Spinal cord injury after a car accident: what a claim involves

What a spinal cord injury is#

The National Institute of Neurological Disorders and Stroke (NINDS) describes the spinal cord as the bundle of nerves and nerve fibers that sends and receives signals from the brain, running from the lower part of the brain down through the lower back. A spinal cord injury can come from direct damage to the cord or from damage to the bones (vertebrae) and tissue around it.

The effects depend on where the injury is and how much damage there is. An injury high in the spinal cord can cause paralysis in most of the body and affect all four limbs, called tetraplegia or quadriplegia. An injury lower down may affect only the lower body and legs, called paraplegia. NINDS notes that paralysis can happen at the moment of injury or develop over time from bleeding and swelling.

Symptoms NINDS lists include numbness or tingling, paralysis, weakness, pain or pressure in the head, neck or back, loss of bladder and bowel control, trouble walking and difficulty breathing. NINDS notes that when a spinal cord injury is suspected at a crash scene, emergency crews place a rigid collar around the neck and move the person on a backboard to prevent further damage.

Complete and incomplete injuries#

NINDS divides spinal cord injuries into two kinds:

• Incomplete injury: the spinal cord can still send some messages to or from the brain, so the person keeps some feeling, function and muscle control below the injury.
• Complete injury: there is no nerve communication below the injury, so the person loses muscle control, feeling and function there.

Since 2015, the most frequent category has been incomplete tetraplegia, at 47.7% of injuries, according to NSCISC. Doctors grade severity on the American Spinal Injury Association Impairment Scale (AIS), and they describe the level of the injury using the spinal nerves:

The level and completeness of the injury shape almost everything in a claim: the care needed, the equipment, the effect on work and the cost. NINDS says doctors can now predict the likely long-term outcome with reasonable accuracy, which helps families plan; those medical assessments also become central evidence.

Vehicle crashes: the leading cause#

NSCISC, at the University of Alabama at Birmingham, keeps the national database of people with traumatic spinal cord injury. Its 2026 data sheet reports that vehicle crashes caused 37.1% of injuries since 2015 and falls caused 32.5%. NINDS likewise names motor vehicle accidents and serious falls as the most common causes, and lists not wearing a seat belt among the risk factors.

NSCISC estimates about 18,482 new traumatic spinal cord injuries each year in the US, and about 311,560 people living with one. The average age at injury since 2015 is 44.3 years, so many injured people are in the middle of their working lives.

Long-term care needs#

A spinal cord injury usually means a hospital stay followed by inpatient rehabilitation. Since 2015, NSCISC reports an average acute hospital stay of 18.6 days and an average rehabilitation stay of 36.3 days. Care continues long after discharge: about 29% of people with these injuries are re-hospitalized at least once in any given year.

NINDS lists the problems that often need ongoing treatment: breathing problems and pneumonia, blood pressure and circulation problems, muscle stiffness, pressure sores, nerve pain, bladder and bowel problems, changes in sexual function, and depression. A rehabilitation team may include a rehabilitation doctor, nurses, physical and occupational therapists, psychologists, social workers and vocational counselors. Depending on the injury, a person may need braces, a wheelchair, electronic stimulators or computer adaptations.

Work is often affected too. Among people injured since 2015, NSCISC reports that 64.5% were employed when they were injured, compared with 17.8% one year later. Lost income and lost earning capacity can be a large part of these claims; our guide to types of damages explains each category.

Life care plans and future costs#

In a serious spinal cord injury claim, future care is often set out in a life care planLife care plan. A report, usually prepared by a medical or rehabilitation expert, that lists the care, equipment and services a seriously injured person is expected to need over their lifetime, and what they may cost. Glossary. This is a report, typically prepared by a medical or rehabilitation professional, that lists the care, therapy, medicines, equipment, home help and other services a person is expected to need over their lifetime, how often items need replacing, and what they may cost. The other side may hire its own experts to challenge parts of it.

Future costs must be proven, not assumed. In California, for example, a jury can award future medical expenses only for care the injured person is reasonably certain to need in the future. Other states use similar standards, which is why life care plans are tied to doctors' opinions.

To give a sense of scale, NSCISC publishes average yearly expenses for people with traumatic spinal cord injury. These are national averages of health care and living expenses caused by the injury, in 2025 dollars. They are not what any claim is worth: NSCISC says the costs vary greatly with education, the degree of impairment and work history.

These figures leave out indirect costs such as lost wages, benefits and productivity, which NSCISC puts at an average of $97,787 a year.

Why these claims take longer#

Several things slow a spinal cord injury claim down:

1. Recovery has to be understood first. Much of the claim is about the future, so it is often not ready until doctors can describe the long-term picture, usually at maximum medical improvement.
2. Experts are often involved. Doctors, life care planners and economists may be needed to describe future care and lost earnings, and the other side may hire its own.
3. Insurance may not cover it all. The losses can far exceed the at-fault driver's policy limitsPolicy limits. The most an insurance policy will pay for one claim or one accident, no matter how large the losses are. Glossary, so other sources, such as your own underinsured motorist coverage or other people who share responsibility for the crash, may need to be found.
4. Others must be repaid. Health insurers, Medicare or Medicaid may have paid bills and hold a lienLien. A legal claim on part of your settlement by someone who paid for your care, such as a hospital, health plan or Medicare. Glossary on the recovery. Our guide to medical liens and subrogation explains how that works.

Taking longer does not stop the clock. Your state's statute of limitationsStatute of limitations. The law that sets the last day to file a lawsuit. After it passes, a court will usually dismiss the case, however strong it is. Glossary keeps running, so a lawsuit may need to be filed while treatment is still under way. Our guide to how long a claim takes explains the stages. A spinal cord injury can come with other injuries, such as fractures or a brain injury, and each needs its own records.