The attorney's fee: compensation for the work
The contingency fee is the attorney's own compensation for handling the case — calculated as a percentage of the settlement or award. It's earnings, not a reimbursement, and it's what the attorney keeps for taking on the risk and the work of the case.
Case costs: real expenses the case required
Case costs are something entirely different: actual out-of-pocket expenses the case genuinely needed. This typically includes expert witness fees, court filing fees, the cost of obtaining medical records, deposition transcripts, and similar litigation expenses. These are reimbursed, not earned.
Massachusetts checks both together against your medical bills
G.L. c. 231, § 60I's unpaid-medical-expense floor specifically calculates the plaintiff's remaining amount after deducting both the attorney's reasonable expenses and disbursements and the attorney's fee — not the fee alone. If that combined deduction would leave you with less than your own unpaid medical bills included in the recovery, the fee itself has to be adjusted; the statute doesn't ask case costs to shrink to make room.
Why the order of deduction genuinely matters
Calculating the attorney's fee as a percentage of the full settlement before subtracting case costs produces a different net result than calculating the fee after costs have already been subtracted. On a meaningful settlement with real litigation costs, that difference in methodology can add up to a real dollar amount — worth confirming explicitly in the written fee agreement rather than assuming either approach.
Who fronts the money while the case is pending
Commonly, the attorney's office advances case costs as the litigation proceeds, with reimbursement coming out of the eventual settlement or award. The specific arrangement, including what happens to those advanced costs if the case doesn't result in any recovery, depends entirely on the individual fee agreement.