Life care plan costing applied to medical malpractice litigation: methodology, deliverables, and case-specific considerations.
In a medical malpractice matter the life care plan often distinguishes the incremental care the injury requires from the care the underlying condition would have required anyway, and the present value must respect that line. The economist values the incremental items only, applies category-specific medical cost growth, and discounts the stream over the life expectancy the medical evidence supports, which may already have been reduced by the condition being treated. Where the physicians disagree on life expectancy or on which items are incremental, the report presents the present value under each scenario so the fact finder can attach the number to its finding.
Reduction of a life care plan's line items to a single present value. The plan's items, frequencies, durations, and unit costs are carried forward with medical cost growth appropriate to each category, then discounted over the applicable life expectancy. Plan authorship stays with the life care planner; our role is the economic translation of the plan into a damages figure that reconciles with the plan and can be examined item by item.
The claim consists of lost earnings and earning capacity attributable to the injury, lost fringe benefits, the replacement cost of household services the patient can no longer perform, the present value of the incremental future care documented in a life care plan or the treating recommendations, and, where the patient has died, the survivor and estate components of a wrongful death analysis. The records that drive the analysis are the earnings and benefit history, the medical opinions that separate the injury from the underlying condition, and the care plan that distinguishes incremental care from the care the underlying condition would have required.
We issue the final report and provide deposition and trial testimony, rebuttal of opposing present value opinions, and revaluation when the plan is updated.
It excludes them, following the plan and the medical opinions that identify which care is incremental. The report states which items were treated as incremental and shows the effect of moving contested items from one category to the other.
The expectancy the medical evidence supports for the patient with proper care, which may be shorter than population tables. The economist applies that figure to the incremental care stream and shows the result under each opinion when the physicians disagree.
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