How Are Future Medical Costs Calculated After a Spinal Cord Injury in South Carolina?

A Lifetime Of Care Doesn’t Come With A Price Tag Attached

September is National Spinal Cord Injury Awareness Month, and the financial impact of these injuries can extend for decades. Current data from the National Spinal Cord Injury Statistical Center shows that the average age at injury has increased from 29 during the 1970s to 43 since 2015. That can leave an injured person facing years of rehabilitation, medical care, equipment replacement, personal assistance, and other expenses that don’t appear on the first hospital bill.

The costs can be substantial. NSCISC estimates that someone who sustains high tetraplegia at age 25 may face more than $6.2 million in direct lifetime health care and living expenses. Even motor-functional spinal cord injuries can produce estimated lifetime costs exceeding $2 million. Those figures don’t include indirect losses such as lost wages, benefits, or productivity.

Twenge + Twombley represents South Carolina families dealing with serious injuries that can require years or decades of care. Attorneys Karl Twenge and Ashley Twombley know that a spinal cord injury claim has to look beyond the bills that have already arrived. When future care is reasonably expected, the evidence needs to show what that care will involve and what it is likely to cost.

A Life Care Plan Connects The Medical Prognosis To Future Costs

A life care plan can help organize the medical treatment, equipment, assistance, and support a spinal cord injury survivor is reasonably expected to need. Depending on the case, a physician, rehabilitation provider, life care planner, economist, or other professional may contribute to the analysis.

The plan should start with the injured person, not a generic description of someone with the same diagnosis. Medical records, current functional limitations, treatment recommendations, age, prognosis, and living situation can all affect what future care is appropriate.

For example, someone with a C5 spinal cord injury may need recurring urology care, replacement mobility equipment, attendant services, therapy, and treatment for complications such as pressure injuries or respiratory problems. Another person with the same neurological level may have different functional abilities and medical needs.

That’s why a life care plan is useful when it reflects what the client’s own medical evidence supports rather than simply assigning standard costs to an injury category.

Several Steps Turn Future Care Into A Financial Projection

Once future needs have been identified, those needs still have to be translated into a defensible financial estimate.

• Document The Injury And Prognosis: The level and completeness of the injury, functional limitations, complications, and expected course of treatment help establish what care may be needed.
• Identify Each Future Need: The analysis may include medical treatment, therapy, medications, equipment, personal assistance, transportation, and home modifications.
• Determine How Often The Expense Will Occur: Some costs happen once. Others recur every month, every year, or each time equipment reaches the end of its useful life.
• Research Appropriate Costs: Local or regional pricing, vendor information, health care rates, and other reliable data can help establish the expected expense.
• Evaluate Long-Term Cost Changes: When appropriate, an economist can analyze how specific costs may change over time instead of assuming every expense will remain flat or increase at the same rate.
• Translate Future Losses Into A Present-Day Valuation: Economic analysis may be used to explain what a stream of future expenses represents in current dollars.

The goal isn’t to produce the largest possible number. It’s to build a calculation that can be traced back to evidence and explained clearly if an insurance company or opposing expert challenges it.

Different Future Costs Need Different Supporting Evidence

Future Need	Evidence That May Support It	What The Evidence Helps Establish
Future medical treatment	Treating physicians, specialists, medical records	Whether additional treatment is reasonably expected and how often it may be needed
Wheelchairs and equipment	Equipment recommendations, vendor pricing, replacement schedules	Type, cost, and frequency of replacement
Attendant care	Functional assessments, care recommendations, regional care rates	Hours of assistance needed and the expected long-term cost
Home and vehicle modifications	Accessibility assessments, contractor or vendor estimates	Changes necessary for mobility, safety, and independence
Lifetime financial projection	Life care plan, cost data, economic analysis	How recurring future expenses translate into a present-day financial claim

South Carolina Future Medical Damages Can’t Rest On Speculation

South Carolina law recognizes future medical expenses as a potential part of a personal injury claim, but the evidence has to support them.

In Pearson v. Bridges, the South Carolina Supreme Court explained that future damages ultimately must be shown to be reasonably certain to occur. The court also emphasized that a jury’s award can’t be based on conjecture, speculation, or guesswork.

That doesn’t mean a family has to predict future care down to the last dollar. South Carolina courts have also recognized that future damages often can’t be proved with mathematical certainty. The evidence instead needs to give the jury a reasonable basis for evaluating what the injury is likely to require.

That distinction is especially important in a spinal cord injury case, where care may continue for decades and the exact medical path can change over time.

Expert Testimony Has To Be Reliable Enough To Help The Jury

Insurance companies don’t have to accept a life care plan or economic projection just because an expert prepared it. They can challenge whether the recommended care is medically necessary, how frequently it will be needed, what it should cost, and whether the financial assumptions are reasonable.

Under South Carolina Rule of Evidence 702, expert testimony must come from a qualified witness whose scientific, technical, or other specialized knowledge will help the judge or jury understand the evidence. South Carolina courts also examine whether the methodology underlying the opinion is reliable.

That means the strongest future-care analysis usually fits together from beginning to end. The medical prognosis should support the services in the life care plan, and the financial projection should reflect those same services rather than introducing assumptions that aren’t found in the medical evidence.

Insurance Companies May Attack The Need, Duration, And Price Of Future Care

An insurer may accept that a spinal cord injury occurred and still dispute much of the future-care claim.

Its experts may argue that fewer hours of attendant care are necessary, that equipment can be replaced less often, that a proposed surgery is too uncertain, or that the injured person won’t need a particular service for as many years as the life care plan assumes.

Similar disputes arise in other serious injury cases. Insurance companies may challenge future medical treatment, reduced earning ability, and long-term disability after severe crashes even when there’s little dispute that the underlying injury occurred.

A detailed spinal cord injury claim therefore needs more than a list of future expenses. Each major item should connect back to evidence showing why the service is needed, how often it is expected to occur, and what supports the projected cost.

The Calculation May Need To Change As Treatment Progresses

Future-care projections aren’t necessarily static. A plan developed early in rehabilitation may need to be revised if the person’s abilities change, additional complications appear, doctors recommend another procedure, or it becomes clear that more or less assistance will be needed at home.

Updating the analysis doesn’t make the original projection unreliable. It reflects the reality that a catastrophic injury can evolve while the legal case is pending.

That’s one reason families should be cautious about resolving a serious injury claim before the long-term medical picture is sufficiently clear. Once a claim is fully settled and released, there generally isn’t another opportunity to seek more compensation simply because future care turned out to cost more than anticipated.

We Build The Case Around What The Injury Is Likely To Require

Twenge + Twombley’s personal injury attorneys understand that a spinal cord injury can affect a client’s medical care, independence, employment, family responsibilities, and finances for years to come. Our firm already works with experts such as life care planners when appropriate to evaluate what a client’s medical and physical needs are likely to be over a lifetime.

We don’t want a serious injury claim valued from one stack of hospital bills. We want the evidence to reflect what the client has already lost and what the injury is reasonably expected to cost in the future.

The number attached to your future shouldn’t be a guess. Contact us today for a free consultation. We can review the medical evidence, explain how future damages may be evaluated under South Carolina law, and help you understand what should be considered before your case is resolved.

“Karl Twenge and his staff were knowledgeable, outstanding & professional in all avenues of the law. He made sure that my recovery came first with the best medical treatment available.” - David, ⭐⭐⭐⭐⭐