So, what does it all cost? Strategies for forecasting rehabilitation and medical management within medico-legal cases.​

Original Release Date: December 11, 2022 | 10:00 PM - 11:00 PM

Life Care Planning both within and outside of Medico-legal litigation, addresses the value of an individual’s long-term rehabilitation, medical management, and medical and nonmedical needs for their lifetime through a determination of costs. While there are many sources and types of cost data, each has pros and cons, and standardization of cost sources and percentiles is still being discussed within the industry. 


In this 50-minute webinar, Medical and Life Care Consulting explores the varying approaches of determining lifetime rehabilitative, medical management costs, and medical and non-medical needs and what to do while the industry continues to evolve and discuss standards. 


The presenters, certified nurse life care planning experts Cynthia Bourbeau and April Pettengill, will discuss the pros and cons of using database resources, such as and Find-A-Code, AHD, The VA, etc. versus using chargemasters, versus calling providers and vendors to get specific cost data. They will also provide thought leadership in determining which percentile breakpoint is the right percentile (is it 80%, or is it lower, 50 or 75%).  Guest speaker, economist Dr. Neville Lee, will discuss what his role is in the final product and how the present rate of inflation impacts the cost. 



  1. Why percentiles matter.
  2. Varied cost sources available for identifying costs in a GEO Zip. 
  3. How to use those databases correctly.  
  4. The strengths and weaknesses of each option and what to do to solidify your opinion and choice.
  5. How to correctly use direct outreach to providers and vendors.
  6. The role of the economist in the medico-legal arena.
  7. What economists look for when reviewing a life care plan and preparing an economist report.
  8. How inflation impacts the cost. 

00:00 Introduction

1:33 Meet Presenters

4:06 Damages in Litigation – What does the future looke like ?

4:29 What is a Medical Cost Projections ?

6:14 What is a Life Care Plan

8:22 What is a Life Care Plan ( cont. )

9:11 How are These Different ?

11:17 Where do These Costs Come From ? Is It Magic ?

11:23 Types of Costing Resources

12:58 National Databases

14:39 Why use a National Database ?

18:01 Disadvantages of National Databases

21:17 Sample Language Regarding Reasonable Charges

24:06 Percentiles and Reasonable Charges

26:35 Chargemaster

30:51 Sample Chargemaster

32:55 VA Community Care Fee Schedule

34:33 Internet Searches

35:33 Internet Searches Drawbacks

36:39 Phone Calls and Past Charges

37:57 Phone Calls and Past Charges Chellenges

39:12 How to Put These Into the Plan

40:44 Economist Role

41:41 Present Value and How It is Generally Figured

42:33 Conclusion and Takeaways

43:37 Q&A Section

Cynthia Bourbeau is a Massachusetts Registered Nurse and certified as a Rehabilitation Nurse, Case Manager, Nurse Life Care Planner, and

Presenter: Cynthia Bourbeau


Cynthia Bourbeau, President and Founder of Medical and Life Care Consulting Services, Inc. (MLCC), has worked as a Massachusetts Registered Nurse, Certified Rehabilitation Nurse, Certified Nurse Case Manager and Certified Nurse Life Care Planner for over three decades. 

Founded in 2001, MLCC provides Life Care Planning, Medicare Set-Asides, Legal Nurse Consulting and more throughout the United States and internationally. MLCC also provides case management services throughout the Northeast Region of the United States, and a wide range of care consultation for catastrophic injuries. 

April Pettengill has over 30 years nursing experience that has included caring for the ill and injured across the continuum of life.

Presenter: April Pettengill


April Pettengill has over 30 years nursing experience that has included caring for the ill and injured across the continuum of life. A strong professional nursing background in catastrophic case management including assessment of and coordination of care needs for severely injured persons. Hands on nursing experience working with chronically ill elderly, pediatric population and acutely ill adults. Hands on experience with patients with cancer, congestive heart failure, chronic obstructive pulmonary disease, wounds, spinal cord injuries, stroke, brain injuries, and progressive neurological disorders such as ALS and MS and Pediatric High-Tech need.

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