Adam Bloomberg: Welcome, everyone. I'm Adam Bloomberg, Senior Client Success Advisor here at IMS Legal Strategies. We partner with trial lawyers to elevate their litigation strategy and give them an edge in the courtroom. Today, it's my pleasure to chat with one of the nation's leading burn injury life care planners, Jennifer Wall. She has more than two and a half decades of experience working in the patient care industry in catastrophic burn and trauma care. She's worked closely with both plaintiff and defense attorneys to testify in support of a life care plan or to challenge one. She's based in Virginia and collaborates with attorneys and healthcare providers nationwide. Jennifer, I hope I got that right. Welcome, and it's great to have you here.
Jennifer Wall: Thank you so much.
Adam Bloomberg: What makes your approach to burn injury life care planning unique?
Jennifer Wall: Sure. I think in that I have been a practicing physician assistant in the areas of burn care and critical care and reconstructive surgery. I think it brings a unique perspective with my hands-on experience working in burn centers on both coasts of the United States, caring for burn survivors in their continuum of their care. So encountering a burn patient when they are first admitted into the emergency room, caring for them throughout their hospital stay, as well as having experience assisting in their surgeries. Not only taking care of them acutely, but then also caring for them in the post-operative and care in the clinic when they have returned home and understanding what their issues may be as a survivor and living potentially with lifelong consequences of their injury. I also have worked internationally, caring for burn survivors in Malawi, Africa, where I started a foundation. And I attend the most up-to-date conferences in burn technology, as well as research. And I'm connected with the Phoenix Burn Society as well, which is an organization that really focuses on the long-term challenges for burn survivors. I think this, as well as my network of working with multidisciplinary burn professionals, gives me a good understanding of the medical, psychological, and long-term psychological aspects that burn survivors need to create a very comprehensive life care plan.
Adam Bloomberg: So softball question. At what stage in a case should attorneys bring you in?
Jennifer Wall: Well, ideally, I would certainly love if they were bringing me in as early as possible. But if they do bring me in later, I do think that there is still value to be added. I will say that recently I was brought in after a lawyer had designated an expert to rebuttal a plaintiff life care plan. And we discovered pretty quickly that that was not the proper expert to be in the case, able to rebuttal the contents of the life care plan. And so with our input, we were able to appropriately bring in the best expert to rebuttal that plan.
Adam Bloomberg: So if you're not engaged early, what's that typical period of time that you're called in in kind of the dispute life cycle where you still can be effective?
Jennifer Wall: Yeah, typically we're involved kind of late in the game for a defense rebuttal because all the pieces of the plaintiff plan have already need to be discovered. And by the time we're brought in, it's possible that it's a thirty day turnaround. Sometimes it could be less. And if it is less, what does that mean for us on the defense side? That could mean a rushed timeline. It could mean lobbying for an extension if possible. In the end, I think I need to be very apparent about with the lawyer to say, you know, can I do a comprehensive job in the time period that you've given me and not compromise the quality of my product? Because that is the most important item for me to make sure that we are delivering a quality and fair product.
Adam Bloomberg: Why is it beneficial for attorneys to work with a life care planner like yourself who understands both plaintiff and defense perspectives? You seem to have a really good balance of that in your cases.
Jennifer Wall: Yeah, luckily I do have a good balance of the cases. And for plaintiff cases, for example, it's incredibly important that we are holistic, comprehensive as possible, and providing the most realistic needs for the long term. You know, as an example, a case that I recently finished, you know, there's so many nuances to a survivor that has a very severe catastrophic injury. For example, you know, does the lawyer understand what it means to have, say, eyelid contractures, you know, eyelid scars? For a person where they can't completely close their eyelid, you know, and you and I are blinking, you know, several hundreds, thousands of times a day, you know, to keep our eyes lubricated. You know, what does that mean for that client if it cannot be fixed properly? Or what does it mean for this catastrophically injured patient who has young children who are school aged? And when she is on the sidelines of her child's softball game, you know, her child is getting bullied because the children can't understand, you know, why her mother looks different. You know, what does that mean for this patient? Plaintiff going forward in this survivor, you know, for what they need to help take care of them, to give them the best possible outcome in the long run. And not just now, but for the rest of their life. I find very, very commonly that burn survivors don't even fully understand the scope of the resources available to them whatsoever. They don't understand the psychological services that could help them. They don't understand that even though they may have had some treatment for a piece of their care, whether it was medical or psychological, that these problems can regress, remit, pop up again, you know, over the course of their lifetime. And I really feel, you know, a good sense of, you know, you know, pride in being able to be an educator, you know, to these clients.
Adam Bloomberg: So when it comes to defense, what does that look like?
Jennifer Wall: When it comes to defense, I really need to very closely evaluate that the plan that was provided on the plaintiff's side is not overestimated, that it's not inappropriate. You know, is the plaintiff life care plan following a legitimate methodology? Can the prices be verified? You know, this is extremely important that we are ensuring that every piece of it is accurate, consistent and legitimate going forward. And I will say I had a recent case where a patient was very catastrophically injured and had amputations. And it was very clear that this client would need lifelong care. And working with the lawyer, we were actually able to remove the pieces of the inappropriate care for that client and actually provide the pieces of care that made sense for the client. And it happened to have been less dollars at the end for the way that we constructed the plan, but still being true to what the client actually needed and staying on the right side of the fence at all times for the evaluee, providing them what they need, whether they are plaintiff or defendant in the case. And I will say I'm a better plaintiff life care planner because I evaluate defense plans and I'm a better defense life care planner because I have plaintiff plans.
Adam Bloomberg: Why is the classification of a burn injury critical in determining treatment needs and long-term care planning?
Jennifer Wall: Sure. We basically assign, you know, terms, you know, diagnosis terms for burn survivors in burn clinical world that might be, you know, foreign terminology to people. We assign a percent total body surface area and we assign degrees of burns, you know, in our documentation, right? And those degrees of burns, you know, equate to different levels of potential care that they need for the rest of their life. For example, it may be very reasonable that a patient who heals from a smaller second degree burn, you know, may need less, you know, amount of care than a third degree burn would need who has required skin grafting, repetitive skin grafting, they've suffered complications from them. And so it is essential to kind of understand the degrees of burn and what is reasonable, what happens to those burns and those scars over time based on the degrees of what they suffered and the complications that they have suffered. And so that terminology, and that's just a simple piece of burn care, that terminology is very foreign to many lawyers. And just dissecting out and being able to tell when we have an intake and I say, please provide me the pictures as soon as possible, I can tell very quickly from their initial burn injury photos and their current photos the progression of what may happen for prognostication over time. And of course, I work with experts that assist in that prognostication. But to give the lawyer an idea of where we stand right off the bat is something that is very helpful to them.
Adam Bloomberg: Beyond the visual injuries, there are obviously hidden complications that an attorney should be aware of. Can you share an example of how hidden injuries impact the long-term recovery?
Jennifer Wall: Sure. Actually, we actually call them in the literature the hidden injury or the hidden burn. And the reason that there's research that surrounds that is because even though a burn-injured person may not have outward scars, perhaps they are, quote unquote, hidden under their clothes. It might be something under their shirt or under their pants. But when they're in a bathing suit, it is very well seen to the rest of the world and always seen to them, you know, in the shower and they know that it's there. And so we call that consequences of a hidden burn. So scars that you might not see, but it also includes other things like the nerve damage that could be associated with a deep burn. Those are very, very complicated consequences of an injury. And it could mean, you know, a lifelong consequence. It can mean using medication for amount of time. It could mean a surgery to release a nerve that is causing problems, as well as things like psychological effects that are not, you know, blatantly seen on a survivor where post-traumatic stress disorder, depression, anxiety, these things aren't just treated initially and go away. These are things that come back. They are re-traumatized with every reconstruction surgery. You know, imagine a child who basically has to come in every summer of their school break to have a reconstruction, and they still remember the pain that they went through from their initial hospitalization. Even coming at them with gloves on or a mask on or, you know, taking them to a tub treatment room is extremely traumatizing, you know, for an adult and a child, actually, of course, anything that causes pain. And, you know, these are not small things to dismiss. You know, when they feel like they're, you know, potentially, you know, being overlooked sometimes, it may be because no one has actually addressed, you know, the problem at hand. No one has actually asked them. You know, have you ever had, you know, thoughts of hurting yourself because of your injury? You know, these are delicate questions that need to be asked.
Adam Bloomberg: Yeah. So attorneys handling burn cases often work with various types of incidents. What are some of the most common burn-related cases that you encounter in your work?
Jennifer Wall: Sure. Very commonly, product liability is a big one. Mass torque, items including very common household items that we all have potentially. Pressure cookers, crockpots, lithium batteries. Car battery fires, gas grill explosions. Of course, there's workplace injuries and workplace explosions, oil rig industry accidents, electrical injuries. Items like fireworks coming up for Fourth of July that are faulty designed and then cause a major explosion or injury. Motor vehicle fires concomitant with major trauma. And childhood burns of all nature, you know, also are not something to dismiss. You know, children being immersed in a hot tub that was set too hot. You know, a child contacting a fireplace at a restaurant where the gas is not, the glass is not safety glass, you know, to be free from heat. Falling into a bonfire that might be at a brewery or a winery because it wasn't properly protected. These have major consequences. And every injury that they have has potential lifelong consequence for them, you know, it's a big ordeal if you have a neck contracture and you can't turn your head when you're driving to see behind you, you know, or it's a major problem for a child whose very small palm was burned and their hand contracted over time and they're unable to open their hand, you know, what are the consequences not when they're young at the age of five, but when they're age eighteen. Or what happens to that burn hand contracture when they're sixty-five or seventy-five? You know, what happens then?
Adam Bloomberg: Burn injuries often come with significant long-term costs. What are the most expensive and unique aspects of ongoing care?
Jennifer Wall: Sure. Burn injuries. Injured clients customarily will need further surgery, of course, physical therapy to restore their mobility, pain management modalities, nerve damage treatments, psychological and supportive care, prosthetics, potentially, and I would say one of the most common pieces of burn care long-term, particularly for burns that occur in the joint spaces, are contractual releases, which is a reconstructive surgery. I did actually bring a picture along that if Carolyn can bring that up, I can display. But I do warn you, there is some graphic nature to it, and it is of a child. It is a picture that I took in Malawi, Africa during some of my mission work. And this was a child who was burned at a very young age and did not have immediate care for likely what was a deep second degree or third degree burn. In that, then what happens is because of pain, a child or an adult will basically flex inward with that joint to avoid any pain with movement. And the burn heals in from edges inward, basically. And it forms this webbing, which is obviously devastating because in this state, this child will never walk on this leg. And so what is required is a reconstructive surgery. Now, this also happens in the United States where a, you know, a joint of like the elbow, the knee, the neck can go on to contract because even if you place a skin graft there in the early timeframe, which I hopefully we do in the United States, it can still go on to contract because the forces of the skin skin graft contracting in as it heals. And the forces of skin tightness due to that can actually form this type of contracture, which requires a reconstructive surgery to fix. And not just once sometimes, sometimes it's multiple times because there are the forces of a child growing and and their bones growing, that's also tightening the skin in this area and causing these deformities. And so obviously, a very specialized team needs to address such deformities. And without it, the quality of life for these individuals would be simply devastating.
Adam Bloomberg: Before we wrap up, what's a key insight you hope attorneys litigating burn cases keep in mind?
Jennifer Wall: Sure. I think burn injuries are simply a devastating injury. They alter lives in ways that people, many people just don't understand. So I would say it's crucial for the attorneys to work with experts who grasp the complexities of burn care to ensure that proper and relevant long-term medical and financial planning can be assured. Partnering with a life care planner who is deeply connected to multidisciplinary experts, as well as the burn survivor community, can only help to make more resources available for these individuals and provide a difference in a survivor's recovery journey.
Adam Bloomberg: Jennifer, thank you for your insights today. And thank you, everyone who tuned into this LinkedIn Live. Have a great day, everyone.
Jennifer Wall: Thank you so much.
Adam Bloomberg: Thank you to our guests for speaking with us today. To discover how the IMS team can help give your case an edge, check out IMSlegal.com or shoot us an email at contactusatimslegal.com. IMS has served trusted law firms and corporations worldwide for more than thirty years in over forty-five thousand cases. As a strategic partner for the full case lifecycle, our integrated teams provide specialized advisory support, expert witness services, litigation consulting, visual advocacy, and presentation technology to elevate strategies and protect hard-earned reputations. Learn more at IMSlegal.com.
