Many people think of attendant care as in-home nursing services. But the definition Iâ€™ve been using when explaining attendant care to my own clients is this: because of how serious the injuries are, an â€œattendantâ€ is required to provide â€œcareâ€ for the accident victim.
The Basics of Attendant Care
Attendant care is for those people who are so debilitated from their auto accident-related injuries that they cannot tend to their most basic needs. These are also called activities of daily living. These activities include eating, bathing, getting dressed and using the bathroom. For people who have been seriously hurt and cannot take care of their basic needs, or who require monitoring and supervision because it is unsafe to be left alone and unsupervised. It is considered a No-Fault PIP benefit that can be recovered from the auto insurance company responsible for paying No-Fault benefits. Attendant care can also be provided through an auto insurance company paying for a nurse, home-health aide or, by someone in the victim’s family. It can also be a combination of two or three, such as a commercial agency to provide attendant care that gives family members needed breaks.
Limits on Attendant Care
The No-Fault Law imposes no limits on the number of hours, days, weeks, months or years of attendant care that an auto accident victim can receive. For instance, it is not uncommon for a doctor to prescribe 24/7 – “around-the-clock” – attendant care. However, a Michigan auto accident victim is entitled to attendant care so long as the charges are reasonable and the attendant care services are reasonably necessary for the victim’s care, recovery or rehabilitation. Be aware that as I write these words, there is pending legislation (HB 4936) that would cap No-Fault insurance PIP benefits - including attendant care - in Michigan if it becomes law. Therefore you should check with an experienced No-Fault attorney to make sure the law has not changed, if you’re reading these words at some point in the future.
Who pays for attendant care?
The Michigan auto accident victim’s No-Fault insurance company pays for the victim’s attendant care – so long as the cost of the victim’s attendant care services is reasonable and the attendant care services are reasonably necessary for the victim’s care, recovery or rehabilitation. Although the hourly rate for attendant care is frequently a source of vigorous debate between auto accident victims and their No-Fault insurance companies, it is not uncommon for victims and their attendant care providers to secure $20 an hour to $30 an hour in compensation for their attendant care providers. Frequently, in determining what constitutes a “reasonable” hourly attendant care rate, Michigan courts will consider the hourly rates charged by healthcare agencies whose business it is to provide attendant care to paying customers.
The attendant care disability certificate
The critical factor in establishing that an accident victim is entitled to attendant care benefits is showing that the victim’s injuries have disabled her from performing her normal “activities of daily living.” A victim’s disability for attendant care purposes is usually verified through an attendant care disability certificate, statement, or prescription by the physicians who are treating the victim. A physician-issued attendant care disability certificate or statement may include the following: the auto accident victim suffered injuries from an auto accident, the injuries have disabled the victim from performing her normal “activities of daily living”, attendant care services are required to assist the victim with performance of her normal “activities of daily living”, a list of specific attendant care services are required, the period of time during which attendant care services will be required and the diagnosis that gives rise to the need for attendant care services.
The affidavit of attendant care services performed
Almost as important as showing the disability that gives rise to the need for attendant care services is showing that the prescribed attendant care services were actually performed. This is also something a No-Fault attorney can help you with. Without proof of both disability and performance, a No-Fault auto insurance company is likely to refuse payment of attendant care benefits. Note also that even when these attendant care services are performed, the insurance company will likely also refuse payment if there is not an expectation of payment on the part of the family member or friend performing these attendant care services. To prove that attendant care services have been performed, the auto accident victim and/or her attendant care provider must complete and submit an “Affidavit of Attendant Care Services Performed” to the victim’s No-Fault insurer.
Information Needed in the Affidavit
Among other things, the “Affidavit of Attendant Care Services Performed” should probably contain the following information: Name of the person who provided attendant care services to the victim, the attendant care services that were provided, the dates and hours during which attendant care services were provided, the hourly charge and the total dollar amount owed for attendant care services provided.