It’s no secret that most civil cases never go to trial, or that insurers would be happy to settle workers comp cases rather than periodically increase their reserves. Unfortunately, it is also true that plaintiffs have no way of knowing how to value their claim or accept their attorney’s recommendation for a reasonable settlement. They drink the Kool-Aid of TV commercials, uninformed friends, and the back-end advice of their city bus.
More importantly, attorneys have a difficult time knowing how to place a proper value on their client’s claim for future medical costs. Looking at past costs and lost wages is a cut and dried process. Asking colleagues for a ballpark figure on surgery, or going to a source like Healthbook, never takes into account the individual needs of client. And the client (patient) lives for the future.
Since mediation is often the final chance to intervene in an injured person’s life, make sure the potential costs are known, and presented in a professional format that facilitates acceptance at the table. Using the proper CPT codes, basing the cost on the State workers compensation fee schedules or the 75th percentile of UCR, including recent office visits, diagnoses and current life expectancies, creates a powerful tool for settlement.
Medical Cost Projections should be based upon the recommendations of the treating physician for potential surgery and medical care; annual costs of physical therapy, psychological care, x-rays, lab work, office visits, medications, DME equipment, bath and kitchen aids, yard and home maintenance if this will be an issue, and other costs that might occur with catastrophic injuries.
Big or small, every settlement matters to the patient whose life continues after both sides of the table go home, or on to the next case.