Life-Care Planners Can Help Simplify Damages For The Jury
BY RONALD
T. SMOLARSKI (Back to Articles)
How do
you determine what care and how much money a chronically or catastrophically
disabled individual will need for the rest of his or her life?
Some attorneys
representing either the plaintiff or the defendant in such cases are
now getting the expert help they need from specially trained rehabilitation
consultants called "life care planners".
Life care
planners do exactly what the name implies: they formulate life care
plans - detailed descriptions of special damages
the disabled individual suffered, what progressive disablement can be
anticipated and, most importantly, the present and future monetary costs
of all necessary care.
In doing
this, the life care planner deals in actual dollar figures, not "guesstimates".
This allows the jury to understand what the disabled person needs, currently
and in the future, and why.
As a result,
the specialized training of a life care planner can simplify the plaintiff
attorney's job, strengthen the case and make the settlement more realistic
in terms of future needs.
For the defense attorney, the life care planner
can point out case weaknesses, exaggerations and unnecessary costs.
Emerging
Expertise
Life care
planning is an emerging expertise that evolved because of a need.
In the
past, attorneys working on a case involving lifetime disablement often
consulted underwriters. But underwriters based their opinions on what
they considered similar or typical past cases. Consequently, the needs
of a specific case were often ignored, as were the probable effects
of the aging process.
Armed with only the underwriter's opinion, the
attorney often would assume that the health-related needs of the disabled,
such as medication, orthopedic equipment and treatment, had stabilized
and would not change in the years to come. So strategic financial needs
of the future often sneaked by unrecognized.
Admittedly,
it is often difficult to foresee future needs.
Consider
the case of Robert L., a healthy young man seriously injured in a swimming
accident. The accident severely impaired Robert's mobility - he could
not return to his job. But Robert could be and was retrained for other
work. Meanwhile, he initiated a lawsuit and received a settlement that
both Robert and his lawyer thought would see him through life.
Unfortunately, that was not to be. As Robert aged, his needs changed.
He eventually became totally immobile. This necessitated constant care.
But Robert's settlement failed to provide money for such care.
Academic Program
To help
prevent poorly planned settlements such as Robert's, the University
of Florida and the Rehabilitation Training Institute have initiated
an academic program specifically designed for rehabilitation
consultants to enhance their expertise to include life care planning.
The program involves
160 classroom hours of post-graduate course study and trains life care
planners to look for future, as well as present, care needs. Specific
areas of study include spinal cord injuries, head injuries, amputees,
pediatric brain injuries, forensic rehabilitation applications, catastrophic
case management, vocational assessment, wage loss and multiple disabilities.
The training
stresses that, to be most useful and valuable, life care planners must
take a holistic and objective approach in making their analyses. It
is vital that the life care planner knows how to look at every aspect
of the disabled person's life, rather than just looking at an isolated
problem.
For example,
one component of a life care plan is a work capacity assessment. The
assessment is important because it determines employability and becomes
a foundation for the vocational assessment.
These assessments
make it possible for the jury to see what transferable skills the disabled
person has and what jobs, if any, he or she could perform presently
and in the future. The assessments also indicate why the disabled person
could not handle specific tasks at a competitive or sustained rate.
Such evaluations require specific training and certification. Ideally,
a rehabilitation consultant performing these evaluations will have training
and be certified by the National Association of Disability Evaluating
Professionals.
Because
the main goal of a life care plan is obtaining optimized care and quality
of life in a cost-effective manner, the rehabilitation consultant must
communicate with others - clinical treatment teams, community resource
people and family members. Through this communication, the rehabilitation
consultant organizes an interdisciplinary team of experts. In turn,
they provide the process that determines the best estimate of projected
services and products for the most effective management of a specific
case.
For example,
cost projections are based on pricing accurate to the geographic region
in which the patient will receive the service. It is vital that the
disabled individual's holistic care and/or quality of life not to be
compromised to save dollars. Therefore, cost projections should not
be stated as possibilities, but as probabilities. Nor should projections
automatically recommend the most expensive equipment when hired by the
plaintiff or the least expensive when hired by the defense. Finally,
projections should never make probability predictions contrary to accepted
fact and literature; they should not neglect to take advantage of free
or discounted services a client may be entitled to; they should not
discount the desires and goals of the client.
The effective
life care plan is like a blueprint that facilitates the rationing of
resources, prioritizes the use of those resources and develops a long-term
strategy.
Not
All The Same
The life
care planner uses specific software tools and a copyrighted format to
analyze and outline the needs of the impaired.
But life
care plans are not all the same; they are geared to the needs of the
individual.
Therefore,
a life care plan may include any or all of the following:
- projected
evaluations;
- projected
therapeutic modalities;
- aids
for independent functioning;
- educational
needs;
- occupational
needs;
- recreational
needs;
- drug
and supply needs;
- architectural
modifications;
- home
care or residential care;
- attendant
requirements;
- mobility
requirements (e.g., wheelchairs);
- transportation
needs;
- assistive
technology, and
- psychiatric
needs.
In other
words, based on current medical knowledge, the rehabilitation consultant
strives to itemize everything the disabled person might need during
his or her lifetime and to make the plan specific so the individual's
needs are met.
Cost is
established using a two-step process.
In the first step, a monetary
sum that will compensate for actual loss and encompass all foreseeable
expenses is determined in current dollars.
In the second step, a rehabilitation
consultant qualified in economic damages evaluation determines present
and future values of damages. To do this, cost is given in current dollars.
Through this process, future cost increases can be more easily seen,
understood and met.
For the
attorney representing a plaintiff, a life care plan strengthens the
argument for a truly realistic settlement sum. A rehabilitation consultant
with specialized skills and training, accredited in life care planning,
can testify in court as an expert or work as a consultant and assist
the attorney in formulating his or her argument.
A life
care planner can be of similar value to the defense. In such cases,
the life care planner can advise the attorney on records to request
and reports to use. The life care planner can also provide expert advice and testimony
disputing the need for requested items or services and unnecessarily
high settlements.
Given the
current tendency of some courts to put a cap on settlements, attorneys will
probably find the expertise of a life care planner increasingly beneficial.
Ronald
T Smolarski (M.A., C.L.C.P, C.R.C, C.C.M., C.V.E., L.P.C, C.D.E. II,
A.B.V.E., A.B.M.P.P.) is a certified life-care planner, vocational expert
and rehab economist with Beacon Rehabilitation Services. He has 21 years
of experience. He can be reached at 1-(800) 821-8463, ron@beaconrehab.com
or www.beaconrehab.com.