DRM Brain and Spinal Injury Handbook

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HANDBOOK

Brain & Spinal Injury


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CONTENTS RECOVERY AND REHABILITATION Symptoms of Spinal Cord Injury P8-9 Warwicks Story P12-13 Understanding Spinal Cord Injury P14-15 Signs of Injury P16-17 MTG’s Range Of ISC Catheters For spinal cord injury victims, the time that elapses between injury and treatment can be critical to the outcome for the patient. Prompt medical treatment in some cases can reduce the severity of an injury if received soon enough after trauma occurs. For these reasons, it is important to recognize the symptoms of spinal cord injury and to act promptly

Emergency Symptoms of Spinal Cord Injury

Severe spinal cord injury is not always immediately obvious. Paralysis or numbness can develop gradually from swelling or bleeding in or around the spinal cord. Anyone receiving significant trauma to the head, neck, or back should be medically evaluated at once for damage to the spinal cord.

LEGAL

P22-23 The Rehabilitation Code and how

FINANCIAL PLANNING

it helps people injured in accidents.

P26-27 Brain Injury Claims, Suffering a brain injury in an accident. P28-29 Professional Profiles P36-37 Specialist Legal Advice

P42-43 Personal Injury and Disability -A personal injury might need a lifetime of support.

P47 Wills + Trusts for vulnerable people. P45 What you need to know about leaving money to a person with a disability P50 FAQ about appointing a deputy P53 Key Guidance on Mental Capacity BUSINESS SERVICES

P56 Plain Sailing on Cost Recovery


The effects of acquired brain injury: An introduction The effects of acquired brain injury Children are a work in progress, as any parent knows. The brain is at the centre of this work, shaping each individual personality as it makes its way through its young life Acquired brain injury can affect almost any aspect of the way somebody functions, which is why it is such a complicated condition. And the effect it has on any of these functions can range from small (and hard to spot) to large (and more obvious). • •

A child may not go on to pick up some of the skills they otherwise would have A child may appear to make a good physical recovery, but some of the effects of acquired brain “It was really important that injury might be hard to spot we were prepared for the fact he • Some of the effects might not come to the surwasn’t going to be quite the same face until later on, when the injured part of the lad he was before. To our friends brain starts to be used and relatives, Michael was home from hospital and everything After an acquired brain injury, some children lose seemed back to normal. But it was the ability to do things they were able to do before, tough to see him getting easily while holding on to the ability to do others. Some frustrated and irritable.” children begin to do things they didn’t before. Parent's experience Many parents say the changes in their child can be one of the most upsetting aspects of acquired brain injury.

All children are unique, and acquired brain injury affects each of them differently As always, we must stress that every child’s experience is different. We’ve brought together some of the difficulties associated with acquired brain injury, but this is not to say any one child will experience all of them. It’s also important to remember that each difficulty doesn’t exist on its own The effects of fatigue (or tiredness), for example, might make a child more irritable in their behaviour. It may also slow down the speed at which they’re able to process information. Not being able to answer a question quickly might lead to frustration on a child’s part, and this in turn might lead to challenging behaviour. Page 4


The young brain is always developing

Another example might be difficulties with memory, which many children with acquired brain injury experience. We use our memories a great deal in our everyday lives, from talking to people to learning new information. If a child struggles with their memory, then their ability to keep up in conversations or at school may be affected too. Acquired brain injury is best thought of as a set of overlapping difficulties that often have an impact on each other. Let’s look at some of them in turn.

Changes in behaviour

Parents say changes in the way their child behaves can be a source of great anxiety. The physical effects of ABI There is a broad range of physical difficulties associated with ABI, from fatigue and tiredness to difficulties with the senses. We look at these effects in more detail here. The cognitive and emotional effects of ABI Our ‘cognitive functions’ are things that go in inside our heads, such as our thought processes. This section looks at difficulties with attention and memory, among other things. It also looks at how children may be affected emotionally by ABI

“I think the hardest thing to explain to other people is that brain injury isn’t just one thing, with certain symptoms. It can affect different children completely differently.” A parent


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Recovery/Rehabilitation

SPECIALISED NEUROLOGICAL CARE SERVICES INCLUDING FAST- AND SLOWSTREAM REHABILITATION FOCUSING ON ABILITY RATHER THAN DISABILITY Our services offer access to a wide range of clinical and professional expertise, with emphasis placed on encouraging independence and choice, gaining skills and improving quality of life for people with complex neurological care needs

Barchester Healthcare’s multi-disciplinary clinical and professional teams design goal-based therapy packages, tailored to each individual’s potential. We work closely with NHS colleagues and partners, providing services through integrated working. Our broad range of specialised services means that we can work with individuals at different stages of their rehabilitation pathway. We offer each individual we support great recreational choices and the fullest possible life in a variety of purpose-built and welcoming environments.

We offer: • Fast- and slow stream neuro-rehabilitation • Complex disability management • Short-term and respite care • Long-term continuing care • Defined care pathways and clinical best practice Barchester offers: • Proven rehabilitative track record • Skilled multi-disciplinary care • Excellent activities programmes • Comfortable environments with great food and drink

Please contact us to find your nearest neuro-rehabilitation centre, or to find out more about the services available.

Call: 03334 149 757 Or visit: www.barchestermentalhealth.com Page 6

• Support for family and friends • Focus on enjoying life to the full • Maximum control over your life


Recovery/Rehabilitation

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Recovery/Rehabilitation

Warwick's Story

Reproduced by kind permission of Headway - The Brain Injury Charity - www.headway.org.uk

“A wet sponge was no good for a fractured skull!" Warwick Jarvis was a keen and talented sportsman. These skills helped him to secure a sought-after place at prestigious Vincennes University in the USA. He was loving life and had a bright future ahead of him. But all his hopes and dreams were shattered by a clash of heads in a 'friendly' football match back home in the UK.

"I was never what you'd call an academic at school," said Warwick. "To me, school was all about the opportunity to play sport, which I was lucky enough to excel at. So securing a football scholarship at Vincennes University was a dream come true. "It was amazing - everything I could have hoped for. My daily routine comprised two hours of playing football, a little study and the rest of the time was left for partying! As an 18-year-old living his dreams, the academic side of things just didn't seem important." After enjoying the best year of his life, Warwick returned to the UK for the summer holiday. Then 19, Warwick was invited to play in a local charity football match. In his own words, Warwick was 'a bit cocky' at the time, and jumped at the chance to showcase his improved skills to his old mates. Sadly, one of his old teammates, who was playing on the same team as Warwick, took exception to his bravado and decided to take him down a notch or two by putting in an aggressive challenge - one which almost cost Warwick his life. Warwick had jumped to head the ball following a goal kick. As he met the ball, his teammate clattered into him, with the two players' heads colliding at force. Despite the initial pain, Warwick picked himself up and tried to continue playing. However, he was unable to finish the game and instead watched the remainder of the match from the sideline with a wet sponge pressed to his temple in an attempt to numb the pain. “Apparently, a wet sponge isn’t much help when you’ve fractured your skull!” Warwick said dryly. Although he went out with friends after the match, he left the party early. The pain intensified and Warwick lost consciousness. He was rushed to hospital where doctors warned his family that they didn’t expect him to survive. Page 8


Recovery/Rehabilitation

He immediately underwent surgery to remove a blood clot the size of a golf ball from his brain. He spent six and a half weeks in a coma following the surgery. When he finally began to wake, it took him a further week to fully regain consciousness. "It's not like it is in the movies," said Warwick. "You don't suddenly wake from a coma and spring into life. It was a strange and confusing time. I understood that I'd missed a sizeable period of time and I couldn't make much sense of the snippets of information and fleeting recollections of people coming to see me while I was awaking from the coma. "It must have been hard on those around me, too, as while there was relief that I'd come round, the doctors couldn't say whether I'd be able to walk again or if I would be cognitively impaired. "Thankfully, my cognitive abilities weren't affected, but it took 18 months of gruelling rehabilitation before I could walk again in any manner and far from what ..you would call normal. It was clear straight away ..that my sporting life was a thing of the past. Even ..today, 20 years later, I have balance problems and ..I need a stick to help me get around.

“What Doesnt Kill Makes You Stronger�

..When I do fall, as I often do, I find it very difficult ..to get back up again unaided. "But I was determined to make the most of my life. ..Put bluntly, when you've been kicked in the privates, metaphorically at least, you have one of .two choices. You can either give up and spend your ..days feeling sorry for yourself or pick yourself up ..and get on with it. I chose to get on with it.

"I decided to return to the US to continue my studies there - albeit without the sport. Although I longed to be able to play again, I was now able to concentrate all my efforts on getting a good degree, which I did. I then returned to the UK and began a further law degree, this time an LLB (Hons)." Today, 40-year-old Warwick has two children - Daniel and Luke - and is married to Nicola, with whom he runs his own business, Jarvis Costs Consultancy. The firm specialises in legal costs drafting for serious personal injury cases, particularly those involving head injuries. "I've always believed in the phrase 'What doesn't kill you makes you stronger'," said Warwick. "I've never taken myself too seriously, and I believe this has helped me achieve all that I have. "I have to put things into perspective, I was lucky to survive and things could have been much worse. "Life doesn't always go the way we plan it. But there's always a way forward." Page 9

D M


Recovery/Rehabilitation

The Home Care Specialists

1 Sewardstone Close Sewardstone Close is a purpose built unit for people aged 18+ with an acquired brain injury. We offer residential and nursing placements including respite services and intermediate placements to clients with different levels of physical or cognitive ability. For further information about the service or to make a referral, please call 0203 434 1085 or email info@enablecare.co.uk 1 Sewardstone Close, Sewardstone Road, Waltham Abbey, London E4 7RG

Supporting those living with a Brain or Spinal Injury Helping Hands has been providing award winning homecare since 1989. A family run company we apply our local knowledge and over 25 years of experience to offer you one to one support that enables you or your loved one to remain at home with compassion and dignity. We are able to balance independent living with creative personalised bespoke care needs and understand that each condition and individual is completely different, needing a unique approach for all. Our Carers focus on enhanced re-enablement, independence, choice, dignity and respect and can provide 1-2-1 support at home, work, college or university.

To find out how we can help you, call: 0808 278 4929 or visit: www.helpinghands.co.uk

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Recovery/Rehabilitation

Christchurch Group is an award-winning neurological rehabilitation specialist. We are proud to achieve life-changing, evidence-based outcomes for adults with neurological conditions resulting from injury, illness or disease. With rehabilitation centres in six UK locations, Christchurch Group provides neurological rehabilitation as well as specialist neurobehavioural rehabilitation, spinal injury rehabilitation, ventilated care and the management of progressive neurological conditions.

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Understanding

SPINAL CORD INJURY

What you should know about spinal cord injury and recovery

Levels of Injury Vertebrae are grouped into sections. The higher the injury on the spinal cord, the more dysfunction can occur. • • • • • • • • • •

Most severe of the spinal cord injury levels Paralysis in arms, hands, trunk and legs Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements. Ability to speak is sometimes impaired or reduced. When all four limbs are affected, this is called tetraplegia or quadriplegia. Requires complete assistance with activities of daily living, such as eating, dressing, bathing, and getting in or out of bed May be able to use powered wheelchairs with special controls to move around on their own Will not be able to drive a car on their own Requires 24-hour-a-day personal care

Low-Cervical Nerves (C5 – C8) • • • • • • •

• • • • • • • • • • •

Corresponding nerves control arms and hands. A person with this level of injury may be able to breathe on their own and speak normally. C5 injury Person can raise his or her arms and bend elbows. Likely to have some or total paralysis of wrists, hands, trunk and legs Can speak and use diaphragm, but breathing will be weakened Will need assistance with most activities of daily living, but once in a power wheelchair, can move from one place to another independentl

C6 injury Nerves affect wrist extension. Paralysis in hands, trunk and legs, typically Should be able to bend wrists back Can speak and use diaphragm, but breathing will be weakened Can move in and out of wheelchair and bed with assistive equipment May also be able to drive an adapted vehicle Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment wheelchair, can move from one place to another independentl

C7 injury • • • • •

Nerves control elbow extension and some finger extension. Most can straighten their arm and have normal movement of their shoulders. Can do most activities of daily living by themselves, but may need assistance with more difficult tasks May also be able to drive an adapted vehicle Little or no control of bowel or bladder, but may be able to manage on their own with special equipment

C8 injury • • • • •

Nerves control some hand movement. Should be able to grasp and release objects Can do most activities of daily living by themselves, but may need assistance with more difficult tasks May also be able to drive an adapted vehicle Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment


Thoracic vertebrae are located in the mid-back. Thoracic Nerves (T1 – T5) • • • • •

Corresponding nerves affect muscles, upper chest, mid-back and abdominal muscles. Arm and hand function is usually normal. Injuries usually affect the trunk and legs(also known as paraplegia). Most likely use a manual wheelchair Can learn to drive a modified car

Can stand in a standing frame, while others may walk with braces Thoracic Nerves (T6 – T12)

• • • • • • • • •

Nerves affect muscles of the trunk (abdominal and back muscles) depending on the level of injury. Usually results in paraplegia Normal upper-body movement Fair to good ability to control and balance trunk while in the seated position Should be able to cough productively (if abdominal muscles are intact) Little or no voluntary control of bowel or bladder but can manage on their own with special equipment Most likely use a manual wheelchair Can learn to drive a modified car Some can stand in a standing frame, while others may walk with braces.

Lumbar Nerves (L1 – L5) • •

Injuries generally result in some loss of function in the hips and legs. Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment

Depending on strength in the legs, may need a wheelchair and may also walk with braces

Sacral Nerves (S1 – S5)

• •

Injuries generally result in some loss of functionin the hips and legs. Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment

Most likely will be able to walk

Spinal Column Anatomy: The Basics

When a spinal cord injury occurs, sensation and movement may be interrupted, resulting in a temporary or permanent loss of function, paralysis and loss of sensation. Here are some basic anatomy facts: • • • • • • • • • • •

The brain is surrounded by the skull. The spinal cord is surrounded by rings of bone called vertebrae. Both are covered by a protective membrane. Together, the vertebrae and the membrane make up the spinal column, or backbone. The backbone, which protects the spinal cord, starts at the base of the skull and ends just above the hips. The spinal cord is about 18 inches long. It extends from the base of the brain, down the middle of the back, to just below the last ..rib in the waist area. The main job of the spinal cord is to be the communication system between the brain and the body by carrying messages that ..allow people to move and feel sensation. Spinal nerve cells, called neurons, carry messages to and from the spinal cord, via spinal nerves. Messages carried by the spinal nerves leave the spinal cord through openings in the vertebrae. Spinal nerve roots branch off the spinal cord in pairs, one going to each side of the body. Every nerve has a special job for movement and feeling. They tell the muscles in the arms, hands, fingers, legs, toes, chest and ..other parts of the body how and when to move. They also carry messages back to the brain about sensations, such as pain, ..temperature and touch.

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Symptoms of Spinal Cord Injury For spinal cord injury victims, the time that elapses between injury and treatment can be critical to the outcome for the patient. Prompt medical treatment in some cases can reduce the severity of an injury if received soon enough after trauma occurs. For these reasons, it is important to recognize the symptoms of spinal cord injury and to act promptly

Emergency Symptoms of Spinal Cord Injury Severe spinal cord injury is not always immediately obvious. Paralysis or numbness can develop gradually from swelling or bleeding in or around the spinal cord. Anyone receiving significant trauma to the head, neck, or back should be medically evaluated at once for damage to the spinal cord.

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Recovery/Rehabilitation

If you suspect that someone has suffered an injury to the spine, it is extremely important not to lift or move the injured person. It could cause permanent paralysis and other serious complications Keep in mind: Call 999 for the Emergency Services. Keep the injured person still. Try and support the neck with towels or clothing Prevent the persons head and beck from moving until the ambulance arrives. Do not administer any medication especially if head trauma is also involved.

Permanent Symptoms of Spinal Cord Injury The nature and level of impairment from spinal cord injury depends on the location and severity of the injury. Paralysis of the body occurs below the level of the injury.

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Recovery/Rehabilitation

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Recovery/Rehabilitation

Tracs Acquired Brain Injury (ABI) Services Our Acquired Brain Injury services across England and Wales are person-centred and dedicated to providing specialist support to the complex needs of individuals with an Acquired Brain Injury. We understand that no two people and no two brain injuries are the same, therefore, we offer different pathways of personalised support to suit different needs.

Individualised Support Pathways Tracscare can offer varied specialised brain injury support: Transitional (short or medium term) rehabilitation goal focused placements Short term community skill assessments/ cognitive assessment placements Specialist emotional/behavioural support placements Slow stream rehabilitation Long term residential care Supported living tenancies Specialist outreach support in your own home Vocational support Respite placements Therapeutic support

We are able to support individuals who have: Traumatic brain injuries Stroke/ aneurysms Alcohol related brain injuries (including Korsakoff’s syndrome) Brain injuries as a result of hypoxia, encephalitis, meningitis and tumours Physical and mobility needs Diabetes, epilepsy & PEG care Behavioural, psychological, emotional and forensic needs Cognitive and executive functioning difficulties (memory, attention skills, information processing, insight, social, problem solving & planning difficulties) Dual diagnosis with Mental Health or substance misuse

We also have neuro-disability services to support individuals with conditions such as early onset dementia and Huntington’s care.

For more information call us today on 0333 24 07770 Page 18 or visit our website at www.tracscare.co.uk


Recovery/Rehabilitation

Neuropsychiatry service St Andrew’s Northampton

For nearly 40 years our purpose has been to transform lives and optimise the potential of those in our care. Our specialists support over 200 people each year and help to restore autonomy and facilitate re-integration to community. We offer: Specialist pathways for brain injury, dementia and Huntington’s disease

Tailored care to manage cognitive, emotional and behavioural challenges

On-site vocational, educational and voluntary facilities

Full-time MDT from the most established service in the UK

Dedicated environments for men and women

Services for patients detained under the Mental Health Act 1983 (amended 2007)

Getting in touch For more information about our neurobehavioural rehabilitation services or to make a referral: t: 0800 434 6690 (we welcome text relay calls) e: enquiries@standrew.co.uk w: standrewshealthcare.co.uk/neuropsychiatry

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The Rehabilitation Code and How it Helps People Injured in Accidents

For a lawyer working with a client unfortunate enough to be injured in an accident the ultimate aim may be to arrive at a fair amount of damages for the claimant. But it is also the role of a modern lawyer to take a very holistic approach to addressing the various needs of their client. One way in which this is done is to utilise a protocol known as the Rehabilitation Code. First introduced in 1999, the latest version came into force in December 2015. The Code was the product of some innovative thinking by a group of lawyers who regularly represented injured people, and insurers who dealt with the claims arising out of these accidents. The crucial objective was a desire to put the injured person at the centre of the process. This involved approaching a compensation claim on the basis that the immediate needs of the injured person assumed equal importance as a payment of damages and were to be addressed as a priority from the outset. Within all versions of the Code, including the 2015 one, provision has been made for an Immediate Needs Assessment to be carried out

by a suitably qualified person. The assessor can be nominated by the injured person’s lawyer or the insurance company. These needs may be medical, social or economic and likely to result in a set of recommendations including, for example, the provision of equipment, physical care and support, social care and support, therapies, vocational input, counselling and anything else that might help the injured person to gain as much independence and normality as possible. This will also take into account the needs of loved ones and those who have responsibility for the injured person.

There is a process for a review of the recommendations by the insurance company, but if agreement can be reached, they will be instituted as soon as possible. In more severe cases the progress of the recommendations and rehabilita-tion will generally be monitored by a case manager, normally appointed by the injured person’s lawyer, and it will be their role to set goals and measure progress. The latest version of the Code has been expanded to address different types of injury in terms of severity and complexity, and to ensure that the process carries on throughout the entirety of a

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claim.


The Code is aimed at fostering a collaborative approach between the insurance industry and legal representatives, recognising that the earliest intervention following an injury usually leads to better outcomes. An added advantage is that, whilst the needs assessor is encouraged to engage with treating medical professionals, the private funding stream through insurers can take pressure off hard pressed publicly funded bodies. Lawyers who represent injured people are keen to demonstrate that, far from being proverbial “ambulance chasers”, a label despised by dedicated professionals who are passionate about what they do, their true role is to help injured people rebuild their lives in a variety of ways.

Neil Sugarman qualified as a Solicitor in 1981. Since that time he has practised almost exclusively in the field of personal injury litigation. He was a partner at Betesh Fox and Co in Manchester for some fifteen years and has been the Managing Partner of GLP Solicitors at Bury, Greater Manchester since 1999. Neil has experience of all types of personal injury work. He is a member of the Law Society Personal Injury Panel. In addition, he is an APIL fellow and executive committee member, and a member of Headway. He has represented many accident victims over the years that have been successful in achieving awards in excess of £1 million and has developed a special interest in the presentation of claims to the CICB and CICA on behalf of shaken babies who have suffered catastrophic brain damage. He received a commendation for his work in the UNICEF Child Rights Lawyer of the year Awards 2001. A Contributor to a major legal text on the handling of serious personal injury claims, Neil is also an updating author to Butterworth’s Personal Injury Litigation Service. He has lectured widely to a variety of groups on the topic of personal injury. He has also been invited to add comment and content to both television and radio programmes on personal injury matters. Neil Sugarman is the Compliance Officer for Legal Practice at the Bury-based practice. Accreditations • Association of personal injury lawyers: brain injury specialist • Association of personal injury lawyers: executive committee • Association of personal injury lawyers: lecturer • Headway Page 23


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There is always a certain degree of risk in everything that we do. Injuries can happen at any time and any place, from home and work, to driving, playing sport or even on holiday. Sometimes these injuries are at the hands of someone else. Suffering such injuries could leave you unable to work, incapacitated and in some cases these injuries could be fatal. If you have been involved in an accident that wasn’t your fault, and have suffered injuries as a consequence, then it is time to seek expert legal advice.

Our qualified legal team can offer advice on compensation enquiries such as: • • • • • • • • •

Fatal accident claims Head and brain injury claims Road traffic accidents Accidents at work Slip-and-trip accidents Clinical negligence Sports and other injuries Product liability and faulty products Personal injury trusts

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Legal Proffessionals

When people suffer serious injuries, they need specialist support. That’s why we’re here. At Simpson Millar LLP we know that when people suffer life-changing injuries, they need support. So that’s what we provide. Our Serious Personal Injury team are experts in helping victims and their families deal with the effects of a devastating accident, so they can get the most out of life again. Support. Rehabilitation. Compensation.

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Simpson Millar LLP is a limited liability partnership registered in England and Wales: No. OC313936. Authorised and regulated by the Solicitors Regulation Authority. Registration number 424940.

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Brain Injury Claims Suffering a brain injury in an accident If you’re involved in an accident which results in a serious injury then the chances are that you’re going to have to spend the rest of your life fighting to overcome it. This is especially the case if you suffer an injury to your brain. Far from being a chance to cash in, for someone suffering from a serious brain injury, a compensation claim may well be the only chance they will possibly have to be able to afford the level of care which they’re going to need for the rest of their life. The brain is the control centre for the vast majority of the body’s vital functions, so even a minor injury can have significant consequences and lead to a substantial compensation payout. If you’re involved in a road traffic accident and injure your brain, for example, then the effects could range from limited movement or psychological problems all the way up to paralysis and almost total incapacity. In the most serious cases the injured party no longer even has the ability to start a case for compensation, and it must be undertaken on their behalf by what is known as a ‘litigation friend’, usually a close family member acting in the best interests of the victim.

Making a claim for brain injury compensation The exact details of your case may vary – you may have fallen from a badly positioned ladder at work, for example, or been seriously injured in a car accident – but the principle is the same. If you’ve been injured and it was caused by someone else’s negligence then you have every right to make a claim for compensation. Indeed, the more serious the brain damage is, the more you’ll need any more awarded so that you, and your loved ones, can set about rebuilding your life.

Page 26


Brain injury compensation amounts The amount of money paid out for a brain injury is listed in the government published Judicial College Guidelines, with the guide amount running from £12,000 for minor brain damage all the way up to £327,000 for very severe damage. This is merely a lump sum to represent the pain and loss of amenity you’ve suffered, however. Far more important will be the additional com-pensation paid to fund the cost of things such as alterations to your living environment and any future medical costs or care needs you may have. The more serious the injury, the more vital this payment will be, since the very worst cases will require the person concerned to have virtual round the clock care for the rest of their life.

Brain injury due to medical negligence Unfortunately, there are rare occasions when someone suffers a brain injury due to medical negligence. This could be during birth, when a newborn baby is starved of oxygen due to mistakes by medical staff, or when surgery goes wrong, resulting in damage to the brain. These types of injuries can be devastating, and compensation is available for the pain and suffering caused. There may also be lifelong financial implications, including costs for ongoing medical care and loss of future earnings. In cases of medical negligence, most claims will be made against the NHS. However, if the negligence occurred at a private practice rather than an NHS hospital, the victim is still entitled to make a claim for compensation. No matter what the circumstances, compensation as described above should be available if negligence was involved. If you or someone close to you has been injured then speak to our personal injury lawyers about pursuing compensation. We work on a no win no fee basis, which means there is little risk financially to starting a claim.

Typical Compensation Payouts Very Severe Brain Damage from £155,000 to £220,000 Moderately Severe Brain Damage from £120,000 to £155,000 Moderate Brain Damage from £23,500 to £120,000 Minor Brain Damage from £8,500 to £23,500 Minor Head Injury from £1,250 to £7,000

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Please find profile template below for advertisement booked into Disability Review M Please complete all areas highlighted in red with relevant information and provide p

PROFESSIONAL PROFILES 81mm Philip Coulthurst

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CLEMENT Please return by email toJONATHAN copy@boldmedia.org.uk BELINDA MEMMOTT Areas of practice: Areas of practice:

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Sally Moore: Partner head Caseand Manager at of AngliaDay Case Management Ltd personal injury at Leigh

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Partner at Simpson Millar LLP enquiries@simpsonmillarllp.co.uk Areas of Practice: Brain Injury, Catastrophic Injury, Military PTSD Telephone 0208 296 9966 claire.roantree@simpsonmillarllp.co.uk


ty Review Magazine. d provide photograph.

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Area’s of Practice: Disputes Over Capacity, Welfare, Property and Affairs, Joint Actions and Complex Medical Cases

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Legal Professionals

What do you need most in the aftermath of a spinal injury? Probably a range of vital things. It’s hard to prioritise. But the chances are that a key future objective is regaining your independence, getting your life back as close as humanly possible to how it was. You’ll have family and friends in support, but some legal and financial aspects crucial to your progress will need professional input. Attwaters Jameson Hill’s specialist lawyers have the compassion and expertise to guide you through complex processes towards a positive outcome. Our personal injury and medical negligence teams are here to help you secure appropriate financial settlement. As part of our ongoing service following settlement we also advise on Court of Protection matters, Special Needs Trusts and other legal planning matters such as Wills and Tax.

ASSOCIATION OF PERSONAL INJURY LAWYERS

Accredited Personal Injury Practice

Page 30

01279 638803 info@attwaters.co.uk www.attwatersjamesonhill.co.uk


Legal Professionals

Putting you and your family's wellbeing at the heart of everything we do. Experienced and compassionate at all times.

Access to early treatment to speed recovery.

We’re there to support you and your family.

“You have a gift for making people relaxed and secure in what can be stressful circumstances…” J.H. At CFG Law we offer expert legal advice and a compassionate approach. We specialise in serious brain and spinal injuries and are recommended by the Legal 500. We ensure your best interests and the interests of your loved ones always come first. We will help tailor a programme of treatment and support for you and your family, whilst securing compensation to truly reflect your injuries and ongoing needs.

Members of the Spinal Injuries Association (SIA) Legal Panel. Members of the BASIC Legal Panel (the Brain and Spinal Injury Centre). Members of Headway’s (the brain injury association) Head Injury Solicitors Directory. Recommended by the Legal 500.

CFG Law is a trading name of Freeclaim Services Ltd. Legal 500 Recommended. Authorised & regulated by the Solicitors Regulation Authority.

Speak to one of our serious injury solicitors today. We’re open 24 hours and we offer a free home visit with no obligation. Email: advice@cfglaw.co.uk or go to www.cfglaw.co.uk

Take the first step

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Legal Professionals

Understanding Serious Injury Carpenters Solicitors have a well-established and respected team of serious injury lawyers dedicated to conducting litigation for high value complex cases, and our experience and expertise includes technical cases involving brain injury, spinal injury, amputation, pain syndromes, multiple fracture and fatality cases. We understand that serious injuries are almost certainly life changing events for the victims and also the people closest to them, often resulting in a permanent change to their quality of life. Serious injuries by nature are very traumatic and need to be handled with due care and expertise and we understand that money alone won’t solve all the problems that our clients face and we work to ensure every aspect of their, rehabilitation, adjustment to their new circumstances or on-going care is facilitated. Our serious injury team have recently reached settlement on a case involving a 19 year old, ‘EG’, who suffered an acute head injury with severe brain injuries, which included a skull fracture, an intracerebral haemorrhage, as well as a fractured left femur and splenic rupture, caused by a road traffic accident in 2012. The Third Party, a bus, had failed to comply with a red traffic light, colliding with the vehicle in which the client was a rear seat passenger. In 2014 a settlement was reached of £2,000,000 and agreed as a lump sum, with periodical payments of £230,000 per year for life for the care and case management to be uplifted by the 80th Centile of ASHE 6115, which is the annual published index of national inflation of carer’s wages. This will ensure that the sum will always meet EG’s care bill. The settlement on a lump sum conventional basis equates to approximately £10,000,000. Contrary to the Defendants wish to place the Claimant in a nursing home, upon reaching the settlement, we were able to secure permanent residence for EG at the family home with 24 hour paid nursing care, in line with the families wishes. Our serious injury team worked tirelessly to achieve the best possible outcome in this case not just for EG, but for EG’s family too and this commitment went far beyond financial compensation. It is important that treatment and care are of primary concern when representing a client in the wake of a serious injury. Members of the Serious Team have panel membership with specialist brain injury charities Headway and UKABIF, and deal with claims of the highest value.

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Legal Professionals

Making your Compensation Award Work For You - Don’t Risk Your Benefits –

Combine Legal & Financial Advice Says Mike Talbot, Partner at Pearson Solicitors. If you have a suffered personal injury or medical negligence and received compensation did you know your award can be put into a Trust so you continue to receive benefits? Even if you are not currently getting benefits there may come a time when this could change, for example if you are made redundant and need to make a claim, or if you need nursing care. A compensation award can be a substantial amount of money but it is not a windfall, it is money in recognition of a breach in duty of care, or for pain and suffering, and often loss of income. With the right advice from the start your compensation can be ring-fenced into a ‘Personal Injury Trust’ (PI Trust) which means existing and future capital is disregarded when local authorities carry out means testing for domiciliary and residential care, thus preventing loss of benefits. A PI Trust is a legally binding document where named trustees hold and manage the compensation award. They can be the settlor (compensated person), family or friends or a Professional Trustee. For example parents in the case of a child, or in brain injury cases when capacity has been lost a representative or relative can be appointed. Your life will have no doubt been changed by what has happened to you, but most of our clients want to get on with their lives post settlement without worrying about finances. A solicitor working closely with financial advisers can make the money you’ve been awarded work harder. The involvement of professional trustees who take financial advice and operate within a legal regulated framework helps clients who may have no experience handling large sums of money. “It is vitally important from the outset where serious injuries are suffered that a solicitor identifies whether the injured person can give proper instructions for the conduct of the case, if not that a suitable person is identified to act as the Claimant’s litigation friend,” said Partner Mike Talbot. “It is also important to identify rehabilitation needs as they arise and ensure that they are actioned. Once liability is admitted even before an award is made, the claimant needs proper financial advice on the options available for the management of the monies and the need for a PI Trust,” he added. To summarise, the advantages of a PI Trust are: • Protection of means-tested benefits. •

Protection of existing benefits (includes the consequential benefit of not having to pay for other things such as Housing Benefit and Council Tax benefit).

Protection of future benefits (what if you are ever redundant and claim out of work benefits).

Nursing fees and long term care.

If clients fear the impact of divorce or separation a trust offers a degree of ring-fencing.

If there is no trust and some money remains managed by the Court of Protection their procedure is unwieldy and you deny yourself the enhanced returns that flexible investment via a financial adviser could achieve.

Personal Injury Solicitors and Financial Advisers

Brain and Spinal injuries are life changing... We can help secure the support and maximum compensation you deserve - working closely with you, your family or carers and making your money work for you.

Helping you with: • Head Injury Claims • Serious Injury Claims • Compensation • Personal Injury Trusts • Rehabilitation • Financial Advice • No Win No Fee

www.pearsonlegal.co.uk

Call and chat to us now

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Legal Professionals

If Medical Negligence is involved,

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Tees are listed in the Legal 500 as one of the leading claimant medical negligence firms. We are members of the Association of Personal Injury Lawyers, Headway and approved by the Child Brain Injury Trust as a provider of legal services.

White coat syndrome? Complaining about medical treatment can be daunting and distressing. Our approachable, sympathetic team is ready to work alongside you. We will keep you informed and guide you every step of the way. We will listen to your account, identify your concerns and objectives and give clear realistic advice on how to proceed. Talk to Janine Collier or Paul Taylor to arrange your free initial consultation.

0800 0131165

advice@teeslaw.co.uk Tees Law is a trading name of Stanley Tee LLP regulated by the Solicitors Regulation Authority. Registered in England and Wales number OC327874.

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Legal Professionals

Darren was left paralysed and with a brain injury after falling through a skylight 40 year old Darren was an experienced building survey manager and was carrying out a building survey. In order to take some photos, he got out of his cherry picker whilst on the roof of the building. He stepped back and fell through a skylight which had been painted over to match in the colour of the existing roof. He fell some eight metres and suffered a traumatic brain injury, a spinal cord injury (which rendered him paraplegic) and many other serious broken bones. His employer’s insurers vigorously denied it was their fault, stating that Darren should not have stepped out of the cherry picker whilst at great height and that he didn’t need to take the photographs. PotterReesDolan Serious Injury Solicitors argued there was no proper guarding equipment and no instruction or proper training given on site. The insurers then accepted they were partly to blame. The case settled for £5 million but, as Darren accepted some of the liability, he was awarded £3.25 million with the option of returning to court to apply for further damages if he develops epilepsy or syringomyelia, a spinal cord disorder. Whilst his case was ongoing, Darren was forced to live in cramped conditions in one small room. His compensation has made a huge difference to his life. We have helped him to buy a beautiful new home, fully adapted to meet his needs, with all the aids and equipment to allow him his independence and dignity back.

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Taking legal action

If you want to take legal action to claim compensation for a personal injury you will need to get advice from a solicitor specialising in these types of cases. This must be done as soon as possible as there are strict time limits on taking legal action (see below).

Time limits

There are different time limits within which you must begin legal action in a personal injury claim. You should therefore get legal advice urgently if you wish to claim compensation. The most common claim in a personal injury case is negligence and the time limit for this is three years. This means that court proceedings must be issued within three years of you first being aware that you have suffered an injury. In some cases, a court may decide to extend a time limit, depending on the circumstances of the case. If you are considering taking legal action and have not yet been to a solicitor you will need to be aware of the time limits for taking action and should seek help from an experienced adviser, for example, a Citizens Advice Bureau.

Paying for legal action

Legal action for compensation for a personal injury can be expensive. You may be able to get help with legal costs from, for example:• • • • • Page 36

A solicitor or organisation providing legal aid For more information about legal aid, see Help with legal costs. A conditional fee agreement An insurance policy. Many house contents policies, car insurance or travel insurance policies have legal expenses cover attached.


Motor Accident Solicitors Society (MASS)

The Motor Accident Solicitors Society (MASS) is an association of solicitors experienced in dealing with personal injuries resulting from motor accidents. Participating solicitors provide a free initial consultation. MASS can be contacted at:St Bartholomews Court 18 Christmas Street Bristol BS1 5BT Tel: 0117 925 9604 Email: office@mass.org.uk Website: www.mass.org.uk

Criminal Injuries Compensation Authority

If you have been injured as a result of a criminal act you may be able to claim compensation through the Criminal Injuries Compensation Authority (Criminal Injuries Compensation Agency in Northern Ireland). You may have been the direct victim of, for example, an assault or your injury may have been sustained when you were attempting to help the police after a crime had been committed. A close relative of a person who died because of injuries can also make a claim. You must report the incident to the police at the earliest opportunity and an application must normally be made within two years of the incident. However, in exceptional circumstances, the authority may be willing to extend this limit. An example would be if you are making a claim for abuse you suffered as a child. Criminal Injuries Compensation Authority Alexander Bain House Atlantic Quay 15 York Street Glasgow G2 8JQ Helpline: 0300 003 3601 (Monday, Tuesday, Thursday and Friday from 8.30am to 5.00pm; Wednesday from 10.00am to 5.00pm) Website: www.cica.gov.uk

Action against Medical Accidents (AvMA)

AvMA can provide information, support and referral to solicitors if you are the victim of a medical accident. AvMA has a panel of medical experts prepared to give independent opinions. Freedman House Christopher Wren Yard 117 High Street Croydon CR0 1QG Helpline: 0845 123 23 52 Website: www.avma.org.uk Page 37


Conditional fee agreement

A conditional fee agreement means that your solicitor will receive no fees if you lose your case. You may, however, have to pay the legal fees and expenses of the other side. Your solicitor will normally ask you to take out insurance to cover this situation. If you win your case, your solicitor's fees and expenses will normally be paid by the other side. If you are considering taking legal action and you have not yet been to a solicitor you may want to seek advice about possible sources of help with legal costs from an experienced adviser, for example, a Citizens Advice Bureau.

Choosing a solicitor

If you want to take legal action over a personal injury you should consult a solicitor who is a member of the Law Society’s personal injury accreditation scheme or clinical negligence accreditation scheme, depending on the nature of the injury. The Law Society can give details of solicitors on these accreditation schemes and can be contacted at: 113 Chancery Lane London WC2A 1PL Tel: 020 7242 1222 Fax: 020 7831 0344 Email: info.services@lawsociety.org.uk Website: www.lawsociety.org.uk

Association of Personal Injury Lawyers (APIL)

The Association of Personal Injury Lawyers (APIL) is a not-for-profit association of solicitors, barristers and academics who specialise in personal injuries work. Many lawyers belonging to APIL are part of an accreditation scheme. The accreditation scheme guarantees members are competent in a particular field of personal injury. Accredited lawyers from Senior Litigator level upwards have at least five years’ experience of dealing with personal injury claims. All APIL members promise to follow a code of conduct and a consumer charter. They may be useful in helping you find a solicitor who can deal with your case. You can find out more about APIL at: 3 Alder Court Rennie Hogg Road Nottingham NG2 1RX Find a lawyer helpline: 0115 958 0585 Tel: 0115 958 0585 Fax: 0115 958 0885 E-mail: mail@apil.org.uk Website: www.apil.org.uk

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Legal Professionals

“Exchange Chambers’ members have a high level of expertise in a variety of complex and niche personal injury matters, including catastrophic injuries…” Chambers UK The personal injury and clinical negligence department at Exchange Chambers has a proven track record in handling the most severe catastrophic claims through to high volume paperwork. With five silks and over forty juniors, the team’s wide-ranging expertise and strength in depth is consistently praised by the independent legal directories, Legal 500 and Chambers UK. Comments about our members include “a leader in the field of catastrophic injury nationally” and “everything a modern barrister should be”.

Please contact Tom Handley, Director of Chambers handley@exchangechambers.co.uk

0845 300 7747 www.exchangechambers.co.uk Liverpool • Manchester • Leeds

The Brain & Spinal Injury Law Experts Geldards’ Medical Negligence specialists have extensive experience of handling all types of brain and spinal injury cases, achieving settlements + £10m in individual cases, including birth injury and cauda equina syndrome. We can represent you on a no win, no fee basis and your initial consultation is free. Our expert team is fully accredited by APIL and the Law Society and provides specialist Court of Protection/Deputyship services.

ASSOCIATION OF PERSONAL INJURY LAWYERS

Accredited Clinical Negligence Specialist

“ I cannot praise Angelina enough for the professional, compassionate way she treated me. I felt from our first meeting that she cared and was determined to see justice done.” W.P. - successful claimant

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Recovery/Rehabilitation/Court of Protection

Some lead, others follow As one of the largest sets of barristers’ chambers in the UK with over 250 members including 34 Queens Counsel, we have the quality and depth of expertise to meet your needs. No5 has a highly respected vibrant group of barristers who are specialists at the forefront of the developing jurisdiction of the Court of Protection. Members of Chambers not only practise extensively in this complex area of the law but also lecture and provide training for practitioners. The annual Court of Protection conferences held by No5 in London and Birmingham are extremely well attended and highly regarded.

“No5 Chambers offers noteworthy expertise in Court of Protection work and is particularly good at welfare matters” Chambers UK 2016

No5’s expertise in all aspects of this specialist area means that it is able to represent a wide variety of parties in property and affairs and health and welfare matters including serious medical treatment cases. For more information, please visit our website www.No5.com, or contact Practice Director Tony McDaid on: Tel: +44 (0) 845 210 5555 or Email: info@no5.com Head of Court of Protection - Negeena Khalique QC Practice Director Tony McDaid Tel: +44 (0) 845 210 5555 Email: info@no5.com

@No5Chambers

www.No5.com

No5 Chambers provides services on an equal opportunity basis.


Legal Professionals

Old Square Chambers specialise in representing the most seriously injured victims of accidents and illnesses We work across the UK to get the compensation our clients and families need to help rebuild their lives and cope with life-changing injuries with expert rehabilitation, medical care and support. Our barristers are leading experts in personal injury and clinical negligence. Our clients are victims of catastrophic injuries, including brain and spinal injuries, childbirth injuries, cerebral palsy, amputations, chronic pain conditions and psychiatric disorders. y

Our clients choose Old Square Chambers because of our first class reputation, because of our experience and knowledge and because we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best results. Don’t just take our word for it… “head and shoulders above most of its peers in terms of client service” “friendly and approachable” “incredibly helpful”

“among the best”

“never fail to deliver a great service”

“a more personal touch than many competitors”

“the go-to set for reliable, client-friendly and no-nonsense counsel” Quotes from Chambers and Partners and Legal 500

London 10-11 Bedford Row London WC1R 4BU

Bristol 3 Orchard Court Bristol BS1 5DP

T: +44 (0) 20 7269 0300 E: clerks@oldsquare.co.uk

T: +44 (0) 117 930 510 E: clerks@oldsquare.co.uk

www.oldsquare.co.uk

@OldSqChambers


Personal Injury and Disability a personal injury might need a lifetime of support

Personal injury claims and compensation typically take some time to settle. Doctors and specialists will assess your injury and help you recover. Your lawyer will help you secure your settlement. And a financial planner will help you manage it carefully over the long term.

You will need to know: • • •

How much money you’ll need now and over time If you need a financial manager, administrator or trustee Managing your settlement to ensure your money lasts.

Before Settlement

while your compensation claim is being settled While you’re negotiating your compensation claim, you will need to know how to manage financially. Your personal injury or disability claim will usually involve: • • • •

expenses – current and future pain and suffering income lost because of the injury, and future income lost.

As you can see, a legal settlement involves many financial issues.

How to Manage Now One of the first financial impacts may be the loss of income. Budgeting to live with less money, and possibly higher expenses, takes some adjusting. It needs you to have a clear understanding of the costs you face, your entitlements and the time lags you may face while you wait for your claim to be settled.

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Funds Management Report

Financial Planning

The fees charged for managing funds for those without capacity can be included in damages claims. It can provide a funds management report which outlines the costs involved in managing your settlement, now and in the future.

After The Settlement Once the compensation payment for your personal injury or disability has come through, you will have some important decisions to make. Your priority is to work out and plan how to access the settlement and use it to create an environment that will help you heal, the way you need to. No two injuries or disabilities are alike.

You may need to: appoint a manager, administrator or trustee The court appoints a manager, administrator or trustee in cases where the injured ..........person doesn’t have the capacity to make their own financial decisions. • choose a financial partner You need to work with a financial adviser who you feel comfortable with and who has ......... the right skills and experience to guide, support and protect you. • choose those who will support you You may need to have your home assessed and some alterations made. You may need ..........a carer, therapy, counselling and equipment to help you manage. •

Managing Your Settlement Your compensation payment is designed to help you create a new life, so it needs to be financially managed in the right way to make sure it lasts as long as you. Your health, safety and security are your priority. It is at this stage you will need some financial advice about how to spend your legal settlement prudently on the elements you need to build an environment of on going care. The issues you will need to consider are: You may need to consider some major expenditure such as equipment, alterations to your home and/or car. Developing a financial plan which works for you Your financial strategy should cater for your immediate needs, long-term plans, maximise your Centrelink entitlements and minimises your taxation. And lasts throughout your lifetime Page 43


Financial Planning

Helping you get on with life after serious injury We provide professional deputyship services allowing you to concentrate on giving loving care rather than dealing with financial and legal matters. The Court of Protection team at Slater Heelis are specialist lawyers, dedicated to managing the property and financial affairs of people who sadly lack the ability to deal with those matters due to a serious brain or spinal injury. Our solicitors can provide you with clear honest advice on: • • • •

Deputyship & Court of Protection applications Professional deputyship services Contested deputyship applications Specific applications to the Court of Protection

Speak with our specialist brain & spinal injury solicitor, Chris Partington TEP & Panel Deputy chris.partington@slaterheelis.co.uk 0161 672 1242 /slaterheelis P

@slaterheelislaw

slaterheelis.co.uk


Financial Planning

Chris Partington TEP, Partner and Head of Private Client at Slater Heelis LLP. Chris is a Professional Deputy and Professional Attorney acting on behalf of or protecting mentally incapacitated individuals. He specialises in advising clients on the best way of protecting their families and their loved ones assets and assisting with Court of Protection applications and giving guidance on Lasting Powers of Attorney. Due to the sensitive and potentially stressful nature of this type of work, Chris has a particularly sensitive approach to advising in these matters, recognising that many clients need friendly support and reassurance in addition to uncomplicated advice on the legal issues.

What areas can you help families with? I help families particularly with the financial aspects following a brain or spinal injury, such as taking care of the financial award or protecting their assets. I also strongly believe that emotional support is as valuable and necessary as legal advice, and will always give guidance and advice.

Who are you and what do you do?

What areas can you help families with?

I’m partner at one of the North West’s largest law firms Slater Heelis LLP. I’m an expert in wills, probate and Court of Protection issues and one of only 72 panel deputies in England & Wales appointed by the Office of the Public Guardian. I act for vulnerable clients who lack complete mental capacity to protect themselves and their assets.

I help families particularly with the financial aspects following a brain or spinal injury, such as taking care of the financial award or protecting their assets.

Tell us more about your personal experience and how it affected the work you do. Unfortunately, last year a close family member was involved in a serious motorcycle accident and suffered a brain injury. I experienced first-hand the emotional impact a life-changing injury can have on a loved one and their families. This, along with my thirteen years’ experience in wills, probate and Court of Protection issues, means I treat each case with individual attention, both legally and emotionally. What are the most common mistakes people make following a brain injury? One of the most common mistakes people make is that they rush into making changes in a loved one’s lifestyle before knowing the full prognosis of their injury. Often family members and those close to the victim don’t fully comprehend or plan for the full outcome of a brain and spinal injury, which can mean they are unprepared for the unexpected changes in a loved one’s injury and recovery. Another mistake people make is that they fail to prepare for an individual’s personality change, especially after a brain injury. This can be particularly hard for families and those close to the loved one to deal with.

I also strongly believe that emotional support is as valuable and necessary as legal advice, and will always give guidance and advice.

What are the three most important things a family should do following a brain injury? The most important, and possibly the hardest thing to do under such a stressful situation, is not to panic. It’s important to remain as calm as possible to ensure you’re able to make decisions rationally for your loved one. Also its useful to remember that there is a lot of help out there from charities and solicitors, so you will never have to be uncertain or lost during such a difficult time. Second of all, don’t rush through decisions for your loved one and before you act make sure you get professional legal advice first. This way you are ensuring you are getting the best help your loved one needs. And lastly, it’s vital to look after yourself as often families neglect themselves during such a distressing situation. Needless to say, a brain or spinal injury of a family member can be very emotional and it’s important to make sure you take care of yourself emotionally to process the situation healthily.

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Financial Planning

Wills & Trusts for Vulnerable People Very simple arrangements can make a huge financial difference to families Doing no estate planning could mean that an inheritance leads to a considerable reduction or loss of means-tested benefits. Leaving the money with another relative may sound like a good idea, but wellmeaning people are not always reliable custodians of finances. Contact us for a no-obligation discussion on the range of very simple solutions to estate planning that look after the best interests of your child, relative or friend.

Further information on Wills & Trusts for vulnerable people is available on the Wrigleys YouTube channel.

t: 0114 267 5588 e: ian.potter@wrigleys.co.uk w: www.wrigleys.co.uk

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Financial Planning

Wills & Trusts for Vulnerable People What you need to know about leaving money to a person with a disability Solicitor, Ian Potter, explains how very simple arrangements can make a huge financial difference to families. Any parent or relative of a child or adult with a disability may have a nagging feeling in the back of their mind that they ought to think about what will happen after they die and how their child or family member will be looked after financially. But life is busy and there is a lot to do looking after or supporting that person. It is not easy to find the time to get around to sorting out your arrangements for the future. Many people are surprised to find that it is in fact not that difficult to arrange your affairs to make sure that the money you want to benefit your child or relative can do so in a very effective way. What if I do nothing? Leaving things as they are can do more harm than good. We are often contacted by people who have inherited money from well meaning family members who do not realise that a direct gift can cause a loss of many welfare benefits and care provision. Can't I just leave my money to someone else in the family? People often think it is best to leave money to a sibling or other relative in the hope that they would look after the disabled person's interests in the future. Sometimes people can have a less generous interpretation of what they are supposed to do with the money, especially if they come under financial pressure themselves. There can be a lot of difficulties if the person who is "looking after" the money becomes bankrupt, gets divorced or dies. Can't my family just change my will once I have died? Although it is possible to do a Deed of Variation to redirect assets from a deceased person's estate for Inheritance Tax purposes, it is likely that any

attempt to do this would be seen as a deprivation by the Benefits Agency or Local Authority. In such circumstances they can refuse to reinstate the entitlement to means tested benefits or care provision. It is also difficult to put in place a Deed of Variation if the disabled person does not have the mental capacity to make this decision themselves or if they decide they do not want to do it anyway. They might prefer to have all the money themselves, even if other people are concerned that that puts them in a vulnerable position. If a person lacks the capacity to make their own decisions then the Court of Protection can become involved, but the process is often time consuming, costly and is no automatic guarantee that the Court will authorise that a Deed of Variation be put in place. When are means tested benefits affected? A disabled or vulnerable person may receive means tested benefits and care now or may become entitled in the future, particularly if their family circumstances change. If they receive money which takes their assets over ÂŁ6,000 then their benefit entitlement will start to be affected and over ÂŁ16,000 they will lose those benefits entirely. Slightly higher limits apply for people in care and for care funding, but the principle is still the same. So what is the right thing to do? Instead of leaving funds to a disabled or vulnerable person outright, it would be appropriate to think about using a Discretionary Trust. You can choose people who you have confidence in to be the Trustees in charge of that money for the future. It can be useful to appoint a Professional Trustee, often alongside family mem-bers, to provide professional advice and support in making decisions about how the money is looked after. A well run Discretionary Trust can save means tested benefits but can also give protection against anyone who may try to take advantage of the vulnerable person. Sadly financial exploitation is all too common and financial protection has to be an important consideration

financial protection has to be an important consideration Is this something I need to do in my will or should I set up a Discretion-ary Trust now? You can set up a Discretionary Trust under your will or during your lifetime. A Discretionary Trust set up in your will does not take effect until your death so there are no running costs until then and you can change it at any time during your lifetime. A lifetime Discretionary Trust can be useful if other family members want to make gifts to the disabled or vulnerable person or if you want to move funds out of your estate during your lifetime. This allows the Trust to start taking action and can also have Inheritance Tax advantages if it is done early enough. Is there any limit on the amount I can put in? There is no limit on the amount you can contribute by will, but you should bear in mind that any gift by will only takes effect on your death. You should also be aware that some of your estate may be subject to Inheritance Tax before the money can go into the Discretionary Trust. If you want to set up a lifetime Discretionary Trust then there can sometimes be an immediate Inheritance Tax charge. However, if the main beneficiary of a Trust qualifies as a "disabled person" under the Tax Legislation and the Trust is carefully written, then the tax charge will not apply . This is a complicated area and expert advice is definitely need-ed before any decisions can be made. Wrigleys has a special focus on meeting the needs of individuals who are or may be vulnerable, injured, disabled or suffering from illness. For further information on Wrigleys' services, please contact us. Wrigleys Solicitors LLP www.wrigleys.co.uk Tel: 0114 267 5588 Email: ian.potter@wrigleys.co.uk

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Financial Planning

Estate Planning after receiving compensation A personal injury compensation award comes at the end of what is often a long process, which is why it is important to protect it - not just for yourself but for your family. There’s a possibility that your estate could be subject to a considerable amount of tax after your death- which is why it is vital to get expert advice and plan properly to help reduce this liability. The rules and regulations surrounding inheritance and what happens to your assets after you die are a minefield, with changes already announced by the Government which will come into force in 2017. It’s so important to ensure your wishes are properly expressed in a Will - and to obtain the proper legal advice to ensure you are taking advantage of every allowance. Depending on the individual circumstances and the size of the estate, tax planning through the use

of a Trust might be a good option, particularly as it can significantly reduce the inheritance tax burden payable after your death. Trusts are also a wonderful vehicle for holding assets without losing control of them, and don’t forget to look at your life assurance and pension policies - as they offer a range of planning opportunities which can help you avoid paying unnecessary inheritance tax. At EMG solicitors, we can help you review your current and potential future assets and advise on whether you could undertake further planning to minimise the inheritance tax that will be payable upon your death. If you would like to chat through the possibilities for your Will or tax planning, please contact our expert estate planning solicitor, Samantha Edward at Samantha.edward@emgsolicitors.com or call 0191 383 7413.

Financial security - the best legacy you can leave for your loved ones. We are experts in protecting the assets of anyone who has received personal injury compensation. Contact us at enquiries@emgsolicitors.com or call for a chat on 0191 383 7425

www.emgsolicitors.com

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Financial Planning

Personal Injury Clients – Why Invest the Money? In the 1980s it was possible to obtain a steady income which comfortably exceeded the rate of inflation, simply by depositing money in a bank or building society. This low risk option of obtaining a reliable inflation busting return is no longer available. Since 2009 high street interest rates have been woefully low generating a return that has little chance of Martin Kettle Chartered Financial Planner keeping up with the rising cost of living. In other words your purchasing power is virtually certain of being eroded over time. What’s more the new era of ultra low interest rates is set to continue; and has become the new norm.

assets tend to offset each other in panic driven markets. For example if share prices are plummeting worldwide, investors routinely seek the safe haven of high quality government bonds which tend to rally as a result. The benefits of diversification is to reduce the incidence of worrying capital losses; helping to produce a less volatile sequence of annual returns.

It follows that if you need to generate a return that keeps up with your future outgoings, this must involve investment in instruments that may from time to time sustain capital losses. Obviously this involves embracing a higher level of risk but at least there is a significantly better chance that your spending power will be protected or even enhanced.

LIBOR is the interbank offered rate, note that bank current accounts pay less than this figure. Our portfolio consists of an 80% exposure to British government stocks of all maturities and a 20% weighting in the FTSE All Share index.

It is well known that share prices (equities) can go up as well as down; but government bonds can also sustain capital losses when interest rates rise. But one of the advantages of having a combination of shares and government bonds in a portfolio is that these different

In the last 5 years to May 2016 an investment at shortterm 3 month interest rates (LIBOR) would have delivered a total return of 2.7%, during this time the cost of living as measured by the retail price index had gone up by 11.5%. So the “money in the bank” option would have delivered an erosion of spending power of nearly 9% in 5 years However a cautious investment portfolio of 80% UK gilts and 20% FTSE All Share index* would have generated a total return of 34%.

Leaving your money in the bank is no longer a viable option for preserving your spending power over time. In order to have a realistic chance of at least maintaining living standards, the risk of short term capital losses needs to be embraced. But the experience of the last 5 years suggests that taking on some risks gives you an opportunity to reach your objectives and more.

Serious Injury Financial Planners

Making your personal injury award last Conçerva are specialists in providing advice to recipients of substantial personal injury awards as a consequence of serious and catastrophic injuries. ■ ■ ■ ■ ■

Decades of experience dealing with vulnerable clients 10 years experience in the Personal Injury Market Welfare Benefits & Trust Advice Cash management Cashflow modelling

For further information please contact

Martin Kettle APFS CHARTERED FINANCIAL PLANNER

07414 924 250 martin@concerva.co.uk

■ ■ ■ ■ ■

Investment portfolio contruction Investment portfolio management Tax Planning Chartered Financial Planners Highest levels of Professional service assured

Conçerva Limited Barnfield House The Approach Manchester M3 7BX t: 0161 819 3636 www.concerva.co.uk

Conçerva Limited is authorised and regulated by the Financial Services Authority, FSA Registered No. 196679

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APPOINTING A DEPUTY | FREQUENTLY ASKED QUESTIONS How do I choose a deputy? You can either opt to appoint a professional deputy or a lay deputy. A lay deputy is generally a family member who is comfortable with taking important financial decisions and has the time to devote to this important role alongside other responsibilities. Often a family member may act as a lay deputy where an elderly parent requires support in managing their finances. A professional deputy is more often chosen where someone has an acquired brain injury because of their expertise in dealing with such cases. This is even more relevant where someone may be making a damages claim where there could be significant and quite complex financial matters to be managed. If lawyers are being instructed to pursue an injury claim they can usually claim any additional costs of using a professional deputy. Several Brain Injury Group law firm members have professional deputies who work with families in this situation and will be happy to advise you individually.

What can I expect from a professional deputy? A professional deputy will take full responsibility for managing the individual’s finances, involving the family fully in any decisions that are made. Practical support often involves some or all of the following, though this is not an exhaustive list: • Ensuring availability of funds to meet day-to-day requirements • Setting and monitoring budgets with clients, families and other professionals • Acting as employer for directly employed care teams and administering the payroll, PAYE and National Insurance • Paying regular household bills • Preparing tax returns, annual accounts and reports • Arranging the investment of an injury claim settlement • Liaising with case managers and care teams • Buying and / or adapting a suitable property • Dealing with benefits applications • Considering the availability of statutory funding to meet care needs • Making applications to the Court of Protection

What does it cost to use a professional deputy? Costs will vary according to who you use and how much you want them to do, although costs are generally determined by the Court either through an assessment process or on a fixed cost basis. If you are seeking an award for damages, it is usually possible to claim the additional costs of a professional deputy being appointed. Our Court of Protection specialists will be able to draft a schedule of costs as part of the claims process. Your solicitor will explain the details to you. If I act as a lay deputy, can I get help if I need it? You may be happy to act as a lay deputy in respect of day-to-day activities but would like some back-up for the more onerous tasks that you don’t have the time or skill to deal with yourself. Our Court of Protection specialists will be more than happy to work alongside you. Can I be paid for being a lay deputy? No, not for your time, but you can claim reasonable expenses for things that allow your to carry out your duties as a deputy (eg. travel, phone calls, postage); only professional deputies can be paid for the time they spend carrying our their duties.

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PI/Financial Planning

Truly independent, specialist advice for damages awards Our highly regarded Personal Injury & Court of Protection Team offers more than 25 years’ of experience in dealing with the specific financial aspects of personal injury and clinical negligence claims, pre- and post-settlement, as well as advising individuals on general financial matters. For more information call us on 0207 065 1747 or email personalinjury@chasedevere.co.uk

Brain and Spinal Injury Legal Experts

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Brain and spinal injuries can drastically change the lives of victims and their families. At 3PB our barristers are committed to obtaining the right amount of compensation for clients to help with recovery and rehabilitation and improve long term quality of life. 3PB Barristers, a leading UK chambers with expertise in brain and spinal injury claims and awards, specialise in securing the best settlements for personal injury and clinical negligence claims, from high value complex cases to smaller personal injury disputes. 3PB also offers mediation and ADR services to clients at any of our five UK locations or at an alternative, suitable venue.

David Wright, Personal Injury and Clinical Negligence Group Director, will be happy to discuss your legal requirements and is contactable on 0207 583 8055, or david.wright@3pb.co.uk

www.3pb.co.uk LONDON

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Court of Protection/Financial Planning

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Key guidance on mental capacity issues Assessing mental capacity The Assessing mental capacity tool aims to help you assess whether a patient has the capacity to make a decision at a specific time. This practical, easy to use tool will enable you to break down the assessment into a number of discrete, legally-compliant steps, as laid down in the Mental Capacity Act for England and Wales. Vulnerable adults and confidentiality Adults who are subject to abuse, may not want confidential information disclosed, even when this would be the best way to ensure they are protected from harm. Our guidance sets out the legal and ethical position for healthcare professionals in this type of challenging situation. Advance decisions and proxy decision-making in medical treatment and research Guidance covering the law and the ethical issues involved in competent individuals making advance decisions about their later medical treatment and proxy decisions about medical treatment made by other people on behalf of adults who lack mental capacity. Statutory advocacy services Health professionals care for some adults who have difficulties representing their own interests or making decisions about their own care or treatment. Our guidance focuses on formal advocacy services and when you should involve them. Doctors acting as health and welfare attorneys for their patients We set out our advice on acting as a health and welfare attorney for your patients under the Mental Capacity Act (2005). There is nothing to prevent you accepting these requests but they should be considered carefully, as it may involve some risk of exposure to potential conflicts of interest.

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Justine Clowes, Chair of Solicitors for the Elderly (SFE), gives her top tips for anyone considering a Lasting Power of Attorney More than two million people in the UK are unable to make their own decisions, perhaps because of dementia, a stroke, brain injury, learning disability, or mental illness, and SFE research shows that only 7% of people have some kind of LPA in place. A Lasting Power of Attorney (LPA) is a document that allows you to choose one or more individuals (called an attorney) to handle your affairs. An LPA acts as a safeguard in the event you are no longer able to make rational, responsible decisions for yourself – this may be needed if someone lacks mental capacity, or for anyone who worries that mental or physical capacities may be lost in the future. Without an LPA in place, if you become incapacitated, there is a risk that your loved ones will have little or no influence over major decisions around your affairs. Instead, these decisions can be left to the court, medical professionals, or even a social worker. An LPA allows you to ensure decisions are left in the hands of someone you trust, but these documents can only be made while an individual has mental capacity, so it is important to think about your options sooner rather than later. An LPA has to be registered before it becomes a valid document and registrations may take a while to be processed and your circumstances could change rapidly, so to minimise the financial and emotional impact on your loved ones, it is advised to plan ahead. For those considering an LPA, it is important to speak with a legal professional. Legal matters concerning your health, care, and finances can be complex, and a specialist lawyer will apply their experience to help you think about things you perhaps hadn’t considered. It is also beneficial to keep your LPA up-to-date. If your circumstances change, such as your marital status, you may want to change the person who is responsible for your affairs. Here are five top tips to keep in mind when considering an LPA: 1. Consult a professional An LPA is an extremely powerful document, so it’s important to consult a professional to ensure you get it right first time around. DIY methods, such as off-the-shelf kits and online applications may lead to mistakes in your documentation, making them legally invalid. 2. Have a discussion with your loved ones It can be difficult to have a conversation and plan your later life with your loved ones, but speaking openly and honestly about your wishes can help them make the right choices on your behalf. Having this conversation takes difficult decisions out of their hands as you make them ahead of time. 3. Consider the options A legal professional can present you with various scenarios you perhaps haven’t considered and advise you on each situation. For instance, you may want to register two people as your attorneys rather than just one. It’s extremely important to pick the right individuals to act as your attorneys and that their views align with your own. 4. Allow plenty of time Registering an LPA can take several weeks. If you are helping a friend or relative set one up, then ensure you plan ahead. Remember, once an individual loses mental capacity they can no longer make an LPA. 5. Ask questions if you are unsure There are two types of LPA, one which covers your health and care arrangements and one for your financial affairs. Your lawyer will be able to advise you on which one you need, although it is often recommended to consider both, alongside a will. These documents require important decisions to be made on your behalf, so make sure you explore any questions or doubt you might have with a professional before going ahead.

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Financial Planning/Cost Lawyers

What do you need most in the aftermath of a spinal injury? Probably a range of vital things. It’s hard to prioritise. But the chances are that a key future objective is regaining your independence, getting your life back as close as humanly possible to how it was. You’ll have family and friends in support, but some legal and financial aspects crucial to your progress will need professional input. Attwaters Jameson Hill’s specialist lawyers have the compassion and expertise to guide you through complex processes towards a positive outcome. Our personal injury and medical negligence teams are here to help you secure appropriate financial settlement. As part of our ongoing service following settlement we also advise on Court of Protection matters, Special Needs Trusts and other legal planning matters such as Wills and Tax.

01279 638803 info@attwaters.co.uk www.attwatersjamesonhill.co.uk

ASSOCIATION OF PERSONAL INJURY LAWYERS

Accredited Personal Injury Practice

We believe we have incomparable experience in dealing with costs issues and pride ourselves on the level of service we provide our clients. Benefiting from the specialist experience of Costs Lawyers, Solicitors, Members of the Chartered Institute of Arbitrators and a non-practising Barrister, we believe we have unrivalled experience in all areas of costs law and a collective skill set that cannot be matched. Our commitment to providing a professional service has led to instructions in some of the largest cases in the commercial, environmental and libel fields, where costs regularly exceed £1million. Our particular areas of expertise include:

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Clinical Negligence Commercial Litigation Construction Litigation (including arbitration) Defamation Insurance Litigation Intellectual Property

Our client base is eclectic and encompasses not only solicitors, but also insurers and re-insurers, public authorities, London boroughs and local authorities. The diversity of our client base and the breadth of our experience gives us an unparalleled advantage in dealing with costs issues. Our strength is also derived from a high level of resources which enables us to provide an efficient service to meet all our clients’ needs. We are particularly proud of the long term relationships we have established with many of our clients. This has been achieved by flexibility in understanding their needs and delivering a consistent service to build and maintain a high level of trust and reliability. The firm continues to move forward with a structured expansion plan supported by our continuous internal training programme and development of increased resources. Our strategy includes maintaining our position at the forefront of the costs field and delivering the optimal levels of service that our clients have come to expect.

3–4 New Street, Bishopsgate, London, EC2M 4HD - 020 7256 3620 www.masters-legal.co.uk

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Plain Sailing on the 7 ‘C’s of Costs Recovery.

Navigating the stormy waters of costs recovery can be at best problematical and at worst disastrous! As professional costs drafters most find a number of recurring factors which can be avoided with careful planning and management. We all know how difficult it is to obtain personal injury claims in a saturated market, and so it is even more important that we charge correctly for all the work that we carry out on behalf of our clients. Our goal as lawyers is to offer a high quality service to our clients and as business men to ensure that we achieve an acceptable level of profit costs and maintain acceptable costs of production. Lawyers are in business selling a service for profit. We need to develop that service and balance the level of profit costs achieved with client care, speed and the costs of production. Here, therefore is a quick guide for a safer passage through the sea of costing:

CONSISTANCY: Develop systems to ensure that all necessary tasks on a file are carried out every time. This will improve cost recovery and avoid negligence claims.

CASE MANAGEMENT:

This is the best way to achieve consistency. Think about what you want from your system and adapt it to work for you.

CFA:

Ensure that your CFA and retainer are correct and compliant with current legislation.

CONSIDERATION OF DOCUMENTS:

The majority of time on a file and therefore the largest proportion of recoverable costs is spent on documents and preparation. Make sure that you have complete attendance notes and that all time is correctly recorded.

CHANGE OF FEES:

Make sure that you inform your client in writing when your charging rates change.

CLOSE THE DEAL:

It sound simple, but ensure that a settlement includes the obligation for your opponent to pay costs!

CASH FLOW:

Don’t leave busy Fee Earners to attempt to settle costs in between ‘real’ work. Instruct CCR as soon as the case settles to ensure costs are recovered expeditiously. Page 56


PUTTING PROFIT BACK INTO LEGAL COSTS

BRAIN & SPINAL INjURy, COURT OF PROTECTION, CLINICAL NEGLIGENCE

For 20 years PIC have been Costs Lawyers and Costs Consultants specialising in Civil Litigation claims including Brain & Spinal Injury, Clinical Negligence and Court of Protection matters. Why Choose Us: • Our commitment to maximising costs recovery for Claimant Solicitors and adding value to their bottom line • Our dedication to releasing lock up in the shortest possible time • Excellent customer service

For further information: T: 03458 72 76 78 | E: info@pic.legal www.pic.legal


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