The MICRA Cap — and Why Elder Abuse Cases Are Different

What Is MICRA?

California’s Medical Injury Compensation Reform Act — better known as MICRA — has limited the compensation available to victims of medical malpractice since 1975. While victims can always recover the full amount of their economic losses, such as medical bills and lost income, MICRA places a cap on non-economic damages: compensation for pain, suffering, disfigurement, and loss of enjoyment of life.

For nearly five decades, that cap was frozen at $250,000 — the same figure in 2022 that it was in 1975, despite everything inflation did in between. That changed when California passed Assembly Bill 35, a landmark reform that took effect in 2023.

How the Cap Works Today

Under AB 35, the MICRA cap is no longer a fixed number. The law created two separate caps — one for medical malpractice cases involving a patient’s death, and a lower one for cases not involving death — and put both on an automatic escalation schedule. The caps now increase every year, stepping upward annually for a decade and adjusting for inflation after that.

Because the figure changes each year, the exact cap that applies to a case depends on when judgment is entered. What has not changed is the basic structure: if your claim is governed by MICRA, the law limits what a jury can award for human losses — no matter how egregious the facts.

Why This Matters in Nursing Home Cases

Here is what most families do not know: when a loved one is harmed in a nursing home or long-term care facility, the facility’s lawyers will almost always try to frame the case as “professional negligence” — a medical malpractice claim — precisely so that MICRA’s limits apply.

It is a strategy, and it works against families who do not have counsel experienced in elder abuse litigation. A claim pleaded as ordinary malpractice is a claim with a ceiling.

The EADACPA Difference: Elder Abuse Claims Are Not Capped

California’s Elder Abuse and Dependent Adult Civil Protection Act (EADACPA) creates a separate cause of action for elder abuse and neglect — and the California Supreme Court has held that claims properly brought under the Act are not subject to MICRA’s limits. In Delaney v. Baker (1999) and Covenant Care v. Superior Court (2004), the Court drew a clear line between professional negligence and the reckless neglect or abuse that EADACPA targets.

To qualify, a plaintiff must prove more than a mistake: the Act requires clear and convincing evidence of recklessness, oppression, fraud, or malice in the commission of abuse or neglect. When that showing is made, the remedies change dramatically:

• Non-economic damages are not capped by MICRA
• The facility can be ordered to pay the family’s attorney’s fees and costs
• A deceased victim’s pre-death pain and suffering remains recoverable — a remedy ordinary wrongful death law does not provide

For a closer look at how damages work in these cases, see our guide to nursing home wrongful death damages in California and our overview of EADACPA — the Elder Abuse and Dependent Adult Civil Protection Act.

How We Build Cases That Escape the Cap

Proving recklessness — not just error — is the entire game. That is why our California nursing home abuse and neglect attorneys focus discovery on the facility’s own records: staffing levels against acuity, budget decisions made at the corporate level, internal complaints that went unaddressed, and state inspection histories. A facility that knew it was understaffed and admitted vulnerable residents anyway is not a facility that made a mistake. It made a choice.

The Elder Justice Firm concentrates its practice on elder abuse and dependent adult abuse litigation throughout California, and our team has recovered more than $200 million in verdicts and settlements over our careers. If someone you love was seriously harmed in a nursing home or care facility, do not let the defense define your case as capped malpractice before you have talked to a lawyer who knows the difference.

Call 855-880-4500 for a free, confidential consultation.

Every case is different, and past results do not guarantee a similar outcome. The damage caps discussed above are set by statute and change over time; the figure applicable to a particular case depends on the law in effect at the relevant time.