Life Care Plans

Life Care Plans . . . What Are They?

Life Care Plans are beneficial when estimating an injured individual’s future medical care needs. A Life Care Plan is defined by the International Academy of Life Care Planners [IALCP] as “a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated cost for individuals who have experienced catastrophic injury or have chronic health care needs.”

Who does Life Care Plans? An appropriately skilled professional, known as a Life Care Planner, should lead a team of other professionals to put the plan together. This Life Care Planner is usually a nurse although physicians, vocational specialist, and therapists are often experienced in this role. Whoever is chosen to develop a Life Care Plan should have a broad background in rehabilitation, disability, and community issues. The Life Care Planner certainly does not work alone; he or she will be working closely with physicians, therapists, vocational experts, equipment providers, economists and caregivers.

Who needs a Life Care Plan? All catastrophically injured individuals. This includes, but is not limited to:  brain-damaged babies, brain-damaged adults, paraplegics, quadriplegics, severe burn victims, ventilator dependent persons and traumatic amputations. It is often asked if every injured person should have a Life Care Plan. It is a generalized philosophy that though every injured person does indeed require a future needs analysis of some sort, a formal Life Care Plan should be reserved for those who are catastrophically injured.

What types of medical care is included in a Life Care Plan? The Life Care Plan will potentially account for an injured individual's needs from the day of injury throughout life expectancy. It includes, but is not limited to: medical needs, psychosocial needs, therapy needs, educational/vocational needs, equipment & supply needs, medication needs, surgical & hospitalization needs, housing needs, transportation needs, and care giving needs related to skilled and non-skilled provisions.

How is a Life Care Plan developed? The Life Care Planner should be provided all available medical records of the injured person. Preexisting issues are of equal importance to the current issues so that analysis can be provided as to pre-injury and post-injury recommendations.  Other records which should be obtained, if appropriate, are school records, employment records and personal accounts of how the individual was prior to the injury. Those Life Care Planners who are working for the plaintiff's attorney are at an advantage, as they will be allowed to spend time with the injured individual. Those working on a plan for the defense are often not allowed this benefit. It needs to be recognized that often when two sides are working up a plan for the same individual, it is advantageous for the defense Life Care Planner to also have a chance to meet the injured party. He or she will be able to give the plaintiff the fairest evaluation of needs, if they are allowed to personally visualize the person's restrictions. Once the Life Care Planner has had the opportunity to evaluate the medical issues from a record review and a personal account when applicable, they then begin to formulate a plan. The Life Care Planner may request to be in contact with the medical providers, caregivers, and other retained damage experts, in order to develop a plan which is medically reasonable and realistic.

What is done with a Life Care Plan once it is developed? This depends on the setting in which a Life Care Plan is done. For insurance purposes, the Life Care Plan is used to set reserves. In litigation it is the primary tool for evaluating damages. Typically a plaintiff's attorney will retain a Life Care Planner to work up the damage issues of an injured client. Once the defense attorney sees that a Life Care Planner has been retained, he or she will do the same. Keep in mind, it is important to find a Life Care Planner who has worked for both sides and who has a reputation for being ethical and consistent with the types of evaluations that he or she performs. Once sides have developed a plan, they are usually compared in a litigation setting and eventually, through arbitration, mediation or trial, a final value of the plaintiff’s damages is then determined. 

 The Life Care Plan Post-Litigation: Once the money is made available, it is highly recommended that someone be in charge of implementing the Life Care Plan. This Plan is not for the sole purpose of coming up with a dollar amount. This Life Care Plan can help to insure that the injured individual’s money will be available for his or her life expectancy. Whether the money is provided as a lump sum, in a structured settlement, or set aside in reserves, is an individual decision; but it must be available and guaranteed for the use by the individual whom the compensation was paid out towards. Often a Case Manager is hired (usually included in the Life Care Plan, therefore the expense of this is accounted for) for the purpose of keeping the plan in place and determining when new needs arise. The Nurse Case Manager can update, improve upon, and adjust The Plan as needed, based upon the individual's potentially changing medical needs.  

Other Purposes of Life Care Plans Outside of Litigation:  Life Care Planners are more commonly called upon in recent years to develop plans for managing the health care needs of the chronically ill, the elderly, and those with developmental or psychiatric disabilities.  A Life Care Plan can assist families and conservators to best provide the necessary medical care while conserving financial resources and preventing medical complications.  Life Care Plans are also used specifically in Worker’s Compensation cases in the format of a Medicare-Set-Aside.