Constitutionality of Medical Malpractice Damage Caps

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 What Is a Medical Malpractice Damage Cap?

Medical malpractice damage caps are statutory limits on the amount of money a patient can collect from a medical malpractice lawsuit.

For example: In 2007, former Dallas Cowboys running back Ron Springs went to the hospital to get a tiny arm cyst removed and—due to medical malpractice—ended up in a coma. He passed away in 2011. His wife filed suit for medical malpractice shortly after that. Due to the Texas medical malpractice cap, Ron’s lawyers could only collect $250,000 for pain and suffering. The Texas Legislature enacted this cap after the success of California’s similar cap, called MICRA.

Some argue that these caps aim to protect the profits of medical companies, while others argue that the caps will keep physicians healing without worrying about potentially huge liability.

What Types of Medical Malpractice Damages Are Available?

When a plaintiff has been injured due to medical malpractice, they are entitled to seek several categories of damages for their injuries. They can recover economic damages, such as medical expenses and lost income, as well as noneconomic damages for pain and suffering. Economic damages may be easy to calculate based on documentation such as receipts, invoices, and tax returns, but noneconomic damages can be difficult to quantify.

Jurors are not given much guidance on how to determine pain and suffering. Some jury verdicts are inconsistent and seemingly arbitrary. The unpredictability and disparity in amounts awarded can impact the public’s perception of the jury system. Additionally, healthcare providers face uncertainty about their potential exposure if they are sued. Skyrocketing insurance rates have resulted in insurance industry crises in many states.

The difficulty of objectively determining pain and suffering has led some states to cap the number of non-economic damages a medical malpractice plaintiff can recover. The cap varies from state to state. In many states with caps, exceptions are made for cases involving wrongful death, permanent disability, or multiple defendants. Courts in many states have struck down damage caps as unconstitutional because they deny equal protection of the law to injured individuals or because they infringe on the right to a jury trial.

What is Controversial About Medical Malpractice Damage Caps?

Patients who are severely injured by a doctor’s malpractice are often crippled for life. Opponents of malpractice caps argue that setting limits on damage awards places the burden of the malpractice on the patient, while incompetent doctors are not punished to the full extent of the law.

However, some recent court decisions, such as the one in Georgia, have overruled the caps, holding them to be unconstitutional. The basic reasoning is that most state constitutions guarantee the right to a trial by jury. At least, in theory, the government is supposed to make the law, and the jury is supposed to analyze the facts to see if the law has been broken. Then, based on “how much” the law was broken, the jury is given the freedom to award the amount of money they think is fair.

Finally, medical malpractice caps are often challenged as a violation of the separation of powers. Separation of powers refers to the division between the three branches of government. For instance, in Illinois, the ability to lower damage awards given by a jury is a power held only by the courts. If the legislature limits damage awards, lawmakers will exercise a power normally used by judges.

The judge can always reduce the jury’s verdict because they may have superior legal knowledge. Some states, such as Florida, grant the judge the discretion to ignore the caps when injustice would otherwise occur.

What are the Pros and Cons of Limiting Damages for Medical Malpractice?

There are pros and cons to capping noneconomic damages in medical malpractice cases. First, more predictable outcomes would reduce insurance risks and allow insurance agencies to charge lower malpractice premiums. This would encourage physicians to remain in their state and improve citizens’ access to health care.

Some states have seen a massive influx or exodus of physicians after enacting or disabling damages caps. Second, damage caps decrease the practice of “defensive medicine.” Physicians may be frightened into ordering unnecessary tests and procedures to protect themselves from malpractice claims.

Opponents of damage caps have stated that they prevent some patients from being fully compensated for the harm they have suffered. For example, suppose a young patient will experience a lifetime of pain and suffering due to a doctor’s negligence. In that case, a cap on recovery may deprive the plaintiff of a fair damage award. Some states with caps have addressed this issue by excluding specific severe injuries from the cap.

Have Some States Rejected Damage Caps on Medical Malpractice Claims as Unconstitutional?

The highest courts in Alabama, Florida, Georgia, Illinois, New Hampshire, and Washington have all struck down caps on noneconomic damages in medical malpractice cases as unconstitutional. In striking down the caps, some courts relied on different constitutional provisions. For example, Florida and New Hampshire held that caps on damages violated the Equal Protection Clause. Other states like Alabama, Georgia, and Washington concluded that damage caps infringed on the right to trial by jury. Illinois held that damage caps violated the separation of powers clause.

The Florida Supreme Court, in concluding that damage caps violated the state constitution’s equal protection clause, held that “medical malpractice claimants do not receive the same rights to full compensation because of arbitrarily diminished compensation for legally cognizable claims” and that the cap “does not bear a rational relationship to the stated purpose that the cap is purported to address, the alleged medical malpractice insurance crisis in Florida.”

The Georgia Supreme Court struck down caps on damages because it violated the constitutional right to a jury trial. The determination of damages rests “peculiarly within the province of the jury.” Malpractice plaintiffs in Georgia have the constitutional right to “the award of the full measure of damages, including non-economic damages, as determined by the jury.”

The separation of powers argument prevailed in Illinois. The argument is that the ability to lower damage awards given by a jury is a power only held by the courts. If the legislature were to limit damage awards by imposing a cap, lawmakers would exercise powers reserved only for judges.

Have States Upheld Damage Caps as Constitutional?

Multiple states with damage caps have rejected constitutional challenges like those raised in Florida and Georgia. For example, courts in California, Colorado, Idaho, Maryland, Minnesota, Missouri, and West Virginia have all upheld damage caps on noneconomic damages in medical malpractice cases by concluding that they are rationally related to a legitimate state interest. That state interest primarily refers to a statewide medical malpractice insurance crisis.

Courts in the U.S. and state legislators continue to grapple with the constitutionality of damage caps.

Do You Need an Attorney Experienced with Medical Malpractice?

Suppose you or a loved one has been injured by medical malpractice. In that case, you should use LegalMatch’s services to speak to a personal injury attorney immediately and learn more about the value of your case. What types of recoveries are available to you will depend on the specifics of your case.


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