What is a Life Care Plan?
A life care plan (“LCP”) is an important tool to assist a practitioner in the resolution of litigation. Whether a person has sustained a catastrophic injury from medical negligence or from a personal injury, a LCP can serve as a comprehensive analysis of both current and future care related costs that will aid in the evaluation and negotiation of case resolution. The purpose of a LCP is to provide a medical basis for projected care, along with any associated costs that the injured person will require in the future.
Oftentimes, an injured person will require future medical treatment, durable medical equipment (“DME”), long-term care needs, and other forms of assistance. To obtain full recovery for the injured person, the determination of the cost of both current and future care related needs is a necessity. A LCP becomes a useful tool in establishing the damages for the injured person and can be offered as part of settlement negotiations or can be offered at trial. A LCP sets forth the details of long-term care needs, including the evaluation of probable complications and certain assumptions related to future care, as well as the life expectancy of the patient.
Dr. Fletcher’s experience with Life Care Plans:
Dr. Fletcher has developed and/or critiqued LCP’s for both plaintiffs and defendants in civil cases, as well as for petitioners and respondents in Illinois Workers’ Compensation cases.
Dr. Fletcher’s experience and background makes him well suited to assist in the creation of LCP’s. With his board-certification in Preventive Medicine and training in epidemiology at the University of California, Berkeley, Dr. Fletcher’s expertise provides the basis for his opinions relating to future life expectancy, which is an essential variable to the calculation of damages. Dr. Fletcher provides realistic determinations of future life expectancy using the latest mortality data from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics as well as other factors that influence life expectancy. Dr. Fletcher has published on the subject of life expectancy and risk factors that may impact mortality.[1] His expertise in providing opinions on life expectancy is an invaluable resource for any practitioner. For example, as a plaintiff’s expert, Dr. Fletcher can assist in rebutting a defendant’s use of a “rated age” to a decrease an injured person’s life expectancy. Likewise, as a defense expert, Dr. Fletcher can provide opinions that a plaintiff’s life expectancy is diminished because of certain risk factors and/or medical conditions.
Dr. Fletcher relies on real life experience. His experience in having cared for more than 19,000 injured persons throughout his career helps Dr. Fletcher in formulating lifetime medical treatment plans for catastrophic cases. Dr. Fletcher has experience in assisting with hundreds of cases to set reserves for insurance carriers and employers regarding future health care and rehabilitation costs. Dr. Fletcher served three years as one of two physician members of the 9-person Illinois Workers’ Compensation Commission (IWCC) Medical Fee Advisory Board (MFAB) from 2016-2018, after being appointed by the Illinois governor, Republican Bruce Rauner. In January 2020, he was reappointed to the WCMFAB by Democrat governor JB Pritzker.
What is Dr. Fletcher’s Approach to Developing a Life Care Plan?
Dr. Fletcher follows a standardized assessment approach in preparing a life-care plan. He:
- Reviews all of the patient’s medical records, testimony of providers and other key witnesses, Independent Medical Examination records, pharmacy records, etc.;
- Summarizes the course of an injury/illness and the subsequent treatment;
- Conducts home or rehabilitation facility visits where the injured person resides; and
- Interviews the injured person and family.
The above information provides a road map for Dr. Fletcher to provide opinions as to the injured person’s future needs. He researches the cost of required items or services to the patient’s geographical locations.
When appropriate, Dr. Fletcher will also contact treating physicians for input on the creation of a LCP. He will send the LCP to treating physicians to review and obtain a letter that they approve of the life care plan. Dr. Fletcher has also prepared LCPs for patients where he has served as their treating physician.
Not only are Dr. Fletcher’s reports easy to read, but they provide a cost projection table that clearly identifies the future care needs and associated costs for each patient. The reports are supplemented with resources for documentation of recommended care. They will also include pictures of recommended DME items that would allow readers to understand why these items are needed for the injured person.
The average life care plan requires a minimum of 10 hours of professional time and will often require 25-35 hours in very complex cases where a patient’s future medical needs are extensive.
When requested, Dr. Fletcher will produce a Power Point Slide presentation that can be used at trial to concisely explain why all this future cost is necessary for the care of the patient.
What Are The Projected Future Cost Areas Included In A Life Care Plan?
- Future Physician Visits;
- Home Modifications;
- Future Hospital/Invasive Procedures;
- Medications;
- Post-Surgery Medications Needs;
- Future Diagnostic Studies;
- Ongoing and Future Therapy/Rehab Needs;
- Home Health Service Needs;
- Durable Medical Equipment (DME) & Other Assistive Devices;
- Orthotics and Prosthetics;
- Nursing Evaluation/ Considerations;
- Case Management;
- Dietary Assessment; and
- Transportation Needs.
The previously enumerated areas are used to describe evaluations and treatment needs that will occur on a periodic basis over the patient’s lifetime. The LCP includes specific recommendations relating to expected costs, frequency over lifetime, and the cost of future care.[2]
To properly evaluate the value of a claim, Dr. Fletcher is able to adjust expected medical costs for inflation, especially important when medical care costs have gone up faster than any other consumer good.
[1] Postgrad Med. 1986 Dec;80(8):69-71, 74-6, 81-2 passim.Health-risk appraisal. Helping patients predict and prevent health problems.Fletcher DJ, Smith GL. AbstractHealth-risk appraisals (HRAs) are self-scored questionnaires or computer programs that use demographic and risk-factor data to estimate the most likely causes of death and to provide guidance on how to reduce risk of death.
So Why Dr. Fletcher?
Dr. Fletcher has worked with both plaintiff and defense attorneys in order to develop LCPs that have led to successful financial settlements in personal injury and work-related cases. His background and experience make him uniquely qualified to provide comprehensive life care plans or testify to their validity in all cases.
Dr. Fletcher is always ready to vigorously defend his opinions and will testify regarding the cost of future medical care, within a reasonable degree of medical certainty. In addition, he will explain how he arrived at his opinions for the LCP.
