Life Care Plan Calculations and Expert Witness Testimony

When an injury or illness results in a lifetime of medical care, the legal system needs a reliable way to put a dollar figure on the cost of that care. A life care plan documents those future needs in detail. A forensic economist then calculates their value. Together, life care planners and forensic economists produce the economic foundation that both sides of a case depend on.

This article explains what a life care plan contains, how a forensic economist calculates its present value, and how that analysis is presented and defended as expert witness testimony in deposition and at trial. It also includes three hypothetical examples showing how the process plays out across different case types.

What Is a Life Care Plan?

A life care plan is a formal document that outlines the future medical and care needs of a person who has suffered a significant injury or illness. These plans are prepared by a certified life care planner, typically a registered nurse or rehabilitation specialist with specialized training in long-term care assessment.

Life care plans focus exclusively on future medical and care needs, providing a comprehensive projection of everything a person may need to maintain their health, function, and quality of life for the rest of their life, and assign projected costs to each component. They do not include lost wages or earning potential due to diminished work capacity. Those are separate components of an economic damages calculation that a forensic economist handles independently.

The specific contents vary by case, but most life care plans address the following categories.

• Future medical services: Ongoing appointments, procedures, and interventions the injured person is expected to need, including specialist visits, surgeries, pain management, and routine monitoring.
• Medications and medical supplies: Long-term prescription medications and disposable medical supplies, projected by type, frequency, and cost over time.
• Assistive equipment and technology: Wheelchairs, prosthetics, communication devices, and other specialized equipment, including projected replacement costs.
• Home care and personal assistance: The number of hours per day or week a caregiver or personal assistant will be needed, along with associated costs.
• Home modifications: Structural changes to a person’s residence, such as wheelchair ramps, widened doorways, and accessible bathrooms.
• Rehabilitation and therapy: Physical, occupational, speech, and cognitive therapy services, projected by frequency and duration.
• Psychological and mental health care: Ongoing therapy, psychiatric treatment, and counseling, particularly common in cases involving trauma, brain injury, or chronic pain.
• Transportation: Adaptive vehicle modifications or medical transportation costs when an injury affects a person’s ability to use standard transportation.
• Vocational rehabilitation: Job retraining, counseling, and supported employment programs in cases where the injured person may return to some form of work.
• Facility or residential care: The projected cost of placement in a skilled nursing facility, assisted living community, or other residential care setting in the most serious cases.

Where a Forensic Economist Enters the Process

It is important to note that the forensic economist does not prepare the life care plan and does not determine what care the injured person will need. That work belongs to the life care planner and the treating medical professionals. The forensic economist’s role begins where their work ends.

A life care plan answers “What will this person need?” but it does not answer, “What is that worth?” Projecting future care needs and calculating their dollar value are two different jobs.

That is where a forensic economist enters the process. A forensic economist takes the cost projections in the life care plan, completes comprehensive economic damage calculations, and converts them into present value. This single dollar figure represents what all of those future costs are worth today.

How a Forensic Economist Calculates the Value of a Life Care Plan

Once the life care plan is complete, the forensic economist converts its elements into a present value figure. The following steps outline how that work unfolds.

Step 1: Review the Life Care Plan

The forensic economist starts by reviewing the life care plan in detail, along with supporting medical records and documentation. They examine each cost category, interpreting the assumptions behind the projected needs, and identifying any areas that require clarification.

It is important to note that the forensic economist is not evaluating whether the recommended care is medically appropriate. That determination belongs to the life care planner and the treating medical professionals. The forensic economist is focused on whether the plan is sufficiently detailed to support a reliable calculation.

In many cases, the forensic economist will communicate directly with the life care planner to work through questions about specific cost projections or the reasoning behind certain recommendations.

Step 2: Establish the Key Variables

Before running any calculations, the forensic economist must determine the variables that will drive the analysis. This is one of the most consequential steps in the process because small differences in these inputs can produce significantly different damage figures.

The foundation of this step is the concept of present value. Present value is the idea that future money is worth less than money available today because a lump sum received now can be invested and grow over time. Converting projected future costs to their present value ensures that any award fairly reflects what those costs are actually worth today. With that foundation in place, the key variables the forensic economist must establish are:

• Discount rate: The rate used to convert future costs into present value. It is typically derived from historical data, current market interest rates, and economic forecasts.
• Medical cost inflation and wage growth: Healthcare costs have historically risen faster than general inflation. The forensic economist accounts for this separately when projecting the cost of long-term care and wages paid to providers,  including categories like treatment, medications, and therapy.
• Life expectancy: This determines how many years of future costs need to be calculated. In cases where a serious injury may affect the person’s lifespan, the forensic economist will consult with a medical expert to assist with life expectancy determination rather than relying solely on standard mortality tables.

Step 3: Calculate the Present Value of Each Cost Category

With the variables established, the forensic economist works through each component of the life care plan individually. Each cost category is analyzed on its own terms. Some categories, like home care or medications, involve recurring annual costs that continue for the remainder of the person’s life. Others, like assistive equipment or home modifications, involve periodic lump sum expenditures at projected replacement intervals. The forensic economist accounts for the timing, frequency, and expected cost trajectory of each category before applying the discount rate to arrive at its present value.

Step 4: Produce the Final Figure

The present value of each cost category is combined into a single total figure representing what the full life care plan is worth in today’s dollars. That figure becomes the foundation for the forensic economist’s expert opinion. The forensic economist documents the methodology, assumptions, and calculations behind the figure in a written report, which becomes a central reference point throughout the legal process.

How Expert Witness Testimony Supports Life Care Plan Calculations

If the case does not settle beforehand, the forensic economist’s role shifts from damage calculation to expert witness testimony once the written report is complete. The following steps outline how that process unfolds through the conclusion of litigation.

Step 5: Consult With Counsel and Co-Experts

Before deposition, the forensic economist works closely with counsel to prepare for the scrutiny the report will face. This often involves reviewing the life care planner’s report alongside the economic analysis to identify any gaps that opposing counsel might target. If there are questions about specific cost projections or care recommendations, the forensic economist may ask the life care planner for clarification. Input from medical experts on life expectancy or the long-term trajectory of the injury may also be revisited at this stage.

Step 6: Deposition

If the case proceeds to deposition, opposing counsel will examine the forensic economist’s methodology in detail. The discount rate selection, medical cost inflation assumptions, and life expectancy inputs are all common targets for challenge. Opposing counsel may also probe the relationship between the forensic economist’s calculations and the life care planner’s projections. An experienced forensic economist anticipates these challenges and can explain the reasoning behind each variable clearly and precisely.

Step 7: Trial Testimony

If the case proceeds to trial, the forensic economist presents their findings in plain language, walking the jury through the logic of present value. Opposing counsel may call their own forensic economist to challenge the methodology and present an alternative figure. The life care planner will typically testify separately about the medical basis for the projected needs. The forensic economist’s testimony is focused on the economics: what the plan costs in today’s dollars and why that figure is reliable.

Hypothetical Life Care Plan Calculations in Practice

The following examples illustrate how a life care plan and the forensic economist’s analysis come together in three of the most common litigation scenarios.

Traumatic Brain Injury Example

Consider the personal injury claim of a 35-year-old who sustains a severe traumatic brain injury in a vehicle accident. The life care planner projects 40 years of future needs spanning nearly every care category, from ongoing neurological treatment and cognitive rehabilitation to home care, psychological support, and assistive technology. The forensic economist calculates the present value of each category as follows:

By applying a 3% discount rate and a 4% growth rate, the present value figures in this case are higher than the unadjusted future costs alone would suggest because medical costs are projected to rise faster than the discount rate offsets them.

Toxic Tort Example

Consider the toxic tort claim of a 50-year-old who develops a chronic respiratory condition following prolonged occupational exposure to industrial chemicals. The plaintiff’s life care planner projects 30 years of future needs, producing a damages figure that the defense then retains a forensic economist to independently evaluate. Rather than building a new life care plan from scratch, the defense’s forensic economist reviews the plaintiff’s report, examines the methodology and assumptions behind each cost category, and produces an independent present value calculation.

In this case, the forensic economist identifies several areas where the plaintiff’s assumptions appear aggressive, including a life expectancy projection that does not account for the impact of the underlying condition and medical cost inflation assumptions applied to categories where generic alternatives are available.

Birth Injury Example

Consider the birth injury claim of a two-year-old diagnosed with cerebral palsy following oxygen deprivation during delivery. The life care planner projects approximately 70 years of future needs, as the condition requires lifelong support across nearly every care category. The forensic economist calculates the present value of each category individually, applying the same 3% discount rate and 4% medical cost inflation rate used in the previous examples.

The extended time horizon in this case produces a dramatically higher damages figure than a comparable adult case would, illustrating how significantly age affects a life care plan calculation.

Life Care Plan Calculations and Expert Witness Testimony You Can Rely On

Life care plan cases are among the most calculation-intensive engagements in economic damages litigation. The margin between a well-supported present value figure and one that does not hold up under cross-examination often comes down to the methodology behind the numbers and the ability of the expert to defend that methodology in court. Whether you are building a case or evaluating one, the forensic economist you retain matters.

The Knowles Group has been providing forensic economic consulting and expert witness testimony to attorneys since 1979. Eric Knowles and his team have worked on behalf of both plaintiffs and defendants in state and federal venues across more than a dozen states and Canada, bringing the same rigorous methodology to every engagement regardless of which side of the table they are on. Contact us today to schedule a complimentary case consultation and learn how our firm can assist with your life care plan calculations.