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While plaintiff and defense life care plans follow the same professional standards, the process behind them differs in important ways. This blog explains how plaintiff life care planners build the basis for their opinions through:
- Client and family interviews
- Home visits
- Physical and cognitive testing
- Direct conversations with treating physicians
It also explains when additional evaluations (vocational, neuropsychological, driving, home modification, and more) are needed and how skipping these evaluations can leave a plaintiff’s recommendations vulnerable to challenge from the defense.
The same standards apply for developing a plaintiff life care plan and a defense life care plan. Both should be developed within the Standards of Practice for Life Care Planners and Consensus and Majority Statements.[1] The Standards of Practice for Life Care Planners say a life care plan should include only costs of goods and services that are reasonably certain (more likely) to be needed due to the injury that is the subject of the litigation.[2] Goods and services for which the need is possible but not reasonably certain (less likely) should be shown as potential costs but not included in the costs included in the life care plan.
Important differences between a plaintiff and defense life care plan are the sources and types of information each life care planner receives.
Both experts should have equal access to medical records, employment records, and other documents produced in discovery.
The plaintiff expert has the opportunity to interview the plaintiff and the plaintiff’s treating clinicians; conduct a home visit and interview family members; and administer physical and cognitive tests. The plaintiff life care planner develops opinions based on an interview with the client, medical records, and conversations with the plaintiff and the plaintiff’s physicians and family. The client interview, besides providing the plaintiff’s demographic information, provides insight into the day in the life of the client and the geographic location of the client and medical facilities.
The plaintiff’s expert has the burden of proving the recommended goods and services are medically necessary due to the event. If the plaintiff’s physicians have not seen the patient in over six months to a year, the plaintiff should schedule an office visit. The plaintiff’s expert will then interview the physician to confirm diagnoses, future care recommendations, and functional limitations.
A functional capacity or physician’s statement describing functional limitations or work capacity can further support the inability to perform activities of daily living (ADLs). Appropriate consultations and evaluations provide the basis for recommended medical procedures, services, and goods related to the event and should be discussed in the life care plan narrative. More evaluations should be completed before writing a life care plan. If this is not possible, an evaluation can be recommended and part of the life care plan’s costs, but all recommendations established by the evaluation are considered a possibility—not a probability—and costs cannot be part of the final calculation of damages.
More evaluations can include, but are not limited to:
- Assistive technology evaluation
- Home evaluation
- Estimate for home modifications (contractor)
- Home care needs assessment[3]
- Driving evaluation
- Neuropsychological evaluation
- Psychological evaluation
- Vocational rehabilitation evaluation
- Educational evaluation
After reviewing the medical records and speaking with the client and family, the expert determines whether the plaintiff needs assistance with ADLs, such as driving, cleaning the house, preparing meals, mowing the lawn, maintaining the home, home modifications, and vehicle modifications. All this should be considered for the life care plan.
Defense experts usually do not have the opportunity to interview the plaintiff, family members, and treating clinicians or to conduct a home visit. In some cases, a defendant will request and a court will order an independent medical examination or a neuropsychological examination to receive information from reports, evaluations, and defense medical expert opinions.
These actions by the plaintiff expert to develop a life care plan establish a basis for the goods, services, and medical procedures recommended in the life care plan. Omitting some of these actions leaves openings for the defense expert to attack the reasonableness or reliability of the plaintiff’s recommendations.
[1] Cloie Johnson, Caroline Williams, Amy MacKenzie, and Brook Feerick, “Consensus and Majority Statements Since 2000: Updated at the 2025 Life Care Planning Summit,” Journal of Life Care Planning 23, no. 2 (2025): 74.
[2] Tanya Rutherford-Owen, Mary Barros-Bailey, and Roger O. Weed, eds., Life Care Planning and Case Management: Across the Lifespan, 5th ed. (New York: Routledge, 2023), pp. 102–103.
[3] Lisa Bushy Thomas, “Assessing Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (ADLs), and Functional Status,” Journal of Life Care Planning 21, no. 2 (2023): 37–56.