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Law in Support of Admission of Medical Bills When Plaintiffs Seek to Keep Them from the Jury

March 16, 2022 By Rebecca K. Schisler-Adams

A growing trend in personal injury litigation is for plaintiffs to waive and attempt to exclude all evidence of medical specials and other economic damages and proceed to trial on the issue of pain and suffering only. Plaintiffs often choose this strategy where the economic damages and medical bills are disproportionately low compared to the claimed pain and suffering. In these cases, plaintiffs claim significant pain and suffering despite having relatively minimal bills and costs, and the defense seeks to admit medical records while the plaintiff seeks to exclude them.

Recent cases consider whether medical bills are relevant to the jury’s consideration of damages when only the plaintiff’s pain and suffering is at issue, excluding their physical condition. For example, the Virginia Supreme Court has repeatedly held that the cost of medical care is a relevant and important consideration for the jury, even when the plaintiff does not seek to recover such costs. See Barkley v. Wallace, 595 S.E.2d 271, 274 (Va. 2004). When the plaintiff sought to introduce her medical bills, the Court found that the bills were relevant as they established the probability of the plaintiff’s claim for pain and suffering. Id.; see also Parker v. Elco Elevator Corp., 462 S.E.2d 98 (Va. 1995) (finding that the trial court erred in excluding medical bill evidence where the plaintiff’s sole purpose was to prove pain and suffering).

More recently, in Gladstone v. West Bend Mutual, 166 N.E.3d 362 (Ind. App. 2021), the plaintiff argued that medical bills are never relevant to assess pain and suffering. Because plaintiff didn’t seek recovery for medical expenses, defense argued that the trial court abused its discretion in admitting his medical bills. The Court disagreed and declined to “adopt a bright-line rule that evidence of medical bills is always inadmissible on relevance grounds when their recovery is not sought.” Id. at 368.

Consistent with Gladstone, states including Alaska, Georgia, and Montana have favored admitting medical bills as evidence of pain and suffering. In Luther v. Lander, the Court found that “evidence of the amount of medical bills is relevant to the severity of a plaintiff’s injury.” 373 P.3d 495, 502 (Alaska 2016). The Luther court cited Georgia’s Warren v. Ballard, which found  medical bills admissible as evidence of pain and suffering showing the severity of the injury, even when the expenses should not have been awarded as damages. 266 Ga. 408, 501 (1996). Similarly, the Luther court cited Meek v. Mont. Eighth Jud. Dist. Ct., 379 Mont. 150 (2015), which had previously found that “medical bills received by a tort victim can be relevant evidence of issues such as the nature and severity of the injuries.”

Defendants should be aware of cases frequently cited by plaintiffs seeking the exclusion of their medical bills. One such case is Payne v. Wyeth Pharms., Inc., 2008 U.S. Dist. LEXIS 91849 (E.D. Va. 2008). The Payne case can be distinguished from many others as it considered medical bills discharged in bankruptcy, and therefore not admissible to prove special damages. The central issue in Payne was whether Virginia’s collateral source rule should prevent the admission of medical records, given that the collateral source rule does not apply in Virginia bankruptcy cases. The Court confirmed that the bills were not admissible because the collateral source rule did not apply to medical bills that had been discharged in bankruptcy.

While Maryland does not have controlling precedent on this issue, in Brice v. Nat’l R. Passenger Corp. the U.S. District Court for the District of Maryland held that the amount of medical expenses incurred is relevant to “the determination of the full extent and nature of the plaintiff’s injuries.”  664 F. Supp. 220, 224 (D. Md. 1987).  Plaintiffs may also cite Wright v. Hixon to support a claim that medical bills do not corroborate pain and suffering. 42 Md. App. 448 (1978). Wright, however, does not address whether the defendant may submit evidence of the cost of medical treatment as evidence of the injury sustained.

These cases show a trend developing in lower courts, but legal precedent has not yet been developed in most states. Defendants seeking to introduce a plaintiff’s minimal medical bills to show a disproportionate claim for pain and suffering should prepare to argue that it is irrelevant which party moves to introduce medical bills. Defendants should remind courts that medical bills, even if not sought by the plaintiff as damages, are relevant to determine the extent of a plaintiff’s injuries.

For more legal authority on this topic, see:

  • Carlson v. Bubash, 639 A.2d 458 (Pa. Super. Ct. 1994)
  • Chapman v. Mazda Motor of Am., 7 F. Supp. 2d 1123 (D. Mont. 1998)
  • Melaver v. Garis, 110 Ga. App. 267 (1964)

This article was co-authored by Law Clerk, Jennifer Nigro