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Vaccine injury

  • 1.  Vaccine injury

    Posted 07-10-2015 06:07

    Hello everyone,

    i am looking for guidance on the topic of vaccine injury and implications for LCP. Has anyone worked on preparing an LCP for vaccine injured client and what are the important issues to consider. I will appreciate all and any suggestions and looking forward to a vibrant discussion. Sorry if this posting is a repeat one but for some reason I have been having difficulty posting messages. 

    Kind regards,

    Nellie

    ------------------------------
    Nellie Kreimer
    nkreimer@msn.com
    North Woodmere, NY United States
    ------------------------------



  • 2.  RE: Vaccine injury

    Posted 07-10-2015 08:35


    I recently completed such a life care plan this past April.  16 year old received a flu shot, subsequently developed acute transverse myelitis resultant in mid-thoracic paraplegia.

    She filed suit against the Secretary of Health and Human Services in Federal Court.  The case was referred to the Office of Special Masters for Adjudication.  The person's attorney hired me to complete a life care plan.  The US government had a life care planner as well.

    Several things about the case were interesting or different from the usual LCPs I complete.  

    Rather than being adversarial, the LCP process was more collaborative with the government's life care planner.  The government informed the person's attorney that we could develop a single life care plan in cooperation with the government's life care planner or we could each develop our own plans.  The attorney chose the latter.

    The government's life care planner flew down from Washington DC to meet with the person.  I took part in the meeting.  We coordinated one of the doctor conferences while the life care planner was in town.

    When I got the case, I immediately scheduled all of the doctor conferences (6 physicians).  I completed three before the government contacted us and asked if we would coordinate them with the government's life care planner as well in order to save time.  This was not a problem.  The government's life care planner was professional and personable.  Very easy with which to work.

    Another interesting point, some life care planners submit a flat fee for the plan or components of the work is grouped together due to the volume of research and work involved.  The government told the person's attorney that I needed to turn in a detailed point by point invoice in order to get reimbursed.  Now I do that anyway but it is something to clarify when you get a case like this.

    Since the government's life care planner is in Washington DC and we are in Louisiana, there was not much contact between the government's life care planner and the evaluee.  So I am thinking that the government has a range in mind concerning the costs of the plan and as long as my plan isn't outrageous and is well supported, I don't see this process being contentious.

    Another point, collateral sources.  I develop my plans without regard to collateral sources.  A legal issue in Louisiana.  I won't get into the ACA.  However, in this vaccine program, the person's health insurance is factored in.  I was told by the government's life care planner that completing the life care plan without using collateral sources was OK as long as I included a statement about this issue in the plan and that we acknowledged that health insurance would be a factor.  The person was covered under a parent's health insurance obtained through employment.

    Other than that, the research and development of the life care plan proceeded per usual and customary methodology.

    I have attached some reference docs that I obtain freely on google.

    If you have any other questions, let me know.  You can also email me.

    ------------------------------
    Burt Ashman
    Vocational Consultant
    burt@outlook.com
    Lafayette, LA United States
    ------------------------------

    Attachment(s)

    pdf
    JLNC_Spring06_Final.pdf   150 KB 1 version
    pdf
    vacinjur.pdf   184 KB 1 version


  • 3.  RE: Vaccine injury

    Posted 07-10-2015 09:18
    Hello Burt,
    Thank you so much for sharing such valuable information and the reference. It sounds like you handled a complex situation with flying colors. I think that when we are faced with complexity and challenges , we become empowered  and use our creativity, knowledge and intuition to achieve resolution. That is exactly what makes our practice as CLCPs so rewarding.I will definitely keep in touch as I am sure I will have more questions. 
    Kind regards,
    Nellie 

    Sent from my iPad





  • 4.  RE: Vaccine injury

    Posted 07-10-2015 20:27

    Thank you Burt for sharing.  Any chance anyone has any more current citations or information to share?  Larry

    ------------------------------
    Larry Rechlin, PT, DPT, MS, ATP, CLCP
    Rehabilitation Consultant / Life Care Planner
    rechlila@comcast.net
    Naples, FL, USA
    ------------------------------




  • 5.  RE: Vaccine injury

    Posted 07-13-2015 00:20

    Hello Mates,

    I've done several of these vaccine injury cases; I seem to get them quite often.  I agree with Burt for the most part as it seems my experiences were similar. Perhaps because I've done so many, however, I've seen more of the not-so-helpful side of the Life Care Planners who work for the Feds on these cases. There are a handful of them scattered around the country. They typically do not meet with the plaintiff but rather they do their plans based on records. They do, in fact, insist on using collateral resources but I refuse to do mine that way.  If they want to consider SSDI, SSI, work comp, Medicare/Medicaid, or any other financial assets, I make them do the calculating.  The last one I just finished, the life care planner asked me to put in place the provisions for Obamacare premiums then offset the costs of lifetime needs with what Obamacare would pay.  I told her that under no circumstances would I do such a thing; it was her job to make the adjustments.

    Another thing to be aware of is that the plaintiff life care planner is capped at a certain dollar amount we can charge  I typically keep my attorney-client in the loop as we go and I stop as we get close to max  I've typically been able to prepare a great LCP within the limits but on the more extensive ones, I've requested an increase. 

    These can be very rewarding plans to do but also very frustrating to anyone with a heart. The government settles these cases for mere eanuts! Not even close to what are the bare necessities for lifetime medical needs.

    i hope this helps.  Be sure you read the fine print if you do one because there are subtle nuances that are unlike the LCPs with which we are all familiar.

    Good luck :-)

    mary

    ------------------------------
    Mary Salerno RN, BS, CRRN, CDMS, LNCC, CCM, CBIS, CLCP
    Certified Life Care Planner
    Catastrophic Case Manager

    M. Salerno & Associates, Inc.
    A Medical Legal Nurse Consulting Corporation
    Maryville, TN USA
    mary.salerno@msalernoinc.com
    ------------------------------




  • 6.  RE: Vaccine injury

    Posted 07-13-2015 01:43
    Hi Mary,
    Thank you very much for such an informative response. It sounds like there is room for much improvement in the area of vaccine injury compensation. As Life Care Planners and especially as nurses, we are in a unique position  to advocate for improvement in quality of care and quality of life. Although advocate may not be the politically correct statement to combine with the actions of Life Care Planners as we are supposed to be objective, impartial, and educational in our efforts to create a reasonable and medically necessary LCP , we are still striving for a means to make the person whole, minimize/ prevent complications  and improve the quality of life.  Although it may take a while and considerable professional effort, I am certain that our strive for quality will not be wasted in vain when it comes to LCP & vaccine injury compensation. It is absolutely amazing to network with our group and exchange ideas and information. It is an amazing opportunity for growth, development , education and formation of new concepts. 
    Kind regards, 
    Nellie 

    Sent from my iPad





  • 7.  RE: Vaccine injury

    Posted 07-13-2015 08:16

    Nellie,

    This is just one of many government programs that needs improvement. The reason we typically don't see a lot of these cases compared to other LCPs is because proving causation is next to impossible!  The range of medical problems I've seen go from an altered gait and fatigue in one person all the way to vent-dependent and death in another. The fact that vaccines are promoted so heavily doesn't help the situation because the fact is that these injuries are quite uncommon. (Still too common for me to get a flu vaccine though).  You nailed it when you said ADVOCATE. Politically correct or not, I'm of the opinion that a fair, unbiased and objective LCP is the best way to advocate for a patient. Whether I'm doing a LCP for the defense or plaintiff, my LCP will be the same on that particular patient. And I get just as many defense plans as I do plaintiff plans. 

    If you are assigned one of these cases you're welcome to call me for advice or help. They are tricky little buggers, those government people!  HAHA

    Mary
    ------------------------------
    Mary Salerno RN, BS, CRRN, CDMS, LNCC, CCM, CBIS, CLCP
    Certified Life Care Planner
    Catastrophic Case Manager

    M. Salerno & Associates, Inc.
    A Medical Legal Nurse Consulting Corporation
    Maryville, TN USA
    mary.salerno@msalernoinc.com
    ------------------------------




  • 8.  RE: Vaccine injury

    Posted 07-13-2015 08:25
    Hi Mary,
    Thank you so much for the support and the offer. I am looking forward to calling on you!!!
    Have a wonderful day and thank you so much again for enlightening me.
    Kind Regards,
    Nellie
     





  • 9.  RE: Vaccine injury

    Posted 07-13-2015 08:39

    The vaccine cases are not typical litigation.  Causations not an issue if the patient ( called the "petitioner")  meets the "table" guidelines.  This saves the petitioner a lengthy trial and unpleasant trial preparation.  The vaccine compensation program has specific rules.  Compensation is not given for every need.  There are guidelines and compensation is only given within the guidelines.  You will avoid some frustration if you familiarize yourself with the guidelines.

     

    The vaccine act compensation is only for out-of-pocket expenses, after all collateral sources have been considered.

     

    The collateral source rule typical for many venues just does not apply.  If you insist that the government's life care planner does these calculations alone you may be doing your client a large disservice.  We have found that many insurance policies have lifetime limits on services such a s physical therapy and have been able to increase the payout to the petitioner  It is important to your client that you  do examine carefully all of the collateral sources available to the petitioner.

     

    We have done dozens of these plans both for petitioners and for the government (called the "respondent".)  It has been our experience that no one is tricky.  Everyone has a job to do.  The respondent's job is to spread around a defined sum of money that has been allocated to the vaccine program to the most petitioners possible.  The petitioner's attorney and experts' job is to get a reasonable allocation for the client.

     

    We would all be best served by respecting professionalism.






  • 10.  RE: Vaccine injury

    Posted 07-13-2015 08:49

    I thought of another issue.  When I met with the psychologist, he recommended counseling for the family.

    The government life care planner told me that the "fund" is only responsible for medical costs that apply directly to the plaintiff.

    ------------------------------
    Burt Ashman
    Vocational Consultant
    burt@outlook.com
    Lafayette, LA United States
    ------------------------------

     



  • 11.  RE: Vaccine injury

    Posted 07-13-2015 09:12
    Hi  Burt,
    When working on LCP & vaccine injury this is an important issue to consider. It appears that the government system is pretty stiff and fragmented with specific coverage in mind without regard to evaluating the whole client and without real intention of improving quality of life. As Life Care Planners, we always evaluate the client as a whole and not just a sum of the parts, we assess all the problems, issues and needs dictated by onset of the disability/injury. I am very proud of  the dedication, persistence and hard work that Life Care Planners have been contributing in order  to improve quality of life for the injured clients. It is a hard job but as LCP's we are in the correct strategic position to initiate change and strive for success.
    Thank you for sharing such valuable information,
    Kind regards,
    Nellie
     





  • 12.  RE: Vaccine injury

    Posted 07-13-2015 10:09

    If counsleing for family member's is aimed at improving their care of the injured party, then it can be included.
    ------------------------------
    Mona Yudkoff
    mona@balacare.com
    Bala Cynwyd, PA United States
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  • 13.  RE: Vaccine injury

    Posted 07-13-2015 11:58

    I put everything into the LCP that I would put in anyone else's (case specific of course) and let the govt LCPer try to argue it. Unless I see something in a federal statute or the VICP rules that state otherwise I go by best practices and standards of care. For what it's worth....

    Mary

    ------------------------------
    Mary Salerno RN, BS, CRRN, CDMS, LNCC, CCM, CBIS, CLCP
    Certified Life Care Planner
    Catastrophic Case Manager

    M. Salerno & Associates, Inc.
    A Medical Legal Nurse Consulting Corporation
    Maryville, TN USA
    mary.salerno@msalernoinc.com
    ------------------------------




  • 14.  RE: Vaccine injury

    Posted 07-13-2015 22:06
    Hi Mary,
    I totally agree with your professional philosophy and would do exactly the same. Thank you so much for sharing your wisdom.
    Kind regards,
    Nellie
     





  • 15.  RE: Vaccine injury

    Posted 07-13-2015 09:31
    Hi Mary,
    I totally agree with you regarding respecting professionalism. I think that this is the most important premise of practice. When we work from that premise, we exchange information in such a way that  each party benefits from the interaction. 
    Thank you again for sharing such valuable information and guiding me. 
    Kind regards,
    Nellie