Care Cost Analyses and/or Occupational Determinations

Medical Cost Projections

A medical cost projection is a detailed document that estimates the future medical expenses for an individual based on their current medical condition and anticipated needs. Using healthcare provider input and current medical billing data, the cost projection specialist estimates the charges associated with the projected medical needs.

Our consultants review the individual’s medical records to understand their current condition and treatment history. Within the report, the necessary medical treatments, therapies, medications, and equipment the individual will need are outlined and costed. The report often focuses on the immediate future needs.

These reports are often used to help determine the compensation needed for future medical expenses in personal injury claims. They provide a basis for negotiating settlements by offering a clear picture of the anticipated medical costs associated with the specific incident in question. Medical cost projections can also help individuals and families plan for future medical expenses to ensure they have the necessary resources to lessen potential financial burdens.

What is the difference from a Life Care Plan? While a medical cost projection focuses on estimating immediate and short-term medical expenses, a life care plan provides a comprehensive, long-term outlook. Life care plans consider not only medical costs but also the broader needs and quality of life for individuals with chronic conditions or serious injuries.

Our experts have experience with assessing individuals with a variety of injuries and disabilities, including spinal cord injury, brain injury, labor/delivery complications, amputation, stroke, musculoskeletal injuries, severe burns, and neurological impairment. We utilize a consistent methodology to organize, evaluate, and interpret patient-specific information. When appropriate, we collaborate with treating physicians, therapists, and other experts to determine current and future needs.

When it becomes necessary to present the Life Care Plan as evidence, our experts articulate their findings clearly and persuasively. A well-written, comprehensive Life Care Plan and accompanying expert testimony are often key to allowing the jury to make an informed decision.

Medical Bill Reviews & Audits

We ensure accuracy and fairness in medical billing through meticulous reviews and audits. Our process identifies discrepancies, overcharges, and unnecessary services by comparing billed services with patient records.

We verify that all charges are justified, accurately coded, and reasonable for the geographical area and type of service. If discrepancies are found, we provide support for disputing charges. Our thorough review process safeguards you from agreeing to unnecessary medical costs, especially in personal injury and medical malpractice cases. We highlight common billing and coding errors, such as duplicate claims and undocumented services, ensuring compliance with regulations.

What are the benefits?

• Accuracy and Fairness: Prevents overcharges and ensures all billed services are necessary and correctly documented.
• Support for Legal and Insurance Claims: Provides evidence-based assessments to strengthen settlement negotiations.
• Cost Containment: Identifies and eliminates overcharges to reduce medical expenses.
• Financial Planning: Offers clear insights into medical costs for better future planning.

What sets us apart? Our findings are compiled into detailed reports that clearly outline discrepancies, overcharges, and any unjustified services. These reports are designed to be easily understood by all stakeholders, including legal and insurance professionals. Our insights support claims and legal cases by reducing costs and mitigating losses.

The impact of a disabling injury is never the same, but the questions that arise in its aftermath always are. While the questions may be simple, the answers are not always clear or easily attained.

• Can the individual work? If so, what are the employment options?
• What can the person earn?
• What appropriate jobs are available?

These inquiries just begin to scratch the surface of a credible Employability Analysis. Our qualified professionals apply their experience to answer them.

Our Employability Analysis considers pertinent medical and non-medical information, functional capacity evaluations, and the most recent therapeutic treatment records. This information is combined with data relating to factors like age, education and work experience as well as psychological and sociological factors to produce a detailed data profile.

Our team employs the latest computer technologies and databases to compare a worker’s post-injury profile with the occupational characteristics of various employment options. We also examine labor market trends and wage estimates in the local market to assess the economic impact of various work options. Our Employability Analysis will determine the individual’s degree of employability, the likelihood of finding appropriate employment in the local labor market, and the range of wages the individual can expect to earn.

Vocational Evaluations

Assessing employment potentials and earning capacity is crucial for cases involving medical impairment and claims of occupational disability and diminished earning capacity. Vocational and disability evaluations are an objective assessment that answers your questions regarding the effect that medical impairment has on occupational capability and earning capacity. Additionally, when medical impairment is not at issue, forensic vocational evaluation can answer questions regarding employability in matters of wrongful death, employment discrimination, marital separation and divorce, or any time an explanation of an individual’s capacities to work and earn money is needed.

Our experts provide a comprehensive evaluation to describe how the unique characteristics of an individual affect their ability to work, factoring in employability, earning capacity, or rehabilitation potential. An individual’s potential for future employment is assessed by vocational specialists with the training and knowledge necessary to provide informed, independent opinions.

Our methodology is consistent with industry standards, and our experts rely on the best available data to arrive at conclusions regarding employability. Several steps may be involved depending on the nature of your request. When appropriate/possible, a best practice in vocational evaluation is to interview the person, and when appropriate/possible, administer standardized vocational testing. The vocational specialist will also review documentation, conduct a transferable skills analysis, and research the labor market as part of the comprehensive evaluation.

In litigation, vocational (disability) evaluation reports are the keystone between medical impairment and economic damages. Our vocational evaluators assess an individual’s future employability and earning potentials and will testify to their reported findings for litigation purposes.