Anyone have information on determination of castrophic or non-catastrophic injuries as per the AMA?

Son was injured in an atv accident resulting in partial spinal cord injury. insurance company still hasn't decided about catastrophic or non-catastrophic. i know what i'm entitled to either way however i want to find out more about determination of catastrophic or noncatastrophic injuries. He was originally paralysed from the neck down at the C5 level but has now been improving and movement is coming back. The neurosurgeon qualifies him as a quadriplegic but now that he's improving we havent received any change in that. He can walk with assistance for very short distances. I want to know more details as to how this determination is made. Any information would be appreciated.

The determination of catastrophic injury must be made by a Qualified Medical Evaluator, Agreed Medical Evaluator, Physican and/or Independent Medical Evaluators in accord with the AMA Guides to the Evaluation of Permanent Impairment, currently in it's 5th Edition.

It comes down to a matter of opinion, based on the criteria set forth in the above mentioned publication.

My advice is to get an attorney of your own. Yes, hopefully your son will continue to improve, insurance companies are doing everything they can to reduce their expenditures. The insurance company will probably insist on another evaluation, but they will try to use their own evaluator.

Depending on the state you are in, look for agencies that will assist you in this matter, because they can sometimes provide legal assistance without having an attorney take a large share of the damages.

Good luck to you and your son.

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