The Life Care Plan as a Settlement Strategy

An experienced personal injury attorney will make sure that all avenues for monetary recovery are thoroughly researched in order to obtain an equitable settlement for the injured client.  One of the main reasons that an injured person will hire an attorney in the first place is so their rights to monetary recovery - past and future - are protected.  One important piece of evidence that can significantly increase the economic damages awarded in a personal injury case is known as a life care plan.

In this article:

• Definition of a Life Care Plan
• Questions to Ask to Determine if a Life Care Plan will be Useful
• Figuring Out Life Expectancy
• What Type of Professional Is a Life Care Planner?
• Getting the Best Life Care Plan
• Life Care Planning: Cost Estimates
• The Use of Visual Aids With a Life Care Plan
• When to Hire a Life Care Planner

A life care plan is a valuable tool used to quantify an injured plaintiff’s current and continuing costs of care.  The plan is prepared by a qualified vocational professional who will have the credentials necessary to testify in court as to the plan’s merits.  It projects future costs in categories such as the following:

• Medical equipment
• Rehabilitation and physical therapy
• Occupational or vocational therapy
• Future surgery or other proposed procedures
• Lost earning capacity
• Costs of modifications to the plaintiff’s home and/or vehicle
• Costs of replacement household services that can no longer be accomplished by the plaintiff
• Home health care
• Continuing medications
• Long-term or short-term care
• Medical equipment and supplies (walkers, diapers, monitors)
• Prosthetics or orthotics
• Transportation needs
• Other medical/household needs

Plans such as these are essential in cases when the plaintiff has suffered catastrophic injuries such as traumatic brain injury (TBI), limb amputation, or spinal cord damage.  Catastrophic injuries almost always result in the need for significant future care.  A life care plan is also useful for other types of injuries, such as those that result in chronic pain or lost/reduced function in a part of the plaintiff’s body.  A life care plan has the potential to greatly increase the economic damages awarded to an injured person.

• Will the plaintiff need extra help with her activities of daily living such as housekeeping, toileting, cooking, dressing, and shopping?
• Does the plaintiff have a current need for medical equipment such as an assistive walking device?  Will the plaintiff continue to need the medical equipment in the future?
• Will the plaintiff require visits to medical specialists such as pain management, physical therapy/rehabilitation, or neurology?
• Will the plaintiff need medication beyond the next year?
• Does the plaintiff’s home or vehicle need modifications to accommodate his limitations, such as wheelchair ramps, expanded doorways, or handrails?

The life care plan will usually include a mortality table published by the Social Security Administration, which accounts for factors such as age, gender, and race.  How much a plaintiff is awarded for future care pursuant to the life care plan is dependant upon what the jury determines to be the plaintiff’s life expectancy.  Life expectancy is usually calculated based on the plaintiff’s health right before the accident so that the amount awarded to the plaintiff is not decreased on the basis of any diminished life expectancy that was caused by the negligent defendant.

Life Care Planners require certification in order to produce evidence that can be used in court.  They come from diverse occupational backgrounds, including:

• Nursing
• Case management
• Rehabilitation
• Occupational therapy
• Social work
• Psychology
• Medicine

It makes sense to look for a life care planner whose background is relevant to the injuries claimed.  For example, if a large part of the plaintiff’s continuing need for services is related to PTSD, a life care planner with a background in psychology or psychiatry would be a good choice.  

A good life care planner will meet with the plaintiff and visit his or her home in order to gather information necessary to create a thorough plan.  The planner will work to uncover minute details in order to ensure that all future needs are captured and documented.  The life care planner will learn about the plaintiff’s lifestyle prior to the accident and contrast those facts with the plaintiff’s post-accident existence.  This can help identify additional items that could improve the plaintiff’s quality of life.  

Often, a life care plan will include cost estimates for future medical procedures, treatments, or surgeries.  An experienced life care planner will be sure to include all related expenses associated with the surgery, such as charges for the surgical facility, anesthesiologist, the surgeon, the equipment used, and post-operative medications, rehabilitation, and home health care.  

Many attorneys and life care planners agree that it is wise to use present-day costs within the life care plan.  Projecting a higher future rate could result in the defense arguing that the rates are inflated, which could bring the planner’s credibility into question.  Keeping the projected future costs at current values protects the integrity of the life care plan.

Utilizing visual aids in conjunction with the life care plan can result in an effective persuasion device for mediation, arbitration, or trial.  A slideshow with each slide depicting how every categorized medical item or service will aid the plaintiff can really drive home the ways in which the plaintiff’s life has been affected by his injuries.  

The decision whether to hire a life care planner and at what point in the case, will depend on the specific medical facts of the case.  In some instances, if pre-trial settlement negotiations have failed, it may be the right time to have a plan prepared in order to present it to the insurance company.  Often times, when an insurance company is unsure of how extensive a claimant’s economic damages are, the claim will be assigned to a newer adjuster with no authority to move their settlement offer beyond a certain dollar amount.  Presenting a life care plan which outlines the cost of a plaintiff’s future care needs may help to get the claim transferred into the hands of a higher-level adjuster who can offer more money. This strategy may result in a reasonable settlement offer without the need for initiating litigation.   

If the production of a life care plan does not get the claim settled, and litigation moves forward, the plan will become a key exhibit at mediation, arbitration, or trial.  

Sometimes, a life care plan will be initiated after litigation has begun, and specifically for use at mediation, arbitration, or trial. If that is the case, the plan should be provided to the insurance company, or opposing counsel, with sufficient time before the hearing so that it can be reviewed and additional settlement authority can be requested.  If you wait until the day before the settlement hearing to produce the document, there will not be enough time for the insurance company to adjust its reserves on the case, and the settlement discussions will be wasted effort.  

The video below explains what a life care planner does.

I’m Ed Smith, a Sacramento Personal Injury Lawyer.  For almost four decades, I have worked diligently to make sure that my injured clients receive fair and equitable settlements.  If you or anyone you love has been injured due to the negligence of another, do not hesitate to call my law offices at 916.921.6400 or 800.404.5400.  We offer free, friendly, and compassionate.

We are included in the Million Dollar Advocates Forum and the National Association of Distinguished Counsel.

Client reviews can be read on Avvo, Yelp, Google.  Some of my past case successes are featured on our verdicts and settlements page.

Photo: Pixabay

:mm cha [CS 1362]