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Medical Cost Projections vs. Life Care Plans: What's the Difference?


Medical Cost Projections and Life Care Plans. You’ve heard of them, and maybe even considered they were different names for the same thing. Both play important roles in representing clients with personal injuries and estimating the costs of associated damages. There are distinct differences between the two, however, and knowledge of these differences is important for personal injury attorneys. 


 

What are Medical Cost Projections?


Medical cost projections provide estimates of the expenses related to medical treatment and care for a specific injury or illness. The creation of medical cost projections, along with the methodologies used in development, rely on evaluation of medical records, research, analysis, and adherence to established methodologies and professional standards. These reports yield financial estimations of injured individuals’ future medical requirements. Typically, these estimations stem from reviews of medical records, often focused on the previous two years.


Medical Cost Projections may be prepared by professionals from a variety of backgrounds, including healthcare professionals, insurance adjusters, and paralegals. These assessments consider factors such as:


  • Current Medical Expenses: This includes hospital bills, physician fees, medication costs, diagnostic tests, surgeries, and any other relevant medical services.

  • Future Medical Expenses: Projections consider ongoing treatments, therapies, medical equipment, and any anticipated surgeries or procedures required in the future.

  • Rehabilitation Costs: Expenses related to physical therapy, occupational therapy, speech therapy, and other rehabilitative services are factored in.


 

Aren’t those the same as Life Care Plans?


In a word: No. While there are some similarities, life care plans are comprehensive assessments that outline the projected medical and non-medical needs of an individual over their lifespan. These reports are prepared by rehabilitation healthcare professionals, such as Physician Life Care Planners, rehabilitation nurses, or even physical therapists. The components of a life care plan will vary by individual, but may include recommendations in any of the following general areas:


  • Evaluations

  • Medical Care and Treatments

  • Therapies

  • Diagnostic Testing

  • Equipment

  • Medications

  • Orthotics/Prosthetics

  • Home or Facility Care

  • Transportation

  • Home Modifications

  • Vocational / Educational Needs


For a more detailed description of the life care planning process, we recommend downloading our free eBook An Attorney’s Guide to Life Care Planning


 

Key Differences and Considerations


While both medical cost projections and life care plans aim to estimate future expenses, there are significant differences:


  • Scope: Medical cost projections focus primarily on medical expenses, while life care plans encompass a broader range of needs, including medical, rehabilitative, psychosocial, and vocational support as noted above. 

  • Records Review: Medical cost projections typically focus on medical history and treatments received within the two years prior to the report being drafted. A life care plan, however, may review records over a much wider timespan if relevant to the injured individual’s complaint. 

  • Interdisciplinary Approach: Life care plans involve not only an evaluation of the injured individual by the life care planner, but also an attempt to consult with outside providers who are treating the individual for injury-related concerns. While all relevant records should be reviewed for a medical cost projection, the injured individual is not evaluated separately by the professional preparing the cost projection. Likewise, attempts to contact treating providers are not standard. 

  • Legal Context: While both may be used in situations of personal injury, a Medical Cost Projection should not be used for litigation purposes. A Life Care Plan will provide the attorney with a specific expert to disclose, who will then be able provide testimony as needed. Additionally, medical cost projections are utilized by the plaintiffs’ counsel, while life care plans may be completed by experts retained by either plaintiff or defense counsel.


 

Conclusion


For personal injury attorneys, understanding the distinctions between medical cost projections and life care plans is essential. While medical cost projections provide estimates of medical expenses over a specific period, life care plans offer a comprehensive roadmap for addressing the ongoing needs of individuals with chronic illnesses or catastrophic injuries. By recognizing the differences between these two assessments, attorneys will be prepared to seek the professionals and reports appropriate for their clients’ unique circumstances.


Still not sure what your client needs? Contact the LCPMD team today. We provide Physician Life Care Planning, as well as Medical Cost Projections, through our MCPMD Division. We’re always happy to assist in getting you connected to the right services for your clients.





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