Jane cycling to work one morning. As she rode alongside a row of parked cars the door of one car unexpectedly flew open. Jane was thrown over the front of her bike and head first into the door. Jane suffered severe whiplash, ligament damage to her left knee and broke both wrists as a result of the incident. Jane required surgery to stabilise her wrist fractures which required her to take three months off work.

Jane was 35 and worked a registered nurse. She was in line for promotions to managerial positions. Because of the injuries suffered in the accident, she has difficulties working for long periods of time. This means she is unable to put in the hours required for her promotion. She has also found that she struggles to complete her clinical duties and cannot accept overtime hours.

As Jane’s weekly income is reduced (because she cannot accept overtime), she is $300 worse off every week. Adding to that, had Jane been successful in her promotions she would have added $500 to her weekly wage.  Combining this and multiplying it by the number of weeks until her retirement, Jane's economic loss totalled $657,600.


What factors influence it?

How is someone's future loss of earnings calculated for personal injury claims?

Someone's future loss is usually calculated by looking at four things.

  • 1
    A person’s pre-injury weekly salary is compared with their pay at trial (or settlement). This difference will fairly quantity any reductions in work hours. Understanding weekly changes in your wage is important, particularly, if the injured person has had to move to part-time work or is no longer able to take overtime work. 
  • 2
    The person's maximum salary over the course of their career is determined. This decision will quantify any lost job opportunities.  A difference between maximum earning potential and the pre-injury wage is determined.
  • 3
    An amount is then deducted from your weekly earnings to compensate for the fact you are likely to accumulate interest on your salary. This deduction is known as applying discount rate (see below). In Queensland, we use 5% multiplier. 
  • 4
    Finally, the superannuation you would have lost is accounted for based on your maximum earning potential.

How future economic loss is calculated sounds complex, but if you follow our worksheet it breaks down the steps into easy to understand (and action) summaries.

Want to know how to calculate your future economic loss?

Our FREE guide shares the secret formula insurance companies use to discover what your future earning capacity. 

  • check
    step-by-step guide
  • check
    clear examples
  • check
    gives you evidence to support your claim that WILL stand up in Court.

Not downloading the guide may be the most expensive mistake of your life. 

In exceptional circumstances, calculations cannot be made.

When a person’s earning capacity is difficult to determine (such as in children’s cases, or where a person hasn’t taken time off work) a court will award a global sum.

This a blanket award of money determined by the trial judge. Such a case was evidence in example 1 above.


More on discount tables...

The discount rate relates to the rate of return that may be expected on money awarded in a lump sum settlement and is expressed as a percentage per annum.

A discount rate of 5% implies an expectation that the money, when invested, will achieve a return of 5% per annum.

Discount rates are used when assessing someone's future economic loss.

They are essential in determining how much needs to be paid now to compensate for amounts that would have been received in the future.

[RELATED: Calculate your Future Economic Loss using our worksheet here)

What evidence will you need?

Critical pieces of evidence required to prove your future economic loss include:

  • Pay summaries
  • Salary estimates or your current and future jobs
  • Examples of colleagues who have progressed and their wages
  • Average retirement age in your industry
  • Medical reports on your likelihood of returning to work
  • Pre-injury medical history

Next Steps...

Like the saying – don’t put all your eggs in one basket - don’t forget to read the rest of the articles in this series on the other areas of compensation available to you.

Part 2: How much is my claim worth? – Care Costs
Emily Billiau Principal Care costs can be the single most significant component of a claim.  Particularly when the injured party[...]
Part 3: How much is my claim worth? – Medical Expenses
Emily Billiau Principal Medical Expenses are a crucial part of all claims for compensation. Why? Well apart from the obvious[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal

SHARE THE POST