Prognosis

What is a prognosis?

A prognosis is a physician's medical opinion regarding the likely future course of a condition, including expected recovery, anticipated limitations, and the likelihood of any further complications going forward.

It differs from a diagnosis, which identifies the specific current condition itself, since prognosis instead looks forward toward what can genuinely be expected to happen over time.

In personal injury litigation, this specific medical opinion becomes genuinely central evidence, since it directly supports claims for future medical expenses, ongoing limitation and permanency itself.

Without a clearly stated prognosis from a qualified treating or retained physician, a claim for future damages generally lacks the necessary medical foundation to actually support it.

What does a prognosis opinion typically address?

A comprehensive prognosis generally covers several distinct but related aspects of anticipated future outcome.

• Whether full recovery is genuinely expected, and if so, over what approximate timeframe
• What specific permanent limitations, if any, are anticipated to remain
• What future treatment, including possible surgeries, is reasonably anticipated
• The likelihood of any future complications or progressive worsening
• Whether the condition has reached, or is expected to reach, maximum medical improvement

Why does this specific opinion carry such significant legal weight?

Because it directly supports the future damages components of a claim, including projected future medical costs and loss of earning capacity, which frequently represent the largest components of overall damages in serious injury cases.

For a claim to satisfy New Jersey's verbal threshold permanency category, a clear physician opinion regarding permanent prognosis, stated to a reasonable degree of medical probability, is generally required.

Speculative or genuinely uncertain future possibilities are treated quite differently under the law from a physician's actual, affirmatively stated prognosis opinion.

How does the defense typically respond to a stated prognosis?

Often by retaining their own expert, through an independent medical examination, who may offer a considerably more optimistic prognosis than the treating physician's own stated opinion.

These competing prognosis opinions frequently become a central, genuinely contested issue for the jury to weigh and resolve at trial.

A treating physician's prognosis, formed through an actual ongoing treatment relationship over time, is frequently found more persuasive than a one time defense examination, though this ultimately remains for the jury to weigh and decide.

Common questions

Is a prognosis the same thing as a diagnosis?

No. A diagnosis identifies the current specific condition. A prognosis instead looks forward, addressing the likely future course of that already identified condition.

Can my prognosis change over the course of my treatment?

Yes, genuinely. As treatment progresses and more information becomes available, a physician's prognosis opinion can reasonably be revised in either direction based on how you are actually responding.

Why does the insurance company's doctor give me a different prognosis than my own doctor?

This is common and reflects the genuinely adversarial nature of the process, though a treating physician's opinion, formed through an actual ongoing relationship, is often found by juries to carry meaningful additional weight over a one time defense evaluation.