Amputation

Considering an expert: level, side and the prosthetic prescription

The considering stage decides whether the case needs a life care planner, a vocational expert or both, and the answer follows from three facts in the record: the level of amputation, whether the dominant or non-dominant side is involved, and what the treating prosthetist has prescribed or recommended. A transtibial amputation in a person who worked at a desk raises a modest vocational question and a substantial prosthetic cost question; an upper extremity amputation in a tradesperson raises both at full strength. Counsel should also ask whether advanced componentry such as microprocessor knees or myoelectric hands has been recommended, because that recommendation, once documented, drives the cost projection more than any other single item.

If the prosthetic prescription is still unsettled, the expert decision can wait for it without loss. A plan written on a device that is later changed will need rewriting.

Retaining: the planner's cost sources and the vocational scope

Retention sets the sources the life care planner will use for device and component costs and the intervals at which each will be replaced. The engagement should provide the prosthetist's notes and current device specifications, and should state whether costs are to be quoted from providers in the person's own market or from published fee data; the two produce different plans, and the choice should be counsel's rather than the expert's default. KWVRS planners quote from the treating prosthetist where the record permits and document every substitution.

The vocational engagement is scoped separately: the pre-injury occupation and its physical demands, the medical restrictions and prosthetic function that now limit them, and the transferable skills that survive. Where an economist is also retained, the three engagements share one set of assumptions about the person's remaining working life, and the retention letters should say so.

Preparing for deposition: quotes, intervals and the occupations excluded

At deposition the plan is tested on its numbers and the vocational opinion on its exclusions. The planner should be ready to produce each cost quote with its date and source, to state the replacement interval for each component and the manufacturer or literature basis for it, and to explain any item that goes beyond the prosthetist's written recommendation. Stale quotes and unexplained intervals are the two findings that most often reduce a plan's weight, and both are avoidable with preparation.

The vocational expert prepares to explain why each excluded occupation was excluded, in terms of the specific physical demand the amputation defeats, and why each identified occupation is realistically open in the person's labor market.

Trial: explaining the device and the work that remains

At trial the prosthesis itself becomes the teaching aid. Jurors understand replacement costs once they understand what a socket is, why it wears, and how a component fails, so the testimony describes the device in ordinary language before it describes the plan. The vocational testimony pairs the job the person held with the jobs that remain and shows the wage difference plainly. When a treating prosthetist also testifies, counsel coordinates the sequence so that the clinical recommendation is on the record before the planner's cost projection of it, and the expert's account stays consistent with the deposition throughout.