Calculating Future Care Costs in Personal Injury Claims

When someone has suffered a serious and disabling physical injury in an accident caused by the negligence of another party, they may be entitled to damages, which may include a monetary award to pay for the costs of their future care.   Future care costs can be defined as the amount required to pay for medical and professional assistance and equipment that will, as much as possible, restore the injured person to the position they were in before the accident occurred. Future care costs are pecuniary, meaning that they are a projection of actual expenses.

The onus is not on you, as an accident victim, to calculate the costs of your future care.  This projected cost is completed on the basis of your current medical and assistive needs, with expert opinion from the appropriate medical professionals and your personal injury attorney.

All reasonable expenses are included in calculating future care costs.  This includes the purchase of items such as pharmaceutical products; assistive devices and household items that aid in care; housekeeping and personal care services; as well as treatments prescribed by health care professionals.  Expenses must be fair, reasonable and medically justified with respect to the specific needs for an accident victim.  There is an expectation that the injured party, and/or the family members that are supporting them, actively participate in the financial administration of their care as well as in their rehabilitation and recovery.

Two Approaches to Calculate Future Costs
The amount of money granted to the injured party can vary from thousands to millions of dollars, depending on the severity of the injuries and the magnitude of the future care that is required. In cases of catastrophic injury, the patient’s injuries may be so severe as to warrant a complete change of lifestyle involving either in-home care or institutional care.  In the case of injuries that are less severe, the injured person’s care may involve only simple additions to their current lifestyle.

1. Total Lifestyle Change Approach

The extent of one's injuries plays a large role in determining the amount of reasonable expenses.  Catastrophically injured persons who are, for example, confined to a wheelchair and/or suffer partial or complete paralysis require substantial future care expenses.  There may be a need for full-time assistance, daily rehabilitation treatments and multiple surgeries. The costs of providing full-time care, revamping a home to make it wheelchair-accessible or of residing full time in a special care facility can be daunting. For patients who have suffered amputation, severe spinal injury, paralysis or traumatic brain injury, large-scale changes to their lifestyle are often needed.  Accident victims with injuries requiring a "total lifestyle" approach to their care may be eligible for all the costs of in-home or resident care, home reconfiguration and transportation costs.

2. The Additional Expense Approach
An accident victim who was seriously injured but is, for the most part, able maintain their previous lifestyle may be entitled to be compensated for the future costs of specific expenses, such as physical therapy, psychological therapy and pain management.   In such cases, the cost of future care will calculate the projected cost for these services for a lifetime or for the disability expectancy, and discount the total sum to its present value. 

In some cases, accident victims who sustained severe injuries and disabilities also suffer from psychological injuries such as depression, for which they may also require ongoing support and treatment.

Decisions as to the amount of money granted to patients who require significant care in a medical facility or at home are made on a case by case basis by a judge or panel.  The determination generally begins with a Board Certified Life Care Planner who prepares a Future Care Cost Report or Life Care Plan.  This process takes into account all medical reports, the patient’s own input and experiences, as well as opinions from the health professionals who have been treating the patient, to calculate what their future care will cost.

In every situation, case law establishes precedence and also gives decision makers a guide in determining the appropriate award for an injured person’s injuries. In Ontario, severely injured persons who have claimed the total lifestyle approach have been awarded tens of millions of dollars for future care expenses, as required by their specific needs.

One of the largest settlements for the cost of future care was awarded to two young men by Ontario Superior Court in the 2007 trial, Gordon v. Greig.   The two young men were both catastrophically injured in a tragic drunk driving accident and subsequently require substantial future medical care and support. One of the men, Derek Gordon, suffered upper spinal injury and brain injury; he was awarded almost $11,400,000 in damages including $8,646,900 for the cost of his future care.  The other young man, Ryan Morrison, sustained severe spinal injury and paraplegia; Mr. Morrison was awarded about $12.3 million in damages including $8,880,000 for the cost of his future care and attendant care.

If negligence in causing an accident resulted in serious injuries for you or a loved one, the first priority is to have your injuries fully assessed and participate in any medical treatments recommended by your physicians.  As soon as you are able after your accident, it is a good idea to consult with a personal injury lawyer to discuss your future care requirements and whether or not you have a case for seeking damages.  There are timelines for making a claim for accident benefits that your attorney will make certain are met, if you choose to go ahead with a claim.    The ILO group are respected personal injury lawyers well experienced in consulting with medical professionals to ensure that the cost of future care calculations is fair and realistic given your unique needs.