This claimant was referred to me by a Solicitor who wanted more information and accurate costings for foot orthotics.
The Solicitor "inherited" the file, which generally means it has had a period of inactivity. This case was over four years old.
The claimant was involved in a road traffic accident in which his left foot and ankle were injured.
Damage was such that the ankle was subsequently surgically fused, and the first and second toes were amputated.
Ankle fixation and amputation of the big toe both materially affect gait, and may also have a damaging effect upon the opposing lower limb, overloading it and the major joints within it (hip, knee, ankle and big-toe joint), and so accelerated wear-and-tear arthritis is a factor to be considered in cases where one limb only is damaged initially.
A Rehabilitation Cost Report obtained earlier for this client suggested that an annual allowance towards future specialist footwear of £400.00 would be sufficient to meet the client needs.
In my opinion this figure was unrealistically low, and probably based on NHS footwear provision costs.
I was able to provide information and references which showed that NHS footwear provision is variable, and that in this case gait, and therefore need, had not been properly assessed.
I was further able to suggest, with references, that privately-sourced orthotics and footwear could provide better comfort and functionality, and better continuity of care.
The initial costings for gait analysis, orthotics and bespoke footwear came to £3,500.00, with annual costs thereafter of £1,850.00. These costs were accepted by the other side as being reasonable.
Conclusions.
In lower limb and foot injury cases rote costings for foot orthotics and bespoke footwear may be unrealistically low.
Gait should always be assessed when lower limb damage is present.
Continuity of care is an important factor in overall rehabilitation.
The Solicitor "inherited" the file, which generally means it has had a period of inactivity. This case was over four years old.
The claimant was involved in a road traffic accident in which his left foot and ankle were injured.
Damage was such that the ankle was subsequently surgically fused, and the first and second toes were amputated.
Ankle fixation and amputation of the big toe both materially affect gait, and may also have a damaging effect upon the opposing lower limb, overloading it and the major joints within it (hip, knee, ankle and big-toe joint), and so accelerated wear-and-tear arthritis is a factor to be considered in cases where one limb only is damaged initially.
A Rehabilitation Cost Report obtained earlier for this client suggested that an annual allowance towards future specialist footwear of £400.00 would be sufficient to meet the client needs.
In my opinion this figure was unrealistically low, and probably based on NHS footwear provision costs.
I was able to provide information and references which showed that NHS footwear provision is variable, and that in this case gait, and therefore need, had not been properly assessed.
I was further able to suggest, with references, that privately-sourced orthotics and footwear could provide better comfort and functionality, and better continuity of care.
The initial costings for gait analysis, orthotics and bespoke footwear came to £3,500.00, with annual costs thereafter of £1,850.00. These costs were accepted by the other side as being reasonable.
Conclusions.
In lower limb and foot injury cases rote costings for foot orthotics and bespoke footwear may be unrealistically low.
Gait should always be assessed when lower limb damage is present.
Continuity of care is an important factor in overall rehabilitation.
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