Why Life Care Plans Differ — and What to Look For

Life care planning is grounded in established methodology, yet its application can vary. Careful attention to how needs are analyzed and projected over time can help clarify the basis for differing conclusions in catastrophic injury cases.

Why Life Care Plans Differ — and What to Look For

Life care plans are often central to discussions of future need in catastrophic injury cases — yet equally qualified experts can produce very different projections.

When this occurs, the difference is rarely explained by credentials alone.

More often, it reflects differences in methodology.

Understanding how a life care plan is developed — not just what it contains — can assist in evaluating its reliability.

A Structured Approach to Long-Term Need

Life care planning has historically been described as a consistent methodology for analyzing needs arising from disability across the individual’s life expectancy.

At its core, the process is intended to identify:
• The impact of a health condition
• The resulting functional implications
• The services or supports that may be required over time

Recommendations are driven by identified needs rather than funding availability.

Moving Beyond Diagnosis

A diagnosis describes a medical condition. A life care plan addresses how that condition affects daily function and participation.

A commonly used clinical framework considers:
Impairment → Activity Limitation → Participation Restriction

This reflects:
• Changes in body structure or function
• Effects on task performance
• Impact on real-world roles and engagement

Individuals with similar diagnoses may experience very different functional implications.

Individualized vs. Generic Planning

Life care plans are intended to be individualized.

This typically involves consideration of:
• Functional presentation
• Environmental context
• Available supports
• Anticipated interactions between condition and daily life

Rather than applying uniform assumptions, planning may reflect the individual’s circumstances and environment.

Lifespan Considerations

Long-term needs may evolve over time.

Planning often considers:
• Anticipated functional change
• Secondary effects associated with long-term disability
• Environmental transitions
• Shifts in independence

Accordingly, life care plans are generally regarded as dynamic documents that may be updated as circumstances change.

The Role of Environment

Needs may be influenced by:
• Living environment
• Access to services
• Transportation
• Work or educational settings
• Community participation

Incorporating environmental context can help align projections with daily life.

Consistency of Methodology

A consistent methodology involves:
• Comprehensive assessment
• Data analysis
• Use of available clinical and outcome information
• Consideration of long-term needs across life expectancy

Consistency refers to the analytical process — not to uniform recommendations across cases.

Questions That May Assist Review

When reviewing or retaining a life care planning expert, attorneys may consider:
• How are impairments translated into functional impact?
• How are activity limitations considered?
• What assumptions were made regarding independence?
• How are environmental factors incorporated?
• Are potential secondary effects considered?
• How does the plan address change over time?

These questions do not favor a particular outcome, but may help clarify how projections were developed.

Applying Methodology in Litigation

When life care plans differ, the underlying methodology often explains why.

Evaluating how projections were developed — including assumptions, functional translation, and consideration of long-term impact — can assist in understanding the basis for differing conclusions.

In some matters, additional analysis may be helpful to:
• Clarify methodological assumptions
• Evaluate consistency with standards of practice
• Examine functional implications
• Assess alignment between projected services and individualized need

Legal teams on either side may seek this type of review when:
• Evaluating an opposing life care plan
• Responding to differing projections
• Clarifying areas of agreement or disagreement

In some instances, even the retaining party may request an independent review when an existing plan raises questions regarding assumptions, scope, or functional alignment.

Closing Perspective

Whether developing a life care plan or reviewing an existing one, attention to methodology can help ensure projections reflect individualized need rather than generalized assumptions.

Turning Point Life Care Planning provides life care planning and life care plan rebuttal services to assist legal teams in evaluating long-term needs across a range of injury types.

How to Vet a Life Care Planner: A Practical Guide for Attorneys

When a case clearly warrants a life care plan, the name of an “expert” often arrives by way of a colleague’s recommendation. A curriculum vitae (CV) may or may not be attached. The real question is:

Will this life care planner truly help – or quietly weaken – your case?

This guide outlines the key qualifications, credentials, and professional activities to look for when evaluating whether a life care planner will provide defensible, trial-ready work for your client.

Section 1: Certification Matters

Is the expert a Certified Life Care Planner?

Life care planning is a distinct profession with its own:

 

“Life Care Planner” is a trademarked title used by professionals who are certified by:

 

Physicians who are certified as life care planners through ICHCC must also meet defined criteria and training standards.

A certified life care planner receives dedicated training in:

 

Section 2: Experience Counts

Does the life care planner have relevant clinical and forensic experience?

Certified life care planners must have at least three years of relevant rehabilitation experience, but the quality and focus of that experience also matter.

Key questions to consider:

 

Section 3: Professional Engagement in Life Care Planning

Are they actively involved in the life care planning profession?

Understanding the history, standards, and evolving practices of life care planning is fundamental to expert credibility.

Look for evidence that the planner:

 

Section 4: Membership in Disability-Specific Organizations

Do they stay current with diagnosis-specific standards and guidelines?

Beyond professional planning organizations, credible experts also monitor or participate in organizations relevant to the populations they evaluate, such as associations for:

 

Section 5: Contribution to the Profession

Do they contribute to advancing the field?

Professionals who publish, present, or teach within the field typically:

 

Section 6: Specialization and Case Fit

Do they have the right expertise for this specific case?

Many experts build specialized experience, such as in:

 

Matching the expert to the case is essential for credibility and reliable cost projections.

Section 7: Establishing a Proper Medical Foundation

How does the planner establish the medical basis for their opinions?

Life care planners are trained neither to:

 

A defensible plan requires a clear medical foundation supported by:

 

Section 8: How Turning Point Life Care Planning Meets These Standards

Turning Point Life Care Planning maintains a team of highly qualified Certified Life Care Planners who meet all of the criteria identified above.

Our team includes:

 

We work collaboratively to ensure accurate consideration of functional capacity, long-term medical needs, equipment, and community integration over the lifespan.

Section 9: Next Steps – If You’re Evaluating a Case Now

If you have a case that may benefit from a life care plan — or if you are unsure whether the injuries rise to that level — we are available to consult.

Ways to get started:

 

Life Care Planning

Life care planning is a profession with its own standards of practice, certified professionals, with peer-reviewed journals, textbooks, and annual conferences. “Life Care Planner” is a trademarked term to be used by those who are certified by the International Commission on Health Care Certifications or ICHCC. When a life care plan is developed using a methodology consistent with the standards of practice for life care planners the plan should be able to be replicated by another life care planner.

Life Care Planning is a transdisciplinary practice. To be a Certified Life Care Planner is to be an experienced rehabilitation professional licensed to practice within a healthcare profession, e.g. Register Nurse (RN), Occupational Therapist (OT), Physical Therapist (PT), Vocational Counsellor or a Medical Doctor (MD). Certification requires 120 hours of education specific to the practice of life care planning, a certification exam and submission of a life care plan to be approved by the ICHCC board. Continuing education in life care planning is required to maintain certification. The education must include a component on ethics.

A Life Care Plan is defined as “a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs.” (International Conference on Life Care Planning and the International Academy of Life Care Planners. Adopted 1998, April.) It is a way to plan for the lifetime needs of an individual with a disability.

Life Care Plans are often used in a forensic setting to help resolve personal injury cases where an individual has sustained an injury at the fault of another person. The subject of the life care plan is referred to as an evaluee. The life care plan is intended to be educational and written so that the plan is understandable by the lay person, using non-technical language which can realistically be implemented.

The standard methodology used to develop a life care plan consists of step-by-step procedures which include: initial case intake, review of medical records and supporting documentation, interview with evaluee and a collateral interview (if appropriate, e.g. TBI), consultation with therapeutic team members, formulation of preliminary opinions, cost research, and confirmation of projections with the evaluee.

Best practice is to conduct the interview at the evaluee’s home; however, due to COVID-19 restrictions and individual preferences, a virtual assessment has become common practice. The home assessment enables the life care planner to consider the social and physical environment that may facilitate or restrict the evaluee’s function. For example, for an evaluee who uses a wheelchair, the need for home or vehicle modifications can be assessed; or for an evaluee with chronic pain, the need for ergonomic equipment or in-home rehabilitation may be considered.

Especially when the evaluee has experienced changes in cognition, collateral interview with a family member, caregiver and/or a close friend will assist with determining the change in function since the subject event and the current level of care being provided. It is standard practice to replace the gratuitous support provided to the evaluee as it is not deemed a reliable source of long-term support.

Given the transdisciplinary nature of life care planning, for areas of the plan that are outside the scope of practice of the life care planner, the life care planner relies on the medical records, consultation with the evaluee’s treating team members (e.g. specialist physicians, chiropractor, physical therapist, psychologist, etc.) or other experts involved with the case (e.g. orthotist, psychiatrist, physiatrist, etc.) to help develop the medical foundation for the life care plan. The life care planner is not intended to be a “secretary” simply providing the cost of the recommendations or others; nor, are they intended to be a “know-it-all,” relying on themselves to provide the foundation for the entire life care plan. In forensic practice, the life care planner applies their knowledge and experience in life care planning to vet care recommendations to ensure each item in the life care plan is likely to be beneficial and appropriate for the evaluee, e.g. a recommendation for pool therapy is not appropriate for someone allergic to chlorine or if an evaluee who would have likely incurred the expense for a gym pass or childcare absent the subject event, they would not be entitled to be compensated for these expenses related to the subject event.

The litigation process is usually the evaluee’s one shot at receiving the funding they require for future care; therefore, it is important that the pricing in a care plan be up-to-date, accurate and enable multiple options of providers within their geographical area. Collateral sources are not relied upon as a reliable source of lifetime funding. There are 18 standard categories of care considered in a life care plan which include: medical services, evaluations, medications, therapies, orthotics and prosthetics, wheelchair equipment, wheelchair maintenance, aides for independent living, home modifications, health maintenance and leisure, vocational/education. Given the potential longevity of the life care plan, e.g. decades, the life care planner provides accurate and geographically specific costing. It is of no help to the evaluee or their caregivers to provide resources that do not provide the intended services, e.g. a case manager who does not work with individuals under the age of 65 with a TBI but specializes in geriatric case management. Providing backup documentation for the resources is best practice and allowed by the majority of subscription fee reference databases given the forensic application.

The goal of each life care plan is to assist the evaluee is to restore function where possible; maintain function and prevent or reduce the risk of secondary complications, e.g. falls, pressure sores, etc. The plan details the services and charges for the services needed by the evaluee over the course of their lifetime. Alternatives for care take into account the developmental stages of the evaluee and the least restrictive environment. The life care planner must be willing and available to communicate the life care plan and objectives to the evaluee and the relevant parties, e.g. attorneys, judge and/or jury.