Michael Pines | August 28, 2026 | Catastrophic Injuries \ Personal Injury
A catastrophic personal injury can make a home that was once comfortable and familiar suddenly difficult – or even impossible – to navigate safely.
A person who uses a wheelchair may no longer be able to enter through the front door. A bathroom may be too narrow to permit safe transfers. Kitchen counters may be inaccessible. Stairs may prevent someone from reaching a bedroom. Even seemingly minor features, such as raised thresholds or narrow hallways, can become significant barriers after a spinal cord injury, traumatic brain injury, amputation, or other permanent disability.
When another person’s negligence causes a disabling injury, the cost of making a home accessible may become part of a personal injury claim. But estimating those expenses involves much more than adding up the price of a wheelchair ramp and a few grab bars.
In catastrophic injury cases, professionals such as life care planners, occupational therapists, contractors, medical specialists, and economic experts may work together to identify the modifications a person is reasonably expected to need and calculate what those changes will cost over the person’s lifetime.
Quick Insights
- Future home modifications may be included when calculating the long-term economic consequences of a catastrophic injury.
- A life care planner or occupational therapist may evaluate the injured person’s functional limitations and how those limitations affect daily life inside the home.
- Necessary modifications can include ramps, widened doorways, accessible bathrooms, stair lifts, lowered counters, flooring changes, and other accessibility improvements.
- Contractor estimates can help establish the actual cost of completing recommended renovations in the injured person’s home and geographic area.
- A life care plan may account not only for initial construction but also for maintenance or replacement of accessibility equipment expected to wear out over time.
- Economists may evaluate the future cost of these needs and, when appropriate, address inflation and present-value calculations.
- Under California law, future medical expenses must be supported by evidence showing that the care is reasonably necessary and reasonably certain to be needed rather than merely speculative.
Why Home Modifications Can Become Necessary After a Catastrophic Injury
Home accessibility is easy to take for granted until an injury changes how someone moves through their environment.
A person who could previously walk up a flight of stairs, step into a bathtub, reach an overhead cabinet, or carry laundry between floors may lose some or all of those abilities following a disabling injury.
Home modifications are intended to reduce those environmental barriers and allow the injured person to function as safely and independently as reasonably possible. Occupational therapy professionals commonly assess an individual’s functional abilities, needs, interests, and goals when recommending modifications to a home.
Depending on the disability and the existing home, modifications could include:
- Wheelchair ramps or accessible entrances
- Widened doors and hallways
- Roll-in or curbless showers
- Grab bars and transfer supports
- Accessible toilets
- Lowered sinks, counters, or cabinets
- Modified kitchens
- Stair lifts or residential elevators
- First-floor bedroom or bathroom access
- Slip-resistant or wheelchair-compatible flooring
- Removal of raised thresholds
- Improved lighting
- Accessible switches, outlets, and controls
- Changes to exterior walkways or parking areas
In some cases, relatively modest modifications may be sufficient. In others, entire rooms may require substantial renovation. Life care planning professionals emphasize that recommendations should be individualized because two people with the same diagnosis may have very different functional abilities, homes, family support, and long-term needs.
Step 1: Evaluating the Person’s Long-Term Functional Limitations
Before anyone estimates construction costs, there must first be a medical and functional basis for the modifications.
Treating physicians and rehabilitation professionals may evaluate whether a person’s limitations are temporary or permanent and what level of mobility, assistance, or adaptive equipment they are expected to require in the future.
For example, an individual with a spinal cord injury may require permanent wheelchair access. Someone who has undergone an amputation may use a prosthesis but still have periods when wheelchair or walker access is necessary. A person with a traumatic brain injury may have balance, cognitive, or coordination problems that create different safety concerns.
These limitations establish the starting point for determining how the person’s home must function in the future.
A comprehensive life care plan can incorporate medical treatment, rehabilitation, mobility equipment, attendant care, transportation needs, home modifications, and other expected requirements over the injured person’s lifetime.
Step 2: Conducting an In-Home Accessibility Assessment
A home modification calculation should generally be based on the actual environment in which the injured person lives, not simply a generic estimate of what accessible housing costs.
That is where an in-home assessment becomes important.
An occupational therapist, life care planner, accessibility specialist, or other qualified professional may visit the property and evaluate how the injured person’s limitations interact with the home’s layout.
They may examine:
- Entrances and exits
- Steps and elevation changes
- Door widths
- Hallway clearances
- Bedroom accessibility
- Bathroom configuration
- Kitchen layout
- Flooring surfaces
- Stairways
- Garage and parking access
- Outdoor pathways
- Transfer space around beds and toilets
- Access to switches, cabinets, sinks, and appliances
Occupational therapists are particularly useful in this process because their work focuses on the relationship between a person’s functional abilities and the activities they need to perform in their everyday environment. The American Occupational Therapy Association notes that occupational therapy practitioners can provide home modification recommendations based on functional status, individual needs, and personal goals.
The goal is not necessarily to redesign the entire home. It is to identify changes that are reasonably necessary to allow the injured person to perform everyday activities safely and with as much independence as possible.
Step 3: Determining Which Modifications Are Actually Required
Once barriers have been identified, the evaluator can develop a recommended scope of modifications.
Consider someone who now permanently uses a wheelchair.
It might initially appear that installing a ramp solves the accessibility problem. But an in-home assessment could reveal that the person still cannot:
- Fit their wheelchair through the bathroom door
- Turn around inside the bathroom
- Transfer safely into the shower
- Reach the kitchen sink
- Access a second-floor bedroom
- Move over certain flooring surfaces
The necessary project could therefore involve a ramp, widened doorways, bathroom reconstruction, kitchen alterations, flooring changes, and modifications to the sleeping area.
Examples from home-modification programs similarly include ramps, doorway widening, bathroom retrofits, bedroom alterations, and lowered countertops.
The appropriate scope depends on the injured person’s specific condition rather than a standard accessibility checklist.
Step 4: Obtaining Realistic Construction Costs
Identifying a necessary modification is only half of the calculation. The claim must also establish what it will reasonably cost.
That may require estimates from contractors, accessibility remodelers, architects, engineers, or specialized equipment providers.
A detailed estimate may consider:
- Materials
- Labor
- Demolition
- Plumbing
- Electrical work
- Permits
- Architectural or engineering services
- Accessibility equipment
- Local building requirements
- Installation
- Restoration and finishing work
The cost of converting a bathroom in San Diego, for example, cannot necessarily be established by relying on a nationwide internet estimate. Labor and construction costs vary substantially by location, and the existing structure can have a major effect on the complexity of the project.
Formal home-modification programs often use on-site assessments and itemized contractor bids separating labor, materials, and individual renovation tasks. In a personal injury case, similarly detailed estimates can provide stronger evidence than a broad guess about what accessibility renovations might cost.
Step 5: Accounting for Equipment That Will Need to Be Replaced
Some home modifications are essentially one-time structural expenses.
Widening a doorway, for example, may not need to be repeated simply because several years have passed.
Other accessibility features contain mechanical or electronic components that may eventually wear out, require maintenance, or need replacement.
Depending on the person’s needs, these could include:
- Stair lifts
- Platform lifts
- Residential elevators
- Automated doors
- Adjustable cabinetry
- Specialized bathing equipment
- Transfer equipment
- Backup power systems for essential equipment
A life care planner can distinguish between modifications expected to occur once and equipment or components with recurring future costs.
This is an important part of lifetime planning. A 30-year-old who suffers a permanent spinal cord injury may need an accessibility device replaced several times during their expected lifetime. Calculating only its initial purchase price could therefore significantly understate the long-term expense.
Life care planning is specifically intended to identify not only the types of future services and equipment required but also their anticipated frequency and duration.
Step 6: Considering How Needs May Change Over Time
A permanent disability does not necessarily mean a person’s functional needs will remain exactly the same forever.
Age can interact with an existing injury.
A wheelchair user who can independently transfer at age 35, for example, may have greater difficulty doing so decades later. Someone relying heavily on their upper body for mobility may eventually experience different physical limitations.
Life care planning therefore considers the person’s prognosis, age, life expectancy, mobility requirements, anticipated medical care, and likely long-term functional needs. Future care calculations commonly account for a person’s age, injury severity, and expected duration of care.
However, future damages cannot simply be based on every conceivable possibility. Recommendations should have appropriate medical and professional support.
Step 7: Adjusting Future Costs for Inflation
A renovation that costs a certain amount today may cost substantially more decades from now.
That becomes particularly important when accessibility equipment will need to be replaced in the future or when modifications are expected to occur at different stages of the person’s life.
An economic expert may analyze projected future costs and account for relevant inflation or cost-growth assumptions. In life care planning cases, economists can use the projected schedule of care developed by medical and life-care professionals to evaluate how much those future needs are expected to cost.
This separates two different questions:
What will the person need?
That issue is generally addressed by medical professionals, rehabilitation specialists, occupational therapists, and life care planners.
What will those needs cost over time?
Contractors, cost researchers, and economic experts may help answer that question.
Step 8: Calculating Present Cash Value
A lifetime projection might show hundreds of thousands – or in especially complex cases even more – in future medical, accessibility, equipment, and care costs.
But a damages calculation may also involve the concept of present cash value.
California’s civil jury instructions explain that present cash value represents the amount of money that, if reasonably invested today, would provide the injured person with the amount necessary to pay future economic damages as they occur.
This calculation can involve assumptions regarding future investment returns and the timing of projected expenses.
An economist may therefore be involved in translating a lifetime schedule of future expenses into an appropriate present-value calculation when the issue applies in the case.
How Are Future Home Modifications Proven in a California Personal Injury Claim?
California law requires future medical expenses to be supported by evidence.
CACI No. 3903A provides that a plaintiff seeking future medical expenses must establish the reasonable cost of reasonably necessary medical care that the plaintiff is reasonably certain to need in the future.
In a catastrophic injury claim, evidence supporting future accessibility expenses may therefore include:
- Medical records
- Physician opinions
- Occupational therapy evaluations
- Functional capacity assessments
- Photographs and measurements of the home
- Life care plans
- Architectural plans
- Contractor estimates
- Equipment pricing
- Expert testimony
- Economic projections
Future medical expenses in California should address both what care the injured person will probably require and how much money will be necessary to provide that care.
The same principle applies to home modifications.
Simply stating that someone “might need an accessible bathroom someday” is very different from presenting evidence that an occupational therapist evaluated the home, determined that the existing bathroom cannot safely accommodate the person’s wheelchair, identified specific required changes, and obtained professional cost estimates for completing the work.
What If the Injured Person Does Not Own Their Home?
A disabling injury can create additional complications when someone lives in an apartment, rents a house, lives with relatives, or resides in a property that cannot reasonably accommodate the necessary renovations.
In some cases, modifying the existing residence may not be practical.
The analysis may instead need to consider other reasonable solutions depending on the person’s long-term needs and circumstances. Because housing arrangements can vary dramatically, these issues require individualized evaluation rather than assumptions about what every disabled person will require.
A life care planner’s role is to develop a plan tailored to the person’s actual situation, functional limitations, and expected future needs.
Why Insurance Companies May Challenge Home Modification Costs
Future accessibility expenses can become a significant component of a catastrophic injury claim, particularly when the injured person is young and has a permanent disability.
Insurers may dispute:
- Whether a proposed modification is medically necessary
- Whether a less expensive alternative would work
- Whether the renovation goes beyond accessibility needs
- The projected construction cost
- How frequently equipment will require replacement
- The person’s expected future functional limitations
- The inflation assumptions used
- Whether an expense is sufficiently certain to occur
This is one reason detailed professional documentation can be so important.
A life care plan that simply lists “home modifications – $100,000” may be much easier to challenge than a projection supported by a functional assessment, photographs, measurements, contractor estimates, medical opinions, and an explanation of exactly why each modification is required.
Insurers may also retain their own medical or economic experts to challenge the scope and cost of a proposed life care plan.
The Cost of a Disabling Injury Extends Far Beyond Medical Bills
After a catastrophic injury, hospital bills may represent only the beginning of the financial consequences.
An injured person may also require years or decades of:
- Rehabilitation
- Prescription medications
- Mobility equipment
- Prosthetics
- In-home attendant care
- Accessible transportation
- Future surgeries
- Home modifications
- Replacement equipment
Pines Salomon Personal Injury Lawyers notes that catastrophic injuries can dramatically change nearly every aspect of a person’s life and may require experts to accurately evaluate the full extent of future damages.
Failing to account for necessary home modifications before a case is resolved can leave the injured person and their family facing substantial expenses years after the settlement money was intended to address those losses.
Contact Pines Salomon Personal Injury Lawyers After a Catastrophic Injury in San Diego
When an injury causes permanent disability, calculating compensation requires looking far beyond the bills that have already arrived.
The question is not only what the accident has cost today, but what it is reasonably expected to cost throughout the injured person’s future.
At Pines Salomon Personal Injury Lawyers, our San Diego personal injury attorneys investigate the long-term consequences of catastrophic injuries and can work with medical professionals, life care planners, economic experts, and other specialists when necessary to document future damages. The firm has represented injured people in San Diego since 1992 and has recovered more than $100 million in settlements and verdicts.
If you or someone you love suffered a disabling injury because of another person’s negligence, contact Pines Salomon Personal Injury Lawyers today for a free consultation. An experienced San Diego catastrophic injury attorney can evaluate your case and help determine whether future medical care, home modifications, assistive equipment, and other long-term needs should be included in your claim.
We proudly serve San Diego, San Diego County, and its surrounding areas:
Pines Salomon Injury Lawyers – San Diego Office
835 5th Avenue #302, San Diego, CA 92101
(858) 551-2090
Available 24/7
Pines Salomon Injury Lawyers – La Jolla Office
4660 La Jolla Village Dr. San Diego, CA 92122
(858) 585-9031
Available 24/7
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