info@hippocratesmed.ca
604-606-0814
604-261-5290COST OF FUTURE CARE
WHAT IS COST OF FUTURE CARE?
An estimated monetary amount of what is required by the claimant for on-going claim-related care, often calculated by an occupational therapist (OT).
WHEN IS THE BEST TIME TO ORDER SUCH A REPORT?
Typically, Cost of Future Care reports are ordered much later in a claim after the claimant has plateaued. Such reports are often ordered when there is a mediation or court date on the horizon in order to facilitate a settlement.
WHAT PERIOD OF TIME DOES THE CARE COVER?
It could be for a specified period of time if the claimant’s condition has not plateaued, but is often for the remainder of the claimant’s life. Some of the needs might be contingent on various environmental factors though. An example would be one member of a couple being injured in an accident, but with cooking and cleaning being carried out by the non-injured member. If that individual develops medical problems that interfere with their ability to continue to provide the service, or if they leave or die, then the claimant might require that service to begin at that time.
The opposite could occur as well, with some needs no longer being required in the future, such as a claimant requiring child care assistance, a diminishing need as the child reaches maturity.
The OT also factors in the estimated frequency that a particular service or treatment might be required, in order to further calculate the cost over time.
As environmental and psychosocial factors can change over time, it is not possible to produce a report that can consider all of these unpredictable events. It is a best estimate based on the information available at the time.
WHAT ARE THE TYPES OF TREATMENTS OR SERVICES THAT MIGHT BE CONSIDERED?
These are, of course, dependent on the medical condition of the insured, as well as whether the impairments are all considered the responsibility of the insurer. The latter is open to debate in the medicolegal arena.
Costs might include medications, therapies (e.g. physiotherapy, massage, acupuncture), equipment (such as bath benches or lifts to assist in transfers), or services (such as a gardener, personal care attendant, maid, etc.) Occasionally, there are also costs related to changes in the claimant’s home environment, an example being ramps.
HOW DOES THE OT CALCULATE THE COST OF FUTURE CARE?
The OT will review the medical file, as well as the opinions from any medical experts that have performed IME’s. Often information from the FCE is used as well, along with that from the claimant during an interview. Finally, the OT performs a physical assessment and observes the claimant in their home environment. The OT will then review the market rate for various pieces of equipment or types of services and treatments, including the range of costs of providing these forms of care.