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How Can Out-of-Pocket Expenses be Paid for in Medical Negligence?
Resources mentioned in this series:
Forecasting out-of-pocket expenses after medical negligence.
As the name suggests, this head of damage covers all immediate expenses, past and into the future. These ‘immediate expenses’ generally refer to things such as:
Classified as ‘special damages,’ - or, damages possible of precise calculation – out-of-pocket expenses are fairly easy to calculate, particularly in reference to those that have happened in the past.
'Special damages' simply refers to damages that are possible of precise calculation.
This is opposed to 'general damages', which refers to subjective items like pain, suffering, and loss of amenities.
Since we use the past expenses to calculate the future expenses, we will be doing this slightly different from the previous heads of damage, calculating the past first.
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Quantifying Your Past Out-of-Pocket Expenses
To quantify your past expenses, you simply need to list the main out-of-pocket costs you have incurred as a result of the medical negligence.
This is generally in the form of:
- 1Medical appointments;
- 2Medication;
- 3Additional equipment; and
- 4Travel.
It’s important to remember (when listing medical costs) to factor in previous payments owed to third-parties, such as Centrelink and Medicare. This needs to be done as the amount will be required to be repaid from the settlement amount.
To calculate your costs:
STEP 1: LIST YOUR COSTS
STEP 2: total the costs
The total will be your past out-of-pocket expenses, but there is one more thing to consider on this amount – the interest!
Interest on past expenses
We can’t forget that there was a potential to earn interest on the past expenses. The law in
QLD takes this into account, allowing you to be compensated for it. To work out what amount
you should be compensated for, follow these steps:
STEP 1: RBA INTEREST RATE
STEP 2: HALF IT
STEP 3: FINAL CALCULATION
EXAMPLE: TOM
For Tom, the current Reserve Bank of Australia interest rate is 0.75. We can put that into the following calculation to work out his interest on past expenses:
0.75% ÷ 2
x
$1709.05
=
$6.71
You can now add this number to your schedule on page XX.
Now that we’re finished with the past, we can move onto the final section – your future expenses.
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Quantifying Your Future Out-of-Pocket Expenses
Once again, predicting the future is difficult – but here’s where we heavily rely on the experts to help us out.
Nearly all of your out-of-pocket expenses will be related to medical necessities – whether that’s appointments and medication, travel to and from, or recommended modifications from an occupational therapist.
The good news from this is that you can rely on a medical professional to identify what future costs you could incur and for how long. They will generally tell you the cost of these items, and you can note them down.
For contentious and varying items such as pain killers, where an amount can’t possibly be
prescribed for ten years down the track, a ‘global buffer’ can be applied. This is an estimated
amount for any unforeseen costs you might experience.
This is the first option but, for a more precise calculation, we’ll be basing your projected requirements off your current requirements (once your injury has stabilised).
We wait for injuries to stabilise so that we have an understanding of what the longterm might look like.
To calculate your future costs using this method:
STEP 1: OUT-OF-POCKET EXPENSES
STEP 2: the years you'll be paying it for
STEP 3: 5% multiplier
STEP 4: THE FINAL CALCULATION
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Putting it all together.
You should now have added your figures to your schedule of damages.
It’s recommended, at this point, to add up your damages so far to see if you’ve reached the
$150,000 quantum threshold.
Below is Tom’s example.
By doing this, you can check if you can surpass the remainder of this workbook and start working out how you’re going to hold your doctor accountable.
If you haven’t passed the $150,000, don’t dispair. You might be in a position where liability is clear cut (or admitted) and you won’t need the expert reports in your situation.
You can fill in this interactive form and will get reviewed by an experienced medical negligence lawyer who will provide you with a step-by-step guide of what to do next.
Want a free review of your schedule of damages?
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PHONE
07 3231 0635
[email protected]
ADDRESS
345 Queen St, Brisbane City, QLD, 4000
MEDICAL NEGLIGENCE
LAWYERS
What is Pain and Suffering and How Can I Calculate It?
Resources mentioned in this series:
Monetising the pain and suffering you've experienced.
In this section, we’re going to focus on the actual victim of medical negligence, and how the injuries have impacted their life.
We call these ‘general damages’.
General damages merely refer to non-pecuniary, or non-monetary, damages.
In simpler terms, it refers to the impacts of medical negligence that cannot immediately be measured in monetary value. These impacts include:
To help quantify something so subjective, the courts created a generalised approached called the ‘Injury Scale Values’ (ISV).
An ISV is a generalised approach to measuring the pain and suffering each type of injury causes.
The scale goes from 0 to 100 and, generally, the higher the ISV number, the greater the injury,
the bigger the compensation.
For example, the impact of paraplegia on your quality of life will be much greater than a stubbed toe – the ISV considers this and produces a general figure for each – $283,800 and $3,160 respectively.
So, now, let’s dig deeper and explore what ‘pain and suffering’ means in legal terms, and convert it to a dollar figure.
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Quantifying Your Pain and Suffering
Despite its subjectivity, pain and suffering is quite easy to calculate because of these ISV’s.
What you need to do is not be intimidated by the number of steps – each is a bite-sized step of a larger, simpler process.
To find out the value (ISV) of your injury and what it’s worth, follow these steps:
STEP 1: LIST YOUR INJURIES
STEP 2: locate them in the isv
STEP 2A: use the contents
STEP 2b: identify the severity
STEP 2C: scale value
This is the final step for physical ISV’s at the moment. We’ll return to it after we’ve
considered the ISV’s for any mental trauma you might’ve experienced. If you are sure
you have no mental trauma to report (or the impact is minor), you can move onto translating your ISV to a dollar figure.
Consideration for mental trauma.
There are a few extra steps involved when recording your mental injuries.
In the CLR, instead of noting what the injury is, such as ‘schizophrenia’, ‘PTSD’, ‘anxiety’, etc., it
instead refers to a ‘PIRS’ rating. This stands for the ‘psychiatric impairment rating scale’.
This is used because the measurement is taken by the level of impairment caused, rather than the ‘injury’ itself.
The Psychiatric Impairment Rating Scale (PIRS) is a similar tool to the ISV, however is used to measure the impact that mental trauma and psychiatric impairment has had on a person.
For example, it will consider in what ways PTSD has affected you, rather than what the level of
PTSD you have is.
Straightforward, we need to work out your PIRS and then convert it to an ISV. This will then be converted to a dollar figure.
STEP 1: THE PIRS
STEP 2: IDENTIFY THE IMPACTS
STEP 3: IDENTIFY THE SEVERITY
STEP 4: NOTE THE SCALE
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You have now measured your level of mental impairment and can translate that to an ISV number. To do this:
STEP 5: RETURN TO THE ISV
STEP 6: TRANSLATE TO ISV
STEP 7: SCALE VALUE
STEP 8: CONSOLIDATION
The conversion from ISV to $
We’ve worked out some numbers... but what do they mean and how do we translate them to a dollar figure?
STEP 1: dominant isv
Variation: unsatisfactory isv
STEP 2: translate to monetary figure
STEP 2A: DATE RANGE
STEP 2b: isv range
STEP 2c: base and variable amounts
STEP 2d: calculate the variable amount
STEP 2E: THE FINAL CALCULATION
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Putting it all together.
You should now have added your figures to your schedule of damages.
It’s recommended, at this point, to add up your damages so far to see if you’ve reached the
$150,000 quantum threshold.
Below is Karen’s example.
By doing this, you can check if you can surpass the remainder of this workbook and start working out how you’re going to hold your doctor accountable.
If you haven’t passed the threshold yet, don’t worry.
We’re about to take on our third most significant head of damage (from a quantum perspective) – monetising your future pain and suffering.
Next article: What are out-of-pocket expenses after medical negligence, and how are they calculated?
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PHONE
07 3231 0635
[email protected]
ADDRESS
345 Queen St, Brisbane City, QLD, 4000
MEDICAL NEGLIGENCE
LAWYERS
What is Gratuitous Care and How Can I Calculate It?
Resources mentioned in this series:
Monetising the care your family provides.
Now that we’ve calculated the biggest head of damage, we can move onto the second biggest – care.
And don’t worry, this one’s easier.
Victims of medical negligence will often find themselves relying on relatives, partners, and other persons for care and assistance.
As opposed to commercially paid or hired help, this type of care is referred to as ‘gratuitous’ – or, free of charge.
Gratuitous care simply refers to the services provided by family members to assist in the day-to-day care of a medical negligence victim.
But, the addition of this care can often have a heavy impact on the providers, taking time out of their social lives, work, and other day-to-day duties.
To compensate for this, the court offers an award for gratuitous care services.
This award is calculated with reference to the market (or commercial) cost of the services, with the extent of coverage stretching far and wide across common duties such as:
Day-to-day duties;
Personal duties;
Home and maintenance duties;
Before we jump in, we wanted to cover off some important limitations, or criteria, that apply to gratuitous care payouts.
EXAMPLE: JESS
Jess experienced birth trauma as a result of her midwife’s negligence. Brett, her husband, now has to take care of day-to-day domestic duties - finishing work early to make sure dinner is cooked, taking time out of his day to provide the necessary care for their newborn baby where Jess normally would.
On top of this, he’s driving her to and from her appointments, helping her buy medication, and running her errands for her.
In this situation, the court would provide an award for gratuitous care to pay for Brett’s time. The amount is based on the commercial price for these services – in other words, what would be the cost of hiring someone commercially to do this?
We’ll continue this in the next section, but what we first need to consider is whether or not Brett is actually eligible to claim for these services. Let’s cover off some of the limitations first.
LIMITATION 1: REQUIREMENTS
LIMITATION 2: ELIGIBLE PROVIDERS
LIMITATION 3: FINANCIAL AWARD CAP
Now that you’ve checked your eligibility for gratuitous care, let’s
jump into calculating it.
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Quantifying your Future Gratuitous Care
Quantifying the future costs can often come with greater room for disagreement because, once again, you’re predicting the future.
Despite this, we’re going to do it before past care because it can often have a larger outcome - and we’re keeping that $150,000 in mind.
To predict the future as accurately as possible, you’ll need to have evidence from a range of
medical professionals. They with their recommended care services and their expectations for
how long you’ll require these services.
We recommend you get one (or multiple) of these assessments before starting this section. If
that’s not possible, then not to worry! Do your best to predict.
EXAMPLE: SASHA
Jess’ obstetrician might recommend 12 weeks of bed rest, six months of part-time postnatal care for the baby, three more ultrasounds in different towns, and 6 GP visits.
From this, an occupational therapist would be able to decipher what tasks Jess will and won’t be able to do, how often they will need to be done, and for what time frame.
This might be 5 hours per week for cleaning and outdoor maintenance until the end of Jess’ life.
Future Economic Loss
To start your calculation, you will need to:
STEP 1: REQUIRED TASKS
STEP 2: FOR HOW LONG
STEP 3: commercial cost
STEP 4: 5% MULTIPLIER
STEP 5: THE FINAL CALCULATION
You should note this number on your own Schedule of Damages table to keep track of where you’re at.
Now that we’ve covered your future care costs, lets take a look at your past care.
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Quantifying your Past Gratuitous Care
Now that we’ve quantified your future care costs – the significant costs – we can start quantifying the care you’ve already received.
And doing that isn’t too hard.
step 1: care received
step 2: COMMERCIAL costs
Putting it all together.
Now you can add this to your schedule of damages.
It’s recommended, at this point, to add up your damages so far to see if you’ve reached the $150,000 quantum threshold.
Below is Jess's example:
By doing this, you can check if you can surpass the remainder of this workbook and start working out how you’re going to hold your doctor accountable.
If you haven’t passed the threshold yet, don’t worry.
We’re about to take on our third most significant head of damage (from a quantum perspective) – monetising your future pain and suffering.
Next article: What is pain and suffering and how is it calculated?
Get Social
Share
We'd love if you joined our Facebook Community. We post things that we are passionate about or that interest medical negligence victims or issues in the systems that are supposed to support their recovery, as well as more unrestricted content like this.
Get in touch.
PHONE
07 3231 0635
[email protected]
ADDRESS
345 Queen St, Brisbane City, QLD, 4000
MEDICAL NEGLIGENCE
LAWYERS
What is Economic Loss and How Can I Calculate It?
Resources mentioned in this series:
Quantifying your contribution to the workforce.
It’s not uncommon that a victim of medical negligence will experience difficulties in trying to return to work in any capacity, let alone the same job.
The strain of an injury, or the mental trauma inflicted, can often cause the victim to lose wages, now, and into the future.
The past and future economic loss head of damage aims to protect the victim from a loss of earnings. It bridges the gap between what they used to earn, what they earn now, and what they will earn 20 years into the future.
Simply put, future economic loss covers a person's reduced income or lost opportunities.
More specifically, it can cover things like:
These are the types of things not accounted for in most government and private insurance
schemes.
Schemes like the NDIS or Private Accident Insurance.
These schemes will pay the immediate out-of- pocket expenses, but not pay for loss of earnings.
The law will, as much as reasonably possible, try to put the injured person back into the position they most likely would’ve been in before the accident, which includes considering their future potential.
And just how you calculate these future losses can be a complicated exercise.
See, if you asked yourself 10, 15, 25 years ago where you’d be today, you’d probably have no idea.
But that’s precisely what this head of damage is asking you to do – predict every wage-earning movement from the date of the incident until the expected time of retirement.
It might seem impossible. But in just 15 minutes you will be able to do it.
Below we’re going to step you through the same process a lawyer would take to help you calculate your economic loss - considering your future first, and then the past.
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Quantifying your Future Economic Loss
For the majority of claimants, future economic loss will be the most significant head of damage they receive. So whilst this section might seem confusing or complicated, it’s not that difficult if you follow a template.
All heads of damage after this will be an easier step towards the quantum threshold of $150,000.
Future Economic Loss
EXAMPLE: SASHA
Sasha was a mother of one who experienced surgical negligence.
After Sasha became a victim of surgical negligence, she found it impossible to maintain her hours at work. She had to halve her hours – from 40 to 20 – which, naturally, halved her income from $850 to $425.
Her doctor told her she would never be able to return to the 40 hours per week in her current job. Below, we will use this example to step you through the first section.
STEP 1: REDUCTION IN INCOME
STEP 2: years until retirement
STEP 3: 5% Multiplier
STEP 4: future loss of earnings
STEP 5: GLOBAL BUFFER
STEP 6: THE FINAL CALCULATION
You should note this number on your own Schedule of Damages table to keep track of where you’re at.
A schedule of damages is the document a lawyer gives to insurers that summarises the losses their client has experienced.
Future Loss of Superannuation
We’ve covered your losses up until retirement, but what about losses after retirement?
Expenses don’t just stop once you retire - if anything, they can get worse.
That’s why (in compensation), superannuation is accounted for, and quite easy to work out. To calculate future losses, we need to look at the future superannuation rate.
As of 2019, the rate of superannuation that an employer has to pay is 9.5% of your wages.
By 2025, this rate will increase to 12%.
For this reason, we will work off the 12% for calculating your future loss of superannuation.