WPI 30.07.01 Measure of Economic Damages—Elements of Past Damages—Medical Expenses

Insert this phrase as an element of past economic damages section in the damage instruction (WPI 30.01.01, WPI 30.02.01, or WPI 30.03.01) if the evidence justifies its use.

The reference to “medical care, treatment, and services” may be replaced by specific references to particular types of treatment or services. For example: “doctor's care”; “hospital care”; “nursing care”; “treatment and services”; etc.

If the plaintiff presents sufficient evidence establishing the reasonable value and necessity of plaintiff's past medical care, treatment, and services, and the defendant elicits no controverting evidence, then the uncontroverted reasonable value of that medical care, treatment and services should be listed as an undisputed line item on the damages instruction to be given (WPI 30.01.01, WPI 30.02.01, or WPI 30.03.01).

RCW 4.56.250(1)(a).

The statute defines economic damages in part as “objectively verifiable monetary losses, including medical expenses.”

Medical expenses must be both reasonable and necessary to be recovered as damages. See Palmer v. Jensen, 132 Wn.2d 193, 199, 937 P.2d 597 (1997). Medical expenses are not reasonable and necessary if they are attributable to an event other than the defendant's negligent act or if they are due to exaggerated injuries. Kadmiri v. Claassen, 103 Wn.App. 146, 151, 10 P.3d 1076 (2000); Hawkins v. Marshall, 92 Wn.App. 38, 45–46, 962 P.2d 834 (1998); cf. Lindquist v. Dengel, 92 Wn.2d 257, 262–63, 595 P.2d 934 (1979) (a defendant who injures another may be liable not only for the defendant's own negligence, but also for a doctor's subsequent negligence in treating the injuries).

The burden of proving the reasonableness and necessity of medical expenses rests with the plaintiff. See Patterson v. Horton, 84 Wn.App. 531, 543, 929 P.2d 1125 (1997). To prove the reasonableness and necessity of past medical expenses, the plaintiff may not rely solely on his or her own testimony as to amounts incurred. See Nelson v. Fairfield, 40 Wn.2d 496, 501, 244 P.2d 244 (1952); Torgeson v. Hanford, 79 Wash. 56, 59, 139 P. 648 (1914). Nor can the plaintiff rely solely on medical records and bills. Patterson, 84 Wn.App. at 543; Carr v. Martin, 35 Wn.2d 753, 762, 215 P.2d 411 (1950). “[M]edical records and bills are relevant to prove past medical expenses only if supported by additional evidence that the treatment and the bills were both necessary and reasonable.” Patterson, 84 Wn.App. at 543.

As the court in Hayes v. Wieber Enterprises, Inc., 105 Wn.App. 611, 616, 20 P.3d 496 (2001), stated (referencing former WPI 30.07, which used the same language as WPI 30.07.01): “And the amount actually billed or paid is not itself determinative. The question is whether the sums requested for medical services are reasonable.”

Generally, expert testimony will be necessary to establish the reasonableness and necessity of medical expenses. See Hills v. King, 66 Wn.2d 738, 741, 404 P.2d 997 (1965) (noting that the “medical testimony” was uncontroverted that plaintiff's medical expenses were reasonable and necessary, resulting from the accident); Lakes v. Vondermehden, 117 Wn.App. 212, 219, 70 P.3d 154 (2003) (suggesting that in the absence of an admission by defendant that certain medical expenses were reasonable and necessary, expert testimony would be needed).

When the plaintiff presents sufficient evidence establishing the reasonableness and necessity of his or her medical treatment and expenses, and the defendant elicits no controverting evidence, the reasonableness and necessity of plaintiff's medical expenses are not a matter of legitimate dispute. Palmer, 132 Wn.2d at 199–200; Ide v. Stoltenow, 47 Wn.2d 847, 851, 289 P.2d 1007 (1955).