Carl's story

I sustained horrific physical injuries in the accident but amazingly, didn’t suffer any head injuries. I was taken to a local hospital’s emergency department where I suffered a massive heart attack because of the trauma his body had been subjected to. A delay in the hospital resuscitating me from the heart attack left me with a significant hypoxic Acquired Brain Injury that affected my ability to walk, talk and move independently.  Luckily it left my cognitive abilities intact and fully functioning.

Two months later and while I was still in hospital, I suffered a stroke.  The stroke robbed me of some of my vision and left me with almost no use of my legs and arms.  It also affected my throat muscles and further reduced my capacity to speak.  I was left trapped in a body that did not work.

Despite these significant impairments, the hospital rehab I received saw me well on the way to learning to walk and speak again.

But 3 months after I was injured and very early in my recovery, I was transferred from hospital to a sub acute “step down” service.  When I entered the subacute service, I was able to do standing transfers and walk a few steps with assistance. I was well on the way to further improvement and determined to become as independent again as I could.

But 12 months after moving to this facility, I was told my rehabilitation would stop. Despite continuing to make good progress, I was told my recovery had plateaued and I should consider moving to an aged care nursing home. I was only 22 years old and I refused to consider this and was supported in my decision by my parents. I am still live in this same facility today.

In the 10 years I have lived there without the rehabilitation and other supports I’ve needed, I’ve gone backwards and actually lost most of the capacities I’d regained.  Because of this, I am now completely dependent on a wheelchair to get around.  I’ve also suffered crippling tendon contractures in both feet and hands that leave me in excruciating pain. 

These contractures and the constant pain I was in eventually meant I had to have tendon release surgery to both feet and my right hand, meaning I would never be able to walk unaided again or have full control of my hand. I refused to have surgery on my left hand as it would have meant I could no longer drive my electric wheelchair and I would be completely dependent.

I still suffer from contractures in my elbows, shoulders, wrists and every finger except my index finger. It is amazingly frustrating not to be able to do more.

Along with other residents, I am now being asked to move out of the facility I have lived in for over 10 years. 

I would love to live in the community like anyone else. But the health and disability services I need just aren’t available despite our complaints and there is nowhere in the community that can support my needs. 

Once again, nursing home placement is being mentioned as the alternative but I will not accept this.  My dream is to have my own apartment in the community with the supports and rehab I need.

Impact of QLD’s fault based CTP Motor Vehicle scheme

Under the Queensland Motor Accident Insurance Commission’s (MAIC) rules, Carl had to prove another driver caused the accident or was in some way ‘at fault’, in order to receive the MAIC’s cover and access the medical and rehabilitation services he needed to fully recover from his injuries. 

He also needed to prove his case as a common law claim for compensation from the at-fault driver’s compulsory third party insurance.

To succeed, Carl needed to do a number of things. 

He needed to identify a negligent and solvent first party as the cause of the accident.

From that point, how much compensation he may have received would have depended on

• Whether the other driver’s car was registered and insured
• The circumstances of the accident
• The severity of his injury
• The extent of his disability and future needs
• Judicial interpretation of liability
• The brinkmanship of the out of court settlement process, and
• The process for assessing damages (1)

A common law claim that requires proof and consideration of these separate areas can take time, time in which crucial rehabilitation and other clinical services may be denied until proof of the scheme’s cover is agreed.

For the at fault driver, things are even more dire. Left without recourse because they caused the accident, they receive no cover or assistance at all and are left at the mercy of the over stretched and underfunded public health system for the clinical supports and limited rehabilitation services it may be able to offer.

Because of his post-trauma ABI induced amnesia, Carl had no memory of the accident – and the other driver who caused it – until one month past the MAIC’s claim cut-off date. Because Carl could not prove another person was at fault, he was denied the MAIC’s assistance.

Carl did investigate legal action to pursue an insurance claim against the hospital regarding delayed resuscitation that left him with a significant ABI, however, after receiving legal advice, Carl decided not to pursue these claims, as he could not be guaranteed of a result in his favour. The risk of having court and other costs awarded against him and his inability to pay these costs in his injured state was, he decided, too great a risk to take.

As a result of his ineligibility for CTP compensation, Carl was denied the clinical and rehabilitation services he needed to recover from his injuries. These services were simply not available in the public health system to him without this eligibility.  This denial of rehabilitation has effectively prevented him from achieving maximum recovery and get on with his life in the community. 

Denying Carl these crucial interventions has increased his dependence on others for his self care and consequently the overall cost of his care.  The ‘saving’ to the government from limiting eligibility to CTP compensation to people like Carl has been more than wiped out over time through these increased costs of care.

Proof of improvement

Over the last 6 months, Carl has been fortunate to access funding from the James Macready Bryan Foundation that has enabled him to attend twice weekly hydrotherapy sessions. Quite apart from the opportunity to leave the facility he lives in and interact with others “outside”, these hydrotherapy sessions have delivered outstanding results across the board.

Carl is now able to stand and walk with assistance again and his health and well being have improved markedly also. Carl has regained his confidence and now actively advocates for other residents of the facility he lives in.

Carl looks forward to his weekly sessions with enormous anticipation.  Not only is he gaining huge benefit from the hydrotherapy itself and the capacity to engage socially with others outside the facility, but Carl is once again actively directing his own recovery. With his eyes now firmly on regaining the life of independence in the community he has longed for, nothing is more important to him than this!

That such significant improvement could be achieved with so little comparative clinical input, only heightens the injustice Carl has suffered.

Carl’s story is proof that limiting opportunities for recovery for the catastrophically injured is not only a cruel policy…it is false economy. It creates increased dependence on care services, greater demands on the already struggling public health system and devastation for families whose lives get diverted to the care and support of people who should have access to specialist services.

As Carl says, “ A catastrophic injury can happen to anyone, anytime, and in 2014 we should expect to have decent cover in place.”

Visit the the James Macready Bryan Foundation to learn more about their work.