Life Care Plans & Lifetime Cost of Care

What is a life care plan?

A life care plan is a comprehensive, professionally prepared document that projects every service, treatment, therapy, and piece of equipment a person with a disabling injury will need over their lifetime, along with the cost and frequency of each. In a birth injury case, it is the evidentiary backbone of the damages claim — the document that turns a child’s future needs into a number a court or insurer can evaluate.

It is not a wish list or an estimate. A credible life care plan follows a published methodology, is grounded in the child’s actual medical records and treating physicians’ recommendations, and prices each item using real cost data. It answers a deceptively simple question with rigor: from today until the end of this child’s life, what will it cost to give them the care their injury requires?

Why the life care plan anchors a birth injury settlement

Every serious birth injury settlement (for cerebral palsy, HIE, kernicterus, or a severe brachial plexus injury) is built on top of a life care plan. The reason is structural: the largest component of these settlements is future medical and attendant care, and you cannot demand what you cannot document. A jury will not award, and an insurer will not pay, a lifetime of care that no qualified professional has itemized and priced.

This is also why no quoted “average” settlement for these injuries holds up. Two children with the same diagnosis can have life care plans that differ by tens of millions of dollars, because one can walk and communicate and the other needs total, round-the-clock care. The plan is where that difference becomes concrete, and why the settlement follows the child’s specific needs rather than a formula.

What a life care plan covers

A birth injury life care plan is organized into standard categories. The table below shows what each typically includes; the largest dollar figure is almost always attendant care.

Who prepares it, and how

A life care plan is prepared by a certified life care planner, often a registered nurse or rehabilitation professional with specialized certification (such as the CLCP credential), working from the child’s medical records, examinations, and the recommendations of treating physicians. The methodology is a recognized professional discipline with published standards and peer-reviewed literature; a well-built plan documents the basis for every item, so each line can be defended as medically necessary rather than aspirational. In litigation, the planner typically serves as an expert witness who can explain and support the plan under cross-examination, which is why methodology and sourcing matter so much.

How economists turn future needs into a present number

A life care plan lists costs in today’s dollars, spread across decades. A forensic economist converts that stream into a single present-value figure: the amount that, invested today, would fund each future expense as it comes due. Two opposing forces shape the calculation:

• Medical cost inflation pushes future costs up, and healthcare has historically inflated faster than the general economy.
• The discount rate pulls them back down, because a dollar set aside today earns a return before it is spent.

The economist also incorporates the child’s projected life expectancy (every additional year multiplies the annual cost of care) and adds lost earning capacity, projected from government and statistical earnings data even though the child never held a job. Small changes in these assumptions move the total by large amounts, which is exactly why they are so heavily litigated.

What published research says about lifetime cost

Independent research confirms how large these lifetime costs are. A CDC-funded study published in MMWR estimated the average lifetime cost associated with cerebral palsy at approximately $921,000 per person in 2003 dollars, roughly $1.6 million after adjusting for inflation to the present. The same study estimated even higher lifetime costs for some other developmental disabilities. Its authors emphasized that these figures are conservative: they capture direct medical costs, some indirect costs, and lost productivity, but exclude the value of unpaid family caregiving, many out-of-pocket expenses, and other real burdens families carry.

Two honest points about that research. First, it is an average across all severity levels: it includes people with mild impairment, so an individual with severe, care-dependent cerebral palsy will typically have a lifetime cost well above it. Second, it measures cost to society, not the value of a legal claim; a life care plan prepared for one child, priced to that child’s specific needs, is what a settlement is actually built on. The research is useful for perspective and for showing that large birth injury settlements reflect documented reality rather than exaggeration.

Where the two sides fight

Because the life care plan drives the damages, the defense contests it line by line. The recurring battlegrounds are: life expectancy (a shorter projection shrinks every future cost), the attendant-care model (skilled nursing versus home aides versus assumed family care can swing the plan by millions), the discount rate and inflation assumptions, and the medical necessity of individual items. Each side typically presents its own life care planner and economist. Understanding that this is a contest between documented projections, rather than a lookup in a table, is the difference between a realistic expectation and a disappointed one.

Getting a life care plan for your child

A life care plan is commissioned as part of building a birth injury claim rather than something families arrange alone. Where your case would be handled depends on where the care occurred: Banville Law attorneys are licensed in New York and Washington, D.C.; The Weitz Firm attorneys are licensed in Pennsylvania and New Jersey; elsewhere, the alliance connects families with its vetted network of local birth injury attorneys. Because filing deadlines vary by state (see the statute of limitations page), it is worth starting with a records review early, even before a life care plan is prepared.

Frequently asked questions

Who pays for the life care plan?

When a life care plan is prepared as part of a birth injury claim, the law firm advances the cost as a case expense under the contingency arrangement; families do not pay for it out of pocket. It is later accounted for from any recovery.

Is a life care plan the same as the settlement amount?

No. The life care plan projects future care costs, which an economist reduces to present value. The settlement also reflects lost earning capacity, non-economic damages, state-law caps, and the liability discount both sides apply for the risk of trial. The plan is the foundation, not the final figure.

Why is attendant care usually the biggest number?

Because human care is expensive and, for a severely affected child, needed around the clock for life. Whether the plan assumes family caregiving, home health aides, or skilled nursing is often the single largest factor in the total, and the most contested.

How accurate can a projection decades into the future be?

It is a reasoned professional estimate rather than a guarantee, grounded in the child’s records, treating-physician recommendations, and published cost data, and defensible item by item. The uncertainty is exactly why life expectancy, inflation, and discount-rate assumptions are argued so carefully by both sides.

Sources

This page is for general education and is not legal, medical, or financial advice. The cost research cited reflects population averages, not the value of any individual claim; every child’s life care plan and every case depends on its own facts. Reviewed by Laurence P. Banville, Esq. and Max Morgan, Esq.