SJS Settlement in California: How Future Care Costs May Be Added
TL;DR: In California personal injury cases (including SJS/TEN cases), a claimant may seek damages for the reasonable value of medical care that is reasonably certain to be needed in the future. The most persuasive support usually combines treating-provider opinions, a structured life care plan, and defensible cost data. See California Civil Code § 3283 and CACI 3903A (Medical Expenses—Past and Future).
Severe Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) can create lasting complications, particularly involving the eyes, skin, mucous membranes, and related systems. When an SJS claim is resolved through settlement or trial, a major question is often whether (and how) to include the costs of care that will continue after the case ends.
If you want help evaluating future-care damages in a California SJS case, contact our team.
What “future care costs” means in an SJS case
In an SJS case, “future care costs” generally means the medical and related expenses a person is reasonably expected to need in the future because of the injury. California law recognizes recovery of future damages when they are established with reasonable certainty (Civ. Code, § 3283; CACI 3903A).
Because SJS outcomes vary widely, the core task is not to predict everything perfectly. It is to present a medically grounded, well-documented projection that a mediator, insurer, defense counsel, or jury can evaluate.
Common categories of future care costs after SJS
Future care is individualized. Depending on the injuries and sequelae, categories may include:
- Specialty follow-up care (often ophthalmology and dermatology, and sometimes ENT, pulmonology, GI, urology/gynecology)
- Eye-related needs (exams, therapeutics, lubricants, procedures, low-vision services)
- Medications and supplies (prescriptions, skin/wound care products, dry-eye therapies)
- Procedures or surgeries (for scarring, ocular complications, strictures, or related sequelae)
- Rehabilitation (physical/occupational therapy, speech/swallow therapy where indicated)
- Mental health treatment (therapy and/or medication management when appropriate)
- Pain management (including interventional approaches when clinically supported)
- Home health / attendant care (when medically necessary)
- Durable medical equipment and assistive technology
- Transportation for frequent specialty appointments
- Home modifications (when medically necessary)
The goal in a damages presentation is to connect each category to (1) a medical reason, (2) a likely frequency/duration, and (3) a reliable cost basis.
How future care is typically proven (and why documentation matters)
In California, future medical expenses are commonly presented as the reasonable value of care that is reasonably certain to be needed (CACI 3903A). In practice, negotiations often turn on whether the proposed future-care numbers are anchored in the medical record and supported by credible expert reasoning.
Evidence used to support future care often includes:
- Treating records addressing diagnosis, prognosis, complications, and recommended monitoring
- Documented follow-up patterns (referrals, visit frequency, testing schedules)
- Diagnostic history consistent with ongoing impairment
- Pharmacy and supply history showing recurring needs
- Life care plans summarizing services, frequency, and justification
- Expert opinions (e.g., ophthalmology, dermatology, rehab)
- Economic analysis calculating projected costs over time
Life care plans: a common framework for future-care damages
A life care plan is a structured projection of future medical and support needs. In SJS/TEN matters, it can be especially helpful when multiple specialties are involved or when chronic ocular and functional issues are expected.
A well-supported plan typically:
- Summarizes the injury course and current diagnoses
- Lists anticipated future services and supplies
- Cites the clinical basis (records and provider input; sometimes clinical literature where appropriate)
- Uses transparent pricing sources and explains assumptions
- Addresses uncertainty with conservative ranges or alternative scenarios when justified
Future care in settlement negotiations: practical considerations
Future care costs are a frequent settlement dispute point. Common defense themes include:
- Causation (arguing the ongoing condition is not attributable to the defendant’s conduct/product)
- Extent (arguing the long-term needs are overstated)
- Medical necessity (arguing the plan includes optional or unsupported items)
- Frequency/duration (arguing the schedule is speculative)
- Pricing methodology (arguing the costs are inflated or not market-based)
California has specific rules affecting how medical expense evidence may be presented, especially for past medical bills. For example, in many cases past medical expense recovery is limited to amounts actually paid or still owed, rather than the amounts originally billed (Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541). Future medical expense proof is often framed around the reasonable value of future care that is reasonably certain to be required, using competent medical and cost evidence (CACI 3903A).
Tip: Make future-care numbers harder to dismiss
Use your real utilization as the starting point. If you have needed monthly specialty visits, recurring prescriptions, or regular ocular therapies since the acute SJS/TEN event, document that pattern and tie the forward-looking projection to it. Pair it with a treating-provider note explaining why the same cadence is expected to continue.
Special issues for minors and long-term care planning
If the injured person is a minor, settlements often require court approval and may involve specific handling of settlement funds (see, e.g., Probate Code §§ 3600–3613; Code Civ. Proc., § 372).
When the future-care horizon is decades, it can be important to consider:
- Transition from pediatric to adult specialists
- Long-term ocular monitoring and potential procedures
- Functional limitations and supports (where medically relevant)
Future care vs. other damages in California SJS cases
Future care costs are only one category of potential damages. Depending on the facts and claims asserted, damages may also include past medical expenses, lost income or earning capacity, and non-economic damages (such as pain and suffering). The law and evidence rules can be nuanced, and issues like liens or reimbursement claims may affect the practical settlement outcome.
Checklist: Steps to add future care costs to an SJS settlement
- Organize the medical record and timeline (drug exposures, onset, hospitalization, follow-ups, current diagnoses)
- Ask treating specialists for forward-looking guidance (what monitoring and interventions are recommended, and why)
- Track recurring out-of-pocket costs (medications, supplies, travel, paid assistance)
- Consider a life care plan for multi-specialty or long-term needs
- Obtain cost support (local pricing, published data, and clear methodology)
- Identify liens early to understand potential repayment obligations and settlement structure
If you would like an attorney to review your situation, contact us.
FAQ
Do I need a life care plan to claim future medical expenses in California?
Not always, but a life care plan can be a useful way to organize multi-specialty needs and explain frequency, duration, and cost support in a form that is easier to evaluate in settlement discussions or at trial.
What standard applies to future medical expenses in California?
Future damages may be awarded for detriment that is reasonably certain to result in the future (California Civil Code § 3283). For medical expenses, California jury instructions focus on the reasonable value of care that is reasonably certain to be needed in the future (CACI 3903A).
Can the defense argue my future-care numbers are speculative?
Yes. Common disputes include causation, medical necessity, frequency/duration assumptions, and pricing methodology. The strongest responses usually tie each item to the medical record, a provider’s prognosis, and transparent cost sources.
Talk to a lawyer about your specific facts
SJS cases can involve complex causation and expert issues (including drug identification, warnings, differential diagnosis, and prognosis). An attorney can help assess whether future-care damages are supportable, identify appropriate experts, and present a coherent damages package consistent with California law. To discuss your situation, contact us.
California-specific general information only; not legal or medical advice. SJS/TEN cases are fact-dependent, and damages (including future medical expenses) require case-specific proof and may be affected by evolving law and evidentiary rulings. Consult a California-licensed attorney and appropriate medical professionals for advice about your situation.