Workers' compensation matters call for a life care plan when future medical exposure drives settlement value, when a Medicare set-aside is anticipated, or when the reasonableness of projected treatment is disputed. Confirm the accepted body parts, the governing fee schedule, and whether the claimant is or will be a Medicare beneficiary before retention.
Checklist
Review the claim file and identify the accepted injuries and conditions
Obtain the treating physician's current treatment plan and projected future care
Confirm the state fee schedule that governs medical pricing
Determine Medicare status and whether a set-aside allocation will be needed at settlement
Questions to ask the expert
Do you have experience pricing plans under this state's fee schedule?
How do you separate injury-related care from treatment for unrelated conditions?
Can the same clinical foundation support a Medicare set-aside allocation?
Timeline
1-3 weeks before retention.
Required documents
Claim file
Treating physician records and treatment plan
Independent or agreed medical examination reports
Common pitfalls
Pricing at usual and customary rates where the fee schedule governs
Overlooking Medicare status until settlement is imminent
Does a workers' compensation plan address return to work?
The plan addresses future medical care. Where return to work is contested, we coordinate with a vocational specialist or forensic economist through our sister practice.
Ready to Get Started on workers' compensation cases?
Contact our team to discuss how KW Life Care Planning can support your case with certified life care planning expertise. Request a Consultation or call (201) 343-0700.