How to Evaluate an Opposing Life Care Plan

When a life care plan is served by the other side, the question for counsel and the reviewing expert is not whether the plan is long or short but whether each significant item in it can be traced to a documented clinical foundation, priced at what the care actually costs where the individual lives, and projected over a defensible duration and life expectancy. A review of an opposing plan works through the document line by line on those grounds, and the same checklist applies whether the plan was served by plaintiff or defense counsel: the questions are about foundation and method, not about which side retained the planner.

A life care plan is a detailed, itemized projection of the future medical, rehabilitative, and support needs of an individual who has sustained a catastrophic or significantly disabling injury or illness. In litigation, it serves as the evidentiary foundation for a forensic economist's present-value damages calculation and as a primary exhibit for communicating the scope and cost of the plaintiff's future care needs to a jury. The quality of the life care plan - the rigor with which it is researched and the defensibility of each recommendation - is one of the most important factors determining the strength of a future damages claim.

What a plan contains and how costs are researched is covered in the guide's components and methodology sections; this post assumes that structure and tests it.

Each line item in a well-prepared plan is supported by an identified medical or clinical foundation. The certified life care planner is not independently recommending medical care; they are systematically organizing and costing out the recommendations made by treating and evaluating physicians, surgeons, and therapists (Weed & Berens, 2018). A plan that includes services without a documented medical recommendation from a qualified provider is vulnerable to challenge on foundation grounds.

Foundation is the first ground. For each significant item, ask whether a specific physician or other qualified provider recommended it, and identify the source document: a treatment note, a consultation report, a deposition answer, or a letter written for the case. A recommendation made in the course of actual treatment carries a different weight from one first stated in the litigation context, and the review should record which it is. An item within the scope of medical practice needs a physician behind it; a planner's own judgment can carry some non-medical items, such as home modifications, but not a surgical revision or a medication regimen.

Cost figures are the second ground. The question is whether each unit cost reflects current market rates in the geography where the individual will receive care, or a list price, a national average, or an outdated comparator that no one actually pays. Medical cost databases such as those maintained by FAIR Health, direct quotations from suppliers and providers, and Medicare fee schedules adjusted for private-pay rates are the usual reference points (FAIR Health, n.d.; Centers for Medicare & Medicaid Services, n.d.), and the plan should identify the source of each figure so that the reviewing expert can reproduce or dispute it.

Historical use is the third ground. A plan that projects an item the individual has not historically used, such as attendant care hours well above what the family has arranged, a therapy discontinued years ago, or equipment never dispensed, has to explain the change. The explanation may be sound, because needs progress and access to care varies, but it must appear in the record rather than in the plan alone; compare the projected frequencies with the pharmacy, therapy, and equipment history in the file.

Life expectancy is the fourth ground. Identify the table the plan used and whether it applied the published figure for the individual's age and sex (Arias et al., 2025) or adjusted it. An adjustment in either direction needs a physician opinion specific to the condition; a planner who departs from the standard tables without one has extended or shortened every recurring line in the plan without foundation.

Frequency and duration are the fifth ground. For each recurring item, the review asks what supports the stated frequency and the stated duration: a treating recommendation, the clinical literature on the condition, or a published standard. Frequencies that run to life expectancy for a service ordinarily tapered, durations that ignore a scheduled surgery that would change the need, and replacement intervals shorter than the manufacturer's stated life are the common findings.

A robust plan anticipates these questions by documenting the basis for each recommendation and the source of each cost, and a review that finds the documentation in place says so. The written critique that results is served like any other expert product, and the reviewing planner defends it at deposition and trial on the same terms as the plan under review.