Life Care Planning — Case Review SOP
This process builds a defensible, causation-driven projection of future medical needs, care requirements, and associated costs over the patient’s remaining life expectancy.
Purpose
- Translate permanent or long-term injury into structured future care needs
- Project lifetime medical, functional, and support requirements
- Anchor all future costs to verified causation pathways
- Eliminate speculative or inflated care projections
- Create a litigation-defensible life care framework
What AI Extracts (Facts Only)
- Confirmed diagnoses and permanent impairments
- Current treatment plans and ongoing care requirements
- Therapy utilization trends and duration
- Medication regimens and chronic management needs
- Assistive devices and durable medical equipment
- Level of care (independent, assisted, skilled, institutional)
- Complication history and recurrence patterns
- Hospitalizations and escalation frequency
- Functional limitations (mobility, cognition, ADLs)
- Physician recommendations for future care (if documented)
- Age, comorbidities, and general health indicators
What Clinician Must Confirm (Validation)
- Future care needs are directly tied to causation (not baseline aging or comorbidities)
- Permanent vs temporary impairment is clearly defined
- All projected services are medically necessary and standard of care
- Frequency and duration of care are realistic and evidence-based
- Life expectancy assumptions are appropriate and defensible
- Risk of future complications is clinically supported
- Care level progression (home → facility → higher acuity) is justified
- No duplication of services or overlapping care categories
- All recommendations align with accepted clinical guidelines
Any future care element not supported by a clear clinical trajectory must be removed or flagged as non-defensible.
Critical Thinking Steps
- Establish permanent injury baseline and residual deficits
- Project disease/injury progression over time
- Map care needs across time horizons:
- Short-term (0–2 years)
- Mid-term (2–5 years)
- Long-term (5+ years)
- Identify predictable complications and secondary conditions
- Determine level-of-care transitions over lifespan
- Evaluate whether earlier intervention would have reduced future burden
- Differentiate maintenance care vs escalation care
- Assess proportionality between injury severity and projected care intensity
- Align all projections with real-world clinical practice patterns
Stop Rules
- STOP if causation is not firmly established
- STOP if permanent impairment is unclear or unsupported
- STOP if life expectancy assumptions are speculative
- STOP if projected care exceeds clinical norms without justification
- STOP if future complications are hypothetical without evidence
- STOP if baseline vs injury-related needs cannot be separated
- STOP if cost assumptions are not grounded in real care models
Life Care Planning cannot proceed on assumption—only on validated clinical trajectory and causation-linked need.
Final Output Requirements
- Structured Life Care Plan (categorized by care type)
- Time-phased care projections (short, mid, long term)
- Causation-linked justification for each care element
- Frequency and duration of each service
- Level-of-care progression model
- Future complication risk integration
- Clear separation of baseline vs injury-related needs
- Defense vulnerability analysis (overreach, unsupported projections)
- Plaintiff strength indicators (permanence, progressive decline, high dependency)
- Seamless integration into damages model and attorney valuation strategy
Final output must withstand expert challenge, cross-examination, and Daubert-level scrutiny.