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Future Medical Expenses in Personal Injury: Challenging Causation, Predicting Future Need, Establishing Costs

Recording of a 90-minute CLE video webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Wednesday, November 4, 2020

Recorded event now available

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This CLE course will examine proving or limiting what is often the largest category of damages in personal injury cases: future medical expenses. The panel will first focus on the pitfalls and strengths of studies that purport to establish a causal connection between a present injury and some aggravated condition or new disease that may arise in the future. The panel will then present strategies and best practices for ensuring that future expenses awarded are appropriate but not excessive, and what type of evidence juries are allowed to consider.


If a plaintiff can prove a defendant's liability in a personal injury case, he or she can potentially recover future medical expenses. Those future expenses may reflect additional treatment arising for new or different diseases or conditions caused by the original injury. To recover future medical costs, especially those related to a progression of the original injury, the plaintiff must demonstrate to a reasonable "certainty" or a reasonable "probability" that the injured party will require additional treatment or develop a particular disease or condition.

Plaintiffs' experts often cite studies showing that people with similar injuries or exposure as the plaintiff have a greater risk of developing a condition or disease. Attorneys defending against this notion must critically analyze scientific literature and studies on which the plaintiff expert relies. They must understand the difference between risk and causation, and the difference between the statistical confidence or certainty in the study result, and the statistical likelihood of adverse future events indicated by the study.

Anticipated future medical costs must be reasonable. When quantifying future damages, counsel must grasp the evidence that will be allowed. Some courts allow juries to consider "billed" or "full price" costs (regardless whether those amounts are ever paid), while others limit to "market rates," i.e., reduced rates negotiated between healthcare providers and insurers. The defense may argue that the negotiated rates apply to future treatment, which plaintiffs must be prepared to rebut.

Listen as our distinguished panel guides personal injury attorneys on proving and disproving causation of future medical expenses. The panel will discuss best practices for calculating damages, conducting voir dire, and preparing jury instructions before trial.



  1. How proof of present medical expenses differs from future expenses
    1. The role of epidemiology in establishing causation for future conditions
    2. Correlation vs. causation vs. statistical significance
    3. Methodologies in epidemiology
  2. Best practices for defending and challenging causation experts
  3. Predicting and calculating future medical costs
  4. Plaintiff strategies
  5. Defense strategies


The panel will examine these and other key issues:

  • What is the burden of proof to recover for future medical expenses when they are and are not directly related to the injury?
  • What is the difference between relative risk and causation?
  • How should epidemiological studies be interpreted?
  • Does the probability of developing a future disease impact other types of economic damages?
  • Is a "market rate" or "billed rate" the more appropriate measure of medical expenses?


Fleischman, Steven
Steven Fleischman

Horvitz & Levy

Mr. Fleischman has expertise in litigating commercial disputes (breach of contract, fraud, business interference) and...  |  Read More

Watson, H. Thomas
H. Thomas Watson

Horvitz & Levy

Mr. Watson is a partner at the firm, where he has practiced since 1992. He has been a California State Bar Certified...  |  Read More

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