TPLCP Logo

Resources

CHT life care planner upper extremity hand injury

By: Elisa Marks

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.

Why a Certified Hand Therapist Life Care Planner Matters in Upper Extremity Injury Cases

How a CHT-CLCP strengthens damages analysis, care projections, and case value for plaintiff and defense attorneys

When upper extremity injuries are involved in litigation, subtle functional losses in the hand, wrist, or elbow can translate into lifelong limitations, diminished earning capacity, and significant future medical costs. These cases benefit from a specialist who understands fine motor function, long-term surgical outcomes, and real-world task performance.

A Certified Hand Therapist who is also a Certified Life Care Planner (CHT-CLCP) brings that level of specialization.

Why Specialization Matters for Hand & Upper Extremity Cases

A Certified Hand Therapist must complete 4,000+ hours of direct upper extremity rehab practice, a minimum of three years of clinical work, and pass an advanced examination focusing exclusively on upper-limb rehabilitation. When that expertise is combined with life care planning training, attorneys benefit from dual-credentialed expertise that strengthens the credibility and defensibility of future care projections.

This specialization becomes invaluable in claims involving:

  • Wrist and hand fractures
  • Crush injuries, tendon/nerve injuries
  • Carpal/tunnel, repetitive trauma, overuse conditions
  • Complex regional pain syndrome (CRPS)
  • Amputations or reconstruction
  • Flexor/extensor tendon repairs
  • Elbow, forearm, distal radius & scaphoid injuries

 

Upper extremity trauma is rarely isolated. Functional consequences often evolve — and a specialist is best positioned to evaluate long-term implications.

How a CHT-CLCP Strengthens a Life Care Plan

A hand-specialized LCP translates clinical impairment into function, independence, and cost impact over a lifetime, ensuring your plan accounts for:

  1. Future treatment + surgical planning
  • Likelihood and timing of revision surgeries
  • Management of chronic pain and arthritis
  • When therapy, injections, or orthoses may be needed long-term
  1. Functional outcome analysis
  • Dominant vs. non-dominant limb involvement
  • Impact on ADLs, IADLs, childcare, homemaking
  • Work endurance, grip/pinch demands, and fine motor tolerance
  1. Equipment & adaptive solutions
  • Custom orthoses, splints, ergonomic modifications
  • Adaptive devices for meal prep, grooming, home tasks
  • Technology and workstation solutions for return-to-work
  1. Aging-related complication forecasting
  • Arthritic changes
  • Reduced endurance and dexterity
  • Long-term scar adhesions or hypersensitivity

 

The result:
A life care plan that is clinically accurate, defensible, and practical, informed by real-world outcomes — not just literature.

Case Example — High-Velocity Dominant Wrist Trauma

A middle-aged nurse sustains a comminuted wrist fracture from a motorcycle crash requiring ORIF and prolonged therapy. Despite maximum rehabilitation, grip strength remains poor and endurance is limited.

Key attorney-relevant questions become:

  • Can she safely transfer patients, start IVs, or complete wound care?
  • What is her capacity for charting, prolonged gripping, or fine motor precision?
  • How will this affect her ability to cook, open containers, manage clothing fasteners, drive, or care for dependents?
  • When will arthritic change or hardware complications require revision treatment?

 

A CHT-CLCP knows how to anticipate these functional issues, verify needs with treating providers, and justify future treatment, equipment, and cost projections with clarity for mediation or trial.

How a CHT-CLCP Supports Your Legal Strategy

Beyond authorship of the life care plan, our expert can assist counsel by:

  • Reviewing records for missed functional details
  • Identifying documentation needed to strengthen damages
  • Developing attorney deposition questions
  • Critiquing opposing life care plans for accuracy and reasonableness
  • Educating attorneys, mediators, and juries on real-world functional impact
  • Providing expert witness testimony grounded in clinical depth

 

For hand-intensive occupations — healthcare, mechanics, laborers, artists, musicians, office professions — work capacity and future earning potential may be significantly affected. A specialized planner ensures those losses are captured accurately.

Meet Our Expert

Elisa Marks, OTR/L, CHT-CLCP
Certified Hand Therapist • Certified Life Care Planner • 25+ years upper extremity clinical experience

Elisa Marks Turning Point Life Care Planning

Elisa brings decades of direct treatment experience in hand and upper extremity rehabilitation, has served as an educator in the field, and is a pre-publication reviewer for the Journal of Hand Surgery. Her evaluations and life care plans reflect the lived reality of upper extremity recovery — not just theory — resulting in highly credible, defensible work product for litigation.

Have a Hand or Wrist Case? Consult With Us.

Early involvement from a hand-specialized life care planner strengthens case value, clarifies future care costs, and improves expert strategy.


crossmenuchevron-right