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If Your Spouse Suffers a Brain Injury, What Are Your Options?

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A spouse’s traumatic brain injury can dramatically alter a marriage’s dynamic and wreak havoc on a previously happy, stable relationship. That is a heartbreaking reality, not every couple survives. Seeking the advice of a knowledgeable legal firm such as Alexander Law Group can provide informed counsel and lawful options suited to helping your family weather mounting recovery challenges, medical expenses and protect your rights through other potential hardships.

However, some hurdles cannot be overcome through court proceedings. In addition to securing the most comprehensive care available to your loved ones, we are here to prepare you for the sudden shifts capable of changing the way you look at the partner with whom you vowed to share your life in both sickness and health.

Establishing Guardianship for Your Spouse After a Traumatic Brain Injury

Guardianship proceedings establish a court-appointed individual as legal caretaker for a person too incapacitated by illness or severe injury to competently manage financial, medical, legal and daily affairs. The guardian is typically a responsible family member, but the court may assign a spouse or next-of-kin blood relative to act as co-guardian alongside a bank representative or other professional estate custodian when considerable assets are at stake or a minor child has been incapacitated. Among other matters, guardians are likely to navigate the following concerns:

  • Healthcare arrangements
  • Social security disability, state medical benefits and other supplemental income
  • Securing an attorney to litigate an injury case and seek insurance compensation
  • Protect the disabled individual’s rights against parties responsible for causing an accident and associated insurance companies
  • Look out for the incapacitated party’s financial wellbeing
  • Monitor and record all financial transactions
  • Maintain bank accounts and write checks
  • Approve or deny access to medical records and fight for the individual’s rights to receive ongoing insurance and healthcare benefits
  • Consult and make decisions alongside doctors concerning proper medical placement and treatment

Most courts will demand thorough medical documentation before declaring an injured person legally incapacitated. Simply having a family member claim as much will not suffice to have a guardian appointed.

Basic Federal Benefits for Traumatic Brain Injury Victims

Victims of traumatic brain injury usually receive disability benefits from two federal programs, Social Security Disability Insurance Benefits (SSD) and Social Security Income (SSI).

Disabled workers and their families may qualify for SSD benefits after earning a given number of pay credits under the program’s standards if a condition eliminates or reduces an injured individual’s earnings and the disability is expected to last longer than 12 months or eventually result in death. To determine the “substantial, gainful activity level” of benefits a worker may earn, the dollar values of disability work expenses and subsidies will be subtracted from gross earnings.

Excessing earnings may reduce monthly SSD payments, but benefits will not terminate if earnings exceed the designated maximum allowance. Recipients may also join a “trial work” program in order to determine prospects for eventually rejoining the workforce without sacrificing benefits.

Alternately, SSI distributes monthly payments to disabled individuals with limited assets and income. These benefits are typically extended to families reporting household income up to around $24,000. However, that income threshold may extend higher depending on the number of people residing in the household and other factors. Additionally, this program can pay $422 or more per month for eligible children, and many states extend free Medicaid health care benefits to children qualifying for as little as $1 of SSI.

A trusted, experienced attorney can help make sense of the maximum benefits your family should qualify to receive.

Traumatic Brain Injury and Medicare/Medicaid

Depending on the sum of circumstances, your spouse’s traumatic brain injury may qualify your household for either Medicare or Medicaid assistance. Knowing the difference is vital.

Federal Medicare benefits are geared toward elderly patients—in the case of Medicare Part A hospital benefits, individuals over 65 years old who qualify for Social Security retirement payments. Enrollment in Part A automatically signs up the applicant for Medicare Part B medical insurance and its accompanying monthly premiums, but you have the option to refuse to pay for the additional coverage.

If you are not yet over the age of 65 and have at least 24 months of SSD benefit eligibility to your credit, you may still qualify for critical Medicare Part A coverage in the event of a traumatic brain injury. Receiving SSD benefits enrols the recipient automatically in Parts A and B after the 25th month, but SSD beneficiaries are exempt from Part A monthly premiums.

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However, declining Part B insurance will still result in an equivalent premium being deducted from your monthly disability payment. You can continue receiving Medicare coverage right up until you are no longer disabled. Be advised, your options for covered long-term care will be limited to hospice care, part-time or intermittent home health care or a Medicare-approved certified skilled nursing facility. Medicare alone will not adequately cover long-term home health care or a nursing home suitable for addressing a traumatic brain injury.

Both the federal government and individual state agencies administer Medicaid while sharing the program’s costs. Eligible beneficiaries meeting income and financial resource standards can receive medical care from any participating hospital, doctor or healthcare provider. Agencies assess applicants based on both categorical and medical need. Families must already receive supplemental benefits including SSI, Aid for Families with Dependent Children (AFDC) or some form of general medical assistance to meet categorical need requirements. If you do meet Medicaid qualifications, benefits can pay for home health care and skilled nursing home care, if needed.

Finally, let’s talk about the dramatic emotional toll traumatic brain injury may exert on your marriage and family. Often, victims have difficulty thinking clearly enough to focus on otherwise simple tasks and conversation for extended stretches of time. That jarring change in concentration can quickly become frustrating enough to ignite miscommunication and conflict between an injured individual and friends, family or colleagues. The effect has been described as not unlike trying to parse the words of a song on the radio through the moderate static.

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At the same time, your traumatized spouse may seem to behave lazily or selfishly. They can respond with sudden, unintended agitation when confronted with everyday responsibility. Often, these personality changes are actually beyond the victim’s control and as difficult to explain as they can be for loved ones to understand.

As much as this new normal may strain your relationship, nothing should come before protecting the people you love to every extent of the law. You may have more tools to defend your quality of life than you know, but trust in a legal professional’s counsel and confidentiality to explain them may prove to be your single most valuable asset. The deepest-cutting aftermath of a traumatic brain injury too often defies description. That doesn’t mean anyone should battle it alone.