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Richard S.

Richard S. Michigan No Fault - Case Management

A Case Study in:

Case Management - Michigan No Fault

AdvancedRM was contacted by Richard S. regarding his Michigan No Fault claim. He was involved in a motor vehicle accident five years prior. He suffered a spinal cord injury in the accident. He was doing fairly well until his Attendant Care benefits were denied. Because of the denial, Richard’s mother, who provided him with round the clock care, had to return to full time employment outside of the home. His physical and mental health began to deteriorate. He requested Case Management services to assist in helping his adjuster to understand the need for attendant care and to help him get his health on track again.

Client History

Richard advised us he suffered from depression after his accident. He had a difficult accepting he was paralyzed and would be spending rest of his life in a wheelchair .  His mother offered him stability and care and accompanied him to all of his medical appointments and therapies.  His mother was his primary support. Without her help, he spends most of his days in bed. Richard is now at home alone for 10 hours per day.  He told us he is extremely lonely and depressed. Richard has been fearful of going out of the home alone since the accident and continues to feel this way. He told us he has begun to feel hopeless and useless.

Process

  • We met with Richard and his mother for an in person interview to ascertain information regarding his accident, his treatment to date, his medical history, and his status prior to the accident.
  • We discussed Richard attending regular counseling sessions and becoming involved in an out-patient program.
  • Richard signed a consent form to allow us to request his medical records to complete a thorough file review.
  • The case manager began to attend visits with Richard and obtained documentation from his treating providers regarding his treatment and care needs.
  • Analysis

    Through regular visits with Richard and his providers, we were able to clearly document the need for additional treatment and services to help him become more independent, overcome some of his fearfulness, and establish a clear understanding of the care needed in the home. We established a network of support for Richard outside of his family to help him through his episodes of depression.

    Outcome

    Due to the information and documentation obtained by AdvancedRM, Richard’s adjuster agreed to reinstate some of the attendant care hours and pay for treatment to help him become more independent. Richard’s mother is providing him with the support he needs to deal with unresolved issues related to his injuries, as she has also received counseling on how to help him. She has been able to accompany him to his appointments and provide encouragement with following through with medical recommendations. Richard has progressed extremely well and is now pursuing a degree in engineering.  He continues to receive Case Management services from AdvancedRM as a benefit of his auto insurance. With this support in place he will continue to overcome hurdles and make advancements to become more independent.