In personal injury cases involving complex regional pain syndrome (CRPS), a CRPS life care plan expert witness may need to be retained to analyze the future medical needs (and associated costs) of an individual. A life care plan outlines the medical and non-medical needs of the individual who has suffered an injury and provides a comprehensive estimate of the associated costs of those needs. Here are some elements of the individual’s medical history that will likely be considered:
1. Diagnosis and Assessment: The CRPS life care plan expert witness will likely start with an assessment of the individual. This includes the evaluation of the individual’s current condition, medical history, and anticipated future needs.
- Medical Assessment: A medical assessment by a CRPS life care plan expert witness is central to establishing the CRPS diagnosis. This should include a detailed examination, imaging studies, and clinical tests to assess the extent and severity of the condition.
- Review of Medical History: A review of the patient’s medical history will provide insight into any pre-existing conditions that might have an impact on CRPS and to differentiate them from the injury-related symptoms.
2. Treatment and Medication: The plan outlined by the CRPS life care plan expert witness will typically include a description of the treatment and medication required to manage CRPS. This encompasses pain management, physical therapy, psychological counseling, and any surgical interventions.
- Pain Management: The plan will likely include various pain management strategies such as medications (e.g., opioids, anticonvulsants, or NSAIDs), nerve blocks, and other interventional pain procedures.
- Physical Therapy: Ongoing physical therapy is often a fundamental part of CRPS treatment. It helps maintain function, manage pain, and prevent muscle atrophy.
- Psychological Counseling: Since CRPS can lead to significant psychological distress, including depression and anxiety, the life care plan should account for regular counseling or therapy sessions.
- Surgical Interventions: In cases where conservative treatments are unsuccessful, surgeries like sympathectomy or spinal cord stimulation may be recommended.
3. Rehabilitation Services: For CRPS patients, rehabilitation services are often essential. The CRPS life care plan expert witness should account for ongoing physical therapy and occupational therapy needs.
- Physical Rehabilitation: This involves a long-term plan for physical therapy to regain and maintain the patient’s physical abilities.
- Occupational Therapy: Occupational therapy can help the patient learn how to perform daily activities despite their limitations.
4. Assistive Devices: Depending on the severity of the CRPS, assistive devices such as mobility aids, orthopedic supports, and adaptive equipment may be necessary.
- Mobility Aids: The plan should address where or not there is a need for mobility aids like wheelchairs, crutches, or scooters.
- Orthopedic Supports: Depending on the affected area, the individual may need braces or orthopedic supports to maintain proper joint alignment.
- Adaptive Equipment: Consider specialized adaptive tools and equipment to facilitate daily activities.
5. Medication Management: The plan may address the long-term costs associated with prescription medications to manage pain and other symptoms.
- Prescription Medications: Specify the medications, dosages, and frequency required to manage pain and symptoms. This should include both short-term and long-term needs.
6. Psychological Support: CRPS can have a significant psychological impact. The life care plan expert witness should account for mental health support and therapy in the plan, if needed.
- Therapy and Counseling: Describe the need for ongoing mental health support and therapy sessions to address emotional and psychological challenges associated with CRPS.
7. Prosthetics or Orthotics: If amputation or limb dysfunction is a result of the injury, the plan should cover prosthetic or orthotic devices.
- Prosthetic Devices: If amputation is required due to the injury, the plan should cover the cost of prosthetic limbs and necessary follow-up adjustments.
- Orthotic Devices: Orthotic devices like custom orthopedic shoe inserts may be necessary for gait and posture correction.
8. Home Modifications: In cases where the CRPS patient needs adjustments to their living environment, such as ramps, wider doorways, or specialized bathroom fixtures, these should be included in the plan.
- Accessible Home Features: Evaluate whether home modifications are needed, such as ramps, wider doorways, accessible bathrooms, and grab bars to ensure a safe living environment.
9. Transportation Needs: Consider whether the patient will require special transportation services due to mobility issues.
- Specialized Transportation: If mobility issues prevent the use of regular vehicles, the plan should account for specialized transportation services like wheelchair-accessible vehicles or medical transport services.
10. Cost Projections: A CRPS life care plan expert witness will provide a projection of the costs associated with these various needs over the individual’s lifetime.
- Detailed Cost Breakdown: Provide a comprehensive financial breakdown of each element, including initial setup costs and ongoing expenses. This should be projected over the individual’s expected lifetime.
11. Expert Testimony: A CRPS life care plan expert witness’ testimony can be invaluable in court to explain the necessity and cost of these elements in the life care plan.
- Legal Expertise: A CRPS life care plan expert witness’ testimony can be pivotal in conveying the medical necessity of these elements in the life care plan to lawyers, judges, and juries.
12. Review and Updates: Life care plans should be regularly reviewed and updated to reflect changes in the patient’s condition and evolving medical practices.
- Ongoing Monitoring: Stress the importance of regular reviews and updates to the life care plan to ensure that it remains current and relevant as the patient’s condition evolves and medical practices advance.
The role of a CRPS life care plan expert witness in legal proceedings is valuable. A CRPS life care plan expert witness helps ensure that the injured individual receives the appropriate care and support they need and outlines the future costs of same.
Dr. Carinci is Chief of Pain Medicine at University of Rochester Medical Center. He is a pain management thought leader, a University of Rochester faculty member and former Harvard Faculty member. He is well-published and has significant teaching experience. Dr. Carinci trained at both Johns Hopkins and Harvard. He is the winner of multiple awards for clinical excellence.
Dr. Carinci has been an expert witness in numerous cases involving CRPS litigation for both plaintiff and defense. He has qualified as an expert witness in federal court and has testified at both deposition and trial. Dr. Carinci has evaluated, diagnosed and treated over 1000 patients with Complex Regional Pain Syndrome. Dr. Carinci has published and spoke nationally on the topic of CRPS.
Dr. Carinci can be contacted at adam.carinci@gmail.com or 845-797-2305.
