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Case Viability Screening — CVA™ Both Sides

Case Viability Screening — Pre-Expert Medical Record Assessment

A physician-authored case screening memo calibrated to how the defense will challenge the medical record — not just whether the treatment was clinically appropriate. Know if the case holds before you commit the expert.

Starting at $350 · 72 hours · 3–5 pages
Founder's Advantage

The screening framework is informed by more than 3,000 payer-side utilization-management reviews. That background helps identify documentation thresholds and foreseeable medical challenges while keeping the conclusion limited to what the supplied record supports. It does not predict a particular opponent’s strategy or replace a retained specialist.

Defense framing — Case Viability Screening

For defense firms, TPAs, and carriers, the same CVA methodology is used in reverse: how strong is the plaintiff's medical case, which documentation gaps concentrate exposure, and which findings are likely to survive defense medical scrutiny. This is the same destination for defense-framed CVA inquiries.

What the CVA answers

Mechanism support: Does the documented injury mechanism align with the claimed pathology at the claimed severity?

Pre-existing conditions: What prior pathology exists, and what is the likely documentation impact on causation?

Treatment gaps & inconsistencies: Where are the documentation vulnerabilities a defense reviewer will exploit?

Expert specialty: What type of expert does this case require — and what documentation must be in place before engagement?

Defense review projection: How is a medical reviewer likely to evaluate this claim under standard utilization criteria?

Best used when

  • Pre-expert decision

    You are deciding whether to retain an expert. The CVA is priced below most expert retainer entry costs.

  • Case intake triage

    High-volume PI firms receiving dozens of cases monthly. Physician screening separates strong records from vulnerable ones.

  • Reserve-setting for TPAs and carriers

    Initial medical exposure assessment before committing reserve — physician-authored analysis of what the record supports and where the plaintiff's case is most exposed.

  • Disputed liability

    Cases where the defense has signaled it will challenge causation aggressively.

  • Complex pre-existing history

    Cases with significant prior spinal degeneration, previous injury, or comorbid conditions.

Starting Fee
$350
Scope-dependent
Turnaround
72 hours
Standard
Output
3–5 pages
Physician-authored memo

Firms may treat the fee as a case cost, subject to their engagement agreement, applicable law, and case outcome. The $350 screen may be credited toward a substantially overlapping larger engagement commissioned within 30 days. Bundle with IME Deconstruction + Defense Medical Lens™ from $1,250 →

Defense & institutional buyers: Invoiced at scope confirmation. Net 15 terms. Retainer arrangements available for recurring volume.

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A pre-expert decision tool

Screen the medical theory before committing major case cost

A useful viability screen does not declare that a case will win or lose. It determines whether the available medical evidence is coherent enough to justify further investigation, identifies what remains missing, and shows which issues are likely to consume expert time.

A compelling client narrative can coexist with a medically weak record, while a poorly organized file can obscure a supportable claim. The screening task is to separate those situations. Medisprudence tests whether the alleged mechanism is compatible with the documented pathology, whether symptoms and function evolve in a clinically intelligible way, and whether treatment choices are supported by the contemporaneous record.

The conclusion is framed as a triage decision: proceed, proceed only after specified documentation is obtained, or do not escalate on the present record. That wording matters. It keeps the screen honest, preserves uncertainty, and gives counsel an action list rather than a vague impression of “merit.”

Review method

The screening sequence

01

Define the proposed theory

The injury, causation, disability, necessity, or standard-of-care question is stated precisely so the review does not drift into issues the records cannot answer.

02

Build the clinical trajectory

Key symptoms, objective findings, treatment, response, function, and prior history are placed in temporal sequence without creating an unnecessarily long chronology.

03

Test coherence

Mechanism, anatomy, timing, severity, treatment intensity, and functional limitation are compared for consistency and plausible alternative explanations.

04

Model foreseeable challenges

Pre-existing disease, delayed care, noncompliance, symptom inconsistency, sparse objective findings, and unsupported future treatment are examined as likely pressure points.

05

Issue a conditional decision

The memo states what the current record supports, what it does not support, and which missing item could materially change the conclusion.

Inputs

What counsel should send

The best screen uses the smallest record set capable of answering the proposed question. Sending every available page without identifying the theory can increase cost without improving the decision.

  • A concise statement of the alleged event and medical theory
  • Core emergency, specialist, therapy, operative, and imaging records
  • Material pre-event records for the same condition or body region
  • Current claimed limitations, treatment plan, and proposed future care
  • Any adverse report, denial rationale, or known defense position already received
Deliverable

What the viability memo answers

The report is organized around decisions, not merely diagnoses. Each concern is linked to the evidence and graded by whether it is curable, contextual, or fundamental.

  • Strength of mechanism-to-pathology and diagnosis-to-function linkage
  • Effect of pre-existing conditions and prior similar complaints
  • Treatment continuity, proportionality, response, and documentation quality
  • Most likely medical challenge and the evidence available to answer it
  • Recommended next record, provider clarification, or expert specialty
Service fit

Where this fits in early case screening

The service is not intended to displace a firm’s intake judgment or a specialist opinion. It fills the gap between initial legal screening and a more expensive expert or full-record engagement.

Internal intake review

Fast and economical for straightforward matters. Complex causation, competing pathology, or functional questions may require a physician layer before the firm commits substantial cost.

LNC merit review

Strong for clinical organization and issue identification. The CVA adds a physician-authored assessment of whether the proposed theory is coherent, what is missing, and which challenge is most likely to matter.

Formal expert review

Necessary where specialty-level opinion or testimony is already required. A CVA is a narrower pre-expert screen used to decide whether that investment is justified and what foundation should be assembled first.

Scope discipline

When this is the right product

Designed to support

  • Before accepting a medically complex matter or advancing a substantial expert retainer.
  • When causation, aggravation, treatment necessity, disability, or future care is uncertain.
  • When the firm needs a repeatable physician screen across intake rather than an open-ended consultation.

Professional and evidentiary limits

  • Not a legal merits opinion, certificate of merit, standard-of-care opinion, or guarantee of outcome.
  • A “proceed” conclusion means the record supports further work; it does not mean every element is established.
  • Raw imaging, vocational capacity, life-care planning, and economic damages require the appropriate specialist where those issues are decisive.
  • The screen is only as complete as the medical theory and record set identified at intake.
Practical questions

Before the engagement begins

What is the difference between a CVA and the Full Intelligence Report?

The CVA is a focused go/no-go or proceed-with-conditions screen. The full report is a deeper integrated analysis used after the matter justifies comprehensive record work.

Can the service be used by defense counsel?

Yes. The same structured review can estimate the medical strength of an asserted claim and identify where exposure is concentrated, subject to conflict screening.

Does a treatment gap automatically make the case weak?

No. The significance depends on the condition, expected follow-up, documented reason, and what occurred before and after the interval.

What happens when the records are incomplete?

The report distinguishes absence of evidence from evidence against the theory and identifies the missing item most likely to change the assessment.

Specimen Deliverable

See a full Case Viability Screening report

Mechanism assessment, pre-existing analysis, treatment gap mapping, and expert guidance. Fictional clinical data.

View Sample → All Samples
Pairs with

Screening tells you whether the case holds; Medical Charge & Necessity Review tells you whether the claimed medical specials are necessary, related, coded correctly, and reasonable in amount.

Screen before you commit the expert budget.

No PHI required to start.

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