Life Care Planning
Individualized, evidence-based life care plans that project the future medical and non-medical needs of individuals with catastrophic injuries or chronic conditions. Each plan details the cost of care across a patient's remaining life expectancy.
What is life care planning?
Life care planning is the projection and pricing of the care a serious injury or a chronic condition will require over the rest of a person's life. A life care plan is its written product: an itemized schedule of the future medical and non-medical needs the condition creates, each line stating its clinical source, how often it recurs, how long it continues and a cost researched where the care will be delivered, across the person's remaining life expectancy.
The plan is prepared for catastrophic injury and for chronic conditions whose care does not end at discharge. Both sides of a case use it as the checkable statement of the future cost of care: the planner defends each line in testimony, and a forensic economist reduces its totals to present value.
What a life care plan covers
- Medical care: routine and specialty follow-up, diagnostic testing, and expected surgical revisions.
- Therapies and medications: physical, occupational, speech and mental health therapy, with prescription and over-the-counter medications and supplies.
- Equipment: durable medical equipment, orthoses, prostheses and mobility aids, each with the interval at which it is replaced.
- Home, vehicle and transportation: modifications to the residence and the vehicle, and transport to and from care.
- Attendant and facility care: home health and attendant care hours, and residential placement where the condition requires it, the plan's high-cost lines.
- Educational and vocational services, and the periodic re-evaluations the plan schedules.
A category appears only where the record and the treating recommendations support an item. Every line is stated in the fields the care line illustration below shows, and the care already in place is separated from the care the plan projects.
Three engagements: a new plan, a review, a projection
Counsel retains one of three engagements, and the choice comes first. A new plan is the full methodology applied to a person whose needs run across several categories and many years, the engagement a catastrophic injury or a chronic condition with long-term needs calls for. A review is retained once the other side has served a plan: it produces a written critique of that plan, item by item. A projection is the narrower product for a case whose future care sits in one medical category or a short horizon, where the full method would price more than the case needs; the comparison of a plan with a projection marks the line.
How a life care planning engagement proceeds
The engagement is fixed in writing first (scope, conflicts and retainer), and the record follows: the medical file, the imaging and the treating providers' details, read into a chronology before any need is projected. The clinical interview and collaboration with the treating providers come when appropriate. The six steps run in the order below; the engagement process page describes what happens inside each.
- Engagement and records collection
- Medical records review and chronology
- Clinical interview and assessment
- Future care planning
- Cost research and plan preparation
- Testimony
Typical timeline
A complete plan is typically 30 to 60 days from receipt of complete records; the phases below overlap where records allow, a plan with many treating providers and a large record runs longer, and each phase's duration is on the timeline page.
- Engagement and records collection
- Records review and chronology
- Clinical interview and provider collaboration
- Cost research and draft plan
- Deposition and trial testimony
What a life care plan costs
Two things set the fee: the engagement retained, because a projection is narrower work than a new plan and a review is sized by the plan it tests, and the record, because each treating provider adds pages to read and each category the condition touches adds lines to research. The cost page carries the fee range, the drivers and the billing terms.
Deliverables
Four products are scoped separately. The written plan is the primary one: an itemized schedule in which every line carries its clinical basis, its frequency, its duration and the source of its cost, with annual totals by category that a forensic economist can take up without re-deriving them; the future medical costs guide follows that hand-off and the plan development method sets out the standards the plan is written to. The written critique of an opposing plan is the second product. Deposition and trial testimony rests on the plan as served, given by the planner who prepared it. The fourth is the update: when the condition, the treatment or the care setting changes before trial, the plan is revised and served again as a supplemental opinion.
Who retains a life care planner
Plaintiff counsel retains a planner to state what the injury will cost in care; defense counsel retains one to test the plan that has been served or to prepare an independent plan for the same person. The engagement changes the question, not the method: a plan KWVRS writes is built to withstand the review it would give an opposing plan. The planner projects the cost of care and stops there; a forensic economist turns the annual totals into a present-value figure. Items within the scope of medical practice rest on physician support, and one of the KWVRS planners is a board-certified physician who also holds the life care planning credential.
Who provides life care planning at KWVRS
- Daniel Wolstein, Ph.D. - CEO & President
- Matthew R. Putts, Ph.D. - Chief of Vocational Services
- Jesse Wolstein, M.D., M.A. - Chief Medical Director
- Christina Rivera, R.N., B.S.N. - Life Care Planner
- Paul J. Bourgeois, Ph.D. - Vocational Rehabilitation Expert & Life Care Planner
Deciding which life care planning engagement to retain
Retain life care planning when future medical and non-medical care has to be projected and priced across a person's remaining life expectancy. Decide first which of three engagements the matter needs: a new plan, a review of a plan the other side has served, or a narrower medical cost projection. Scope, records, and cost differ.
Three engagements, one methodology
| Engagement | What it produces | When it fits |
|---|---|---|
| New life care plan | An itemized plan across the care categories - routine and specialty medical care, diagnostic testing, therapies, medications, durable medical equipment with replacement intervals, home modifications, transportation, and attendant care - with the clinical basis, frequency, duration, and geographically matched cost of every item, prepared to published life care planning standards. | Catastrophic injury or chronic condition with long-term needs across several categories. |
| Review or rebuttal of an opposing plan | A line-by-line review of the opposing plan: whether each item within the scope of medical practice carries physician support, whether frequencies and durations track the literature and the treating recommendations, whether cost sources are geographically matched, and whether the arithmetic holds, documented in a written critique. | The other side has served a plan and its foundation needs to be tested item by item, particularly the high-cost lines such as attendant care, specialized equipment, and residential placement. |
| Future medical cost projection | A narrower projection limited to medical categories that does not apply the full life care planning methodology. | Scope limited to a single medical category or a short horizon. |
The plan versus projection comparison sets out where a narrower projection may suffice and where a full plan is warranted.
How a single care line is built
| Item | Clinical basis | Frequency | Duration | Cost source type |
|---|---|---|---|---|
| Durable medical equipment - manual wheelchair | Treating physician recommendation documented in the record | One unit, replaced at a stated interval | Remaining life expectancy | Local provider quotation or published rate schedule |
Illustration of the plan format only. It is not drawn from any case, and no dollar figure is implied.
Every line in a plan carries these fields so counsel can check the basis for each recommendation and a forensic economist can reduce the annual totals to present value. Items within the scope of medical practice require physician support; some non-medical items, such as home modifications, can be recommended by an appropriately credentialed planner or allied professional within scope.
What to send
- The complete medical record and imaging, with treating provider information and current clinical status.
- Any plan, cost projection, or medical opinion already served in the case.
- Whether a clinical interview, home assessment, or physician collaboration is anticipated, and the disclosure deadline that governs the plan.
Who prepares the plan
Life care plans are prepared by the life care planners on the KWVRS roster, with physician support for items within the scope of medical practice. The leadership team includes a board-certified physician who holds the life care planning credential.
- Christina Rivera, R.N., B.S.N. - Life Care PlannerRegistered nurse; applies clinical nursing experience to future care cost projections.
- Paul J. Bourgeois, Ph.D. - Vocational Rehabilitation Expert & Life Care PlannerCertified life care planner and Fellow of Vocational Experts; develops evidence-based life care plans for catastrophic injury and chronic conditions.
- Jesse Wolstein, M.D., M.A. - Chief Medical DirectorBoard-certified emergency medicine physician and certified life care planner; specializes in medical-legal consulting.
KWVRS's dedicated life care planning practice site is kwlcp.com. Visit kwlcp.com
Frequently asked: Life Care Plan
Does KWVRS prepare life care plans for plaintiff and defense?
Yes. The plan is built the same way for either side: the same record, the same published standards for frequency and duration, and the same regional cost sources, so the opposing planner can trace every line and dispute it. A plan retained to support a claim can project fewer needs than expected, and a review retained to test a plan can confirm it, because the record decides the answer.
How long does a life care plan take?
A new plan is typically 30 to 60 days from receipt of complete records. What moves it is the record: imaging and current provider details in hand at engagement let the chronology begin at once, while a plan that waits on a provider's file or an interview date runs past the window. Testimony follows the court's calendar once the plan is served. The timeline page sets out each phase and its duration.
What does a life care plan cost?
The total follows the engagement retained and the file behind it: a new plan across several care categories takes more hours than a projection confined to one, and a review grows with the plan it reads, while every treating provider adds records to read and reconcile before any line is priced. KWVRS puts an estimate in writing before confirming the engagement. The cost page explains what drives the total and how billing works.
Is a life care plan admissible?
Generally yes, when a qualified planner followed the accepted method and the medical items carry physician support; the court where the case is pending makes the ruling, and it turns on foundation: the planner's background and credential, the standards the plan follows and the recommendation behind each medical item. A KWVRS plan records that recommendation and the cost source, so the foundation can be shown line by line.
Can KWVRS review a life care plan the other side has served?
Yes, as a separate engagement with its own written critique. The review reads the served plan for the documented source behind each recommendation, the basis for each frequency and duration, the region each price came from, the care the person has actually used, and the life expectancy table the plan runs to, then re-adds the totals. How to Evaluate an Opposing Life Care Plan is the checklist the review follows.
What does KWVRS need to start a life care plan?
Three things open the file: the complete medical record with its imaging, from which the chronology of diagnosis and treatment is built; the treating providers' names and roles, so collaboration can be scheduled; and the person's current clinical status, the baseline every projection starts from. Add any plan or opinion the other side has served and the disclosure deadline, so scope and due date can be fixed in writing.
Can a life care plan be prepared from records alone?
Sometimes. The interview with the person and the family, and collaboration with the treating providers, are held when appropriate; they record the person's day-to-day function, the care in place and needs the file does not show. A review of the other side's plan, or a narrower projection, can rest on the record, and whether a new plan needs the interview is decided at scoping from what the record shows.
Who converts the life care plan into a present-value figure?
A forensic economist, not the planner. The plan states each item's cost, frequency and duration and totals them by year; the economist applies medical cost growth and a discount rate to those annual totals and reports one present-value sum with the assumptions stated. When both are prepared at KWVRS the two sets of assumptions are kept consistent. The forensic economics practice describes that analysis, and the life care plan guide covers the definition and the methodology.
Related reading
- What is a Life Care Plan?The definition, the components, the methodology and who writes plans.
- How to Evaluate an Opposing Life Care PlanThe review checklist: foundation, cost sources, history of use, life expectancy, frequency and duration.
- Future Medical Costs in Personal Injury CasesHow projected care costs move from the plan to a present-value figure.
- Life Care Plan DevelopmentThe standards, the data sources and the six steps behind a plan.
- Life Care Plan vs. Future Cost ProjectionWhich cases need the full method and which can carry a narrower projection.
- Certified Life Care Planner (CLCP)The credential, its issuer and what it requires.
- Life Expectancy CalculatorThe remaining years a plan and its present value both run to, from the 2023 US life tables.
Case Types
Life Care Plan by Case Type
How life care plan applies to the specific demands of each case type: methodology, deliverables, and what counsel should expect.
Life Care Plan by State
Northeast
Southeast
Midwest
Ready to Get Started on Life Care Plan?
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