Why Life Care Plans Are Essential in Catastrophic Injury Cases

A catastrophic injury can change virtually every aspect of a person’s life. A traumatic brain injury, spinal cord injury, amputation, severe burn, or other life-altering injury may require medical treatment and supportive care for years or even for the remainder of the person’s life. The financial consequences can be enormous, particularly when the injured person needs ongoing therapy, medications, assistive equipment, home modifications, or personal assistance.

In a catastrophic injury case, calculating the cost of care that has already occurred is only part of the picture. A settlement or judgment may need to account for medical and rehabilitation needs that will not arise until years in the future. A life care plan can provide a structured assessment of those anticipated needs and the costs associated with them.

At Kalfayan Merjanian, LLP, we understand that catastrophic injury claims require careful attention to the long-term consequences of an injury. Life care planning can be an important part of establishing the future medical and supportive care an injured person may reasonably require.

What Is a Life Care Plan?

A life care plan is a comprehensive assessment of the future medical, rehabilitative, and supportive services a person with a catastrophic injury may reasonably need. A life care plan is typically drawn up by a trained life care planner, many of whom hold professional certification. A life care planner evaluates the person’s medical records, diagnoses, functional limitations, treatment history, prognosis, and recommendations from treating physicians and other healthcare professionals. The planner then identifies anticipated future needs and, where appropriate, projects the frequency and duration of those services. The resulting plan can address far more than hospital treatment. Depending on the injury, it may include ongoing physician care, medications, therapy, equipment, home modifications, transportation, attendant care, and other services.

Why Are Life Care Plans Important in Catastrophic Injury Cases?

The full financial impact of a catastrophic injury may not be apparent immediately after the accident. Someone with a spinal cord injury, for example, may initially focus on emergency treatment and rehabilitation. But the long-term consequences could include recurring medical appointments, specialized equipment, wheelchair replacement, home accessibility modifications, physical therapy, medications, and assistance with activities of daily living. Similarly, a person with a traumatic brain injury may require cognitive rehabilitation, psychological care, medication management, supervision, and other services long after the initial hospitalization ends. A life care plan helps identify these future needs so they can be evaluated as part of the person’s damages.

What Does a Life Care Plan Include?

There is no single life care plan that applies to every catastrophic injury. The contents depend on the person’s diagnosis, prognosis, age, functional abilities, and anticipated needs. A plan may address, for example:

• Future physician and specialist visits
• Medications and medical supplies
• Physical, occupational, and speech therapy
• Diagnostic testing
• Surgeries and other medical procedures
• Prosthetic or orthotic devices
• Wheelchairs and other durable medical equipment
• Home accessibility modifications
• Vehicle modifications or transportation needs
• Personal attendant or nursing care
• Psychological or behavioral health services
• Rehabilitation and vocational services
• Future replacement or maintenance of medical equipment

The purpose is to develop a realistic picture of the care the injured person may require over the course of their life.

How Does a Life Care Planner Determine Future Medical Needs?

Life care planning is not simply an exercise in estimating expenses. The planner generally begins by reviewing extensive medical documentation and evaluating the individual’s current condition. Recommendations from physicians, therapists, surgeons, rehabilitation professionals, and other qualified providers can help establish what care is medically appropriate. The planner may also consider the expected progression of the injury and the person’s anticipated life expectancy. For example, an individual who uses a wheelchair may require replacement equipment periodically throughout adulthood. A person with a prosthetic limb may require future prosthetic replacements, maintenance, and adjustments. The life care plan attempts to account for these recurring needs rather than treating the initial equipment purchase as the person’s only expense.

Can Life Care Plans Account for Future Surgeries?

Some catastrophic injuries require additional surgeries or procedures after the initial treatment period. A life care planner may incorporate reasonably anticipated procedures into the plan when supported by appropriate medical evidence. This could include revision surgeries, orthopedic procedures, spinal procedures, reconstructive surgery, or other treatment necessitated by the underlying injury. The anticipated timing, frequency, and cost of such procedures can then be evaluated as part of the person’s future medical damages.

What About Rehabilitation and Therapy?

Rehabilitation can be a lifelong need for some people with catastrophic injuries. Physical therapy may help maintain strength, flexibility, and mobility. Occupational therapy may help a person develop strategies for performing daily activities. Speech therapy may be necessary after certain brain injuries.

The need for therapy may change over time. A person may require intensive rehabilitation initially and periodic treatment later to maintain function or address complications. A life care plan can account for the anticipated frequency and duration of these services when supported by medical evidence.

Can a Life Care Plan Include Home Modifications?

Catastrophic injuries can make an otherwise suitable home inaccessible. A person with a spinal cord injury may need ramps, widened doorways, accessible bathrooms, modified kitchens, or other structural changes. Someone with a severe mobility impairment may require specialized flooring, lifts, or other adaptations. The plan can identify anticipated modifications and, where appropriate, account for maintenance or future replacement. The objective is to determine what changes are reasonably necessary to allow the injured person to live safely and function as independently as possible.

Does a Life Care Plan Address Assistive Equipment?

Assistive equipment may be essential for mobility, communication, personal care, or other daily activities. Depending on the injury, equipment may include wheelchairs, walkers, communication devices, hospital beds, transfer equipment, prosthetics, orthotics, or specialized seating. Equipment does not necessarily last indefinitely. A comprehensive plan may therefore account for expected replacement and maintenance throughout the person’s life. Especially for a young person with a permanent catastrophic injury, those recurring costs can become substantial.

How Is the Cost of Future Care Calculated?

Once future needs have been identified, the financial component of a life care plan can estimate the cost of obtaining those services and products over time. The calculation may consider current costs, anticipated frequency of treatment, replacement schedules, the person’s life expectancy, and other relevant economic factors. An economist may then use the information from the life care plan to calculate the present value of future expenses. This distinction can be important. A life care planner generally identifies what the injured person will need, while an economist can address how those future costs should be valued in financial terms.

How Does Life Expectancy Affect a Life Care Plan?

Life expectancy can significantly affect projected costs. If an injured person is expected to require a particular medical device every five years, for example, the number of anticipated replacements will depend partly on how long that person is expected to live. Similarly, recurring medical appointments, therapy, medications, and attendant care can accumulate over decades. Catastrophic injury cases involving children or young adults can therefore involve particularly substantial future care projections because the period over which services may be required can be many decades.

Who Prepares a Life Care Plan?

Life care plans are typically prepared by professionals with appropriate training and experience in assessing long-term care needs. Depending on the circumstances, a life care planner may have a background in nursing, rehabilitation, case management, occupational therapy, or another relevant healthcare discipline. The credibility of the plan depends heavily on the qualifications of the person preparing it and the methodology used. The plan should be grounded in the individual’s actual medical condition and supported by appropriate medical evidence rather than simply assuming that every conceivable treatment will be necessary.

Do Doctors Contribute to a Life Care Plan?

Treating physicians and other medical professionals can provide important information about the injured person’s prognosis and future treatment needs. For example, a neurologist may address the expected progression of a brain injury. An orthopedic surgeon may identify potential future surgeries. A rehabilitation physician may discuss long-term therapy or equipment requirements. The life care planner can incorporate these medical recommendations into an organized projection of future needs.

How Does a Life Care Plan Affect a Personal Injury Claim?

A life care plan can provide evidence supporting a claim for future medical and related expenses. Without a comprehensive assessment, it may be difficult to demonstrate the full scope of care that a catastrophic injury will require. A claimant might have substantial medical bills today but face much greater expenses over the next several decades. The plan provides a framework for presenting those anticipated costs and connecting them to the injury. It can also help demonstrate why a catastrophic injury case cannot be valued solely by adding up bills already incurred.

Can a Life Care Plan Be Challenged by the Defense?

Defense attorneys and insurance companies may retain their own experts to dispute the assumptions or conclusions in a life care plan. They may argue that certain treatments are unnecessary, that the projected frequency of care is excessive, that less expensive alternatives exist, or that the injured person is unlikely to require certain services. The qualifications and methodology of the life care planner therefore matter. A well-supported plan should be based on the person’s actual medical condition, appropriate professional recommendations, and reliable evidence concerning future care. A well-crafted life care plan is a valuable tool in settlement negotiations and can also be considered by a jury at trial.

What Other Experts May Be Needed in a Catastrophic Injury Case?

A life care planner is often one component of a larger expert team. Medical experts can address the nature of the injury, causation, prognosis, and appropriate treatment. Vocational experts can evaluate how the injury affects the person’s ability to work. Economists can calculate future medical expenses and lost earning capacity in financial terms. Depending on the circumstances, rehabilitation specialists, psychologists, neuropsychologists, prosthetic specialists, or other professionals may also contribute. These experts can provide different pieces of evidence that, together, demonstrate the long-term consequences of a catastrophic injury.

Why Are Life Care Plans Particularly Important for Children?

A catastrophic injury to a child can create needs that extend over most or all of the child’s lifetime. A child with a permanent brain injury, spinal cord injury, or severe physical disability may require continuing medical care, therapy, specialized equipment, educational support, and assistance with daily activities well into adulthood. Because the child’s future needs cannot be measured simply by looking at current medical expenses, a detailed projection of lifetime care can be especially important. The child’s development also needs to be considered. Future needs may change as the child grows, making periodic reassessment and appropriate medical input important.

What Happens If Future Care Needs Change?

A life care plan is an informed projection, not a guarantee that every future medical event will occur exactly as predicted. Medical conditions can evolve, and new treatments or technologies may become available. Some anticipated services may become unnecessary, while other needs may emerge. The goal is to establish a reasonable, medically supported projection based on what is known about the person’s injury and prognosis.

Why Should a Catastrophic Injury Claim Address Future Needs Early?

Early attention to future care can help prevent an injury claim from being evaluated only on the basis of immediate expenses. The consequences of catastrophic injuries can unfold over many years. By identifying anticipated care, equipment, rehabilitation, and other needs early in the case, the legal team can begin developing evidence concerning the true scope of the damages. This can also help the injured person and family understand what resources may be necessary to manage the consequences of the injury in the future.

Contact Kalfayan Merjanian, LLP

A catastrophic injury can create medical and financial needs that continue for decades. Emergency treatment and current medical bills may represent only the beginning of those expenses. A carefully prepared life care plan can help identify future medical treatment, rehabilitation, equipment, home modifications, attendant care, and other services that may be necessary because of a permanent injury.

Kalfayan Merjanian, LLP understands the importance of developing comprehensive evidence of future losses and working with qualified professionals to evaluate the long-term consequences of catastrophic injuries. If you or a loved one has suffered a catastrophic injury in California, contact Kalfayan Merjanian, LLP to discuss your case and learn how the firm can help pursue compensation for both present and future needs.