Individuals are often exposed to toxic substances and may require a significant period of diagnostic testing to determine the presence of environmentally-induced disease. The cause of toxic exposure may be due to tortious behavior in the form of environmental contamination, pharmacological error, or other actions in which pathogens are released upon the public. Some jurisdictions provide for a special category of economic damages intended to fund medical testing to detect the suspect chemicals and the pathology caused by these toxins. The first medical monitoring damages model was introduced by Barrett and Brookshire (2001). This decision tree model calculates the present value necessary to fund a medical monitoring protocol (see Figure 1). Since the development of this model, opportunities for forensic application have occurred. These applications have uncovered issues related to the calculation of damages which were not discussed in the early research. The purpose of this paper is to discuss these issues as they relate to refinements in damages calculations and the presentation of these findings to triers of fact.