When an insurance adjuster offers a $1 million settlement for a spinal cord injury, it sounds like a fortune. To a family reeling from a catastrophic accident, it might seem like enough to cover everything.
It is not.
According to the latest NSCISC data, the lifetime cost of care for a 25-year-old with high tetraplegia now exceeds $6.2 million. That figure is before accounting for lost wages or pain and suffering.
Accepting a “standard” settlement for a permanent spinal injury is a financial death sentence. Once the money runs out in year five or ten, the cost of medical supplies, wheelchair replacements, and home nursing falls entirely on you.
This guide explains how we calculate the true value of a spinal cord injury claim using a Life Care Plan, and why the “Lifetime Cost of Care” is the only number that matters.
The “Two-Phase” Financial Reality
Spinal cord injuries (SCI) are unique because they have two distinct financial phases. Insurance companies love to focus on Phase 1 and ignore Phase 2.
Phase 1: The Acute Crisis (Year 1)
This is what you see immediately. It includes the helicopter ride, the ICU stay, the spinal fusion surgery, and the initial inpatient rehabilitation.
- Cost Reality: For high tetraplegia (C1-C4), first-year expenses average $1.4 million.
- The Trap: Adjusters often base their offers on these past medical bills, adding a small multiplier for “future needs.”
Phase 2: The “Maintenance” Marathon (Years 2–50+)
This is the silent financial killer. It includes the daily, recurring costs of staying alive and healthy with paralysis.
- Cost Reality: After the first year, annual expenses for high tetraplegia average $244,879 every single year.
- The Danger: A $1 million settlement, after paying the initial $500k in hospital liens and attorney fees, leaves barely enough to cover two years of maintenance care. What happens for the next forty?
The Evidence: What Is a “Life Care Plan”?
We do not guess at these numbers. In Nevada spinal cord injury cases, we work with medical experts (physiatrists and rehabilitation specialists) to create a Life Care Plan.
This is a comprehensive, itemized report that details every single medical and non-medical need the victim will have for the rest of their life expectancy. It is the roadmap for your financial survival.
The 4 Pillars of a Life Care Plan
1. Attendant Care (The Highest Cost)
For many tetraplegics, the single biggest expense isn’t the wheelchair. It is the human help.
- The Need: Assistance with bowel/bladder programs, bathing, dressing, and transfers.
- The Cost: 24/7 home health care can range from $150,000 to over $300,000 per year.
- The Fight: Insurance argues family members can provide this care for free. We argue that family members are not nurses, will age, and cannot provide 24-hour skilled care forever.
2. Durable Medical Equipment (The “Replacement Cycle”)
A power wheelchair costs $30,000 to $50,000. But you don’t just buy one.
- The Reality: Wheelchairs last about 5 years. If you are 25 now, you will need 10–12 replacements over your lifetime.
- The Hidden Items: The plan also includes specialized mattresses (to prevent pressure sores), standing frames (for bone density), and shower chairs. All of these must be replaced regularly.
3. Home & Vehicle Modifications
- Housing: Widening doorways, installing roll-in showers, and building ramps.
- Transport: A modified van with a lift can cost $80,000 to $100,000, significantly more than a standard car. Like the wheelchair, this van will need to be replaced every 7–10 years.
4. Medical Complications (The “What Ifs”)
SCI survivors are prone to secondary complications like urinary tract infections (UTIs), pressure ulcers (bedsores), and pneumonia. The Life Care Plan factors in the statistical probability of these hospitalizations so you aren’t paying for them out of pocket.
The Actual Numbers (2025 NSCISC Data)
The National Spinal Cord Injury Statistical Center (NSCISC) releases updated cost estimates that serve as the gold standard for these calculations. These 2025 figures show just how expensive these injuries truly are:
| Injury Level | Severity | First Year Cost | Annual Cost (Thereafter) | Lifetime Cost (Age 25) |
|---|---|---|---|---|
| High Tetraplegia | C1–C4 (ABC) | $1,410,163 | $244,879 | $6,256,937 |
| Low Tetraplegia | C5–C8 (ABC) | $1,018,966 | $150,222 | $4,571,708 |
| Paraplegia | T1–L5 (ABC) | $687,262 | $91,042 | $3,059,615 |
| Incomplete Motor | Any Level (D) | $460,224 | $55,900 | $2,090,344 |
Source: NSCISC 2025 Facts and Figures (costs in 2024 dollars). These estimates cover health care and living expenses only. They do not include lost wages, productivity, or pain and suffering.
Proving “Future Damages” in Nevada
Nevada law allows personal injury victims to recover damages for future medical treatment, care, and loss of earnings. However, the burden of proof is on you.
Nevada jury instructions state that damages cannot be based on “speculation or guess.” This is why the Life Care Plan is non-negotiable. It converts “speculation” into evidence-based projection, a detailed, expert-supported forecast that juries can rely on.
The Inflation Factor
Medical inflation typically rises faster than the standard Consumer Price Index (CPI). A dollar awarded today will not buy a dollar’s worth of nursing care in 2045. Our forensic economists adjust the Life Care Plan to account for this specific rate of inflation, ensuring the money actually lasts.
Action Plan: Securing Your Future
- Don’t Settle Early: The full extent of an SCI often isn’t known for 12–18 months. Settling before your condition stabilizes (known as “Maximum Medical Improvement”) guarantees you will under-settle.
- Demand a Life Care Plan: Ensure your attorney retains a certified life care planner. If they are relying on rough estimates, fire them.
- Identify All Defendants: A $50,000 auto insurance policy will never cover a $6 million injury. We must look for deep pockets such as trucking companies, auto manufacturers (defective roof crush?), or government entities (unsafe road design).
- Protect the Money: Consider a Special Needs Trust to manage the settlement. This ensures the funds are used for care while preserving eligibility for certain government benefits.
- Know Your Deadline: Nevada’s statute of limitations for personal injury is two years from the date of injury (NRS 11.190). While you should not settle before reaching Maximum Medical Improvement, you also cannot wait indefinitely. If you are approaching the 18-month mark without legal representation, contact an attorney immediately.
Why You Need Experience on Your Side
A spinal cord injury case is not just a lawsuit. It is a fight for the funding necessary to live a dignified life. The difference between a good settlement and a great one is often millions of dollars in future care costs.
With 40+ years of experience, Jack Bernstein understands the long-term reality of these injuries. We don’t just fight for a check. We fight for the wheelchair you’ll need in 2035, the nursing care you’ll need in 2040, and the peace of mind you need today.
Contact Jack Bernstein Injury Lawyers for a free consultation to evaluate your spinal cord injury claim: (702) 633-3333.
