FAQ: If my concussion symptoms worsen and I need long-term treatment, will that affect my personal injury settlement?

Short answer: Yes — how your symptoms evolve can strongly affect the amount and structure of a personal injury settlement. If you settle too early without protecting future care, you often give up the right to recover later for new or worsening problems. If you preserve your future claims (or negotiate payments that account for likely future needs), a settlement can cover long-term treatment. This article explains what that means under South Dakota law and practical steps to protect your recovery.

Detailed answer

When a concussion (mild traumatic brain injury) worsens or causes prolonged problems, those changes affect the items that determine a personal injury recovery:

• Past medical expenses: Costs already incurred for emergency care, imaging, therapy, medication and related treatments.
• Future medical expenses: Reasonably certain costs you will likely need for ongoing treatment, therapy, durable medical equipment, and home or vocational support.
• Lost income and reduced earning capacity: Time off work now and any permanent reduction in ability to earn income in the future.
• Non‑economic damages: Pain and suffering, loss of enjoyment of life, and other subjective harms that can grow if symptoms become chronic.

If your symptoms worsen before you reach a final agreement or judgment, those new facts should be presented to the insurer or opposing party so that future damages are calculated appropriately. If you settle after worsening symptoms are documented, the settlement amount should reflect the increased need for care and other losses.

What happens if I already accepted a settlement?

Generally, an executed settlement agreement that releases the defendant closes the case and prevents you from later suing the same defendant for the same injury. That means:

• Unless the written settlement specifically reserves the right to reopen or includes a provision for future medical needs, you usually cannot recover more later if symptoms worsen.
• Some settlements are structured to provide periodic payments or include a specific medical set‑aside for future treatment; those tools protect you from later cost increases.
• If a settlement was obtained by fraud, misrepresentation, or without full disclosure of medical facts, there may be limited legal avenues to challenge it — but those are difficult, fact‑specific, and time‑sensitive.

How do insurers and courts value future concussion-related care?

To claim future damages you will generally need convincing evidence, including:

• Medical records and treating-provider projections.
• Expert opinions (neurologists, neuropsychologists, life‑care planners) estimating the type, frequency, and cost of future treatment.
• Documentation of current impairments and their impact on work, daily activities, and quality of life.

Courts and insurers discount future damages to present value, and they want proof that treatment and costs are reasonably certain, not speculative.

What about health insurance, Medicare, or Medicaid repayments?

If an insurer, Medicare, or South Dakota Medicaid paid medical bills that are later covered by your settlement, those payers may have subrogation or recovery rights. Federal Medicare rules also require that Medicare be reimbursed for conditional payments related to an injury that is later settled or resolved. Failing to address these lien or repayment issues can reduce the money you actually keep from a settlement.

Helpful links for more information:

• South Dakota Codified Laws (statutes) — for statutes and state law research.
• CMS: Medicare Secondary Payer & Recovery — federal rules on Medicare reimbursement.
• South Dakota Department of Social Services — for information on Medicaid in South Dakota.

Options and protections to consider before settling

• Delay a full release until your medical condition stabilizes: If possible, don’t sign a comprehensive release until your treating providers say your prognosis is stable or until you can reasonably estimate future costs.
• Include a re‑opener or reservation clause: Some settlements carve out the right to reopen claims if certain medical events occur.
• Negotiate a structured settlement or medical set‑aside: Periodic payments or a dedicated fund for future medical expenses can protect you from running out of money if care continues long term.
• Obtain a life‑care plan and expert cost projections: These are persuasive when asking for money to cover long‑term needs and help justify a higher settlement amount.
• Address liens and subrogation before closing: Resolve or reserve for payments owed to insurers, Medicare, or Medicaid so you know your net recovery.

Practical example (hypothetical)

Hypothetical: Jane had a collision and suffered a concussion. Initial symptoms improved after six weeks of therapy, and she accepted a settlement covering past bills and short‑term therapy. Three months later she developed persistent cognitive slowing and required ongoing neurorehabilitation and vocational therapy. Because Jane signed a full release with no reserve for future medicals, she cannot recover the new treatment costs from the same defendant. Had Jane delayed the final release or negotiated a medical set‑aside or structured payments based on a life‑care plan, she could have preserved recovery for the new care.

What you should do now

1. Keep thorough records: all medical records, test results, therapy notes, work‑status letters, and bills.
2. Talk to your treating providers about prognosis and likely future care; ask for written estimates when possible.
3. If you haven’t settled, insist on accounting for future medical needs in any settlement demand or agreement.
4. If you already settled and your symptoms worsen, gather documentation and consult an attorney promptly to evaluate whether any narrow remedies may remain.
5. Check and resolve any potential medical liens or subrogation claims before finalizing a settlement so your net recovery is clear.

Helpful Hints

• Do not rush to sign a full release while concussion recovery is still evolving.
• Ask for a medical reserve or structured settlement if future care is likely.
• Document symptom progression with treating clinicians and objective testing (neuropsych testing can be especially useful).
• Get cost projections and a life‑care plan if long‑term treatment is probable.
• Resolve subrogation and Medicare/Medicaid liens before closing a settlement to avoid surprises.
• Contact a South Dakota personal injury attorney experienced with brain injury claims to evaluate settlement language and protection options.

Disclaimer: This article provides general information about South Dakota personal injury issues and is not legal advice. It does not create an attorney‑client relationship. For advice about your specific situation, consult a licensed South Dakota attorney who can review your facts and applicable law.