Life Care Planning in Personal Injury and Workers Compensation Cases
A Life Care Plan Addressing Future Medical Needs for Catastrophic Injuries Can Support Your Damages Claims and Settlement Demands in Auto Accident and Occupational Injury Cases
Life care planning testimony and reports can prove the cost of future medical needs related to a car crash or an occupational injury.
Therefore, life care plans are critical documents for determining damages in personal injury lawsuits or the settlement value of workers compensation cases. Life care planning evidence can justify your settlement demands to the insurance company and support how much money you ask the jury to award in civil litigation.
This article explains what a life care plan is, when to hire a life care planner as an expert witness, and what the plan should include to increase the value of the personal injury case.
Read on for more information on life care planning.
Then call us to see if we will accept representation in your personal injury claim: (804) 251-1620 or (757) 810-5614. See why legal publications, past clients, and fellow attorneys regularly name us as one of Virginia and Maryland’s top law firms for injured workers and accident victims.
What is a Life Care Plan?
The International Association of Rehabilitation Professionals defines a life care plan as “a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs.”
In short, the life care plan projects the lifetime medical needs of a person with an injury or illness causing permanent disability and estimates the costs of this health care. You can think of this report as a budget for future medical expenses.
Who Uses Life Care Planning?
These fields often use life care planning and reports:
- Personal injury litigation (automobile accidents, semi-truck crashes, product liability, medical malpractice, slip and fall, construction site accidents, maritime injury, etc.)
- Medicare Set-Aside (MSA) allocations for tort claims
- Elder care
- Children with special needs trusts
- Vaccine injury fund cases (a federal program)
Do I Need a Life Care Plan in My Case?
Life care planning is vital in legal claims involving catastrophic injuries that:
- May result in revision surgeries, such as spinal fusion or total knee replacement, or
- Interfere with your independence and ability to perform activities of daily living (ADLs). Examples of ADLs include cooking, cleaning, grooming, dressing, walking, lifting, carrying, driving, and paying bills.
We find life care plans helpful in scaring insurance adjusters into offering reasonable settlements in litigation involving these injuries:
- Spinal cord injury resulting in paralysis (paraplegia, quadriplegia, etc.)
- Birth-related neurological injury
- Burn injury requiring skin grafts
- Eye injury resulting in partial or total blindness
- Lower back or neck injury resulting in ongoing pain management
- Psychological trauma, such as post-traumatic stress disorder (PTSD) or major depressive disorder, requiring inpatient hospitalizations and outpatient therapy
We recommend asking your attorney how life care planning can help you if you or a loved one suffered one of these injuries. Sometimes a life care plan that details your future medical needs and how much these services cost can persuade the insurance company to increase the reserve amount.
What Items Does a Life Care Plan Include?
A life care plan should include all medical attention for disability, impairment, and physical and mental deficits related to the injury suffered in the motor vehicle crash or work-related incident. In addition, the life care plan should include services that will prevent or minimize potential health complications and improve your quality of life.
However, the plan should not include medical care you would get anyway, such as annual physicals, dental exams, and routine blood tests or screenings).
Examples of categories often included in life care planning reports include the following:
- Assisted living: Moving to a facility that provides long-term nursing and the ability to socialize with others may be the ideal choice.
- Assistive technology: Adding smart technology to your home that controls doors, lights, televisions, computers, and heating and air conditioning systems can keep or improve your quality of life after injury.
- Childcare: You may need childcare while you attend your medical appointments.
- Diagnostic testing: Catastrophic injuries often require extensive diagnostic testing. Brain, spine, and orthopedic injuries may require CT scans, Magnetic Resonance Imaging (MRI), and X-rays. This testing may increase as you age. Similarly, traumatic brain injury or physical trauma resulting in psychiatric injury may require neuropsychological or psychoeducational testing periodically.
- Durable medical equipment: Your physician may prescribe standing desks, special chairs, crutches, canes, quad canes, bath benches, chair lifts, hallway railings, walkers, or scooters to help with mobility problems or increase function.
- Educational or vocational needs: After a severe injury, you may need to complete vocational training or educational courses to return to the workforce. For example, suppose you are a truck driver or nurse who suffers a permanent injury affecting your ability to lift or drive. Then, you may need rehabilitation to return to a job at a lower exertional level.
- Functional evaluations: You may require intermittent evaluations to see if treatment methods are working or should be adjusted. For example, severe injuries may result in audiology, vision, swallowing, diet, and speech evaluations.
- Future medical visits: You will likely need to see multiple medical specialists regularly (for example, every three to six months). Life care planning includes an assessment of routine medical appointments you will need over your life expectancy.
- Future medical procedures: Your permanent condition may require experimental or aggressive treatment, such as Botox injections for abdominal spasms from paralysis or surgical intervention.
- Home furnishings: You may need a unique bed or mattress to prevent bedsores.
- Home health care: You may need to hire caregivers for attendant care or skilled nursing.
- Home modifications: You may need to add ramps to your home entrances, place bars in your showers, and widen doors and hallways to accommodate your wheelchair or prevent falls.
- Life expectancy: The life care plan should provide your life expectancy and the basis for the finding (for example, whether the life care planner used a mortality table published by the federal government or the Virginia Code). How long you may live influences the cost of future medical expenses because many of these needs will continue for the rest of your life.
- Medical supplies: Spinal cord injury may result in neurogenic bladder or bowel and the need for catheters or adult diapers. In addition, any medical impairment that limits mobility increases the risk of ulcer wounds (bed sores) requiring skin creme.
- Medication needs: Your medical condition may require prescription and nonprescription medications for extensive periods.
- Orthotics and prosthetic devices: Prosthetics for lost limbs, braces, and foot orthotics help with foot drop, muscle spasms, pain, and other injuries or degenerative conditions from overuse.
- Potential complications: Many chronic conditions, such as amputation or paralysis, put you at a greater risk for serious or life-threatening complications. For example, you may develop traumatic arthritis or contractures or have adverse reactions to pharmaceuticals taken for lengthy periods. Life care planning considers these possibilities.
- Recreational activities: The goal of litigation is to put you as close to your pre-injury quality of life as possible. Therefore, a life care plan should include allowances for taking part in sports and hobbies with accommodation and special devices.
- Reduction to present value: The life care plan should reduce the projected medical expenses to present value (the amount in today’s dollars). Using the non-reduced figure opens your life care planning witness to reduced credibility on cross-examination.
- Therapy: Your treating physician may prescribe ongoing occupational therapy, physical therapy, speech therapy, or mental health counseling.
- Transportation: Your injury may prevent you from driving and require transportation to and from medical appointments, shopping, and social outings. Alternatively, you may be able to drive, but only with vehicle modifications. Life care planning includes allowances for mileage, reimbursement, and vehicle modifications.
- Wheelchairs: Your injury may confine you to a wheelchair. Depending on your limitations and conditions, you may need a power wheelchair with multiple configurations, such as reclining or tilting your head. In addition, your treating physician may suggest you use cushions for skin care. Wheelchair maintenance is expensive, and you may require replacement or backup wheelchairs.
Who Develops the Life Care Plan?
Life care planners come from many backgrounds. For example, nurses, occupational therapists, physical therapists, psychologists, vocational rehabilitation counselors, medical doctors, osteopathic doctors, social workers, and case managers may qualify as expert witnesses in court for life care planning.
When choosing a life care planner, we recommend looking for someone:
- Who a court has found qualified to present expert testimony on life care planning;
- With experience developing life care plans for individuals with medical diagnoses and impairments like yours;
- Who is familiar with and follows the Standards of Practice for Life Care Planners
- Documents the records and research materials (medical, case management, rehabilitation, and psychiatric resources) used to create your life care plan and calculate future medical costs. Courts have held that life care planners may rely on the opinions of other medical experts to develop the plan.
- Who has certifications (for example, having CLCP, CNLCP, or CPLCP certifications, or being a member of the American Association of Nurse Life Care Planners)
- Who has practical experience, such as nursing in critical care and trauma units or helping injured workers in finding new employment after an occupational injury or illness
- Who works with your medical doctors and other health care professionals to ask them to review and endorse the life care plan
- Who is willing to update the life care plan as your condition progresses and your medical needs change
By using these factors, you should be able to find a life care planner who will satisfy Federal Rule of Evidence 702 and can explain how:
- Their technical or other specialized knowledge will help the trier of fact to understand the evidence or decide a material fact
- Facts or data support their testimony
- The testimony comes from reliable principles and methods
What is the Life Care Planning Process?
Experts in this field follow standardized procedures for life care planning to formulate the plan.
These procedures include:
- Requesting and receiving all medical records related to the accident
- Reviewing recorded statements, sworn statements, and deposition testimony from the litigation
- Interviewing you and your family members
- Reviewing your school records, employment records, and tax documents from the years before and after the accident
- Speaking with your medical providers
These actions help the life care planner:
- Confirm your diagnosis
- Figure out the nature and extent of your injuries
- Find out the potential consequences and complications of your injuries and condition
- Estimate your prognosis
- Decide your future medical needs
- Research and calculate the costs of this medical attention in your geographic area
The life care planner will then memorialize this information and their opinions on future medical needs in a written report they can amend as updated reports or testimony become available.
Who Pays the Life Care Planner?
Usually, the party that hires the life care planner for litigation pays for the services.
If you have a personal injury attorney, they will front the cost for life care planning evidence.
Then you will repay the expenses from your settlement or verdict.
How Much Does a Life Care Plan for Personal Injury Litigation Cost?
The cost of life care planning evidence varies depending on how you and your attorney plan to use it.
In our law firm’s experience, a life care plan to evaluate the pre-litigation settlement value of a personal injury lawsuit or calculate a workers compensation settlement demand typically costs $2,000 to $7,500.
However, this expense increases if you file a civil action (complaint) for personal injuries and go to trial. Indeed, you may have to spend $10,000 or more on the life care plan if the insurance company takes the life care planner’s deposition or the planner testifies at trial.
Attorneys that Use Life Care Planning to Obtain Results in Personal Injury and Workers Compensation Cases
You are likely researching life care planning to learn how much treatment for your injuries will cost and to calculate a reasonable settlement figure or verdict for your personal injury or occupational injury case.
Our attorneys can help you collaborate with experts in the field to create a life care plan and use it to achieve the best possible result in your case. Often, agreements and disagreements over life care planning estimates drive settlement negotiations.
Contact us to see if we can accept representation for your bodily injury claim.
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