If life care recommendations are coming from a medical doctor, the name of the doctor should be included in the life care plan. Life expectancy should be ascertained from a medical professional, familiar with the case. In addition, after speaking with the recommending medical professional, it is prudent to send a follow-up letter confirming the medical service recommendations. 

Future medical care considers medical costs for appointments with one or a variety of medical specialties. Specialties such as an orthopedic surgeon, neurologist, rheumatologist, or dental; if, as a result of the injury or disease, dental needs would exceed the normal twice per year cleaning and examination. 

Future Surgeries

Although it is almost impossible to call a hospital to determine surgical costs. There are online resources able to provide a range (from lowest to highest) of hospital costs for specific procedures. These costs do not include possible post-surgical complications. In addition to hospital costs, the life care planner will also need to include surgeon fees which include pre-surgery consultation, surgical costs, and post-surgical follow-up evaluations.

Medications and Over-the-Counter Supplements

In addition to the possible need for lifetime medications, this cost may include medications taken post-surgery; for a closed period of time. There are some medications that may require periodic laboratory testing (blood and/or urine) because of possible side effects. The frequency and type of laboratory tests should be at the recommendation of the medical professional(s) involved in the case. This category may also include over-the-counter supplemental costs.

Diagnostic Testing

Includes laboratory tests for individuals taking medications, as well as laboratory work to monitor disease progression. In addition to laboratory work, diagnostic testing may include tests such as x-rays, computed tomography (CT), ultrasonography, radioisotope (nuclear), magnetic resonance imaging (MRI), positron emission tomography (PET) or angiography.

Projected Evaluations

The most common annual evaluations may include psychological therapy, speech therapy, occupational therapy, and/or physical therapy. The purpose of the evaluation is to determine the effectiveness of treatment, as well as the justification for continued treatment. 

Therapeutic Modalities

Psychological therapy (the specific type of psychological therapy should be identified, such as cognitive behavioral therapy or rational emotive therapy, for example). Therapeutic modalities may also include, speech therapy, occupational therapy, as well as physical therapy. Typically, these modalities are not lifetime needs but occur for a closed period of time. However, as the person with a disability ages, dependent on the disability, additional physical and/or occupational may be considered.

Independent Functioning Home Furnishing and Accessories

Home furnishings or accessories recommendations should maximize an individual’s independence and improve quality of life.  These can be relatively inexpensive such as a Reacher ($15-$20) to assist someone in getting something off the floor or from a high shelf. More costly accessories, such as an adjustable motorized bathroom sink for $3,500. The cost for all home furnishings and accessories should include installation, as well as delivery costs. An additional expenditure may be incurred if a therapist needs to be hired to train someone on equipment use. 

Wheelchair/Scooter

Wheelchair/scooter costs should include, not only the cost of the device, but the maintenance cost (usually 10% of the total cost of the wheelchair or scooter). Also included should be replacement cost, depending on frequency of use, which may vary from 5-10 years. Consult the wheelchair/scooter manufacture for replacement recommendations. 

Orthotics/Prosthetics

Orthotics are devices used to support the neuromuscular and skeletal systems when there is abnormal motion in one or both of these systems.  A prosthetics replaces a body part, such as an arm, leg, breast, heart, etc. When pricing either of these items, cost should include the evaluation for appropriate fitting of the device. If the device is for a child, increased replacement costs will need to be considered for the child because of growing spurts.

Home/Facility Care

Home/Facility cost include in-home attendant care or nurses (LVN or RN). It may also include the cost for respite care for the parent of a child with a chronic disease or catastrophic injury. The cost of home care will vary depending on how comprehensive the care. If home care is not possible then the annual cost of facility care will be included. Or, if a child is living at home, receiving in-home health care and will someday leave home, then facility care will need to be costed, if home care is not reasonable.

Architectural Renovations

Include modification cost to the home as the result of requiring equipment or providing independence to the person. Cost such as lowering shelves, adjusting counter height, lowering closet bars to hang clothes. Included in this cost will also be the cost for an architect, if necessary. One of the best ways to determine the type of architectural renovations needed in a home is to ask the person with the catastrophic injury or disease. 

Orthopedic Equipment

Would include exercise products, patient lifting incontinence supplies, skin care, bath safety, mobility, respiratory, bed comfort and safety, to name a few that the life care planner may need to price.

Transportation

Would include any modifications to a vehicle as well. Included in the cost should be the cost of training the person with a disability how to drive using the adaptive equipment. Or, the cost of hiring someone to drive, if the person is unable to drive themselves. 

Life care plans are used in civil litigation, worker’s compensation, or mediations to quantify damages for individuals who have suffered a catastrophic injury or chronic disease. A comprehensive life care plan addresses foreseeable costs associated with the onset of a disability and assist the court in determining the cost for current and ongoing life care needs.

HEIDI PAUL, PH.D., CRC, CLCP, LPCC
Associate Professor
Coordinator MS Counseling, Option Rehabilitation
California State University, Los Angeles