Catastrophic and Serious Injuries: When the Future Is the Biggest Part of the Claim

Most of what is written about injury claims is about injuries people recover from. This page is about the ones they don’t. When an injury is permanent, the hospital bill and the missed paychecks are the smallest part of the loss. The rest is decades of care, a working life cut short, and a family that has to reorganize itself around what happened. I’m Frank Younes. This page explains what makes a catastrophic injury case different, what Nebraska law allows, where the money actually comes from, and what a family should do first.

What Counts as a Catastrophic Injury?

The term comes from medicine and insurance, not from Nebraska’s injury statutes. The closest thing to a legal definition is in a federal benefits program for police officers, firefighters and emergency medical workers, where a catastrophic injury is one that will “permanently render an individual functionally incapable” of “performing work, including sedentary work” (34 U.S.C. § 10284). That definition does not govern an injury lawsuit. In an injury case the label matters less than the facts: what the person can no longer do, for how long, and what care they will need.

The National Institute of Neurological Disorders and Stroke defines a spinal cord injury as “damage to the spinal cord—the bundle of nerves and nerve fibers that sends and receives signals from the brain,” and reports that “motor vehicle accidents and serious falls are the most common causes of SCI in the U.S.” (NINDS). The national spinal cord injury database counts roughly 18,500 new traumatic spinal cord injuries a year and attributes about 37 percent of those since 2015 to vehicle crashes, the leading cause (NSCISC). Brain injuries are covered in depth on my traumatic brain injury page.

Why Catastrophic Injury Cases Are Different

In most injury cases the largest numbers are already in the past by the time the claim is resolved. In a catastrophic case, most of the cost is still ahead: attendant care, therapy, equipment, medication, surgeries that have not happened yet, changes to a home or vehicle, and the income a person would have earned over a career. Nebraska law lets you recover those future losses. It also requires that they be proved, and that is where these cases are won or lost.

Future medical care

The Nebraska Supreme Court has said that future medical expenses do not have to be “established with mathematical certainty,” but “conjecture or possibility regarding future medical expenses is insufficient” (Renne v. Moser, 241 Neb. 623 (1992)). It has also said that “the need for future medical services and the reasonable value thereof may be inferred from proof of past medical services and their value.” In a serious case, the proof usually comes from the treating physicians and from a life care plan, which the Nebraska Supreme Court has described as “a comprehensive document which includes the items of service, medications, doctor’s visits, and equipment a disabled person will need over the course of his or her life, as well as the costs associated with each of these items.” The planner has to be reasonably certain each item will be needed; the court has said an opinion that is “merely speculation or conjecture is inadmissible” (Gourley, 265 Neb. 918 (2003)). Done properly, a plan carries real weight: in one case, a certified life care planner’s plan supported future medical expenses of more than $7.3 million over a 40-year life expectancy, valued at the private-party rate rather than the Medicaid rate (Fickle v. State, 274 Neb. 267 (2007)).

A lifetime of lost earning capacity

Loss of earning capacity is the reduction in what a person is able to earn, and it is separate from lost wages. “Proof of an actual loss of wages or earnings is not essential to a recovery for loss of earning capacity,” which matters for a young person injured before a career began. But the loss “must be shown by competent evidence that such damages are reasonably certain as the proximate result of the pleaded injury,” and an award for future loss is reduced “to its present worth” because it is paid now (Uryasz, 230 Neb. 323 (1988)). More on this in lost wages and earning capacity.

How long the losses will last

Juries may use standard life expectancy tables, but the tables are “not conclusive, but may be considered in connection with other evidence bearing on the probable life expectancy of the plaintiff, such as health, habits, occupation, and other activities” (Oberhelman v. Blount, 196 Neb. 42 (1976)). Life expectancy sets the length of every future number in the case, and a serious injury can itself shorten it, which the defense will argue. This is one of the places where the medical evidence and the economics have to agree.

What Nebraska Law Lets You Recover

Nebraska’s statutes define economic damages as “monetary losses, including, but not limited to, medical expenses, loss of earnings and earning capacity, funeral costs, loss of use of property, costs of repair or replacement, costs of obtaining substitute domestic services, loss of employment, and loss of business or employment opportunities” (Neb. Rev. Stat. § 25-21,185.08). On top of those are noneconomic damages: physical pain, mental suffering, disfigurement, and the loss of the life the person had before. See emotional distress damages.

The absence of punitive damages surprises people, especially in drunk-driving cases. The Nebraska Supreme Court has held that “punitive, vindictive, or exemplary damages … are not allowed in this jurisdiction” (Distinctive Printing & Packaging Co. v. Cox, 232 Neb. 846 (1989)), and it said again in 2015 that “Nebraska law does not permit a plaintiff to obtain punitive damages over and above full compensation for the plaintiff’s injuries” (Golnick v. Callender, 290 Neb. 395). The one recognized exception is a federal civil-rights claim under 42 U.S.C. § 1983. The recovery is compensation for the harm, which in a catastrophic case is large enough on its own. Iowa does allow punitive damages in limited circumstances; see the Iowa personal injury page.

The Real Limit Is Usually Insurance

A verdict is only worth what can be collected, and in a catastrophic case the insurance is often the hardest part. Nebraska’s minimum auto liability coverage is $25,000 for one person’s injuries, $50,000 for everyone hurt in the crash, and $25,000 for property damage (§ 60-310). That is a small fraction of a lifetime of care. Finding every other source of coverage is part of the work.

• Your own underinsured motorist coverage, which pays when the at-fault driver’s limits are too small. See underinsured motorist coverage.
• An employer. Under Nebraska law, “an employer is held vicariously liable to third persons for the employee’s negligence in the course of the employer’s business” (Cruz v. Lopez, 301 Neb. 531 (2018)). When the driver was working, the employer’s coverage is usually far larger than a personal policy.
• A trucking company. Federal rules require an interstate for-hire truck over 10,000 pounds hauling ordinary freight to carry at least $750,000 in liability coverage, and $1 million or $5 million for many hazardous loads (49 C.F.R. § 387.9). See my truck accident page.
• A property owner or business, when a fall, a fire or an unsafe condition caused the injury.
• A manufacturer, when a defective vehicle part, machine or product caused or worsened the injury.
• Umbrella policies that sit above an auto or homeowners policy.

Every one of these has to be identified early. Some carry notice requirements, and the evidence that proves them disappears.

Protecting a Large Recovery

The amount of a settlement is only half the job. In a catastrophic case it has to last, and it cannot be allowed to wipe out benefits the injured person depends on.

• Payments over time. Part of a recovery can be paid as a structured settlement. Under federal tax law, damages received “on account of personal physical injuries or physical sickness” are excluded from income “whether as lump sums or as periodic payments.” See are settlements taxable.
• Medicaid and disability benefits. Settlement money can affect eligibility for needs-based programs such as Medicaid. Federal law allows the money of a disabled person under 65 to be placed in a special needs trust, established “by the individual, a parent, grandparent, legal guardian of the individual, or a court,” provided the State is repaid for Medicaid from what remains at the person’s death (42 U.S.C. § 1396p(d)(4)(A)). It is set up with a lawyer who handles benefits planning, before the settlement is paid.
• Repayment claims. Medicare, Medicaid, health plans and providers who paid for care may have a right to be repaid from the settlement, and most of those claims can be reduced. See medical liens and subrogation.
• Children. A parent may settle a child’s claim without court involvement only if it is $40,000 or less after expenses (§ 25-3110). A larger settlement for a child goes through the court, which protects the money until the child is grown.
• Wrongful death. When an injury is fatal, “a personal representative shall not compromise or settle a claim for damages hereunder until the court by which he or she was appointed shall first have consented to and approved the terms thereof” (§ 30-810). See my wrongful death page.

Deadlines

• Four years for most Nebraska injury claims (§ 25-207).
• Two years after the death for a wrongful death claim.
• One year to make a written claim against a city, county, school district or other political subdivision (§ 13-919), and different rules for claims against the State.
• Children: under section 25-213, a person “within the age of twenty years” when the claim arises may bring it within the normal period after reaching 21. Treat the government-claim deadlines as firm even for a child.
• Iowa: two years for most injury claims.

Every deadline is quoted and linked in my Nebraska and Iowa deadline guides.

What a Family Should Do First

• Focus on care. Everything else can be organized around treatment, and nothing in the claim should interfere with it.
• Keep one notebook: every provider, every appointment, every bill and insurance statement, and every person who calls about the claim.
• Preserve the evidence. The vehicle, photographs, video and witness names. See dashcam video, phone records and vehicle data.
• Find every policy in the household: auto, umbrella, health, disability and life.
• Do not give a recorded statement to the other side’s insurer, and do not sign anything. See recorded statements and the first settlement offer.
• Apply for the benefits you qualify for, including disability benefits, rather than waiting on the claim.
• Talk to a lawyer early. In a case this size, the first weeks decide what evidence will exist and what insurance will be found.

I handle catastrophic and serious injury cases across Nebraska and Iowa, on a contingency fee. More about the rest of my practice is on my Nebraska personal injury page.

Medical information is summarized from federal health agencies and is not medical advice. Statutes and cases quoted on this page were read at their sources in October 2026. Past results do not guarantee a similar outcome.

Your Attorney

Frank Younes

Every page on this site is written by Frank Younes, a Nebraska trial attorney with a published record of verdicts and settlements, selection to the National Trial Lawyers Top 100, and a practice that covers every county in Nebraska and Iowa. No case is handed to an associate — the lawyer you read here is the lawyer who works your case.

More about Frank → · Free consultation: (402) 378-9208

Frequently Asked Questions

What is a catastrophic injury?

An injury that permanently changes what a person can do, such as a brain or spinal cord injury, amputation, severe burns, or injuries that end a working life. There is no single legal definition for an injury lawsuit.

Is there a cap on damages in Nebraska?

Not in an ordinary negligence case such as a vehicle crash or a fall. Medical malpractice cases and claims against political subdivisions have statutory limits.

Can I get punitive damages in Nebraska?

No. Nebraska does not allow punitive damages. The recovery is compensation for the harm.

How are future medical costs proved?

Through the treating physicians and usually a life care plan that itemizes future care and its cost. Future expenses do not need mathematical certainty, but they cannot rest on conjecture.

What if the at-fault driver has only minimum insurance?

Look for every other source: your own underinsured motorist coverage, an employer, a trucking company, a property owner, a manufacturer, and umbrella policies.

How long do we have to file?

Four years for most Nebraska injury claims, two years for wrongful death, and one year for a written claim against a city or county. Iowa allows two years.

Can a family member call for someone who cannot?

Yes. A spouse, parent or adult child can make the first call and start preserving evidence while the injured person is in treatment.