Verdica
The Proof Engine

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Step through Verdica analyzing two real-shaped cases: one clean, one a messy pile of scanned faxes. Every finding points back to the page it came from.

Source document · page 1 of 5
Typed emergency department record on Riverbend Regional Medical Center letterhead: a triage vitals block, a chief complaint line describing neck and low back pain after a rear-end collision on I-40 eastbound, a clinical impression section listing cervical strain S16.1XXA and lumbar strain S39.012A, and a discharge section with cyclobenzaprine and ibuprofen prescriptions plus an off-work note through September 15.
What Verdica foundStep 1 / 12
ExtractionLocate date of loss and mechanism

Date of loss 2025-09-12. Mechanism: rear-end collision on I-40 eastbound at approximately 35 mph. Restrained driver, no loss of consciousness, airbags did not deploy.

CC: Neck pain and low back pain s/p rear-end MVC today on I-40 EB. Pt was restrained driver, struck from behind at approx 35 mph. No LOC. Airbags did not deploy.

About this data: every document in this demonstration is fully synthetic, created from scratch for the replay. The patients, providers, records, handwriting, and fax artifacts are all invented. No real patient data was used at any stage, and no records were de-identified or adapted from real cases.

Read the full analysis

The same breakdown as the replay above, in plain text.

Rear-End Auto Accident

Clean typed recordsRear-End Auto AccidentFive clean typed records, one objective MRI finding, and one treatment gap the engine does not hide.

Source documents

  • Page 1: Typed emergency department record on Riverbend Regional Medical Center letterhead: a triage vitals block, a chief complaint line describing neck and low back pain after a rear-end collision on I-40 eastbound, a clinical impression section listing cervical strain S16.1XXA and lumbar strain S39.012A, and a discharge section with cyclobenzaprine and ibuprofen prescriptions plus an off-work note through September 15.
  • Page 2: Typed new-patient orthopedic consultation on Lakewood Orthopedic Group letterhead signed by Elaine Marchetti, MD: a history of present illness paragraph referencing the September 12 collision, a physical exam section noting cervical paraspinal tenderness left greater than right and restricted range of motion in degrees, and a plan section ordering physical therapy twice weekly for six weeks with a 20 pound lifting restriction and MRI if symptoms persist.
  • Page 3: Radiology report on Summit Diagnostic Imaging letterhead for a cervical spine MRI without contrast, CPT 72141, dated November 6, 2025: exam and technique paragraphs, level-by-level findings including a 3 mm posterior central disc protrusion at C5-C6 mildly effacing the ventral thecal sac with mild disc desiccation, and a numbered impression noting straightening of the cervical lordosis.
  • Page 4: Physical therapy discharge summary on Meridian Physical Therapy Associates letterhead signed by Sarah Lindqvist, DPT: total visit count of 18, Neck Disability Index scores improving from 34 percent to 8 percent, a treatment note documenting the patient's out-of-state holiday travel from December 19 to January 4, and discharge to an independent home exercise program with residual intermittent stiffness.
  • Page 5: Itemized billing ledger compiled across four providers: line items with dates, CPT codes, and charges for the level 4 emergency visit, cervical and lumbar X-rays, ED physician fee, four orthopedic visits, one cervical MRI, and 18 physical therapy visits at 165 dollars each, ending in a bolded line reading TOTAL MEDICAL SPECIALS $9,471.00.

Analysis, step by step

  1. 1. Locate date of loss and mechanism

    Date of loss 2025-09-12. Mechanism: rear-end collision on I-40 eastbound at approximately 35 mph. Restrained driver, no loss of consciousness, airbags did not deploy.

    Cited from page 1: “CC: Neck pain and low back pain s/p rear-end MVC today on I-40 EB. Pt was restrained driver, struck from behind at approx 35 mph. No LOC. Airbags did not deploy.”

  2. 2. Extract emergency department diagnoses

    Two ICD-10 coded diagnoses at the ED visit: cervical strain (S16.1XXA) and lumbar strain (S39.012A). Cervical and lumbar X-rays read as no acute fracture.

    Cited from page 1: “Clinical Impression: 1. Strain of muscle, fascia and tendon at neck level, initial encounter (S16.1XXA). 2. Strain of muscle, fascia and tendon of lower back, initial encounter (S39.012A). XR C-spine and L-spine: no acute fracture or malalignment.”

  3. 3. Capture discharge medications and work status

    Discharge prescriptions: cyclobenzaprine 5 mg PO TID for 7 days and ibuprofen 600 mg PO q6h as needed. Work note: off work 09/12 through 09/15, return 09/16. This is the only lost-time documentation in the file.

    Cited from page 1: “Rx: Cyclobenzaprine 5 mg PO TID x 7 days. Ibuprofen 600 mg PO q6h PRN pain. Work status: off work 09/12/2025 through 09/15/2025, may return 09/16/2025. F/u with orthopedics within 1 week if not improving.”

  4. 4. Extract orthopedic exam findings

    Initial orthopedic consult 2025-09-19 with Elaine Marchetti, MD, Lakewood Orthopedic Group. Objective exam: cervical paraspinal tenderness left greater than right, cervical flexion 40 degrees and extension 30 degrees with pain, Spurling's negative bilaterally, lumbar flexion limited to 60 degrees.

    Cited from page 2: “Exam: Cervical paraspinal tenderness L > R. Cervical flexion 40 deg, extension 30 deg with pain at end range. Spurling's negative bilaterally. Lumbar flexion limited to 60 deg with paraspinal guarding. Strength 5/5 all extremities, DTRs 2+ and symmetric.”

  5. 5. Capture the treatment plan and restrictions

    Plan from the 09/19 consult: physical therapy 2x weekly for 6 weeks, no lifting over 20 pounds for 4 weeks, re-evaluate in 6 weeks, cervical MRI if axial or radicular symptoms persist at re-evaluation.

    Cited from page 2: “Plan: PT 2x weekly x 6 weeks. No lifting > 20 lb x 4 weeks. Home ice/heat, continue NSAIDs. Re-evaluate in 6 weeks; will order cervical MRI if axial or radicular symptoms persist.”

  6. 6. Extract the objective MRI finding

    Cervical MRI without contrast (CPT 72141) on 2025-11-06 at Summit Diagnostic Imaging: 3 mm posterior central disc protrusion at C5-C6 mildly effacing the ventral thecal sac, no cord compression. The report also notes mild disc desiccation at the same level, which the defense can argue is degenerative.

    Cited from page 3: “C5-C6: 3 mm posterior central disc protrusion mildly effacing the ventral thecal sac. No spinal cord compression or foraminal stenosis. Mild disc desiccation at this level. Straightening of the normal cervical lordosis, which may reflect muscle spasm.”

  7. 7. Extract physical therapy outcome measures

    PT discharge 2026-02-04 after 18 visits at Meridian Physical Therapy Associates. Neck Disability Index improved from 34% to 8%. Residual complaint at discharge: intermittent cervical stiffness with prolonged desk work. Discharged independent with home exercise program.

    Cited from page 4: “Discharged after 18 visits. NDI improved from 34% (initial eval 09/24/2025) to 8% at discharge. Pt reports intermittent cervical stiffness with prolonged desk work. Independent with HEP; no further skilled PT indicated.”

  8. 8. Reconcile the billing ledger

    Charges reconcile across all four providers: Riverbend ED $3,486 (99284 $1,912 + XR 72040 $438 + XR 72100 $486 + physician fee $650), Lakewood Orthopedic $1,140 (99204 $420 + 3 x 99213 at $240), Summit MRI 72141 $1,875, Meridian PT $2,970 (18 visits x $165). Total medical specials $9,471.00, and the line items sum to the stated total.

    Cited from page 5: “TOTAL MEDICAL SPECIALS: $9,471.00”

  9. 9. Assemble the treatment timeline

    11 events over 22 weeks, from the collision on 2025-09-12 to the final orthopedic release on 2026-02-11. Every event is sourced from a page in the file.

    • 2025-09-12 · Rear-end collision on I-40 eastbound, date of loss (Incident)
    • 2025-09-12 · Emergency department evaluation, cervical and lumbar X-rays, work note through 09/15 (Riverbend Regional Medical Center)
    • 2025-09-19 · Initial orthopedic consultation, PT ordered, 20 lb lifting restriction (Lakewood Orthopedic Group)
    • 2025-09-24 · Physical therapy initial evaluation, NDI 34% (Meridian Physical Therapy Associates)
    • 2025-10-31 · Orthopedic re-evaluation, persistent axial neck pain, cervical MRI ordered (Lakewood Orthopedic Group)
    • 2025-11-06 · Cervical spine MRI without contrast, C5-C6 disc protrusion (Summit Diagnostic Imaging)
    • 2025-11-13 · Orthopedic follow-up, MRI reviewed, continue conservative care (Lakewood Orthopedic Group)
    • 2025-12-18 · PT visit 13, last visit before holiday travel (Meridian Physical Therapy Associates)
    • 2026-01-06 · PT resumed after 19-day break, symptom plateau reported (Meridian Physical Therapy Associates)
    • 2026-02-04 · PT discharge at visit 18, NDI 8%, independent home program (Meridian Physical Therapy Associates)
    • 2026-02-11 · Final orthopedic visit, released at maximum medical improvement (Lakewood Orthopedic Group)

  10. 10. Flag the December treatment gap

    One gap in care: 19 days between PT visits, 2025-12-18 to 2026-01-06. The PT record attributes it to documented out-of-state holiday travel. Flagged because adjusters read unexplained gaps as recovery or noncompliance; this one is explained in the record itself.

    Cited from page 4: “Pt resumed 01/06/2026 after holiday travel out of state 12/19 through 01/04. Reports symptom plateau during break; no new injury or exacerbating event.”

    • 19-day gap (2025-12-18 to 2026-01-06): Defense will read a December gap as resolution of symptoms. The PT note documents holiday travel and a symptom plateau with no new injury, so the demand should cite that note preemptively rather than leave the gap unexplained.

  11. 11. Estimate the settlement range

    Estimated range $24,000 to $42,000 against $9,471.00 in medical specials. The objective C5-C6 protrusion supports the upper half of the range; the full conservative-care recovery to NDI 8%, the desiccation note, and the December break cap it. Assumptions listed verbatim below.

    Estimated range: $24,000 to $42,000

    Assumptions:

    • Assumes undisputed rear-end liability; no comparative negligence is indicated anywhere in the file.
    • The MRI notes mild disc desiccation at C5-C6, so the defense may argue the protrusion is degenerative rather than traumatic; this range does not assume that argument is won.
    • Assumes the 19-day December treatment break is accepted as explained by the documented holiday travel and is not treated as a failure to mitigate.
    • No surgical recommendation and no injections appear in the file; the range reflects conservative-care outcomes only.
    • The only off-work documentation is the ER note covering 09/12 through 09/15, which spans a weekend (two business days at most); no wage records were located, so wage loss is not priced into the range.

  12. 12. Draft the demand sections

    Three sections drafted from the extracted record, with every factual claim traceable to a cited page. Excerpts below.

    Liability

    On September 12, 2025, Mr. Ashwell was driving eastbound on Interstate 40 when your insured struck his vehicle from behind at approximately 35 miles per hour. The mechanism documented at Riverbend Regional Medical Center on the date of loss is consistent across every subsequent treating record, and nothing in the file suggests comparative fault.

    Injuries and Treatment

    Mr. Ashwell was diagnosed in the emergency department with cervical strain (S16.1XXA) and lumbar strain (S39.012A). When axial neck pain persisted through six weeks of orthopedic-directed physical therapy, cervical MRI on November 6, 2025 demonstrated a 3 mm posterior central disc protrusion at C5-C6 effacing the ventral thecal sac: an objective structural finding, not a soft-tissue complaint. He completed 18 documented therapy visits before discharge on February 4, 2026.

    Damages

    Medical specials total $9,471.00 across four providers, itemized in the enclosed ledger. Mr. Ashwell was placed off work from September 12 through September 15 per the emergency department work-status note. At physical therapy discharge his Neck Disability Index had improved from 34 percent to 8 percent, but he continues to report intermittent cervical stiffness with prolonged desk work, a residual his treating therapist recorded rather than one asserted for this demand.

This replay depicts a fully synthetic case created from scratch for demonstration. The patient, providers, records, and every detail on every page are invented. No real patient data was used at any stage, and no records were de-identified or adapted from real cases. Nothing here is legal advice or a promise of case value.

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The Scanned Mess

Messy scanned recordsThe Scanned MessFaxed, handwritten, rotated, and photocopied: the record quality every firm dreads, read anyway.

Source documents

  • Page 1: Faxed urgent care encounter note from Cresthaven Urgent Care dated 09/12/2025. A fax transmission banner reading RX'D 03/02/2026 14:22 FROM 555-0117 PG 02/06 runs across the top edge and partially obscures the clinic letterhead. Below it: a chief complaint paragraph describing a slip on standing water on a loading dock during a delivery, an exam findings section, an assessment block listing lumbar strain S39.012A and right wrist sprain S63.501A, a plan with naproxen 500mg BID, cyclobenzaprine 5mg TID, and an order for a three-view lumbar X-ray, a work status line reading no lifting over 15 lbs and no repetitive bending for 14 days partially crossed by a vertical toner streak, and a small footer line reading DOS: 09/12/2025 18:47 PT: PRENTISS, YOLANDA ACCT 44-70213.
  • Page 2: Single page of handwritten chiropractic SOAP notes on a lined progress-note form from Alden Chiropractic and Rehab, covering two visits dated 9/22/25 and 9/25/25 in cramped cursive ballpoint. Legible fragments include LBP 6/10 worse c sitting, Palp tender L4-5 paraspinals, CMT L/S ther ex, and in the 9/25 plan a medication line reading methocarbamol 750mg TID where the dose digits are cramped enough that the line could plausibly read 500mg instead. Ink pressure varies and one line is struck through and rewritten.
  • Page 3: Patient billing ledger from Alden Chiropractic and Rehab scanned about 4 degrees off square with a dark scanner-lid shadow down the right edge. Thirty-six charge lines across sixteen encounter dates run from 09/18/2025 to 01/16/2026, listing CPT codes 99203, 98940, 97140, 97110, and 99213 with per-line charges of 185.00, 65.00, 55.00, 50.00, and 95.00. A visible date jump sits between the 10/24/2025 row and the 12/08/2025 row. The bottom line reads BALANCE DUE: $2,270.00.
  • Page 4: Low-quality photocopy of a lumbar spine X-ray report from Clearview Diagnostic Imaging listing an exam date of 09/12/2025 and a report date of 09/13/2025, with heavy toner banding, a faded and partially missing letterhead, a technique line describing a three-view lumbar series, a findings paragraph, and an IMPRESSION section reading: No acute osseous abnormality. Mild disc space narrowing at L4-L5, likely degenerative. The electronically-signed radiologist line at the bottom is half cut off by the copy edge.
  • Page 5: Typed re-examination note from Alden Chiropractic and Rehab dated 12/08/2025. The subjective section states the patient returns after self-discontinuing care in late October and reports pain increased to 5/10 after return to full delivery duties. Objective findings note recurrent L4-5 paraspinal tenderness with reduced lumbar flexion, and the plan section prescribes resumed care at 8 visits over 6 weeks with a 99213 re-examination charge noted. Clean laser print, the only undamaged page in the set.

Analysis, step by step

  1. 1. Recover the date of service from a faxed page

    The fax banner (RX'D 03/02/2026 14:22 FROM 555-0117) overprints the clinic header, so the letterhead date block is unreadable. Date of service recovered from the encounter footer instead: 09/12/2025, 18:47, Cresthaven Urgent Care.

    Cited from page 1: “DOS: 09/12/2025 18:47 PT: PRENTISS, YOLANDA ACCT 44-70213”

  2. 2. Pin down the mechanism of injury

    Chief complaint parsed despite compression artifacts along the fax fold line: patient slipped on standing water on a loading dock while making a delivery, landed on her right side, and braced with the right wrist. Onset same day as the visit.

    Cited from page 1: “Pt states she slipped on standing water on the loading dock while making a delivery, landing on her R side and bracing with her R wrist.”

  3. 3. Extract diagnoses and medications

    Assessment block recovered cleanly below the fold artifact: lumbar strain, ICD-10 S39.012A, and right wrist sprain, ICD-10 S63.501A. Plan: naproxen 500 mg BID with food, cyclobenzaprine 5 mg TID as needed for spasm.

    Cited from page 1: “A: 1. Lumbar strain S39.012A 2. Sprain R wrist S63.501A P: Naproxen 500mg BID c food, cyclobenzaprine 5mg TID prn spasm”

  4. 4. Capture the work restrictions

    The work status line sits under a vertical toner streak but reads through: no lifting over 15 pounds and no repetitive bending for 14 days, recheck as needed. Restriction window runs 09/12/2025 through 09/26/2025.

    Cited from page 1: “Work status: no lifting > 15 lbs, no repetitive bending x 14 days. Recheck prn.”

  5. 5. Read the handwritten SOAP note

    Handwritten 9/22/25 entry read as: LBP 6/10, worse with sitting. Palpation tender over the L4-5 paraspinals. Treatment: CMT lumbar/sacral plus therapeutic exercise. Chart shorthand ('c' for with, ther ex) expanded per standard conventions.

    Cited from page 2: “LBP 6/10 worse c sitting. Palp tender L4-5 paraspinals. CMT L/S, ther ex.”

  6. 6. Flag an ambiguous dosage instead of guessing

    Medication line in the 9/25/25 entry read as methocarbamol, dosage read as 750 mg at low confidence: the cramped digits could plausibly read 500, and methocarbamol ships in both 500 mg and 750 mg tablets. Flagged for review against the pharmacy record rather than guessed.

    Cited from page 2: “methocarbamol 750mg TID”

  7. 7. Deskew and total the billing ledger

    Ledger arrived rotated roughly 4 degrees with a scanner-lid shadow down the right margin. After deskew, all 36 charge lines across 16 encounter dates recovered, 09/18/2025 through 01/16/2026: 99203 x1 at $185, 98940 x16 at $65, 97140 x10 at $55, 97110 x8 at $50, 99213 x1 at $95. Computed total $2,270.00 matches the printed balance exactly.

    Cited from page 3: “BALANCE DUE: $2,270.00”

  8. 8. Pull the impression from a bad photocopy

    The photocopy drops most of the letterhead and bands the findings paragraph, but the impression is intact: no acute osseous abnormality; mild disc space narrowing at L4-L5, likely degenerative. That last clause matters: expect the defense to lean on it.

    Cited from page 4: “IMPRESSION: No acute osseous abnormality. Mild disc space narrowing at L4-L5, likely degenerative.”

  9. 9. Read the re-examination note

    Re-examination note, 12/08/2025, the one clean page in the set: patient self-discontinued care in late October, attempted full delivery duties, and returned with pain at 5/10. Plan: resume care, 8 visits over 6 weeks, 99213 re-exam billed.

    Cited from page 5: “Pt returns after self-discontinuing care in late October; reports pain increased to 5/10 after return to full delivery duties.”

  10. 10. Assemble the treatment timeline

    Eight events assembled across four documents, three of them degraded. The incident site and the report to the store manager come from the matter intake, not the medical record; the restriction end date is computed from the 14 day order; every other entry is read directly off the pages.

    • 2025-09-12 · Slip on wet loading dock during a delivery; reported to store manager per client intake (Hollis Market & Deli (incident site, per intake))
    • 2025-09-12 · Urgent care evaluation; lumbar X-ray taken; restrictions issued (Cresthaven Urgent Care)
    • 2025-09-13 · Lumbar X-ray read finalized (Clearview Diagnostic Imaging)
    • 2025-09-18 · Chiropractic initial examination (99203) (Alden Chiropractic & Rehab)
    • 2025-09-26 · Work restriction window ends per the 14 day order (Cresthaven Urgent Care)
    • 2025-10-24 · Visit 11; last visit before an unexplained break in care (Alden Chiropractic & Rehab)
    • 2025-12-08 · Re-examination (99213); care resumes after 45 days (Alden Chiropractic & Rehab)
    • 2026-01-16 · Final chiropractic visit; the ledger shows no charges after this date (Alden Chiropractic & Rehab)

  11. 11. Flag the 45 day treatment gap

    45 days with no treatment of any kind, 10/24/2025 to 12/08/2025. No referral out, no discharge, no reason documented at the time; the patient simply stopped coming. Flagged bluntly because the adjuster will find it in minutes.

    Cited from page 3: “10/24/2025 98940 CMT 1-2 REGIONS 65.00 12/08/2025 99213 RE-EXAM EST PT 95.00”

    • 45-day gap (2025-10-24 to 2025-12-08): An unexplained 45 day break reads as recovery. The 12/08 re-exam ties the flare to a return to full delivery duties, which explains the return but not the silence. Expect the carrier to discount everything after 10/24 unless the demand addresses this head on.

  12. 12. Estimate the settlement range

    Specials: $342 urgent care evaluation (99204) and $260 in imaging ($196 technical for the three-view lumbar series, 72100, plus a $64 professional read), both taken from the billing pages of the six-page urgent care fax, and the $2,270 chiropractic ledger shown here. Total $2,872. Soft tissue diagnoses, a 45 day gap, and a degenerative finding on imaging keep the range wide and the top end modest.

    Estimated range: $8,000 to $16,000

    Assumptions:

    • Assumes the mild L4-L5 degenerative narrowing on the 09/12/2025 X-ray predates the fall and was asymptomatic; expect the defense to attribute part of the low back complaint to it.
    • The 45 day treatment gap caps the high end; this range prices the gap argument as partially succeeding.
    • Source records are fax and photocopy quality and one dosage was extracted at low confidence; the range should be re-run once certified records arrive.
    • Assumes no wage loss claim: restrictions were documented but no employer wage records were provided.
    • Assumes care ends at the final 01/16/2026 ledger entry with no injections and no surgical referral.

  13. 13. Draft the demand sections

    Three sections drafted. Every medical fact is tied to a cited page or the billing set; the incident location and the report to the store manager come from client intake and are flagged for corroboration before the demand goes out. The gap is addressed directly instead of hidden.

    Liability

    On September 12, 2025, Ms. Prentiss was completing a scheduled delivery at Hollis Market & Deli when she slipped on standing water that had been allowed to accumulate on the loading dock. The urgent care record created that same evening documents the mechanism as she reported it: she slipped on standing water, landed on her right side, and braced the fall with her right wrist. The dock condition was reported to the store manager on the date of loss.

    Injuries and Treatment

    Ms. Prentiss was diagnosed the day of the fall with a lumbar strain (S39.012A) and a right wrist sprain (S63.501A). Same-day X-ray imaging confirmed no fracture. She completed sixteen chiropractic visits between September 18, 2025 and January 16, 2026. Her care was interrupted when she attempted a return to full delivery duties; her treating chiropractor documented on December 8, 2025 that the attempt raised her pain to 5/10 and required a renewed course of care that concluded January 16, 2026.

    Damages

    Medical specials total $2,872.00: $602.00 in urgent care and imaging charges and $2,270.00 in chiropractic care, itemized in the attached billing records. Ms. Prentiss worked under a 15 pound lifting restriction for the first two weeks after the fall, and her premature return to unrestricted duty measurably worsened her condition, as her treating records reflect.

This is a fully synthetic demonstration case created from scratch. The patient, providers, and every document, including the handwriting and fax artifacts, are invented. No real patient data was used at any stage, and no records were de-identified or adapted from real cases. Nothing here is legal advice or a promise of case value.

Run Verdica on one of your own cases →