Personal Injury Damages Calculator
Produces a defensible, auditable PI damages model: every figure traced to a source document, billed and paid columns carried, general damages justified by methodology, and adjustments (comparative fault, liens, caps) applied transparently.
Quick Start
- Gather incident, billing, medical, wage, and future care documents (Intake below)
- Structure the model with special damages, general damages, and adjustments sections
- Calculate each category with source-traced line items
- Apply jurisdictional adjustments and produce final demand summary
- Verify with Quality Audit checklist before delivery
Intake (Mandatory)
Ask every time unless user says "use defaults" or "just draft":
- Incident & liability — date, mechanism, parties, comparative fault, prior injuries, jurisdiction
- Insurance — BI limits, med-pay/PIP, UM/UIM, coverage disputes
- Medical billing — itemized bills, EOBs (billed/paid/adjusted), lien statements (Medicare, Medicaid, ERISA), pharmacy, DME
- Medical records — EMS, ER, imaging, operative reports, PT, pain management, discharge summaries
- Wage/employment — employer verification, 13+ weeks pay stubs, W-2s/1099s (3 years), disability notes, FMLA/STD, used PTO/sick time
- Replacement services — home care, childcare, cleaning, transport invoices
- General damages support — pain journal, witness statements, injury photos, mental health records, functional limitations
- Future care — life care plan, surgeon recommendations, PT plan, vocational evidence
Defaults if user doesn't respond: carry both billed and paid columns; present multiplier and per diem for general damages; flag comparative fault and liens for attorney resolution; flag jurisdictional rules [VERIFY].
Pause for missing categories before finalizing numbers.
Step 1: Model Structure
Line-item table format: date, provider/source, amount billed, amount paid, causation notes.
Medical expense measure — critical decision:
| Measure | When | |---|---| | Billed charges | Collateral source rule jurisdictions (e.g., NY) | | Paid/incurred | Howell v. Hamilton Meats, 52 Cal. 4th 541 (2011) jurisdictions | | Reasonable value | Reasonable value standard jurisdictions |
If counsel cannot specify, carry both columns and flag for attorney determination.
Sections: A. Special damages (past/future medical, past/future wages, out-of-pocket, replacement services) · B. General damages (pain/suffering, emotional distress, loss of enjoyment, disfigurement, consortium) · C. Adjustments (comparative fault, offsets, policy limits, liens, statutory caps)
Step 2: Past Medical Specials
Extract per line item: service date, provider, CPT/DRG code, amount billed, amount paid/adjusted.
Causation screen (all three required):
- Temporality — treatment began promptly for complained-of body parts
- Consistency — records document injury complaints throughout
- Medical necessity — care related to diagnosis and mechanism
Flag items failing any criterion as "potentially contested."
Columns: gross billed → contractual adjustments → insurer payments → patient responsibility → outstanding balances/liens.
Ancillary: co-pays, Rx, OTC (if documented), DME, mileage, parking, childcare for visits.
Step 3: Wage Loss Specials
- Establish disability period from work notes/restrictions — flag gaps between incident and first visit
- Calculate wage base:
| Type | Method | |---|---| | Hourly | Avg weekly hours × rate from pay stubs | | Salaried | Annual ÷ 52 | | Tipped/commission | Historical earnings documentation | | Self-employed | Tax returns + P&L (gross ≠ earnings); flag for expert if large |
- Add lost overtime, bonuses, used PTO/sick, lost employer benefits (retirement match, health premiums)
- State gross vs. net methodology explicitly; flag tax treatment for jurisdictional review
Step 4: Future Economic Damages
Only calculate with evidentiary foundation. Typically requires expert testimony for admissibility.
| Source | Approach | |---|---| | Life care plan | Use plan categories and totals directly | | Specific recommendation | Unit cost × quantity; label assumption-based | | Vague reference ("may need surgery") | Do NOT assign dollar figure; flag for medical opinion |
Present value: Discount projected costs at appropriate rate; account for medical inflation. Flag methodology for jurisdictional verification.
Future earning capacity: BLS work-life expectancy tables. Without expert input, produce labeled "scenario analysis" (conservative/aggressive) with all assumptions marked.
Step 5: General Damages
Build harm narrative from records before calculating: pain duration/intensity, objective findings, treatment invasiveness, daily life disruption, permanency/scarring.
Multiplier Method
Total economic damages × severity factor:
| Severity | Range | Indicators | |---|---|---| | Mild/full recovery | 1.5–2× | Soft tissue, short treatment, full resolution | | Moderate | 2–3× | Extended treatment, residual symptoms, functional limits | | Severe | 3–5× | Surgery, permanent impairment, disfigurement, prolonged disability |
Never select a multiplier without articulating severity justification.
Per Diem Method
Daily rate by recovery phase:
| Phase | Rate | Example | |---|---|---| | Acute | Higher | $200–400/day | | Subacute | Moderate | $100–200/day | | Residual/chronic | Lower | $50–100/day |
Benchmark: plaintiff's daily earnings (a day of pain ≥ a day of work).
Present both methods. Convergence strengthens demand; divergence requires reassessment. Flag per diem trial permissibility — some courts prohibit per diem arguments [VERIFY].
Step 6: Adjustments and Final Summary
Double-counting check:
- Wage loss not also counted as diminished earning capacity
- No overlapping facility/global charges
- Non-economic subcategories as single total with narrative components, not additive line items (unless jurisdiction requires)
Comparative fault:
| Regime | Rule | |---|---| | Pure comparative | Recovery reduced by plaintiff's % fault | | 50%-bar modified | No recovery if plaintiff ≥ 50% at fault | | 51%-bar modified | No recovery if plaintiff ≥ 51% at fault |
Present gross damages, then risk-adjusted range if fault disputed.
Collateral source: Show both billed and paid; flag recoverable measure for attorney.
Liens: Net-to-client sensitivity analysis when data available. Flag resolution steps (Medicare conditional payments, ERISA reimbursement).
Statutory caps: Uncapped value + capped maximum as separate lines. Flag med-mal caps, government entity limits [VERIFY].
Policy limits: Present full case value separately; note how limits affect demand posture.
Output Structure
- Past medical (billed/paid)
- Future medical (if supported)
- Past wage loss
- Future wages / diminished earning capacity (if supported)
- Other out-of-pocket
- Non-economic damages (method justified)
- Total demand
- Notes: liens, caps, jurisdictional issues
Every figure must trace to a document. Missing documents → label as estimate.
Post-Draft Alignment (Mandatory)
Ask after delivering initial calculation:
- Billed or paid as primary medical expense measure?
- Is comparative fault estimate accurate?
- Additional lien holders unaccounted for?
- Does general damages result align with counsel's valuation?
If no response, recommend resolving billed-vs-paid (highest-impact variable) and proceed if authorized.
Quality Audit
- [ ] Every dollar traces to source document (or labeled estimate)
- [ ] Both billed and paid columns carried until counsel selects
- [ ] Causation screen applied to each medical charge
- [ ] Wage loss methodology correct for employment type
- [ ] Future damages supported by evidence, not speculation
- [ ] General damages justified by both multiplier and per diem
- [ ] No double-counting between categories
- [ ] Comparative fault applied correctly for jurisdiction
- [ ] Lien accounting complete with net-to-client analysis
- [ ] Statutory caps identified and applied
- [ ] All legal rules verified or flagged
[VERIFY] - [ ] Assumptions documented prominently
Jurisdiction Checklist
Flag and resolve before finalizing:
- [ ] Collateral source / billed vs. paid rule
- [ ] Comparative negligence regime and threshold
- [ ] Non-economic damages caps (by case type)
- [ ] No-fault/PIP serious injury threshold
- [ ] Per diem argument permissibility
- [ ] Present value discount requirements
- [ ] Joint and several liability rules
- [ ] Wrongful death framework (if applicable)
- [ ] Loss of consortium availability
Pitfalls
- No invented data. Never fabricate citations, verdict data, or "average settlement values." Use
[VERIFY]for any unconfirmed citation. - No speculative futures. Do not assign future damages figures without medical support.
- All legal rules verified or flagged. Caps, collateral source, comparative negligence — verify or mark
[VERIFY]. - Ethics: ABA Model Rules 1.1, 3.1, 4.1, 3.3.
- Scope notice: "Attorney work product draft requiring review. Jurisdictional rules must be verified. Figures based on provided documentation and stated assumptions."
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