Probable vs. Possible Costs in Life Care Planning

Life Care Plans are designed to present information regarding anticipated medical expenses throughout one’s life expectancy. These costs are calculated and based on “today’s dollars.” They have not been adjusted to include factors such as inflation or discounted value, usually the purview of a forensic economist or CPA.

Generally, a probable vs. possible level of medical certainty must be met for an item/recommendation to be included in a life care plan. Probable recommendations are determined to have a greater than 50% chance of being medically needed and thus likely to be incurred within an individual’s lifetime. Possible recommendations cannot be determined on a more probable than not basis. These items are usually stated as “may, possibly, or if” statements by the treating or consulting health care providers. Once recommendations have met the inclusion criteria, cost research can be conducted to reflect usual and customary charges for the identified care. If the treatment or service does not meet the criteria for inclusion, they are not included in the life care plan.

Although possible recommendations and costs should not be included within a life care plan, it is often helpful to acknowledge these treatment possibilities in some instances. For example, suppose the final course of care has not yet been determined at the time of trial or deposition. In that case, it may be helpful for the trier(s) of fact to have information regarding future costs associated with each treatment option being considered. Although the costs for possible treatment and services are not included in a life care plan, these costs are typically researched for “informational purposes only.” The life care planner can present the information to assist the court if treating or consulting physicians change their opinions between their deposition and trial testimony. It is incumbent on the testifying life care planner to reiterate that the informational costs are not included in the life care plan summary totals but are presented for the above contingencies.