Plaintiffs are entitled to be reimbursed for all of the medical expenses
attributable to their injuries. They must first prove that the expenses were
due to the defendant's conduct rather than a preexisting or coincidental
condition. They must then prove that the expenses were reasonable and
necessary. Finally, they must project the cost of future medical care
necessitated by the injury. Each of these issues requires expert testimony,
usually available from the plaintiff's treating physician. (This is true even
in medical malpractice cases because it does not require questioning the
competence of a fellow physician.) The defendant must then contest the
plaintiff's need for medical care. This is complicated by the general
assumption that a plaintiff has no incentive to submit to unnecessary medical
care. Unfortunately for the defense, medical expenses have great strategic
value.
Unlike medical malpractice litigation, most personal injury cases begin with a
plaintiff who was in good health and suffered an acute injury. In an automobile
accident case, the plaintiff must prove that the accident was due to the
defendant's negligence. The plaintiff also must put on evidence that the
accident caused the injuries in question. This is usually a perfunctory matter
because the link between the accident and the plaintiff's injuries is obvious.
The only question is whether some of the medical expenses are attributable to a
preexisting condition and would have been incurred without the accident. Even
if the plaintiff has chronic back pain, she may still claim that the accident
aggravated her problems. The defendant will be liable for the additional
expense of treating the now-worsened back pain. Determining the extent that a
defendant's conduct aggravated a plaintiff's preexisting condition is difficult
even in simple automobile accidents. It is frequently the pivotal issue in
medical malpractice litigation.
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