Sep 19, 2022
After a sexual assault, undergoing a rape kit (also known as a SANE exam, conducted by a Sexual Assault Nurse Examiner) can be an important step in ensuring that the perpetrator is brought to justice. Such sexual assault exams are extremely invasive, however, and can be burdensome on a number of levels.
A sexual assault can be very traumatic, and having to undergo a rigorous exam can add to the already substantial stress a survivor is experiencing. Moreover, the exam typically takes at least four hours to complete, and the swabbing, photographing, and other elements involved could easily lead one to question whether such an ordeal is worthwhile given the pain and suffering involved.
But while completing a rape kit is strongly recommended – as it can be a critical tool in identifying and arresting suspects – the costs involved can be yet another drawback which unfortunately discourages survivors.
Sexual assault survivors who seek emergency room medical care after an incident can be left with exorbitant bills afterward, a trend that disproportionately affects those without health insurance. A new study shed further light on the costs involved in sexual assault medical care by looking at 35,807,950 hospital-based visits to emergency departments from the 2019 Nationwide Emergency Department Sample database.
The study – Uncovered Medical Bills After Sexual Assault – was published this month in the New England Journal of Medicine. The findings are troubling for a number of reasons, not the least of which is the economic burden often placed on survivors. In addition, the invasive nature of rape kit exams combined with the potential high cost makes the likelihood for underreporting – an already widespread issue – even greater.
112,844 emergency department visit records linked to sexual assault were included in the study. Among the survivors who sought treatment, 88% were women. The majority, 53%, were between 18 and 44 years old. 38%, however, were between 0 and 17.
The following findings were confirmed by the study:
Additionally, survivors with private insurance didn’t fare much better.
“Emergency department charges may discourage the reporting of rape and seeking of medical care for both short-term and long-term sequelae of sexual assault,” the study’s authors cautioned. “Incurring such charges may further harm survivors – even those with full insurance coverage – by serving to disclose a potentially stigmatizing event to parents, partners, or employers. Moreover, such bills may further traumatize survivors by suggesting that they are personally responsible for their assault.”
Moreover, the combination of experiencing a sexual assault, undergoing a rape kit, and being hit with major expenses can have emotional consequences for victims.
“This can be re-traumatizing for many survivors,” said lead researcher Dr. Samuel Dickman, a physician with Planned Parenthood of Montana.
Dr. Dickman and his colleagues who authored the study also noted that the prospect of a “huge E.R. bill” could further discourage survivors from seeking care in the first place, according to a report from U.S. News.
Currently, according to the U.S. News report, only 20% of sexual assault survivors in the United States receive medical care after an incident occurs.
The 1994 Violence Against Women Act does technically mandate that survivors should not be charged for evidence collection during any post-sexual assault medical care. However, which states actually adhere to the VAMA varies.
Although it is a requirement for states to cover the costs of sexual assault medical care in order to be eligible for certain federal grants, the law does not mandate medical services beyond the forensic exam (that which is used to gather evidence for law enforcement).
“Hospitals can still charge for things like injury care, counseling, emergency contraception, and medication to prevent HIV due to possible exposure,” U.S. news said.
“In the absence of federal requirements, many states have stepped in and do cover additional medical services,” Janine Zweig, associate vice president for justice policy at the Urban Institute, a Washington, D.C.-based research organization, told U.S. News.
“But it really does vary state to state,” Zweig added, telling U.S. News that a broader change would help make victims’ care more equitable: Expanding the federal definition of what medical services must be covered by states. And Dr. Dickman agreed.
“That’s what we need – expanded financial protections for survivors,” Dickman said.
One of the primary concerns the new study puts into perspective is the potential for decreasing reporting of sexual assault by discouraging the potential for completing a rape kit at all. But how great of an issue is underreporting of sexual assault?
As it turns out, it’s a systemic problem throughout the United States.
Some statistics underscoring the issue of sexual assault underreporting include:
And reporting of sexual violence is so important because even when crimes are brought to the attention of law enforcement, they rarely lead to actual charges. For example:
Filing a sexual assault civil claim can help a survivor obtain justice as well as financial compensation on his or her own terms. Moreover, holding your perpetrator accountable can be an empowering decision.
Contact Dordulian Law Group’s (DLG) proven sexual assault attorneys today for a free and no obligation consultation to discuss your case at 866-GO-SEE-SAM. DLG has successfully helped countless survivors recover maximum financial damages awards and obtain the justice they deserve.
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Sam Dordulian is an award-winning sexual abuse lawyer with over 25 years' experience helping survivors secure justice. As a former sex crimes prosecutor and Deputy District Attorney for L.A. County, he secured life sentences against countless sexual predators. Mr. Dordulian currently serves on the National Leadership Council for RAINN.
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