What is medical record review in litigation?

Medical record review in litigation is the process of examining and analyzing a person’s medical records to support legal cases. Used extensively in personal injury, medical malpractice, product liability, and mass tort matters, this process goes beyond basic record examination to include extraction, validation, and synthesis of legal and medical data. The resulting work products, ranging from detailed chronologies to high-level comparative analyses, equip legal teams with accurate timelines, flag inconsistencies, identify key events, and support the development of evidence-based legal strategies.

How are medical record review documents used in litigation?

Medical record review documents are used for: 

Fact-Finding and Case Evaluation 
•    Confirm injuries or conditions 
•    Establish cause and effect (e.g., injury due to a drug or device) 
•    Determine pre-existing conditions 
•    Evaluate the extent of damages 

Discovery and Trial Preparation 
Medical record review documents are often used during discovery to support claims or defenses and are prepared as exhibits for depositions, mediation, or trial. 

Settlement Negotiation
A thorough record review helps both sides assess the value of a case, which can lead to fairer settlements.

Shifting Priorities: Medical Chronologies Overtake Overviews as the Preferred Review Format in Litigation 

Internal research reveals a clear shift in the types of medical record review documents most frequently used by our clients. Over the past decade, medical overviews were consistently the most requested format, favored for their high-level summaries and ease of use across large volumes of cases.  

However, in the last two years, there has been a notable change in preferences. Medical chronologies have emerged as the leading format, now used by approximately 48% of clients, compared to 37% who continue to rely on medical overviews. This trend reflects a growing demand for deeper, event-driven insights and stronger causation analysis, particularly in complex and high-stakes litigation. 

How to Choose the Right Type of Medical Record Review Document for Your Case 

Choosing the right type of medical record review document depends on your case’s complexity, stage, and goals.  

Costs begin to mount in the discovery phase of mass tort litigation. A medical record review is a critical part of this phase. Your legal team must be well informed on the options available to make the most cost-effective decision to fit your particular matter. One size does not fit all, and customizations can be made to better fit your matter. 

Here are the most common types of medical record review documents and how each can be used.  

We created an infographic to complement this blog—scroll to the bottom of the page to check it out.

5 Types of Medical Record Review Documents Used in Litigation
 

1. Using a Medical Chronology 

A medical chronology provides a timeline for all allegation-related medical events. Pertinent information is extracted from records and placed into customized report formats determined by you and your legal team. A clear, chronological timeline of medical events (diagnoses, treatments, hospital visits, etc.) is essential to understand what happened and when. 

USE WHEN: 

• You need a timeline breakdown of medical events
• Comparing medical events to product use or alleged exposure
• Preparing for deposition, mediation, or trial
• Building strong bellwether case files or fact sheets
• Tracking treatment progression and causation 

WHAT IT INCLUDES: 

• Chronological summary of key events
• Dates of symptoms, diagnosis, treatment, and outcomes
• Source references (e.g., record page numbers or provider name)
• Product exposure or use dates (when applicable)
• Reviewer notes or highlights (e.g., potential causation links or red flags) 

BENEFITS: 

• Simplifies complex records into a clear, linear format
• Supports causation arguments by aligning events with exposure timelines
• Highlights inconsistencies or gaps in treatment that may affect case value
• Speeds up record review for attorneys, experts, and claims professionals
• Can be started at any time throughout discovery
• Appropriate for any case size 

BEST FOR:  

• Bellwether case preparation or trial selection
• Mass tort and product liability litigation
• Personal injury, medical malpractice, and wrongful death cases
• Cases with years of treatment across multiple providers 
   

2. Using a Case Overview

The case overview is a data-driven, case-specific work product that aggregates and analyzes information from legal sources (e.g., complaints, fact sheets, intake forms) and medical records. It systematically identifies patterns, inconsistencies, and data gaps between allegations and medical documentation. This structured output supports case strategy development, informs expert analysis, and enhances data integrity throughout litigation.

USE WHEN:  

• Correlating alleged injuries with medical documentation
• Preparing data points for depositions or plaintiff interviews
• Assessing accuracy and completeness of plaintiff fact sheets
• Validating claims for bellwether selection or early settlement
• Identifying missing records or unsupported allegations 

WHAT IT INCLUDES: 

• Structured comparison of allegations vs. medical findings
• Summary of key events: injury onset, treatment timeline, outcomes
• Flagging of inconsistencies or contradictions in records
• Index of missing, vague, or unsupported data fields
• Clarification of medical terminology relevant to legal arguments
• Abstracted findings related to the medical facts for purposes of claim validation 

BENEFITS 

• Early identification of risk indicators for bellwether or trial selection improves credibility of case presentations with fact-based alignment
• Saves time by consolidating key insights in one document
• Strengthens expert preparation and litigation strategy
• Enhances accuracy and consistency across legal and medical narratives 

BEST FOR: 

• Mass tort or product liability matters with a large volume of plaintiffs
• Legal teams conducting pre-settlement or trial reviews or prioritization
• Steering committees in MDL leadership roles managing claim evaluation workflows
• Defense counsel reviewing plaintiff-specific fact sheets and records
   

3. Using an Executive Summary 

An executive summary is tailored based on the specific allegations of each case. Unlike a medical chronology, which is strictly date-based, a medical summary is typically topic-driven and structured around key themes or issues relevant to a specific case or purpose. The executive summary is typically used as a supplement to a medical chronology but can also be used as a stand-alone document.

USE WHEN: 

• You need a quick overview to evaluate case viability
• Early-stage review for a large group of plaintiffs
• Screening for bellwether eligibility 

WHAT IT INCLUDES: 

• Key diagnoses and injuries
• Brief timeline of treatment
• Product exposure summary
• Notes on causation or red flags 

BENEFITS

• Highlights the substance
• Provides a clear conclusion
• A concise, narrative format 

BEST FOR: 

• Mass torts
• Early plaintiff vetting
• Settlement inventory building 
   

4. Using a Medical Case Assessment

A high-level clinical and legal review of a plaintiff’s medical records to determine the overall strength, risks, and potential value of a case. It is often performed early in the litigation process to identify causation, severity of injury, and whether the case meets inclusion criteria (such as in a mass tort or class action). 

USE WHEN: 

• Evaluating new or potential claims
• Screening plaintiffs for inclusion in mass torts
• Assessing causation and injury severity early on
• Prioritizing cases for bellwether or early settlement 

WHAT IT INCLUDES: 

• Summary of key diagnoses and treatments
• Overview of product or exposure history
• Evaluation of causation and medical plausibility
• Flags for comorbidities or pre-existing conditions
• Preliminary injury categorization (e.g., mild, moderate, severe) 

BENEFITS 

• High-level case evaluation
• Early risk identification
• Gain quick insights into case strategy 

BEST FOR: 

• Evaluating large volumes of claims
• Assessing risk and exposure  
• Early case valuation or triage decisions  
• Third-party administrators supporting settlement programs
   

5. Medical Billing Analysis (allegation-related)

A medical billing analysis (allegation-related) is a targeted review of a plaintiff’s medical bills to isolate and evaluate only the charges related to the alleged injury, exposure, or product use in litigation. This analysis helps legal teams separate relevant costs from unrelated or pre-existing care and determine whether the billing is accurate and necessary.   

USE WHEN: 

• You need to identify charges specifically linked to the alleged injury
• Preparing for settlement negotiations, mediation, or trial
• Evaluating claim strength and potential damages in mass torts or personal injury cases
• Supporting or challenging causation and medical necessity
• Clarifying which charges are recoverable and should be included in damages 

WHAT IT INCLUDES: 

• Review of all medical bills with a focus on allegation-related treatments
• Identification of procedures, medications, and services directly tied to the claimed injury
• Exclusion or flagging of unrelated or pre-existing treatment costs
• Cross-reference with medical records to confirm treatment relevance and necessity 

BENEFITS 

• Controls legal spend
• Ensures damages reflect only injury-related costs
• Reduces costs
• Ensures compliance
• Strengthens causation and necessity arguments with data-backed support 

BEST FOR: 

• Plaintiff attorneys seeking to justify allegation-related medical damages
• Defense teams aiming to dispute unrelated or excessive billing
• Mass tort leadership teams preparing settlement inventories
• Insurance carriers and third-party payers reviewing claim legitimacy
• Cases with long treatment histories or comorbidities that complicate damages

Looking for Medical Record Review Services?

Establishing a detailed strategy at the outset of mass tort litigation will position parties to pivot in the uncertainty and changing variables associated with its complexity. LMI specializes in end-to-end medical record collection and review, backed by a dedicated staff of experienced nurse analysts.  

Whether you're handling a single complex injury or managing thousands of mass tort claims, we deliver customized work products tailored to your needs. Partner with us and put medical clarity at the center of your case strategy.  

Contact us today.

[See: Identifying Alternative Causation in Mass Tort Litigation]