In any claim involving catastrophic or permanent disabilities, including medical malpractice claims, it is likely the claimant’s attorney will have a life-care plan prepared. That plan is intended to spell out the future needs and costs associated with the injury-related disability. The plan can be prepared by different professionals: there are many nurses who do such plans, but they can also be done by vocational specialists, physicians (especially physiatrists), and others who have special training or expertise in assessing the future needs of those who suffer life-altering injuries.
The common thread of all such plans is that they all reflect, and are based on, what a physician projects as future medical care needs. If the life-care planner is not a physician, he/she will usually discuss those future needs with a treating physician so that they are accurate and realistic. Other professionals, including nurses, vocational specialists, and housing specialists, may be consulted in the process.
The importance of the life-care plan is to not only project the future care needs but also the cost of meeting those needs. In a case involving permanent disabilities as an element of damages, the costs outlined in a life-care plan will likely be a major part of the damages claim. For example, in a birth trauma case with a child who has hypoxic ischemic brain damage and a long life expectancy, those costs may total in the tens of millions. But even for a case involving an older person who can no longer live independently, the costs of future 24/7 care or special housing costs may be very large.
For most life-care plans prepared for trial, an economist is also needed to calculate the present value of the future stream of costs. Washington law requires that future costs, as well as future income losses, be reduced to present value. If a care plan outlines annual or monthly costs, for example, the amount of money needed to pay those costs will be less than the simple total of the costs. This is because a sum of money, invested today, will provide an income stream that is greater than the amount invested.
Claimants’ attorneys must assess what items of the plan will be accepted by a jury. A life-care planner may think that a swimming pool would be helpful for aquatic therapy for a disabled claimant, but the attorney may decide that a swimming pool would be rejected by some jurors as excessive, even though the need may be defensible. Some attorneys feel that it is important to have a basic plan that meets minimal needs rather than one that meets all of the possible needs that could be projected, i.e., a “Chevy” plan rather than a “Cadillac” one. Sometimes an attorney will have a focus group view possible life-care plans so that potential juror reactions can be assessed.
