Anatomy of a Demand Package

I spent years as an attorney before I helped build Expert Radiology, and I kept running into the same problem from both sides of the table. The imaging was usually the strongest, most objective evidence in a case. It was also the part the other side found easiest to argue with. Not because the injury was not real, but because the document describing it was never written for the person who decides the number.

A demand package is where that gap shows up most expensively. So it is worth being precise about what a demand package is, what it contains, and where the value leaks out.

Section 1 What a demand package actually is

A demand package is not paperwork. It is the first complete, persuasive account of a case, assembled before litigation costs start running, and built to move one specific reader: the claims adjuster. It bundles liability, damages, and the human impact into a single narrative and asks for a number.

The adjuster is not a physician. They are not a radiologist. They are a busy non-medical professional weighing many files at once, looking for reasons to discount yours. Everything in the package either helps that reader reach your conclusion or gives them room to reach a cheaper one.

That framing matters, because the imaging section is usually prepared as if the reader were another doctor. It is not.

Section 2 The parts that carry the weight

Demand packages vary by firm and by case, but the load-bearing pieces are consistent.

The liability narrative

The story of what happened and why the other party is responsible. This is where most packages are strongest, because it is the part attorneys are trained to build.

The medical records

The treatment record that connects the incident to care: the emergency visit, the referrals, the course of treatment, and the providers who delivered it. Volume here is easy. Clarity is harder.

The imaging and its report

The objective evidence of injury: the MRI, the CT, the X-ray, and the report that interprets them. This is the spine of the damages argument, and it is the part this article is about, because it is the part that most often underperforms.

The billing and the specials

The economic damages: medical bills, the cost of care, and lost income. Numbers the adjuster can check and will check.

The impact on the person

How the injury changed the claimant's daily life, work, and function. The human story that turns a set of findings into a person.

Section 3 Where demand packages lose money: the imaging section

The imaging is the most objective evidence you have. A finding on an MRI is not a witness who can be impeached or a memory that fades. It is there or it is not. So it is strange how often the imaging section is the weakest link in the package.

The reason is simple. A standard radiology report is a text document written by one physician for another. It assumes the reader can picture the anatomy, translate the terminology, and supply the clinical context. The adjuster reading your demand can do none of those things. The finding is real, but to the decision-maker it is invisible.

Then there is the language. Standard reports lean on hedging: cannot exclude, clinical correlation recommended, may represent. That language is normal in clinical practice, where it manages uncertainty between physicians. In a demand package it reads as doubt, and every hedge word is an opening the other side will use.

So the package arrives with a powerful piece of evidence that the reader cannot see and a description of it that sounds uncertain. The injury did not get weaker. The exhibit did.

Section 4 What an illustrated, defensible report adds

The fix is not to overstate the imaging. It is to make the imaging legible to the person who has to act on it. That is the entire idea behind the PrecisionPlus v3™ report.

A PrecisionPlus v3™ report presents each significant finding three ways: the radiologist's diagnostic language, a colorized key image that shows the finding on the patient's own anatomy, and a plain-language explanation a layperson can follow. The same finding that was invisible in a wall of text becomes something the reader can actually see and understand.

It stays defensible because of how it is built. Every report is authored and signed by a board-certified radiologist, references the specific images behind each finding, and uses standard diagnostic criteria. The visual elements illustrate the documented findings. They do not add claims the images do not support. That distinction, clarity rather than exaggeration, is what lets the report hold up under scrutiny.

There is also the question of who read the study in the first place. Many first reads are performed by general radiologists covering every body part under time pressure. A radiologist with subspecialty experience in that exact anatomy, reading with case context and the relevant prior studies, often refines or corrects what the first read said. When the imaging is the spine of your damages argument, the quality of that read is not a detail.

Section 5 How to build a stronger imaging section

Start with the right read

If the original report is vague, hedged, or thin, consider a subspecialty second opinion before the package goes out. An independent re-read by a radiologist focused on that anatomy can surface findings that were undercalled and state them with appropriate confidence. The time to learn the imaging is stronger than the first read suggested is before you send the demand, not after the other side does its own review.

Make every finding visible

For the findings that matter to the case, include the colorized key image and the illustration alongside the text. The goal is that the adjuster can look at the page and see the herniation, the tear, or the stenosis, rather than take a sentence on faith.

Connect the imaging to the person

Tie each significant finding to the symptoms, the treatment, and the functional impact already documented elsewhere in the package. The imaging answers what is wrong. The rest of the package answers what it cost this person. The demand is strongest when those two threads are obviously the same story.

Keep it defensible

Resist the urge to characterize the imaging beyond what the report supports. A clear, accurate, well-illustrated finding is more persuasive than an aggressive one, and it does not hand the other side an easy argument. Let the radiologist's signed findings and the images do the work.

Section 6 Where the report fits, and where it does not

An illustrated report makes the imaging evidence clear and defensible. It is documentation, not testimony. Whether and how it is used in deposition, mediation, or trial depends on the case, the retained expert, and the court. Setting that expectation honestly is part of what keeps the evidence credible.

The point of all of this is narrow and practical. The person deciding the number is not a radiologist, and the imaging is your most objective evidence. Make that evidence something they can see and understand, and you have closed the gap where demand packages most often lose value. The injury was always there. Now the reader can see it too.

Written by

Cara Rosenthal, J.D.

Co-Founder and Chief Strategy Officer

Reviewed by

Avery J. Knapp Jr., M.D.

Founder, Board Certified Radiologist