Foundations, costing, and documentation for a future-care projection that withstands admissibility review.
Abstract
A life care plan is an itemized projection of the future medical, rehabilitative, and support needs of an individual with a catastrophic injury or chronic condition, together with the cost and frequency of each item. It is the evidentiary foundation for the economist's present-value calculation of future care damages. This paper describes how a plan is built on the medical record, costed from defensible sources, and documented so that each recommendation can be traced and tested.
Key takeaways
Each item in a life care plan should trace to a medical foundation in the record, not to unsupported assumption.
Frequency, duration, and unit cost are stated for every item so the projection can be reproduced.
Costs are drawn from defensible, geographically appropriate sources and documented.
A plan that distinguishes injury-related needs from pre-existing or unrelated needs is more defensible.
What is inside
What a life care plan is for
Grounding the plan in the medical record
Specifying frequency, duration, and quantity
Costing from defensible sources
Separating related from unrelated needs
Documentation and admissibility
Handing off to the economist
What a life care plan is for
A life care plan translates a person's future care needs into a structured, costed projection that a jury can understand and an economist can value (Weed & Berens, 2018; Reavis, 2002). It addresses the medical and non-medical needs that flow from the injury or condition over the relevant horizon, including physician and therapy services, medications, equipment, supplies, attendant care, and home or transportation modifications where supported.
The plan does not decide the medicine. It organizes and projects care that the medical record and treating or evaluating providers support, and it makes the basis for each item explicit.
References
Agency for Healthcare Research and Quality. (n.d.). Clinical guidelines and recommendations. U.S. Department of Health and Human Services. ahrq.gov
Centers for Medicare & Medicaid Services. (n.d.). Physician fee schedule. U.S. Department of Health and Human Services. cms.gov
Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993). supreme.justia.com
Reavis, S. L. (2002). Standards of practice. Journal of Life Care Planning, 1(1), 49-57. International Academy of Life Care Planners / International Association of Rehabilitation Professionals. doi.org
Weed, R. O., & Berens, D. E. (Eds.). (2018). Life care planning and case management handbook (4th ed.). Routledge. doi.org
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