Written and reviewed by Josh Kohanim, Esq., California Bar No. 328609 · Reviewed
Quick questions
Key issues in spinal cord claims
We represent people with a traumatic spinal cord injury and the families now running their care, anywhere in Los Angeles County. The claim turns on what the injury is, what it costs over a life, who pays, where the insurance comes from, and the deadlines. Degenerative spine disease and the workers' compensation system are addressed below where each changes the answer.
Most injury claims argue about the past. This one argues about the next forty years. The trauma center bills are the only part anyone can count today, and what decides whether the money lasts is the care nobody has paid for yet.
Four supporting pages go deeper. Paralysis, paraplegia, and tetraplegia works through each level of injury. What a spinal cord injury costs over a lifetime publishes the full cost table and its methodology. Incomplete spinal cord injury claims is for the majority, whose function is partial. Back and neck injuries that are not cord injuries is for readers with a disc injury.
Spinal cord injury defined
The spinal cord is the bundle of nerves running down the middle of the back that carries signals between the body and the brain. MedlinePlus, published by the National Library of Medicine, describes the mechanism: the injury begins with a blow that fractures or dislocates a vertebra, and most injuries do not sever the cord. The damage comes when bone tears into cord tissue or presses on the fibers carrying the signal. The bone is the column. The tissue inside it is the cord.
Complete and incomplete
The words do not mean what most people assume. The American Spinal Injury Association draws the line at the lowest segment of the cord, tested by whether any movement or sensation survives in or around the anus. An injury is complete when nothing gets through, incomplete when something does, even if the person cannot walk.
Tetraplegia and paraplegia
Both words describe where the injury sits, not how severe it is. Tetraplegia, also called quadriplegia, follows an injury in the cervical spine, the eight segments in the neck, and affects the arms as well as the trunk and legs. Paraplegia follows an injury in the thoracic, lumbar, or sacral segments and spares the arms. High tetraplegia at C1 to C4 and low tetraplegia at C5 to C8 are counted separately, because about $400,000 in first year expenses sits between them.
Injury grading
Hospitals grade the injury with the International Standards for Neurological Classification of Spinal Cord Injury, the exam most people hear called the ASIA exam. It produces the two things the claim depends on: the neurological level of injury, the lowest level at which sensation and movement are normal, and a grade on the ASIA Impairment Scale (AIS), A through E.
| Neurological category | What it means | Share |
|---|---|---|
| Incomplete tetraplegia | Neck level injury, some signal crossing it | 47.7% |
| Incomplete paraplegia | Chest level or lower, some signal crossing | 20.4% |
| Complete paraplegia | Chest level or lower, no signal crossing | 19.6% |
| Complete tetraplegia | Neck level injury, no signal crossing | 11.8% |
| Normal | Neurological exam normal at discharge | 0.4% |
Nearly half of everyone injured since 2015 has an incomplete injury at a neck level, which often means partial hand function. Insurers know it, and that is where they discount. Our page on incomplete spinal cord injury claims covers that grade by grade.
Causes of spinal cord injuries
The 2026 data sheet reports about 54 new traumatic spinal cord injuries per million people each year in the United States, roughly 18,482 cases, and about 311,560 people living with one. Average age at injury has risen from 29 years in the 1970s to 44.3 since 2015, which is why so many of these cases now start with a fall.
| Cause | Share | The claim that usually follows |
|---|---|---|
| Vehicular | 37.1% | The driver, the employer if the driver was working, and every insurer above them |
| Falls | 32.5% | The property owner, or the contractor who controlled the site |
| Violence | 15.2% | The assailant, and often negligent security against the property |
| Sports and recreation | 7.6% | The waiver and assumption of risk come first |
| Medical or surgical | 3.8% | Medical negligence, with its own deadlines and its own cap |
| Other | 3.9% | Varies with the mechanism |
A crash on the 405 and a fall in a parking structure produce the same injury and different cases. Vehicle cases run through our Los Angeles car accident, truck accident, and motorcycle accident pages. A commercial driver on the clock brings the employer's policy in, often the difference between a case that funds care and one that does not.
Falls are the second cause and the one tracking that rise in age. The Centers for Disease Control and Prevention reports that more than 14 million older adults, about one in four, fall each year, and that the age adjusted fall death rate rose 21% from 2018 to 2024. A fall claim is a property claim: see our slip and fall, premises liability, and construction accident pages.
Lifetime spinal cord injury costs
This is the number the case turns on. It comes from the 2026 SCI Data Sheet of the National Spinal Cord Injury Statistical Center, published in March 2026 from data collected through August 2025 on 38,647 people at 31 federally funded Model Systems centers.
| Severity of injury | First year | Each later year | Lifetime if injured at 25 |
|---|---|---|---|
| High tetraplegia, C1 to C4, AIS A, B or C | $1,446,827 | $251,246 | $6,419,617 |
| Low tetraplegia, C5 to C8, AIS A, B or C | $1,045,459 | $154,128 | $4,690,573 |
| Paraplegia, AIS A, B or C | $705,131 | $93,409 | $3,139,165 |
| Motor functional at any level, AIS D | $472,190 | $57,353 | $2,144,693 |
Two things decide how that table can be used. The expenses are health care costs and living expenses directly attributable to the injury, in 2025 dollars, discounted at 2%. The figures exclude indirect costs entirely, including lost wages, fringe benefits, and productivity, which the same document puts at an average of $97,787 per year. Lost earning capacity is a separate line and is in none of the numbers above.
The legal use of the table is narrow. It is not a settlement value and not a prediction about one person. It is a floor for the real question, which is whether the money will still be there in year thirty. Our page on lifetime cost of care adds the age 50 column and the methodology.
Costs the claim must cover
California measures tort damages by Civil Code section 3333: the amount that compensates for all the detriment proximately caused, whether it could have been anticipated or not. That becomes line items an insurance adjuster can check.
| Category | What it covers | What proves it |
|---|---|---|
| Past medical care | Ambulance, surgery, acute stay, rehabilitation | Billing records and the chart |
| Future medical care | Surgery, therapy, medication, catheters, wound care | A life care plan |
| Attendant care | Paid help with transfers, bathing, bowel and bladder care | Life care plan, nursing assessment |
| Equipment and access | Power chair, lift, ramp, roll in shower, accessible van | Life care plan, contractor quotes |
| Lost earning capacity | What you can no longer earn, not the paychecks missed | Vocational evaluation, economist |
| Noneconomic damages | Pain, disfigurement, the loss of what your days held | Your testimony, and people who knew you |
Attendant care is usually the largest single line, and the one insurers challenge first. It is paid human help with what the body no longer does alone, priced by hours per day and by whether those hours need a licensed nurse or a trained aide. Durable medical equipment is the gear replaced on a schedule: a power wheelchair, a transfer lift, a hospital bed. Both come out of a life care plan, with a cost and a replacement interval for each item.
Home and vehicle modification is the category families discover during the discharge meeting. A doorway a power chair cannot clear is a doorway the person cannot use. Ramps, a roll in shower, a lift, and a van with hand controls all recur, because vans get replaced and houses get left.
Care after discharge is not a straight line either. About 29% of people with a traumatic spinal cord injury are re-hospitalized at least once in any given year, averaging about 18 days, most often for genitourinary disease and then skin disease. A demand built on the bills that already exist prices only the first year.
Two terms carry the future half of the claim. Lost earning capacity is the earning power the injury took, measured against what the person could have done. Present cash value is the amount that, invested today, funds the future payments the plan calls for. It is why a $6 million lifetime estimate is not a $6 million demand, and why the discount rate is worth contesting.
Proving liability
Negligence is the failure to use the care a reasonable person would use in the same situation. Civil Code section 1714(a) is its root: everyone is responsible for an injury occasioned to another by want of ordinary care in the management of their property or person. CACI No. 400 is the negligence instruction a jury is read, and premises cases add CACI No. 1000 on the duty of an owner or occupier.
Who that points at depends on the mechanism: a driver and the company that put the driver on the road, an owner or contractor who controlled the area, or a manufacturer when a seat or a ladder failed. When the defendant is a city, a county, the state, or a transit agency, the rule is Government Code section 835: the property was in a dangerous condition, the condition caused the injury, it created a reasonably foreseeable risk of that kind of injury, and either an employee created it or the entity had notice in time to protect against it.
Comparative fault is the argument that some of the blame is yours, and in California it reduces a recovery by your percentage instead of barring it. Above that sits Civil Code section 1431.2(a): each defendant's liability for noneconomic damages is several only and never joint. Economic damages stay jointly recoverable, meaning any one defendant can be made to pay all of them. That split is why a verdict against three defendants, one of them insolvent, can still leave a family short.
Finding every policy
In a catastrophic case, proving fault is often the easier half. Policy limits are the most an insurer will pay under a policy regardless of what the injury cost, and minimum limits on a private car do not come close to a first year of tetraplegia care. The work is finding every policy that touches the event.
- The at-fault driver's auto policy, and any excess or umbrella policy above it
- A commercial auto policy, if the driver was working or in a company vehicle
- The employer's liability coverage, which answers for the employee
- An owner's or tenant's policy after a fall, and the contractor's policy on a jobsite
- A product manufacturer's coverage, when equipment failed
- Your own underinsured motorist coverage, often the last layer standing
Underinsured motorist coverage is the part of your own auto policy that pays when the at-fault driver's limits run out before your damages do. People forget they bought it, and it most often decides whether this case can be funded. Check the declarations page, the summary page listing coverages, of every policy in the household, not only the car that was hit.
A lien is a right to be repaid out of your recovery, asserted by a health plan, a hospital, Medi-Cal, or Medicare for what it paid. Liens are negotiable, they follow different rules depending on who holds them, and they get resolved before anything is disbursed. A settlement that looks adequate on the check and ignores a six figure lien is not.
Filing deadlines
| Who the claim is against | Deadline | Source |
|---|---|---|
| A private person or company | Two years from the injury | Code of Civil Procedure 335.1 |
| A public entity | Six months to present a written claim | Government Code 911.2 |
| A public entity that mailed a rejection | Six months from that notice to sue | Government Code 945.6 |
| A public entity that gave no written notice | Two years from when the claim accrued | Government Code 945.6 |
| A child injured by a private defendant | The clock is paused during minority | Code of Civil Procedure 352 |
The pause for children has an exception. Code of Civil Procedure section 352 stops the clock while a person is a minor or lacks legal capacity, and subdivision (b) says it does not apply to claims that must first be presented to a public entity. A child hurt on public property is on the six month schedule like everyone else.
Recovery data
Some function returns for many people, and full neurological recovery is rare. The 2026 data sheet reports that less than 1% of people experienced complete neurological recovery by the time of hospital discharge. That is measured at discharge, and it describes a population, not anybody's chart.
Improvement by grade is a different question. The StatPearls review of spinal cord injuries, published by the National Library of Medicine and updated June 2, 2025, reports that 19% of patients graded ASIA A improve by at least one grade, against 73% of grade B, 87% of grade C, and 46% of grade D. None of that predicts one person, and no lawyer should offer you a prediction.
One trend matters for the claim. Average acute care stays have fallen from about 30 days in the 1970s to 18.6 since 2015, and rehabilitation stays from about 110 days to 36.3. People go home far sooner than they used to, and sooner does not mean needing less. It moves the cost from a hospital bill an adjuster can read to a household that absorbs it.
Our process in spinal cord cases
- 1Get the medical side stable first
Treatment before paperwork. We take the insurer's calls, the recorded statement request, and the forms off the family so they can stay on the ward.
- 2Preserve the scene and the hardware
Vehicles get sold for salvage, scaffolds get struck, and video is overwritten in days. We send preservation demands early and inspect the evidence.
- 3Run the coverage investigation in parallel
Every entity, every policy, every layer above the primary policy, and your own underinsured motorist coverage. It starts the same week as the liability work, not after it.
- 4Build the life care plan, then price it
A life care planner sets out the treatment, attendant hours, equipment, and modifications required. An economist reduces the schedule to present cash value.
- 5Make the demand around the plan, not the bills
The first offer is anchored to the medical specials, meaning the bills already incurred, because that number is small. We anchor to the plan and prepare the case for trial.
There is no fee unless we recover. Our case results page lists what the firm recovered and what the first offers were, and Josh Kohanim's page identifies the responsible attorney.
Back and neck injuries
The cord was never involved. Many people searching for a spinal injury lawyer have a herniated disc, a fracture, or a whiplash injury, with an intact cord and a real claim. The firm's $1,250,000 recovery came from a rear-end crash that caused a herniated disc requiring surgery, not a cord injury. If that is your situation, read back and neck injuries that are not cord injuries.
The injury happened at work. Labor Code section 3602(a) makes workers' compensation the exclusive remedy against your employer, with three statutory exceptions: willful physical assault by the employer, fraudulent concealment of an existing injury, and injury from a defective product the employer made and sold to a third party who supplied it back. Section 3706 adds that an employer who never secured compensation can be sued as if the division did not apply. The claim that matters is usually against someone who is not your employer.
Nothing traumatic happened. Spinal stenosis and disc degeneration that arrived without an event are medical problems, not injury claims. They matter here because the defense will attribute a traumatic injury to them, and the answer is the imaging from before the incident.
The claim is against a surgeon or a hospital. Medical negligence claims carry their own deadlines, their own notice requirements, and a statutory cap on noneconomic damages. Say so on the first call so the case is handled under the right rules.
Next steps
A spinal cord injury claim has to fund a lifetime, and the first offer will be built from the bills that already exist. The distance between those two numbers is the case. Get the neurological level and the ASIA grade into the record, have a life care plan built, find every layer of coverage, and watch the six month claim rule if a public entity is involved.
If you are reading this from a rehabilitation unit and none of it has started, nothing is lost. Keep every discharge summary, write down what you remember, and photograph the doorways and the bathroom at home before anyone changes them. Then tell us what happened.