What is The Financial Value of an LIS Lawsuit?
When someone is diagnosed with locked-in syndrome (LIS) due to an accident, medical error, or negligence, families want to know...
Legally Reviewed By
Attorney Rich Newsome
Catastrophic Injury & Medical Malpractice Attorney
25+ years experience
Locked-in syndrome (LIS) is a condition where a person can’t move or speak, but their mind stays fully awake and aware. Most people with LIS can only communicate by moving their eyes or blinking, and they usually need a breathing machine, a feeding tube, and around-the-clock help with everything from eating to moving to personal care.
If your family is dealing with LIS because of an accident or medical mistake, you may be facing a few big questions:
A Certified Life Care Planner (CLCP) can answer the questions above. This trained professional builds a report called a life care plan, listing everything your loved one will need in the future, including medical care, equipment, therapy, and daily help, and putting a price on each item. This report becomes one of the most important pieces of evidence in a lawsuit, because it shows the court what your family will actually need to pay for.
The International Conference on Life Care Planning and the International Academy of Life Care Planners describe a life care plan 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.”
The person being cared for is called the “evaluee;” in your case, the evaluee is your loved one with LIS. The plan works like a roadmap, built to get the best care possible and to plan ahead for problems that might come up, like a breathing infection, a pressure sore, or broken equipment.
Because someone with LIS depends completely on others for breathing, eating, moving, and communicating, the plan has to cover a lot of ground. And because courts rely on it, it has to be clear, backed by evidence, and easy for anyone to double-check.
The costs in a life care plan aren’t guesses. This matters a lot for LIS, because two people with the same diagnosis can need very different care, depending on things like how much movement they have left, whether they’re on a ventilator, and what their home is like.
Instead, life care planners follow guidelines built by a large group of professionals, including nurses, doctors, rehabilitation counselors, case managers, psychologists, and social workers. Some of the most important rules about cost:
Every cost in a life care plan is based on Usual, Customary, and Reasonable pricing, UCR for short, a guideline set by the American Medical Association. A price counts as UCR when it’s:
For a loved one with LIS, this research usually covers:
To find fair prices, planners call providers, pharmacies, and equipment companies to ask what they’d actually charge, then average several numbers together. Many also check pricing databases built for this purpose, like the Physicians Fee Reference.
A planner pricing out doctor visits for someone with LIS might look up specialists in the same city, confirm that doctor treats this condition, and write down exactly how each price was found, so anyone reviewing the plan later can see where each number came from.
Not every possible future health problem gets added to the cost list. This matters for LIS, where many complications are possible, such as pneumonia, blood pressure swings, stiff joints, and skin breakdown. However, “possible” isn’t enough. To be included, an item has to be more likely than not, i.e., over a 50% chance it will happen. Anything that’s only a “potential” problem, rather than a likely one, doesn’t meet the standard needed to include it.
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Pricing each item is only step one. Next, a planner adds up the yearly costs to build a yearly budget, then uses research on life expectancy to stretch that number out over the person’s whole expected lifetime.
Life expectancy is an especially important number for LIS. With good medical care, people with locked-in syndrome can live for decades, meaning the lifetime budget may need to stretch out much further than in other cases.
But a lifetime total in today’s prices isn’t the number a jury is actually asked to approve. Care needed 30 years from now will cost more than it does today, and money awarded today can be invested and earn interest. So the plan’s costs are converted into present value: one dollar amount, in today’s money, that would cover the whole plan for the rest of the person’s life. This math isn’t done by the life care planner, but by an economist, who looks at two things for every item:
Medical costs don’t all rise at the same speed; medical services (like nursing and hospital care) have historically gotten more expensive faster than medical products (like equipment). This matters for LIS, since categories like 24-hour nursing usually fall into that faster-growing group.
The effect can be dramatic. For example, a doctor visit that costs $1,000 today could cost $1,500 in a few years. A hospital stay that costs $150,000 today could cost $225,000 in a few years. This pattern matters for LIS plans: nursing and hospital-level care, with their higher growth rates, can end up making up a very large share of the total.
Regular inflation—the kind you hear about on the news—doesn’t rise nearly as fast as medical costs. That’s why life care plans use a separate, higher medical inflation rate. This means the cost of required treatments could double over the course of a few years.
Not everything rises at the same rate, though. Sorting out which rate applies to which item is part of building a plan that holds up to scrutiny. Some costs are also harder to pin to an exact year—a likely future surgery without a set date, for example—so planners may spread that cost across an estimated time window, as long as they clearly explain the assumption.
Everything above exists to answer one big question: how much money, given today, would be enough to cover your loved one’s care for the rest of their life? For a family dealing with LIS, that number has to hold up over what could be decades of round-the-clock care, which is why the process matters just as much as the final number. If a plan skips proper price-checking, mixes up growth and interest rates, or lists a cost without showing where it came from, the whole plan and the amount awarded because of it become an easy target to challenge.
This is why the profession has so many rules: agreed-upon standards, billing codes, and present-value math aren’t red tape. They’re what make sure a life care plan answers the court’s questions clearly, instead of raising new ones. For your family, that same care and attention is what stands between a plan that truly provides for your loved one’s future and one that falls short.
A life care plan is only as strong as the work behind it. The right documentation, pricing, and present-value calculations can mean the difference between a settlement or verdict that truly covers your loved one’s lifetime of care, and one that falls short.
We work with life care planners to ensure your case includes an accurate valuation of the care your loved one will need. If you are interested in learning more, the locked-in syndrome attorneys at Newsome Law are ready to talk with you.
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