Medical Cost Projection

or, surgery cost projectionA Medical Cost Projection is appropriate at the time of acute injury or new diagnosis of a chronic condition. These are usually requested by the plaintiff for early demands and negotiations, and by defense for setting reserves. Sometimes I’ll get a very limited request, for example, “What’s a rotator cuff surgery going to cost?” Well, that depends. (See, “Are you leaving money on the table?”)

A Medical Cost Projection includes general information about the injury and diagnosis, usual course, expected diagnostics, expected routine care and rehabilitation, common interventions, and usual and customary costs. Information is most often obtained from medical records, online sources, and representative service providers in the subject’s geographical area. It’s most useful for short term projections, usually a few months to a year.

Medical Cost Projections are most often used to get an preliminary understanding of the potential scope of a case, but shouldn’t be considered to be final. For example, if I’m asked to do a Medical Cost Projection eight weeks after a spinal cord injury, I’ll do that, and I’ll also tell you that the case should be revisited in six months to a year, when the patient’s actual condition, complications, and progress in rehabilitation are clearer. At that point, if you’re a plaintiff attorney I’d recommend you ask me for a Life Care Plan to give you a more comprehensive idea of damages beyond what a physician can provide. If you do defense work, I’ll be able to give you an opinion on whether a plaintiff Medical Cost Projection or Life Care Plan is done by a qualified life care planner, developed with reasonable standard of practice, is complete or incomplete, or contains duplicate or unrelated items.

Most Medical Cost Projections take me between five and twenty hours. I can usually do them on an expedited basis, generally within two weeks.