A medical malpractice claim needs an economist when the injury has changed what the patient can earn, created ongoing care costs, or ended the patient's ability to do household work. The added feature of these matters is the comparison: the loss is measured against the outcome the patient would have had with proper care, not against perfect health. Counsel considering an economist should be prepared to describe both paths, because the economist needs the causation opinions to define what the patient would have earned and needed regardless of the negligence.
Checklist
Confirm the expected outcome with proper care from the causation opinions so the but-for path can be defined
Gather the patient's earnings history: tax returns, W-2s or 1099s, and pay stubs
Identify any pre-existing condition that affected work or life expectancy independently of the injury
Determine whether a life care plan or treating recommendations will define the incremental future care
Note the patient's role in household work before the injury
Questions to ask the economist
How do you apportion the loss between the injury and the underlying condition?
What do you need from the causation and treating opinions before you can build the two paths?
How do you handle life expectancy when the underlying condition shortened it independently?
Can you give a preliminary range before the medical opinions are final?
Timeline
Two to three weeks to a preliminary view, because the but-for path depends on causation opinions that may still be in progress. The full report follows the retention and records phases.
Required documents
Tax returns and wage records for the years before and after the injury
Employer benefit summaries
Causation and treating opinions describing the expected outcome with proper care
Medical records bearing on the pre-existing condition and its effect on work
Common pitfalls
Retaining the economist before the causation opinions define the but-for path, so the report must be rebuilt later
Ignoring the pre-existing condition's own effect on earnings, which the opposing economist will raise
Assuming the incremental care will be small when the underlying condition already required substantial treatment
Why does the economist need the causation opinions before starting?
Because the loss is the difference between two paths, and the but-for path in a malpractice case is not full health but the outcome proper care would have produced. Without a medical opinion on that outcome, the economist cannot state what earnings, care, and life expectancy the patient would have had regardless of the negligence.
Is the economic analysis different when the patient survived with a permanent injury rather than died?
The structure differs, not the method. For a surviving patient the components are lost earnings and earning capacity, fringe benefits, household services, and incremental future care, each measured as the difference between the two paths. For a death the analysis becomes a wrongful death loss to the survivors, still measured against the outcome proper care would have produced. Both use the causation opinions to define the but-for path.
Can a preliminary range be prepared before the causation opinions are written?
A limited one. The economist can establish the earnings base, the fringe benefit rate, and the household services baseline from the financial and household records, and can show what the loss would be under stated assumptions about the two outcomes. The figures are labeled as provisional, and the full report waits for the medical opinions that fix the but-for path.
References
U.S. Bureau of Labor Statistics. (n.d.). Current Population Survey (CPS). U.S. Department of Labor. bls.gov
National Center for Health Statistics. (n.d.). Life tables. Centers for Disease Control and Prevention. Retrieved August 26, 2026. cdc.gov
National Association of Forensic Economics. (n.d.). NAFE's ethics statement. Retrieved August 27, 2026. nafe.net