Damages in Personal Injury Lawsuits

By Guest Author Rasa Fumagalli, J.D., MSCC, CMSP-F – Director of MSP Compliance Services

Personal injury lawsuits seek to secure compensation for individuals who have suffered harm due to the negligence of others. Although injured parties can never be fully made whole, for personal injury attorneys it is important to highlight all of the various damages injured parties have suffered when negotiating settlements. This article will focus on the future medical expenses and how to maximize their recovery.

 Future Medical Damages

Determining the future medical expenses in a case is pivotal in assessing damages, crafting arguments, and ultimately securing just compensation for the injured party. Central to this process is the use of Medical Cost Projections (MCPs), a tool that forecasts the potential healthcare expenses incurred due to an injury.

Medical Cost Projections entail a meticulous evaluation of the injured party’s medical history, prognosis, treatment plans, and anticipated healthcare needs. By leveraging medical records, MCPs aim to forecast the future expenses directly and indirectly attributable to the injury sustained.

The methodology involved encompasses a multifaceted approach. It involves analyzing past medical bills, considering potential complications or additional procedures, and factoring in rehabilitation and long-term care costs. Additionally, MCPs rely on Standard of Care and Evidence-Based Medicine guidelines to project costs accurately.

Standard of Care (SoC) and Evidence- Based Medicine (EBM) Guidelines

SoC guidelines represent a benchmark defining the level of care, treatment modalities, and diagnostic approaches that healthcare professionals are expected to provide for patients suffering from a specific medical condition or undergoing a particular procedure. These guidelines are formulated by medical societies, expert panels, and healthcare regulatory bodies based on a thorough review of available evidence, best practices, and expert consensus.

SoC guidelines encompass a spectrum of recommendations, covering diagnostics, treatment options, follow-up care, and expected outcomes for various medical conditions. They serve as a framework for healthcare providers, outlining the most appropriate and effective approaches to patient care based on the current understanding of the medical field.

EBM, on the other hand, forms the cornerstone of clinical decision-making, emphasizing the integration of the best available evidence from systematic research with clinical expertise and patient values. It involves critically appraising scientific literature, clinical trials, meta-analyses, and other sources of empirical data to inform medical decisions.

The core principles of EBM revolve around the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. It encourages healthcare practitioners to evaluate the validity, reliability, and applicability of evidence before incorporating it into clinical practice.

In the realm of Medical Cost Projection, SoC guidelines and EBM significantly influence the accuracy, reliability, and comprehensiveness of cost projections. Here’s how they intertwine within MCP reports:

1. Treatment Protocol Adherence: MCP reports rely on SoC guidelines to outline the expected course of treatment for a particular medical condition or injury. Adhering to these guidelines ensures that the projected costs encompass treatments that are considered standard and appropriate within the medical community.
2. Validity of Projections: Evidence-based approaches underpin the validity of MCP reports. By aligning projections with empirical evidence derived from studies, clinical trials, and accepted practices outlined in SoC guidelines, MCPs maintain credibility in estimating future medical expenses.
3. Effectiveness of Interventions: SoC guidelines, based on evidence, often highlight the most effective interventions or treatments. MCP reports factor in these interventions to project costs accurately, reflecting the expenses associated with evidence-supported treatments and expected outcomes.
4. Rationale for Projections: Incorporating SoC guidelines and EBM into MCP reports provides a rationale for the projected costs. It establishes a clear link between the anticipated medical expenses and the recommended, evidence-backed treatments and interventions.
5. Dynamic Nature of Evidence: EBM acknowledges the evolving nature of medical knowledge. MCP reports must consider updates and revisions in SoC guidelines and emerging evidence to ensure projections remain aligned with the latest evidence-based practices.

In personal injury cases, adherence to SoC guidelines and EBM principles in MCP reports strengthens the medical damages arguments. It substantiates claims regarding the necessity and reasonableness of projected medical expenses, providing empirical support for the damages sought on behalf of injured individuals.

Value of Medical Cost Projections in Personal Injury Cases

MCPs offer profound value and serve multiple critical purposes in settlement negotiations. First, they provide a tangible framework for assessing damages. Furthermore, attorneys armed with precise projections can devise long-term strategies, including structuring settlements to cover future medical expenses adequately. This foresight safeguards clients from being undercompensated and helps in securing resources for continued care and rehabilitation.

Synergy is here to help you quantify the future medical damages portion of your case. Our attorneys and nurses have the knowledge as well as expertise to help maximize the recovery.  Contact Synergy today to learn more about how our MCP report can simplify the negotiation of future medical care for your case.