What if I have future medical care needs after I resolve my Oregon or Washington Injury Claim?

The Problem:  Future Medical Expenses in the Oregon Auto Injury Claim

The cost of medical care has almost doubled in the last couple of decades, and it’s fair to assume the trend will continue upward.  Our Oregon and Washington auto injury clients face special challenges when their injuries require future medical care.  This article provides a summary of how we handle claims for future medical expenses.

First, Some Definitions

First a little background.  Both Washington and Oregon split the kinds of compensation you can claim into two different categories:  What is objective, and what is not. 

In Oregon and Washington, medical expenses are in the objective category, because the medical bill is a specific amount.  Everyone will agree on the amount of the medical bill, but they may not agree that it is part of the case.  More on that below.

In Oregon, medical expenses fall into the “economic” damage category.  In Washington, medical bills are a form of “special” damage.  These are just two different labels for the same thing.

How You Prove Medical Expenses

First, you need to show that the medical treatment reflected in the medical bill was necessary to treat injuries related to the collision.  Some medical expenses are obvious, like ambulance and emergency room bills.  Others are not.  If a case goes to trial, a medical expert’s testimony is needed to prove that the medical expenses are related to the auto collision injuries.

You must also prove that the medical treatment reflected in the medical bill is a reasonable charge.  This is usually a formality, but some insurance companies may attack the amount of the medical expense as being unreasonable.

How Future Medical Expenses Are Different

The rules for future and past medical expense are the same but proving that something will happen in the future is always a different challenge.

To prove future medical expense, a medical expert needs to explain what care will be required, and why.  But you will also need someone to talk about how much the care is going to cost over the long run.  When our client is facing life long medical care needs, we work with life care planners.  A life care planner is a special expert that reviews medical records, confers with medical providers, and our client, to create a life care plan.  The life care plan that is created sets out a schedule of all the medical care our client will need throughout their life.

Just like any issue in a serious Oregon personal injury case, there is no guarantee that an insurance carrier or defense attorney is going to accept a life care planner’s report.

Other Claims Related to Future Medical Care

In many cases, a doctor will not be able to say that our client will probably need future medical care but can say there is an increased risk of developing future problems, or that there is a very good chance that some kind if treatment, like surgery, is in our client’s future.

Oregon law allows us to argue for non-economic damages where your injuries put you at greater risk for developing future problems that could require more medical care.  Some people say that this is compensation for “fear of future disease.”  In plain English, someone having to deal with the possibility that their injury is going to come back to haunt them is entitled to compensation for living with that real possibility.

When The Settlement Does Not Cover Future Medical Care

We can prove all the future medical treatment needs possible for our client, but at the end of the day, there is a limited amount of liability insurance coverage available for every claim.  Sometimes, the available insurance will cover future medical expenses, but often, it does not.  When faced with this situation, the challenge shifts to doing everything we can to make sure our client has access to medical care after their case is completed.  That involves negotiating with health care plans or structuring the settlement so our client can get the medical care they need.

Questions?

We help people with serious injury cases all the time.  If you have questions, contact us.  At the very least, we can help you know where you stand.

Joe Di Bartolomeo
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Top-rated Personal Injury Lawyer Helping Oregon and Washington Families