A 49-year-old chemist working in Frankfurt, Germany, was left paralyzed after her taxi got into an accident. There were tremendous complications and plenty of questions for me to attempt to answer, all while I worked the case from the United States.
Would she ever walk again? When could she fly back home?
Soon enough, the details started trickling in.
An elderly man driving in the wrong direction struck the taxi. The driver and another passenger were killed and the claimant was trapped in the backseat. The police came quickly but struggled for almost an hour to free her from the wreckage. The ordeal left her with a spinal cord fracture forcing doctors to perform a spinal fusion.
During a conference call with the risk manager, it was made clear to me that this employee was highly valued and that we were expected to do everything humanly possible to assist her and her family. That included the prompt initiation of statutory benefits and referral to a local nurse case manager.
I set the medical reserve projection to $500,000 but knew that the ongoing hospital costs, repatriation and potential for home and car modifications would increase costs to the million-dollar range. I requested that our Brussels office send a field claim representative and nurse case manager to Frankfurt to meet with the claimant, her family and physicians.
More details started coming in. The European nurse case manager reported co-morbidities including obesity, Type 2 diabetes, high blood pressure, high cholesterol and elevated liver enzymes. The claimant was running a high fever, suggestive of a massive infection, and the German doctors weren't sure if she would live.
Surely, it would be a while until she could return home.
By the fourth week the claimant's condition could best be described as a roller coaster -- after one infection was brought under control, she'd be plagued by another. She remained bedridden without even light physical therapy. I knew that unless she got some time out of the bed, she would risk getting blood clots and bedsores.
Meanwhile, back in the States, an attorney representing the claimant said the proper jurisdiction should be Connecticut (and its higher weekly comp benefit maximum rate), not Pennsylvania. She lived in Pennsylvania but had a child attending college in Connecticut so the carrier obliged.
By week eight, it was time for her to come home. I lobbied for a facility specializing in spinal cord injury, but the claimant instead elected to be in a hospital closer to her children.
Within days of her return, the fever resumed along with severe back pain. It was discovered that one of the screws in the spinal hardware was loose. She underwent surgery to tighten it, but the pain and fever persisted. Doctors decided to remove the original spinal hardware and re-stabilize the spine.
Through it all, the claimant was confused and her words were muddled at times. A neurologist found that the German hospital admitted her in a semi-conscious state and that her actions were suggestive of a brain injury.
In yet another surgery, the neurologist removed a small brain hematoma.
The claimant's condition was finally stabilized. Now, she could begin to adjust to daily life. She even began working again by using video conferencing.
MICHELLE KERR is the editor of this column and
can be reached at firstname.lastname@example.org. This column is based on the experiences of a group of long-time claims adjusters. The situations they describe are real, but the names and key details are kept confidential.
July 22, 2013
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