Orthopaedic Injuries INA Case Study


A joint instruction was received to provide rehabilitation for a claimant who had sustained multiple, complex orthopaedic injuries, sustained during a high-speed motorcycle accident. Her injuries included multiple spinal fractures, multiple rib fractures, three fractures to and degloving of the left leg.

The claimant was discharged from her local NHS hospital back home with minimal equipment and she was still non-weight bearing on her left side. The index accident occurred in November 2019 and the INA took place in mid-December 2019, 2 days after being discharged from the hospital.

The INA took place at her home with the purpose of identifying her rehabilitation needs. The claimant was living in the dining room at that point and sleeping on a sofa. She was very distressed and only had her husband at home to care for her.


Our rehabilitation case manager highlighted urgent problems which required immediate action. These included the provision of toileting equipment, washing and dressing equipment, adequate pressure relief cushions and a mattress as well as the need for some short term domiciliary care. The recommendations within the INA were split into ‘urgent’ and ‘routine’ with emphasis that the urgent ones were immediately actioned. Prior to writing the report, the rehabilitation case manager liaised with both instructing parties, clearly outlining the importance of the urgent recommendations. She was able to obtain approval to proceed with these immediately.

The routine recommendations included hydrotherapy, physiotherapy, psychotherapy, a gym membership, personal trainer sessions and provision of a taxi account. These were also approved and were linked to clear goals and milestones. The case was overseen by the case manager throughout and further home visits were undertaken alongside telephone sessions to monitor progress.


Over a period of 12 months, the claimant improved her mobility and was able to return to her previous hobbies of gardening, swimming and jogging. 

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4 January 2024

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