Special Damages – Future Medical Expenses
As we discussed last month in the first part of our series, the definition for Special Damages is the monetary losses someone incurs from an accident such as medical bills (past, current and future), the cost to repair damaged property, and lost earnings. This month we’ll discuss the key information associated with measuring future medical expenses incurred for a claim.
To restate from last month,the Internal Revenue Service (IRS) defines medical expenses to be “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes.” Please click here for IRS Publication 502 >>
The estimation of future medical expenses is one of the most challenging tasks to project an accurate Special Damage amount. Once you have gathered all of your past bills and future medical estimates associated with your injury, it is important to begin planning for your future care and rehabilitation.
If you were hurt at work, the adjuster, insurance company and/or attorney will observe your rehabilitation until you have reached Maximum Medical Improvement (MMI). MMI means that your medical condition has stabilized to the point that no major medical change can be expected in your condition. If you are not able to return to work at that time, temporary disability payments are terminated and a settlement is developed.
If you were not injured at work, you may be receiving care from medical service providers as a result of your accident or disease. You may be bearing the cost of this service yourself, or having the expenses covered by your health insurer. If so, you and/or your insurer will have a potential claim against the responsible party of your injury or their insurer.
In either case, it is important to keep all records of treatment to prove your current care, and to project your future care until you have returned to normal. If your future care is complex, or you will have any future disabilities, it may be best to utilize qualified and licensed claim and legal representatives to help you gain your desired result.
The next step is to measure your ongoing medical treatments, medications, physical therapy and associated medical costs. Often, this planning is done with your team of medical providers coordinated by a Life Care Planner. For more information about Life Care Planning, please visit our webpage Life Care Plans for Chronic and Legacy Claims.
After you have consulted with your medical team about your present and future care, you should be ready to begin negotiating your settlement. As a first step, the claim and legal team will want to know how far you have progressed in understanding the underlying requirements for your future care. To begin planning, you may want to use a calculator like our What Is Your Claim Worth? Portal for further help and study.
It may be worth the time to think about what would be best for you and your family, so that you have a general idea of what costs will be incurred in the future. Your entire medical, claim, and legal team should be part of this discussion to gain insights about your future care and related concerns. If you are having difficulty with this type of analysis and planning, please contact us, your adjuster, or attorney for additional help.
By Robert J. Blackburn, Managing Principal, Blackburn Group, Inc., contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..