Lifecare Planning for the BK Amputee: Future Medical Costs

Convincing proof of an appropriate lifecare plan for the survivor of a below the knee amputation of the leg requires a combination of human services, special equipment and home modifications, based upon the professional evaluation of medical doctors and an experienced lifecare planner.

The “future” costs listed below are in addition to “past” medical costs, lost income, life-altering pain and the daily ramifications of the loss of a lower leg.

The following recommendations while comprehensive, are not complete and require further personalized consideration necessary in every case and to provide for special medical needs. All values are in 2003 dollars for Northern California.

• MEDICAL HEALTHCARE PROVIDERS. Access on an as needed basis (PRN) to a combination of suitable and appropriate medical healthcare providers, including:
  1. Medical doctors (e.g., neurology, physiatry, orthopedics, psychiatry, dermatology, otology, etc.), three to five times/year (4 times per year median), $165.00 to $195.00/consult ($180.00/consult median). Annual median cost $620.00.
  2. Assessment and evaluation services (e.g., radiology, CT, MRI, EMG, medical technology, orthotics, psychological and neuropsychological tests and measurements, pain evaluations, etc.), $1,950.00 to $2,250.00 ($2,100.00/year median). Annual median cost $2,100.00.
  3. Allied medical-health specialists to deliver specific care (e.g., clinical psychologist, clinical neuropsychologist, physical therapist, occupational therapist, kinesiologist, pain management, audiologist, etc.), four to eight times/year (6 times per year median), $135.00 to $155.00/consult ($145.00/consult median). Annual median cost $870.00.
  4. Therapy and support services (e.g., physical and occupational therapists, psychotherapy, cognitive remediation, exercise therapy, pain therapy, orthotic-prosthetic therapy, etc.), a median of twelve times/year, $135.00 to $155.00/intervention ($145.00/intervention median). Annual median cost $1,740.00.
  5. Alternative medicine treatment sources (e.g., chiropractic, osteopathic, naturopathic, acupuncture-acupressure, ultra sound, hypnotherapy, aromatherapy, yoga, aqua-therapy, massage therapy, etc.), a median of twelve times/year, $105.00 to $125.00/consultation $115.00/consult median). Annual median cost $1,380.00.
  6. Pain center treatment program, $15,000.00 to $19,000.00/event ($17,000.00/event median), every two to four years (3 years median). Annual median cost $5,666.00.
• COMPANION AND ATTENDANT SERVICES from a licensed, bonded home health agency for companion and attendant , eight hours/day (2,920 hours/year, $18.00 to $22.00/hour ($20.00/hour/median). Annual median cost $58,400.00.

• HOMEMAKER-CHOREPERSON SERVICES for physically demanding aspects of housework, a median of four hours/week (208 hours/year) from a licensed, bonded agency, $15.00 to $18.00/hour ($16.50/hour median). Annual median cost.$3,432.00.

• HANDYMAN SERVICES to assistance with maintaining the residence and immediately adjacent property, one-hundred hours/year (1.9 hours/week), $14.50 to $18.50/hour ($16.50/hour median). Annual median cost $1,650.00.

• HEALTH CLUB MEMBERSHIP in a physical conditioning program, $50.00 to $60.00/month ($55.00/month median; $560.00/year median) and a certified physical trainer (monthly interventions), $60.00 to $70.00/intervention $65.00/intervention median; $780.00/year median). Annual median cost $1,440.00.

• ARCHITECTURAL MODIFICATIONS AND RENOVATIONS of the family home to provide wheelchair and prosthesis accessible and barrier-free mobility. Installation of two-person elevator and single person stairglide between ground floor and upstairs; grab bars in the bath, shower and commode areas; standing poles in the kitchen area; ramps and guard rails at two entrances-exits; bath and shower stall renovation; modifications to door hardware, light switches and plumbing fixtures for wheelchair height access and floor surface changes to aid in wheelchair, walker and prosthesis ambulation, $150,000.00 to $190,000.00 ($170,000.00 median), with a fourteen year useful life. Annual median cost $12,142.00.

• VARIABLY ADJUSTABLE BED SYSTEM, split-half, for independent position, firmness and/or configuration control, as an aid to pain system management and to provide the patient and her spouse an opportunity to share a common bed, $4,950.00 to $5,495.00 ($5,222.50 median), with a fourteen year useful life. Annual median cost $ 373.04.

• ULTRALITE EVERYDAY BKA WALKING PROSTHESIS with flex foot features and all inherent components, $12,500.00 to $14,000.00 ($13,250.00 median); Ultralite BKA sport prosthesis with all inherent components and flex foot, $13,500.00 to $15,000.00 ($14,250.00 median) and BKA aquatic prosthesis for swimming and aqua-therapy, $11,750.00 to $13,000.00 ($12,375.00 median), with a two to four year useful life (3 years median). Annual median cost $4,125.00.

• STUMP PROTECTOR custom designed for use when prosthesis is not being used, $550.00 to $700.00 ($625.00 median), with a three year useful life. Annual median cost $208.33.

• AMBULATION – MOBILITY DEVICES. Roll-about four-wheel walker, standard caliper brake walker, crutches and related ambulation and mobility aids, $950.00 to $1,100.00 ($1,025.00 median), with a five year useful life. Annual median cost $ 225.00.

• LIGHT WEIGHT COLLAPSIBLE WHEELCHAIR. Titanium framed, collapsible, manual wheelchair for home use and more efficient out of the home ambulation, $2,895.00 to $3,425.00 ($1,360.00 median), with a six year useful life. Annual median cost $ 526.67.

• WHEELCHAIR MAINTENANCE/REPAIR. Manual wheelchair maintenance and repair, a median of $125.00/year. Annual median cost $ 125.00.

• POWER CONVEYANCE. Battery powered scooter or other motorized conveyance for traversing long distances and for use in the absence of the prosthesis, $4,500.00 to $5,995.00 ($5,247.50), with a six year useful life. Annual median cost $ 874.58.

• POWER CONVEYANCE MAINTENANCE AND REPAIR. Median annual maintenance and repair cost of $250.00.

• MODIFIED LIFT OR RAMP VAN. Ramp or lift van with suitable and appropriate accessories, $43,550.00 to $46,225.00 ($44,887.50 median), with an end-use equity after seven years of $4,500.00 ($40,387.50), less the cost of a mid-sized automobile ($16,500.00), van cost differential of $23,887.50. Annual median cost $3,412.50.

• VAN VERSUS AUTOMOBILE COST/MILE OPERATIONAL DIFFERENTIAL. The difference in the operational cost/mile of a van ($0.63/mile) and a mid-sized automobile ($0.40/mile) over 12,000 miles of driving is $2,760.00/year ($7,560.00 versus $4,800.00/year). Annual median cost $2,760.00.

• PHARMACEUTICALS-NUTRACEUTICALS-PATIENT MEDICINES. For pain, sleep assist and emotional-psychological issues (stress, tension, depression, anxiety, etc.), $235.00 to $295.00/month ($265.00/month median). Annual median cost $3,180.00.

The annual median cost for goods and services in 2003 dollars in this specific example is approximately $105,000.00.

If you or a family member have been wrongfully injured call us at 1.888.777.1776 or use this form, delays can hurt your case, so please don’t hesitate to contact us.