What Goes into a Life Care Plan?

The Role of Life Care Planners in Personal Injury Cases

Life care plans are prepared for several reasons. A family trust might hire a life care planner to estimate the costs of future care for a trust beneficiary. Insurance companies may need a life care planner’s analysis to set appropriate reserves for an anticipated claim for a catastrophic injury.

Lawyers retain life care planners as expert witnesses when they bring lawsuits for personal injury , medical malpractice , or other claims involving a long-term or permanent disability. When juries decide damages, life care planning experts help them understand the amount of money a disabled injury victim will need over the course of a lifetime to cope with a disability.

Life care plans are an evidence-based assessment of the current and future needs and the cost of meeting those needs for individuals who have experienced catastrophic injury or have chronic health care needs. By following professional standards and practices and basing opinions on reliable sources of information, life care planners are able to

1. identify the current and lifetime needs that are caused by an individual’s disabling condition.
2. develop an integrated plan that meets those needs.
3. determine the present and future costs of implementing the plan.

Life care plans are unique to each individual. Here are some of the many needs that life care planners consider as they construct a life care plan.

Current and Future Medical Care

Based on medical records and reports written by health care providers, life care planners identify current medical care needs that have not yet been addressed. Rehabilitative surgery that is needed but has not yet been provided is an example of a current medical need.

Life care planners also identify medical treatment and monitoring a disabled individual will likely need in the future. Prescription and nonprescription drugs are an additional expense that can be significant over time. Other necessary healthcare products, such as medicated skin creams, might also be part of a life care plan.

Past and Future Evaluations

Life care plans are based on an assessment of a disabled individual’s needs. Many of those needs will have been assessed before the life care plan has been constructed. A life care planner might encourage a lawyer to recommend additional assessments after reviewing medical records and functional assessments that have already been performed. Many critical assessments are performed by nonphysicians and will not necessarily appear in medical records.

For example, catastrophic injury victims might benefit from:

• physical therapy evaluations
• speech therapy evaluations
• occupational therapy evaluations
• recreational therapy evaluations
• psychological evaluations
• audiologist evaluations
• vision screening
• swallow studies
• dietary assessments
• educational assessments (when the victim is a minor)

A life care planner will want to assure that every necessary evaluation has been performed. When evaluations will need to be repeated or updated during the course of the injury victim’s life, the life planner will want to take those costs into account when projecting the expense of a life care plan.

Case Managers

Disabled injury victims may need a case manager to assess their ongoing care. Case managers help disabled individuals improve their physical, mental, emotional, or vocational functioning by assuring that they get the services they need in order to achieve their goal. They review ongoing care and make sure that recommended future care is provided. A key purpose of a case manager is to make sure that a disabled injury victim does not fall through the cracks when the victim is unable to manage his or her own care.

Case managers are often provided by institutions when disability victims live in a nursing home or residential facility. They may be included in the cost of institutional care. Life care planners include that cost in a life care plan when institutional living is necessary.

When a disabled injury victim can live in his or her own home, however, it may be necessary to retain the services of a case manager to assure that the victim’s needs are met. If the victim needs vocational rehabilitation, for example, the case manager will take responsibility for locating an appropriate rehabilitation program and assuring that transportation is provided so that the victim can attend the program. Life care planners include the cost of case managers in their life care plans.

Wheelchair Needs

Catastrophic injury victims must typically cope with impaired mobility. A life care planner will assess the victim’s activity level and needs. The planner will then determine what types and configurations of wheelchairs will meet those needs and suit the victim’s lifestyle. 

Manual, automatic, reclining, tilting, and standing wheelchairs are designed to meet different needs. A disabled injury victim may need more than one wheelchair to achieve that person’s goals. A life care plan must also account for wheelchair accessories, including trays, bags, and cushions.

Wheelchair maintenance and replacement is also a critical component of a life care plan. Many disabled veterans depend on wheelchairs that are falling apart. Individuals who must rely on government benefits to replace durable equipment understand the frustration of depending on a public healthcare system that does not meet their needs. A life care plan should take account of the cost of a lifetime of wheelchair replacements and repair.

Prosthetics

An accident victim who will benefit from an artificial limb might need a limb replacement every three years. Prosthetic devices wear out at varying rates, depending on the device and the amount of use it receives. Patients’ bodies also change over time, making it necessary to replace sockets and liners to accommodate those changes, or to replace an aging device with a new one.

Housing and Vehicles

Transportation is a key component of helping a disabled individual regain independence. A wheelchair accessible van that can be operated with hand controls may be a necessity for some disabled accident victims.

Homes may need to be adapted to meet the needs of a disabled injury victim. Wheelchair ramps, widened doors, and stair elevators are among the improvements that may be required to meet the needs of a disabled individual.

Injury victims who are capable of living in their own home may need assistance to perform household chores, including lawn care and home repairs. They may also need a home health aide or visiting nurse to help them meet their health care needs.

Unfortunately, not all disabled individuals can live independently. The cost of an assisted living facility or nursing home can be a substantial component of life care plans for accident victims who are immobile and those who need daily assistance with their activities of living and health care.