Damages Integration — Case Review SOP
This process translates validated clinical findings into legally defensible damage categories, linking injury, impact, and cost exposure directly to causation.

Purpose

  • Convert clinical injury into structured damages framework
  • Link causation → injury → functional impact → economic and non-economic damages
  • Establish defensible valuation logic for litigation use
  • Identify gaps, inflation risks, and unsupported claims

What AI Extracts (Facts Only)

  • Documented injuries (diagnoses, complications, adverse outcomes)
  • Treatment course (procedures, interventions, medications)
  • Functional status pre- and post-incident
  • Length of stay, readmissions, and escalation events
  • Therapy utilization (PT, OT, ST, behavioral health)
  • Assistive device requirements
  • Care level changes (independent → assisted → dependent)
  • Billing data and charge records (if available)
  • Documented pain complaints and symptom progression
  • Work status changes (if recorded)
  • Life expectancy indicators (age, comorbidities)

What Clinician Must Confirm (Validation)

  • All injuries are causally linked (not incidental or pre-existing)
  • Baseline function is accurately established and supported
  • Functional decline is clinically real and not documentation bias
  • Care needs are medically necessary and not inflated
  • Future care projections are realistic and evidence-based
  • Pain and suffering claims align with clinical trajectory
  • Comorbidities are properly separated from incident-related harm
  • Recovery trajectory (partial vs permanent impairment) is accurate
  • Any inconsistencies between records, therapy notes, and physician reports
Clinician must reject any damage element that cannot be directly tied to a causation pathway established in prior analysis.

Critical Thinking Steps

  • Map each injury to a confirmed breach in standard of care
  • Trace functional decline step-by-step from baseline to current state
  • Differentiate temporary vs permanent impairment
  • Identify cascading complications (e.g., fall → fracture → immobility → pneumonia)
  • Evaluate proportionality of claimed damages vs clinical reality
  • Assess whether earlier intervention would have reduced damages
  • Determine if damages are single-event or cumulative failure driven
  • Stratify damages into categories:
    • Economic (medical costs, care needs)
    • Non-economic (pain, suffering, loss of function)
    • Future damages (life care needs)

Stop Rules

  • STOP if causation has not been firmly established
  • STOP if baseline function is unclear or undocumented
  • STOP if damages rely on assumptions not supported in records
  • STOP if future care projections lack clinical justification
  • STOP if comorbidities cannot be separated from incident impact
  • STOP if documentation conflicts cannot be resolved
No damages model proceeds forward without validated causation and baseline comparison.

Final Output Requirements

  • Structured damages summary (clear categories)
  • Causation-linked injury list
  • Functional impact narrative (baseline vs post-incident)
  • Economic damages framework (with supporting rationale)
  • Future care considerations (if applicable)
  • Defense vulnerability points (overreach, unsupported claims)
  • Plaintiff leverage points (clear injury progression, permanence)
  • Clean integration into final case report and attorney brief
Output must be litigation-ready, causation-driven, and defensible under expert scrutiny.