Episode 6: Conversation with Nurse Shirley Daugherty on Medical Life Care Plans

Shirley Daugherty:

I will take a look at all of your medical records and see, what were your injuries, and what potential complications or future medical care I think you might require based on those entries. It doesn’t matter what your injury is, even if you feel like it’s not that serious of an injury. There may be an aspect of future medical care that you don’t even think about, and that’s where I come into place.

David Craig – Host:

Today we’re excited to have Shirley Daugherty as our guest. And Shirley is a nurse. She goes to Ashil conferences all over the county. More had the opportunity and pleasure of working with Shirley over the years, and when you’re presenting people who had serious injuries or have been in serious wrecks, one of the concerns is what kind of future care is someone going to need? And more importantly, how much will it cost? This is After The Crash.

David Craig – Host:

I’m attorney Dave Craig, managing partner and one of the founders of The Law Firm of Craig, Kelley and Faultless. I’ve represented people who have been seriously injured, or who have had a family member killed in a semi or other big truck wreck for over 30 years. Following the wreck, their lives are chaos. Often, they don’t even know enough about the process to ask the right questions. It is my goal to empower you by providing you with the information you need to protect yourself and your family. In each and every episode, I will interview top experts and professionals that are involved in truck wreck cases. This is After The Crash.

David Craig – Host:

Shirley, welcome, and can you tell us a little bit about yourself? A little bit about your background?

Shirley Daugherty:

Well, thank you for having me. I am a registered nurse. I originally obtained my nursing degree in 1994, so I’ve been a nurse for a few years. My main background was longterm care though. When I came out of nursing school I was kind of drawn to the elderly population, and as I started my nursing career and really got deep into my career as a nurse one of the things that I found I became very passionate about was determining what the future medical or future care these patients needed.

Shirley Daugherty:

What kind of care is it that we, as nurses, needed to provide to our patients? Our residents, is what they’re called in the nursing home. So, I was drawn to developing care plans for my patients and for my residents. And that would establish what is it that we, as nurses and the nursing staff, needed to do for each of our patients? And as I grew older and more knowledgeable as a nurse, I came across Nurse Life Care Planning and I felt that that might be something that I could use my experience in developing care plans into developing future care plans for people that are injured.

David Craig – Host:

And I know that you’re actually certified, right? Tell us a little bit about what that is.

Shirley Daugherty:

I am a certified nurse life care planner. I obtained that certification back in, around 2009, so about over 10 years. Part of that process is I did coursework and it took about a year to complete that coursework. I prepared a life care plan that was peer reviewed, and then, I sat for a national certification, an examination, which I passed on the first time. Yay!

Shirley Daugherty:

And once I obtained that certification, I continued to maintain that certification through continuing education. I’m also very, very active within our nursing, certified nurse life care planning organization.

David Craig – Host:

And I mean, tell the folks that… This podcast is mainly directed towards everyday people, people who unfortunately may have had a loved one or themselves who’ve been seriously injured. It’s not geared towards professionals or lawyers, or whatever, although I certainly have lawyers that watch it. But it’s geared toward just the average person. I want to empower them. I want them to understand things that are going on with their cases, whether on their journey or whoever their journey is. Oftentimes they’re kind of intimidated to ask the lawyers questions.

David Craig – Host:

I want them to be able to go to the podcast and learn, and say, “Okay, guys I am worried about my future care. The cost of the future care or my loved one’s future care, and I want to learn about that.” So, I guess first of all, I mean what do you think is important for people to know about life care planning and putting together these medical plans going forward?

What is the Most Important Thing for Injured People to Know About Medical Plans?

Shirley Daugherty:

I think the main thing is it doesn’t matter what your injury is, even if you feel like it’s not that serious of an injury. There may be some aspect of future medical care and costs that are related to that down the road, and as you age. So, even though you may be feeling pretty good right now, something may happen as you age. And I see that a lot with people that maybe they’ve injured their knee in a fall. Or, they were in the car accident and injured their shoulder. They got a rotator cuff.

Shirley Daugherty:

They may not want to have that repaired now, but as they age and that arthritis sets in, that’s related to the accident, not necessarily aging. So, there’s always… There may be an aspect of future medical care that you don’t even think about. That’s where I come into place. I will take a look at all of your medical records, and see what were your injuries, and what potential complications or future medical care you might require based on those injuries.

David Craig – Host:

Yeah, and I think that it’s real important because if someone settles, and let’s say they settle their case. Then, that’s all the money they get. They don’t get to go back and ask for more money.

Shirley Daugherty:

Right.

David Craig – Host:

So, it’s important they get enough on the front end to take care of these things.

Shirley Daugherty:

And another thing is, you may think, “Well, I’ve got insurance. I’m covered for now. I’m covered, so I can go to the doctor and get that taken care of.” Well, what happens if you lose that insurance? What happens if, god forbid, Medicare goes under? And we don’t have Medicare when it’s time for us to have that benefit. So, you have to make sure that you are financially able to cover the cost of these services, because we all know that medical care is not the cheapest card of our lives.

David Craig – Host:

Well, I think that’s important too, because if you’re young, and you’re injured and you’ve got future medical care, sometimes you’re on health insurance policies. Well, you and I both know that back not that many years ago preexisting conditions used to be excluded.

Shirley Daugherty:

Right.

David Craig – Host:

[inaudible 00:07:25] excluded, and now they’re, of course, not excluded. But there’s always controversy with respect to that aspect, and there’s cases going up in front of the Supreme Court on whether or not that can be eliminated. So, we don’t know five to 10 years from now whether preexisting conditions will be mandatory in health insurance plans or not.

Shirley Daugherty:

Exactly.

David Craig – Host:

And that’s scary, I mean, because if you know that your future medical care can be taken care of as long as you have health insurance, that’s one thing. But if you don’t know, and you don’t plan accordingly, you could be stuck with necessary medical treatment that’s not paid for.

Shirley Daugherty:

Exactly. And when I prepare a life care plan, or a cost projection, I am taking insurance and any kind of ancillary coverage out of the equation completely.

David Craig – Host:

That’s great. I mean, so at least the people that have been injured will know and they can make decisions on their own, but they’re making informed decisions.

Shirley Daugherty:

Right.

What Are Nurse Life Care Plans?

David Craig – Host:

They’re making decisions on, “Hey, how much will this cost me for the rest of my life?” So, tell me a little bit, what is a nurse life care plan, what does it consist of? What is one?

Shirley Daugherty:

So, a nurse life care plan is what we call the dynamic document. So, basically, the first steps are we receive the case. We get the referral from the client, which is the attorney. Very, very, very few cases would I be retained or hired by a lay-person, the actual person. There’s other weird things that are involved with that. So, typically we do go through either an attorney or an insurer, or a third party administrator.

Shirley Daugherty:

We get that referral. We take a look at the case, and what’s this all about? What happened to this person? And, part of that is reviewing the past medical records. So, we take a look at not only what happened during the injury or the accident, but we also look back, how were they functioning prior to this accident? So, part of that is gathering all these medical records.

Shirley Daugherty:

And we do a medical record review, and that’s part of our process. Another part is meeting with the injured person, or with the client. So, whether I do a home visit, which is ideal, or a Zoom call, or just a phone call is really dependent upon their injuries. If it’s a chronic pain issue, I may just be able to just do a phone call interview. But, those people that are severally injured and maybe have a spinal cord injury, and they have adaptive equipment or home health assistance, I will go to their home and I will talk with everyone that’s involved in their care. And talking with that injured person as well.

Shirley Daugherty:

I’d like to get input from everyone. I want to know how they were prior to this accident, and now, what’s changed? And so, I can put that into the plan as well. Not everything has a dollar amount, unfortunately. So, part of the plan is, in that meeting with the family and the caregivers and the client, is to determine how are they functioning? Physically but also mentally and psycho socially.

Shirley Daugherty:

So, as a nurse life care planner, I utilize the nursing process. That involves the assessment, which is, again, evaluating the patient via the medical records and the home visit. Then, I determine a nursing diagnosis, and that’s based on everything that I’ve just reviewed. So, that nursing diagnosis is separate than a medical diagnosis. You’re going to see all kinds of medical diagnosis. Traumatic brain injury, spinal cord injury at whatever. And the nursing diagnosis is the functional diagnosis of that individual.

Shirley Daugherty:

So based on that medical diagnosis, and then the nursing diagnosis, then I’m going to come up with a plan. That plan then becomes the life care plan. Part of the life care plan, we call it the tables, is the future medical care portion of it. And I have to rationalize, and I have to defend what I put into a nurse life care plan for future medical care. I can’t just make it up. You know? It has to be individualized. It has to be based on that patient or that client, and their injuries. It can’t be a cookie-cutter plan. Every plan is different.

Shirley Daugherty:

Determining the future medical care, again, you have to look back at the past. What kind of treatment have they received? And at what frequency? And are they going to continue needing that same treatment, or are they going to need different treatment?

David Craig – Host:

And you talked about you talk to the family, you like to go meet them whenever possible, certainly on a significant case with horrific injuries. What about the doctors? Do you ever have an occasion where you need to talk to the doctors that have seen them or treat them?

Shirley Daugherty:

That is definitely a part of the life care plan, that’s the collaboration portion of the life care plan. Oftentimes I will make contact with the providers to try and get their input. Sometimes they’re very helpful, sometimes they’re not. And that just is dependent upon that practice itself. I do utilize the HIPPA laws, so I do obtain a consent or a release to be able to speak to those providers.

Shirley Daugherty:

But yeah, speaking with the current treating provider is very important in preparing a nurse life care plan.

David Craig – Host:

And I think one of the things clients always want to know though, like how do you determine the amounts? So, you come up with this plan, but then how do you know what numbers to put with it, because obviously I don’t know how much a surgery cost, or how much the doctor’s appointment cost, and those type of things.

Shirley Daugherty:

A lot of that comes with not only experience, but my review of hundreds and hundreds and hundreds of thousands of pages of medical records and billing records. So, part of my medical record review is, as I’m looking back at the office, let’s just talk about the office visits. At the visits that they go to, I will compare that visit with their billing records. And there are what’s called common procedural technique codes, CPT codes, associated with every procedure, medical procedure that a person may have.

Shirley Daugherty:

So, you go to your doctor’s visit. You’re seen for 15 minutes and that doctor bill’s at a particular code, code level. They have a chart that is associated with that code, that billing code, and part of what I will do is either contact those facilities and get their billing codes and their costs. Or, I try to take a look at the medical records, and the billing records and see what was charged before. Or, I have databases that I can use.

Shirley Daugherty:

The office visits are typically the easy ones. When you get involved in surgeries there are different codes that are involved with those surgeries, but also, just a whole host of other things that are involved; anesthesia, the facility, how long do they have to stay in the hospital? So, that comes with research, and not only research but reviewing other cases, gathering that experience from reviewing other cases. And then, the education that I receive through my organizations.

David Craig – Host:

And so, the goal, explain to me what the goal is then, when you’re preparing this document, what do you hope to accomplish for the clients or for this purpose, but ultimately for the person who’s injured?

What Are Nurse Life Care Plans Used For?

Shirley Daugherty:

What I hope to accomplish is to develop a plan that will take this person throughout their lifetime and give them a roadmap of what the treatment is that they should be getting based on the injuries that they sustained. My ultimate goal is for that person to have a copy of the life care plan, because I do such an extensive medical record review; I have given a copy to clients as a case is settled, and they’re able to take that to their doctor and say, “Hey, this is what I’ve been through.”

Shirley Daugherty:

They go and every time you go to a new doctor you have to explain what has happened to them. You know? So, this helps them and part of that, it’s a road map. Now, we all know that other things may happen, other circumstances or other injuries may occur that may change that plan. But, that’s why it’s called a dynamic document. It can change, and sometimes it needs to be updated, but the ultimate goal is for that client to be able to have a copy of that and to follow the plan as that it’s outlined.

David Craig – Host:

I think that’s important because a lot of times attorneys look at their job as my job is to get a recovery for a client. And, I look at it a lot bigger than that. I mean, my difference is I look at my responsibility as a plaintiff lawyer or an injury attorney, is to make a positive difference in the lives of my client. And only part of that has to do with getting money.

Shirley Daugherty:

Right.

David Craig – Host:

The other part of it is getting some guidance and help, and that’s one of the reasons we do the podcast is I want people to know information. It’s hard to ask your doctors, or your nurses, or your surgeons especially. You get a very limited period of time that you get to talk to them, and some are friendlier than others.

Shirley Daugherty:

Right.

David Craig – Host:

So, this document you prepare, I use it to help make the recovery. I use it as a lawyer to show the other side, “Here’s how much money I need to take care of my client.” But then, we give it to the client so they have that road map so that they can have the guidance. And my gosh, a lot of times when they look at that, like you said, they have no idea because the doctors haven’t told them everything. Sometimes the doctors don’t even tell them what the future holds or what kind of problems or complications they may have. Do you see that?

Shirley Daugherty:

I do. Excuse me. I do see that. And again, when I do those medical record reviews, there are times when they had no idea that they went through that, or that that was even put in their medical records that, “Gosh, that happened to me? I didn’t know that.” You know? So, that’s sometimes of a shock.

Shirley Daugherty:

And I kind of forewarn the patient, or the clients, that, “Hey, there’s things in this medical record that you’re just going to be maybe a little uneasy with. But this is what happened to you.” Especially those individuals that have had significant injuries that are still having problems with those injuries. Psychologically they’re struggling with the injuries and the impact of their injuries, and then they don’t want to look back and see everything that’s happened to them. But it is important to know.

David Craig – Host:

When you’re looking at these, do you take into consideration anything other than the medical need? Like non medical needs, or is it just purely medical?

Shirley Daugherty:

It is everything. So, not only medical but non medical. So, I will look at their home environment and if they need to have any modifications to their home I could either put in a stipend of amount of money that could recover those. Or, I could have someone come in and do a home evaluation and provide me with basically a collaborative effort on what needs to be done and what that cost would be. I have worked with they’re called certified aging in place specialists, CAPS, and they are individuals that can come to the home, look at everything in that home that may need to be modified or make that compliant with their medical or physical needs. And they will put that in a plan and provide the cost for me.

Shirley Daugherty:

I also look at transportation. Can they drive now? If they can’t, who’s driving them? Do they need to have a transportation company? Do we need to provide a wheelchair van, or a modified vehicle for them? And also, home health assistance, do they need personal care assistance versus a skilled nurse that comes in? So, there’s a lot of different things.

Shirley Daugherty:

When I work with children there’s an educational aspect sometimes. So then, do I need to look at a tutor? Do I need to have adaptive equipment for learning? So, those are not necessarily medical products, but those are definitely something this needed because of the injury. They would not have needed it otherwise.

David Craig – Host:

I have had the pleasure of working with you for a number of years, and I think it’s real important for people to be able to recover all they need to take care of them. And I had one particular case we had where my client had a traumatic brain injury. And I think it might be helpful for people who are actually not maybe… the podcast, you can listen to it on Apple or Spotify or whatever or whatnot, any other place where the podcast are. But, in addition to that, you can go onto YouTube and you can watch them, you can look at YouTube and actually see the video.

David Craig – Host:

And for those people who go on YouTube, I’d like to show them what one of your plans looks like, and obviously I’ve taken my client’s name out. But let me see if I can share it on the screen here. But just kind of so people, again, a lot of people who are listening to this or watching this have never seen a nurse life care plan. They have no idea what we’re talking about. And you’ve done a great job explaining it, but I think sometimes it’s helpful to see it. So, I’d encourage people to go to the YouTube podcast side and see this.

David Craig – Host:

But this is the first page of your plan where you identify the date of birth, the age, and the date of injury. And I assume life care life expectancy is important to you because that’s helping you plan forward.

Shirley Daugherty:

It is, and when I include the life expectancy that is determined through the CDC life expectancy tables. There’s tables for the total population, and so basically I go to those tables, the age. This particular person, her age was 22 at the time of the injury. So, based on those CDC tables a 22 year old would have a life expectancy of an additional 58 years. That’s not a total life expectancy of 58 years. That’s an additional 58 years.

David Craig – Host:

A lot of times when I take these cases, sometimes we settle. A lot of times we settle. Sometimes you have to take cases to trial and I like to refer to these as kind of a minimum life care plan because if somebody lives beyond 58, obviously they’re going to have needs. 58 years, an additional 58 years in this case if this 22 year old lives beyond that. She would have continuing life care plans.

David Craig – Host:

So, to me, they’re a minimum life care plan.

Shirley Daugherty:

Right.

David Craig – Host:

So, let’s go through and this gives people an idea of the table of contents. So, this is an extensive document. This is not just a one letter, one page report or letter. Here’s some of the things that are discussed in there. Medical diagnosis, methodology, and you go through your assessment and a whole variety of things are all… Is this the type of thing that we typically see in one of your reports?

Shirley Daugherty:

It is, yes. Preparing a document, nurse life care plan, like you said it’s not a one or two, or three or four page document. It is a whole nursing assessment. Again, starting with the nursing assessment, coming up with a plan, implementing it, and putting the whole plan together. So, I could say that this is probably a good sized plan.

David Craig – Host:

So, and you talked about before, part of your assessment is your pre-injury as well as your post-injury.

Shirley Daugherty:

Yes.

David Craig – Host:

And that’s important to understand what the difference is, what was caused by whatever trauma that brings this person to a law suit.

Shirley Daugherty:

It is. So, when I’m reviewing the medical records, and I will speak with the patient about this as well, what was going on with them prior to the injury? Instances of the easy ones that I call are if somebody has hypertension or high blood pressure or hyperlipidemia prior to the accident, you know that I’m not going to include anything related to those costs. Where we start getting into gray areas is if they already had maybe some arthritis in an area and now, they have exacerbation of that arthritis. Then, I have to determine how much am I going to include?

David Craig – Host:

And so, we’ll go through. In this particular case, so the first part of your report goes into the medical diagnosis. In this particular case you can see, there’s three, four, five, six, seven different diagnosis that were determined. Then, an explanation on how you go about doing this plan.

Shirley Daugherty:

Yes.

David Craig – Host:

So, we’ll go on down, and then so here you talk about, I think, kind of the holistic approach to these plans.

Shirley Daugherty:

That’s correct.

David Craig – Host:

And then we get into some of your assessment. You always have, obviously, some background information.

Shirley Daugherty:

Correct.

David Craig – Host:

Then you get into the assessment, and this kind of talks about more like the history, like what happened to her?

Shirley Daugherty:

Right.

David Craig – Host:

What brought her here, what happened? Kind of summary of what she’s been through. And you guys, she had to go through a big stack of records in this particular case-

Shirley Daugherty:

Yes.

David Craig – Host:

… to get all this and summarize it. And like you said, the clients oftentimes do not know a lot of this information.

Shirley Daugherty:

Right.

David Craig – Host:

And so then, here again, it talks about some… Unfortunately, this client had a significant traumatic injury and talks about a lot of that, and some cognitive issues that she was having. And the doctors that she saw, and some of their impressions and their stuff, and their diagnosis. So, I just wanted to show how much detail is put into this, of her injuries, the condition and how it was effecting her.

David Craig – Host:

Then, we look at it, it’s your pre-injury and where you talk a little bit about her pre-injury. The nursing process outcome identification. What is that part of the report?

Shirley Daugherty:

So, the outcome identification is determined… is out of the collaboration. So, have collaborated using standard for practice, and that would be maybe reviewing the medical records, or researching in different aspects of future medical care. And then, I determine, there’s a medical record review, which is in a different appendix, but that is part of that outcome identification. Then, I determine what the summary of future medical care needs are.

Shirley Daugherty:

This is the rational for why I am including certain items in the life care plan tables. Back on the medications, I just wanted to point out. When I’m determining and providing the cost for the medications, it’s what they are currently taking at the time that I prepare the life care plan. Those medications may change based on they may not work any longer, or something new may come along that may be more expensive, or may be less expensive, but I can only include what they are currently taking at the time that I prepare the life care plan.

David Craig – Host:

Okay. Then, you also talk about projected therapy and evaluations.

Shirley Daugherty:

Yes.

David Craig – Host:

In this case it was significant, because of her traumatic brain injury.

Shirley Daugherty:

Correct.

David Craig – Host:

And then, you talk about home care, facility care. Then, you get into case management and kind of explain to us what you mean by case management.

Shirley Daugherty:

Specifically individuals that have catastrophic injuries, in this case a traumatic brain injury, a case manager, a nurse case manager is what I recommend. They may not have that nurse case manager currently, but that doesn’t necessarily mean that they don’t need to have a case manager. And this person will assist them throughout their lifetime with their medical needs. And it may be that they go to their doctor visits with them, but they want to make this nurse case manager will be the person that will help implement the life care plan with them. Possibly go to the doctor’s visits, but ensure that they are receiving the medical care and treatment that they require based on the entries.

David Craig – Host:

And I assume that’s real important with a traumatic brain injury client.

Shirley Daugherty:

Absolutely, especially those with cognitive difficulties and they can’t remember to take their medications on a daily basis. How are they going to know to go to the doctor?

David Craig – Host:

Then, you go into your nurse process planning and your implementation evaluation.

Shirley Daugherty:

Yes.

David Craig – Host:

Then, we get to a plan, and so as their appendix, this is an example of your nurse life care plan tables. And again, it’s not my goal to go through the specifics, but this gives people an idea of how detailed one of these reports are. Where you’re a physical medicine and rehab specialist, you’re estimating four times per year for one year and what the cost associated with that is. Then, physical medicine and rehab specialist of two per year for a lifetime. And that’s obviously a very expensive lifetime cost, it’s $22,000 in this case.

Shirley Daugherty:

Correct.

David Craig – Host:

So you’re breaking it down for somebody using that line table. Well, you talk about how long someone’s expected to live, looking at all of the type of treatment that someone might need. Then, you’re figuring out the cost associated with that.

Shirley Daugherty:

Right.

David Craig – Host:

In this case, also psychiatric and group therapy. Then, this is an example of what you talked about earlier, the medication. So, you look and see what kind of medication is someone taking and then, you figure out what cost is associated with that, correct?

Shirley Daugherty:

Correct, correct.

David Craig – Host:

And so, you can see, I mean these are significant numbers that if someone didn’t do this and they don’t have insurance and they’re young, and for some reason they’re not on Medicare, this could cause major problems for them.

Shirley Daugherty:

Yeah, and specifically some of the medications that an individual, and in her instance, she was a traumatic brain injury and medications that she takes are very, very expensive. Psych meds are historically expensive. All medications are expensive, but when they’re new and they don’t have a generic component involved with them, then they are definitely very, very expensive. And as I discussed earlier, those medications may change, especially people that have behavioral issues or cognitive issues. That pervigil may stop working and she may have to require another medication at another time. So, this is based on, again, what she was on at the time I prepared the life care plan.

David Craig – Host:

Sure, and it’s our best guess. I mean, that’s what we have to do, is we have to use our best guess and we know somebody’s on a certain medication. And so, we know that they’re going to be on medication for the rest of their life.

Shirley Daugherty:

Right.

David Craig – Host:

Give them an estimate. Then, here’s some therapies and recommended therapies, and again how often you need the therapy and then, the total cost. So, ultimately you come down and in this particular case, the life care plan came out to be between, say, roughly $1.3 million to $1.5 million.

Shirley Daugherty:

Correct.

David Craig – Host:

And this was, it’s an 18 page of 36 pages. So, I mean, you’re ultimately at a 36 page report. Then, you substantiate and you guys show the resources that you mention in your report, and you go through a lot of… showing, like you said, the life tables, all those type of things are documented in detail because you may, if this case doesn’t settle, then ultimately you may have to go to court. And obviously, the other side, the other attorney is going to be asking you questions and you have to be able to defend your position.

Shirley Daugherty:

Yes, I do. And not only that, it has to be, I guess the best words is transparent. So, if say I’m working for you and if the defense wants to hire an expert to take a look at my plan, they have to be able to replicate my plan or prepare a life care plan that’s based on the same information that I have had. So, they will look at my life care plan and go, “Okay, I see this is what she’s doing. This is where she’s got that information.” And they can then replicate it if they need to.

David Craig – Host:

And I know you’ve had a case, I assume, to testify at trial?

Shirley Daugherty:

I have, yes.

David Craig – Host:

And, so not all cases settle. Sometimes they take your depositions as well, I assume, and go through your plan.

Shirley Daugherty:

They do. I’ve had many, many depositions.

David Craig – Host:

Yeah. So, the life care plan process, what part do you like the best? What part gets you up in the morning and helps you realize you’re doing something that you love, and you’re passionate about?

Shirley Daugherty:

Honestly, the whole process, other than depositions, right? Using my nursing skills to determine what somebody’s going to need. Again, it goes back to my early days in the nursing home, and developing a care plan on what kind of care we need to provide for this patient. For me, it’s determining what kind of care does this person need? And am I going to be able to do the best that I can for this individual?

Shirley Daugherty:

So, getting into those records and speaking with them, and being compassionate and having an open mind on the kinds of problems that they’ve gone through, and can I help them to make things just a little bit better?

David Craig – Host:

And I know that with me, a lot of times talking to nurses is far more beneficial than talking to some doctors.

Shirley Daugherty:

Right.

David Craig – Host:

I think that it’s reassuring to my clients when you do talk to them or their family. They feel comfortable talking to you, and I think that’s probably an important part of gathering the information. So, you must enjoy it.

Shirley Daugherty:

I do. I do very, very much.

David Craig – Host:

Is there anything that you think of, so if somebody’s listening to this who’s been in an injury, been severely injured, or maybe not as severely injured but they’re listening to this; when should they think they might talk to their attorney about, “Hey do we need one of these life care plans? One of these nursing life care plans?”

When Should an Injured Person Talk to their Lawyer About Life Care Plans?

Shirley Daugherty:

I would start as early as you possibly can, at least putting that bug in your attorney’s ear. Just say, “Hey, I’ve still got these medical issues going on, and my doctors are saying that this may be something I’m going to have to live with for the rest of my life. Maybe we need to get a life care planner involved.” Like you said, the majority of my cases are not necessarily for catastrophic injuries, like traumatic brain or spinal cord injuries. But I do a tremendous number of abbreviated, what I call, they’re medical cost projects. Those are just based on medications and doctor’s visits, or physical therapy and doctor visits because someone has suffered maybe a soft tissue injury or a herniated disc, or maybe they need to have surgery, but they don’t want to have that surgery now. They’re too young to have a fusion, but maybe they have to have that later on, but the case is wrapping up.

Shirley Daugherty:

Talk with your attorney about a future medical plan, life care plan, or cost projection as early as you possibly can. Where I run into a sticky problem is if it’s too early in the case and they’re still treating actively. I mean, where they haven’t even reached what we in the legal field you call the maximum medical improvement. If they’re still getting better and better, that’s more difficult for me to prepare a plan because I don’t know at what point are they going to stop getting better? And now, we’re just going to be doing maintenance.

David Craig – Host:

Don’t you think, I mean I don’t want to assume. Unfortunately, there’s some lawyers that I see that they wait until a case doesn’t settle. Then, they start looking at, “Oh guys, I better get my ducks in order.”

Shirley Daugherty:

Right.

David Craig – Host:

They start after the case doesn’t settle, maybe after a mediation, that’s when they start putting together the plan. Would you agree though that these are really important for the lawyers to have, and the injured party to have before they talk settlement?

Shirley Daugherty:

It is very important, and as an example, I had a client just last week that had a mediation and he calls and says, “Hey, I’ve got this mediation. I know he’s going to have future medical care. Can you put something together for the mediation so we can talk about it?” He goes, he called me on Friday afternoon after the mediation, and he’s like, “Hey, we settled for way more than we ever thought we would because of that plan.” And so, it was not only beneficial for the client, for the injured person, but it was beneficial for the attorney as well.

David Craig – Host:

And it scares me. It scares me on how many cases may get settled though every day.

Shirley Daugherty:

Yes.

David Craig – Host:

Where the people don’t have a clue what their future care plan is.

Shirley Daugherty:

And, as a nurse and also, I mean I’m a member, I’m pretty active in my community. So, when I talk to people and they ask me, “Oh, well you’re a nurse. What do you do?” I tell them and they’re like, “I had no idea that that was even out there, or that was even something that was possible to do.” And they would tell me about their people that they knew that were in car accidents and they settled for minimal amount. They’re still in so much pain.

Shirley Daugherty:

So, not only do I talk with you at conferences and attorneys at conferences, but I talk to people in the community about what it is that I do. And just try to get that word around.

David Craig – Host:

Well Shirley, thank you for being on a guest on After The Crash, the podcast, and thank you for everything you do for my clients and all the other lawyer’s clients out there.

Shirley Daugherty:

It is absolutely my pleasure. Thank you very much.

David Craig – Host:

It’s David Craig, and you’ve been listening to After The Crash. If you’d like more information about me or my law firm, please go to our website CKFLAW.com or if you’d like to talk to me, you can call 1-800-ASK-DAVID. If you would like a guide on what to do after a truck wreck, pick up my book, Semi Truck Wreck: A Guide For Victims and Their Families. It’s available on Amazon, or you can download it for free on our website CKFLAW.com.