Spinal Injections and Surgeries Are on the Rise–How Can the Defense Push Back?
Every defense attorney or claims manager has seen the pattern: a seemingly minor auto case suddenly involves back injections, maybe even spinal cord stimulator discussions, allegations of the probable or possible need for surgery and—of course—the same doctors on liens, paired with a demand letter that doesn’t leave much room for compromise. It’s a well-worn path, and a profitable one for plaintiff attorneys who know how to turn a seemingly simple soft tissue case into a much higher value exposure.
A plaintiff lawyer recently asked publicly whether we can all agree to stop treating every auto case like a spine surgery candidate. Paul, our Chief Claims Officer, responded—let’s say—honestly. Because here’s the thing: what exactly is the incentive for a plaintiff lawyer to back off a strategy that’s proven lucrative? If the combination of a cooperative surgeon and a sympathetic jury keeps working, they have no reason to change.
That’s why we can’t just hope this trend reverses itself. Defense teams need to step up—strategically, not just tactically. And that starts with predictive analytics. When you know where these injury severity escalation tactics are most likely to occur, which venues are especially plaintiff-friendly, which doctors appear repeatedly in lien-heavy cases, and which attorneys tend to steer their clients toward early injections or surgeries—you stop reacting and start controlling the narrative.
This data isn’t hidden. It’s just underused. With the right tools, you can identify patterns that show up long before the first IME request goes out. You can make informed reserve decisions early. You can flag cases that may benefit from aggressive early resolution before they morph into high-dollar surgical demands. And most importantly, you can position yourself to refute those demands with facts, not just gut instinct.
Quaker Analytics offers two solutions to help you get ahead of this problem. First, our predictive analytics tools flag potential high-exposure claims early—so you’re not caught flat-footed when injections start showing up in the records. You’ll have the right reserve in place, designate the right claims for early resolution, and deploy strategies designed to interrupt what often feels like an inevitable severity escalation. Carriers and self-insureds using this tool consistently report tighter reserving, faster BI claim closure, better reserve-to-paid variance, and a noticeable reduction in loss adjustment expense—especially in litigation-heavy files.
Second, Quaker Focus™ gives you a way to pressure test your key evidence. It's not just about validating a theory—it’s about seeing how actual jurors in your case venue react when the plaintiff’s narrative meets your medical and liability defenses. You can simulate how the case might evolve, including what changes if you challenge the injury story with a timely, credible IME. One particularly effective tactic we’re seeing is the demand for a pre-surgical IME before any invasive procedures are performed. This isn’t about skepticism—it’s about preserving a clean record of injury status before things get murky. In high-exposure injury cases, some defense teams are using a seldom-invoked strategy: demanding a pre-surgical IME and warning that proceeding with surgery without it may lead to a spoliation motion. While plaintiffs’ counsel often object—citing lack of precedent—the defense stance is that this may be the first time the issue is brought before a judge. The resulting uncertainty shifts risk onto the plaintiff, creating a powerful pressure point in early litigation.
When predictive analytics and targeted case simulation come together, the result is a new kind of defense strategy—one that anticipates, intercepts, and redirects. The most effective defense doesn’t start when surgery is on the table—it starts much earlier. It’s about changing the calculus for the other side. If they know your team is prepared, knows their playbook, and won’t blink when the word “fusion” shows up in a demand letter, the entire dynamic shifts.
We don’t change the game by asking for fairness. We change it by shifting the risk. Make them think twice before pushing for procedures that may not play well in front of a well-informed jury. That’s the new defense playbook—and we’re here to help you write it.
See also
Motor vehicle accidents are the leading cause of spinal injuries