How To Get The Most Out Of A Life Care Plan?

If you’re in the middle of representing a client in a personal injury case, you might be considering whether you should leverage physician life care planning. After all, you have to do everything in your power to deliver the best outcome for the plaintiff, so why not?

There’s a caveat, though. Since these plans can influence the jury, you shouldn’t surrender all control. Life care plans are only as beneficial as their content and you have to ensure you and your client are getting your money’s worth. 

To get the most out of physician life care planning, you should first learn a thing or two about it to understand to expose any weaknesses in the life care plan itself.

Let’s get started.

What Is Life Care Planning?

In short, a life care plan is a dynamic document that outlines the plan of current and future medical costs for individuals requiring long-term care. Physician life care planning is the best solution for planning out the lifetime needs of individuals dealing with disabilities and chronic health issues.

It includes the cost of evaluations, diagnostic testing, therapies, and any adaptive equipment, as well as medical care, medication, etc. As such, physician life care planning can be considered an integral part of personal injury cases, workers’ comp, and similar cases as it can clearly demonstrate the full extent of the plaintiff’s ailments and the associated costs.

Generally, this is a diverse profession as life care planners come from a wide variety of medical professions such as nursing, occupational therapy, general practice, and so on.

How To Ensure That The Life Care Plan Checks Out?

If you’ve decided to leverage physician life care planning, the battle is not yet over, so to speak. You still have to make sure that the report and testimony check out before filing anything. You can do so by checking the following things and asking some key questions.

1. Are pre-existing medical conditions included?

Ask the life care planner if the plaintiff had any pre-existing medical conditions and if those costs are included in the report. Pre-existing conditions and the costs for threatening that particular condition should not be included in the life care plan because treatment would have been required even if the injury never occurred.

The only exceptions are some chronic illnesses or prior orthopedic injuries that were aggravated by the injury central to the case.

2. Did any injuries happen at a later date?

Illnesses or injuries that occurred after the event in question should be separate in the report if it’s determined that certain diagnoses or treatments aren’t connected to the injury addressed in the life care plan. In other words, the costs of the later injuries shouldn’t be a part.

3. Were potential complications included?

The treating physician needs to provide their opinion about the certainty of future medical service. For instance, if the physician states that a medical service will be required within a reasonable certainty, the cost of the service in question should be included in the life care plan.

On the other hand, if the physician states it’s possible that a service may be required, then it’s considered a potential complication. Then, it should be listed separately and its cost shouldn’t be included in the life care plan.

4. Is the life expectancy adjusted?

Since the life expectancy of the plaintiff has a direct effect on the costs of future care, it should be addressed in the life care plan. Inquire with the life care planner about their process and how they sourced their data.

This is especially important in cases with catastrophic injuries that may drastically decrease the life expectancy of the plaintiff. Ask them if they had consulted a life expectancy specialist who concurred with the data in the report.

5. Did an interview with the plaintiff take place in person?

You should ask the life care planner if they had visited the plaintiff in their home. This is crucial as the full extent of the disability can only be realized if the interview took place in person. Conducting an in-person interview is a way for the life care planner to gain a better understanding of the impairments, as well as the living situation. 

This may help them come to a better understanding of whether the plaintiff will require additional assistance and/or any home modifications.

6. Did the life care planner use the relevant medical records?

An accurate life care plan can only be created by using the most recent medical records. You should always ask a life care planner if they used the latest records. This is because, in some instances, the life care planner may not have been provided with the up-to-date information or the medical records available to attorneys.

7. Were the treating physicians interviewed?

Even though the life care planner may have a medical background, they should still interview the treating physicians. The current physician can explain the person’s current condition and also offer recommendations on future care.

A life care planner should also document any discrepancies between their own recommendation and the recommendation of the treating physicians. If the physician denied the request from the life care planner, that request should also be documented.

8. The sources for costs used by the life care planner

Typically, life care plan standards necessitate the use of usual, customary, and reasonable prices to provide sources for the current cost of services and goods. Some life care planners may use costs from an individual practitioner which may be unreasonable and thus, shouldn’t be included in the life care plan.

9. Generic drugs vs. brand-name drugs

Unless specifically required, the life care planner should include only the cost of the generic version of drugs. Since these usually cost much less than brand-name versions, the lifetime costs can be sizable if the latter is used in the report.

Ask the life care planner which costs they used as failure to correctly average them may result in over-funding or under-funding a plan.

The Devil Is In The Details

Physician life care planning can make all the difference in your client’s quality of life. Thus, you should see to it that the life care plan accurately reflects their needs and provides a precise assessment of the costs.

Since life care plans can be vast and complex, mistakes can happen and overworked life care planners might miss a few things or even deliberately cut corners. To make sure this doesn’t happen to you, always check the things we outlined above before signing off on the report.

That way, you’ll save everyone the trouble of going back and reevaluating a life care plan that may include pages and pages of content.