In a Texas injury claim, future medical expenses require evidence that the care will probably be needed and that its cost is reasonable. The standard is reasonable probability, not certainty. Pilgrim's Pride Corp. v. Smoak, 134 S.W.3d 880, 905–06 (Tex. App.—Texarkana 2004, pet. denied), explains that distinction.
A doctor's note may say that surgery is possible. Before treating that surgery as a future expense, counsel needs to ask what makes it likely for this patient. Cost raises a separate question: what would the recommended care reasonably cost? Build the estimate around those two questions. Identify the treatment, when it is expected, how often it would occur, and how long it would continue. The diagnosis alone cannot supply all those answers.
The process below is a practical way to organize the evidence, especially when care is complex or expensive. It is not a list of documents or experts required in every case. Smoak recognizes that the injury, past care and condition at trial may support the estimate. The evidence still has to support the particular treatment and amount claimed.
Why future medical evidence matters to your recovery
Leaving supported care out of an estimate may understate your claim. Including speculative treatment or counting a procedure twice gives the other side a reason to challenge it. Before signing a settlement release, ask your lawyer which claims it resolves and how the proposed amount accounts for future care. Keep treatment decisions with your medical providers; the estimate should follow their recommendations.
Start with the treating clinician's prognosis
A note saying “consider surgery after therapy” leaves several things unresolved. The patient may still be attending therapy, or may be waiting to learn whether it helped. Ask the clinician when that decision can be made and what findings would support it. There may be another option before surgery. Record the answer in the plan, so the cost calculation does not get ahead of the treatment recommendation.
Look back as well as forward. Imaging and examination findings may explain the recommendation; the patient’s response to treatment may explain why it changed. An older injury or a later accident may need attention too. Ask the clinician what difference those events make. Counsel needs evidence of probable future care caused by the injury and its reasonable cost, not a list of everything that could happen to a person with that diagnosis.
Make the cost plan traceable
A life-care plan should let another reader check the arithmetic. For a course of therapy, for example, identify the provider, number of visits, length of the course and charge per visit. Include the setting and geographic area. Keep the dated quote or database entry behind the price. If the number comes from a regional benchmark rather than a quote for this service, say so. Apply the same approach to each item in the plan.
Keep the medical recommendation separate from the pricing work. Who recommended the care? Who calculated its cost? A life-care planner’s title alone does not answer the medical-necessity question. A treating physician’s recommendation, on its own, does not establish a market price either. Each witness should be able to identify the records relied on and explain the work that falls within that witness’s expertise.
Account for branches and avoid double counting
Not every patient follows one fixed treatment path. Therapy may help; if it does not, a physician may consider a procedure. A complication could require additional visits. Show those alternatives separately, with the medical recommendation and cost assumptions for each. Do not assign a percentage to a possible outcome just because a spreadsheet accepts one. A qualified witness needs a basis for any probability used. If two courses of treatment are mutually exclusive, do not automatically add both full costs to one total. Explain which scenario each amount represents.
Before totaling the claim, compare the life-care plan with the physician’s recommendations, the economist’s calculations and the other damages schedules. The same operation may appear in more than one document. Count its cost once. Also identify care left out of the plan and explain the omission; otherwise a reader cannot tell whether an item was deliberately excluded or simply missed.
Check what is assumed about the facility, location and frequency of care. Then review inflation and future-price assumptions. If an economist discounts a stream of future costs to present value, retain the method and inputs with the calculation. Showing the result at two supported treatment frequencies can reveal how much that assumption matters. It cannot establish which frequency the patient will actually need.
Questions to ask about a disputed estimate
Take one disputed charge and follow it back to its source. For example, an annual therapy allowance should lead to a recommendation, a number of visits and a price per visit. A missing link in that chain is a question for the person who prepared the estimate. Check the setting and duration too. Once that charge is explained, compare it with the other schedules to see whether it appears twice.
Consider an illustrative $250,000 life-care plan that already includes a $150,000 revision operation. Adding another $150,000 for that operation would count it twice. There is a medical question too: if the physician mentioned revision surgery only as a last resort, what would make it necessary? The demand should explain that condition and the basis for the cost. These figures are examples, not treatment recommendations or estimates for a particular patient.
Organize proof by service
Use this practical evidence checklist to keep each proposed service connected to its support. The materials needed will depend on the claim.
| What must be explained | Supporting material to examine |
|---|---|
| Connection to the injury | Current treatment notes, medical history, examination and imaging findings, and the clinician's explanation of causation. |
| Likely future treatment | Prognosis and recommendations, marked as expected care or conditional alternatives, with the patient's response to prior treatment. |
| Frequency and duration | The proposed schedule, quantities, duration and assumptions, with the records used in the life-care plan. |
| Reasonable cost | Dated local quotes or other pricing sources for the provider and setting, with the pricing calculations. |
| Economic calculation | Arithmetic and any inflation or present-value calculations, with their methods and inputs. |
| Absence of duplication | Comparison of each procedure, medication and follow-up visit across treatment and damages schedules; explanation of resolved duplicate entries. |
What the cases show about the evidence
In Smoak, 134 S.W.3d at 905–06, testimony about possible future problems did not establish probable additional medical procedures. The appellate court set aside the $25,000 future-care award.
Compare the record in Moore v. Sullivan, slip opinion at 5. Surgery had provided only slight relief; the patient described continuing pain, medication and use of a cane, and his doctor described lasting pain. The court upheld the $12,000 award. Moore is a 2000 opinion not designated for publication. Under Texas Rule of Appellate Procedure 47.7(b), it has no precedential value. Its facts are a useful illustration, not a rule that a complex life-care plan needs no reliable medical or cost evidence.
More recently, Lutkus v. Garcia, No. 01-24-00115-CV, slip opinion at 24–25 (Tex. App.—Houston [1st Dist.] July 3, 2025), cited Smoak when rejecting speculative future treatment. The court reduced a $162,500 future-medical award to $2,500 supported by the record. A forecast need not be exact, but the evidence must support the care and cost being claimed.
Resource: How future care fits the injury claim
Future treatment is one part of valuing a claim. The Texas Injury Claim Value and Litigation Knowledge Hub explains how damages, responsibility and available recovery fit together. For bills already incurred, see How to Prove Past Medical Expenses in Texas.
Common questions
Can I recover future medical expenses before receiving the treatment?
Yes, if the evidence supports reasonably probable future care and its reasonable cost. The treatment need not have happened already; a possibility alone does not establish the claimed expense.
Does a possible future surgery automatically count?
No. Ask what would make the surgery necessary for this patient and whether that condition is likely. Keep the medical explanation separate from the price estimate.
Do I need a life-care planner?
That depends on the care and the proof. A complicated plan involving several providers or years of treatment may benefit from a planner. Neither the planner's title nor a spreadsheet replaces support for the recommended care and reasonable cost.
How are future medical costs estimated?
Identify the services, frequency and duration, then connect them to dated pricing for the relevant provider and setting. Check the arithmetic, supported economic assumptions, conditional alternatives and duplicate entries.
Related reading
For the broader questions affecting an injury claim, see the firm’s personal injury practice areas.
Discuss an injury claim
Contact The Law Firm of Aaron A. Herbert, P.C., at (214) 200-4878 or request a consultation. Free consultation. No fees or expenses unless you recover.
Legal sources
- Pilgrim's Pride Corp. v. Smoak, 134 S.W.3d 880, 905–06 (Tex. App.—Texarkana 2004, pet. denied): future-care probability and reasonable cost.
- Moore v. Sullivan, No. 14-98-00842-CV, slip opinion at 5 (Tex. App.—Houston [14th Dist.] Feb. 17, 2000) (not designated for publication): evidence supporting estimated future expenses on that record.
This article provides general information, not legal or medical advice about an individual claim. Treatment decisions belong with the patient’s medical providers.
ABOUT THE ATTORNEY
Aaron A. Herbert
Founding Attorney
Board Certified in Personal Injury Trial Law
Aaron founded The Law Firm of Aaron A. Herbert in 2010 to focus on developing each client's case and seeking its maximum value. For over a decade, he has represented people seriously injured in major accidents and industrial catastrophes, pursuing trial verdicts and settlements while working to reduce the stress of litigation.
Education
- Texas A&M University · B.S., Criminal Justice, 1999
- University of Oklahoma College of Law · J.D., 2002; graduated in the top of his class
Trial experience & approach
Aaron earned numerous jury verdicts at boutique personal injury litigation firms. According to his biography, he spent a year as the top-earning litigation attorney at a firm that frequently appeared in verdict searches as having one of the highest numbers of trial wins in Texas. At another Dallas personal injury firm, he moved from managing pre-litigation attorney to managing litigation attorney over seven years as the firm grew into one of Dallas's largest personal injury firms.
His biography describes a reputation as one of America's most aggressive trial lawyers, with noteworthy recoveries from judges and juries and substantial pretrial settlements. Most of those settlements included confidentiality agreements requested by the defense. Aaron has said the recoveries were justified by the injuries and losses involved, which no amount of money could make someone choose to experience.
His approach combines passion, preparation, persistence and courtroom imagination. He believes a well-supported, engaged and motivated team working cooperatively helps deliver strong representation, with the goal of achieving the best possible result for every client.
Dallas roots, military service & publication
Born and raised in Dallas, Aaron enlisted in the United States Marine Corps after high school and later received an Honorable Discharge. He completed his university and law degrees after his military service and became a lifelong Sooners football fan in law school.
Publication: “Litigating Dog Bite Cases,” Texas Dog Law Seminar, Dallas, 2009.
Professional affiliations & recognition
Professional affiliations and recognition listed in Aaron’s biography:
- State Bar of Texas
- American Bar Association
- Association of Trial Lawyers of America (now American Association for Justice)
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
- Dallas Bar Association
- Tarrant County Bar Association
- Million Dollar Advocates Forum
- The National Trial Lawyers – Top 100 Trial Lawyers
Trial experience & approach
Aaron earned numerous jury verdicts at boutique personal injury litigation firms. According to his biography, he spent a year as the top-earning litigation attorney at a firm that frequently appeared in verdict searches as having one of the highest numbers of trial wins in Texas. At another Dallas personal injury firm, he moved from managing pre-litigation attorney to managing litigation attorney over seven years as the firm grew into one of Dallas's largest personal injury firms.
His biography describes a reputation as one of America's most aggressive trial lawyers, with noteworthy recoveries from judges and juries and substantial pretrial settlements. Most of those settlements included confidentiality agreements requested by the defense. Aaron has said the recoveries were justified by the injuries and losses involved, which no amount of money could make someone choose to experience.
His approach combines passion, preparation, persistence and courtroom imagination. He believes a well-supported, engaged and motivated team working cooperatively helps deliver strong representation, with the goal of achieving the best possible result for every client.
Dallas roots, military service & publication
Born and raised in Dallas, Aaron enlisted in the United States Marine Corps after high school and later received an Honorable Discharge. He completed his university and law degrees after his military service and became a lifelong Sooners football fan in law school.
Publication: “Litigating Dog Bite Cases,” Texas Dog Law Seminar, Dallas, 2009.
Professional affiliations & recognition
Professional affiliations and recognition listed in Aaron’s biography:
- State Bar of Texas
- American Bar Association
- Association of Trial Lawyers of America (now American Association for Justice)
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
- Dallas Bar Association
- Tarrant County Bar Association
- Million Dollar Advocates Forum
- The National Trial Lawyers – Top 100 Trial Lawyers