The “prognosis report” (or final medical-legal report)
Serious cases usually result in the need for future medical services and the costs associated with them (as well as disability and loss of income during the period of recovery, and increased pain and suffering from the impact of the services and recovery).
The medical records pertain to past services rendered, but rarely contain a “prognosis” (i.e., a reasoned prediction about a medical condition such as how a scar will heal or when a disability will end).
One of the matters requiring broad experience and wise judgment on the part of the attorney is the engagement of medical experts and other experts to write reports that clarify the nature and extent of the victim’s injuries as well as their future consequences in terms of pain, disability, duration, possible treatment, and anticipated costs.
These reports are referred to as “medical-legal reports” and the final such report is often called the “prognosis report” to distinguish it from the prior reports. A prognosis report may include the following points:
- A brief history of the patient’s condition
- A description of his current condition
- Treatments and tests that may be required in the future
- The anticipated costs of treatments and tests that may be performed in the future
- Operations that may be scheduled in the future, such as scar revision
- The costs of the future operations, including the surgeon, anesthetist, assistants and surgical facility
- The probable outcome of the treatments and operations that may be performed in the future
- The success rate of the treatments and operations that may be performed in the future
- Possible complications of the treatments and operations that may be performed in the future
- The length of time probably required for recovery from the future treatments and operations
- Disability to be probably expected as a result of the future treatments and operations
It is important to understand that a physician who writes a prognosis report is expected to relate what might occur based onreasonable medical certainty — not complete certainty. Medicine is as much an art as a science. Anything might possibly happen, but the law is not interested in remote possibilities when fixing compensation for a victim. The law needs to know what is probably going to happen, based on reasonable medical certainty.
Additionally, a physician is only expected to provide estimated treatment costs based on currently accepted standards of care, current costs, in current dollars.