Economic Damages Due to Spinal Cord Injuries: Trends and Policy Implications

Article excerpt

I. Introduction

Economic damages for workers injured on or off the job typically consist of: lost income (both present and future) if earning capacity is impaired; additional health care and medical expenses both present and future; household services lost; and some allowance for any present and future increase in pain and suffering and reduced quality of life. One key factor mitigating damages occurs if the injured worker eventually returns to a worklife and homelife similar to that enjoyed prior to injury.

When the injury involves spinal cord injury (SCI) the economic damage picture is dramatically altered because the worklife and homelife pattern do not return to normal. This study utilizes National Spinal Cord Injury Statistical Center data to examine these differences. Section II of this study examines the trend and the status of SCI in the US and provides estimates for the economic damages for various types of SCI. Section III summarizes the findings and provides some policy recommendations. Overall, one purpose of this article is to acquaint forensic economists with the SCI data base and its many uses.

II. An Overview of the SCI in the US: Status and Trends

About 7800 SCI events are estimated to occur every year. Researchers believe this is an underestimate because many injured people die instantaneously and these cases are not reported as spinal cord injuries. Between 250,000 and 400,000 individuals are living in the U.S. with Spinal Cord Injuries and spinal dysfunction. The leading cause of SCI in the US is motor vehicle accidents (44%), followed by acts of violence (24%), falls (22%), sports (8%) and others (2%). The leading cause of sport SCI is diving (66%). About 82% of SCI patients are male and 57% are age 16 to 30 at the time of injury.(1)

Table 1 shows the elements of damage for spinal cord injuries. The table suggests that persons with SCI have higher lifetime unemployment rate, higher income losses, reduced life expectancy, additional health care and living expenses, increased pain and suffering, reduced quality of life, and reduced likelihood to marry or to remain married. Each of these will be discussed in turn.

Table 1 Economic Damages For Persons With Spinal Cord Injury (SCI)

1. Lost Income

* Time Required to Recover From Injury and Retrain If Needed

* Higher Lifetime Unemployment Rate

* Reduced Life Expectancy 2. Additional Lifetime Health Care and Living Expenses 3. Increased Lifetime Pain/Suffering 4. Reduced Quality of Life 5. Reduced Life Expectancy 6. Reduced Likelihood To Marry or To Remain Married

Source: Author's Analysis

People with SCI experience high unemployment rates. The national Spinal Cord Injury Association reports that 61.0% of the injured are employed at the time of injury but that this falls to 13.6% at the end of the first year after injury as shown in Table 2. Unemployment among SCI patients averages about 50% during the 20 years after injury and large percentages are in non-employed categories including student, retired or home worker. Table 2 provides detailed information about employment and occupation for SCI patients by year post injury. Overall, about 40% of paraplegics and 30% of quadriplegics eventually return to work.(2)

Table 2
Occupation of SCI Patient By Year Post-Injury

        Percent      Percent      Percent          Percent
Year    Employed    Unemployed    Student    Retired and Other(*)

 0        61.0         22.1        11.1              5.8
 1        13.6         63.4        15.8              7.2
 2        13.9         60.1        19.2              6.8
 3        18.1         55.8        19.4              6.7
 4        21.8         52.6        19.7              5.9
 5        23.8         51.4        18.9              5.9
 6        25.5         50.5        16.2              7.8
 7        26.1         49.9        16. …