When to Instruct a Case Manager in Serious Injury Claims

In serious injury litigation, the need for case management is rarely determined by diagnosis alone. The more useful indicator is instability.

A claimant may be discharged but not coping. Family members may be providing substantial care without recognising it as care. Rehabilitation may be fragmented. Equipment may be delayed. Housing may be preventing progress. Several professionals may be involved, but no one may be holding the overall plan.

For experienced solicitors, the question is not whether case management is helpful in principle. The question is whether the absence of coordinated rehabilitation input is likely to affect recovery, evidence, family resilience, interim payment strategy, future care analysis or the overall direction of the claim.

Harrison Associates provides catastrophic and complex case management services for solicitors handling serious injury, personal injury and clinical negligence claims. Our work is focused on practical rehabilitation, clinical coordination and the real-world consequences of injury.

The real trigger is drift

Some claims plainly require early case management: severe brain injury, spinal cord injury, amputation, polytrauma, serious paediatric injury or complex clinical negligence resulting in long-term disability.

The more difficult cases are those that appear stable from the outside. The claimant is home. Appointments are happening. Family members are helping. The claim is progressing. But underneath, rehabilitation may be drifting.

That drift matters. It can lead to avoidable deterioration, family burnout, poor engagement, delayed equipment, unclear care evidence, fragmented therapy and weaker future needs analysis. It may also leave the solicitor trying to coordinate practical rehabilitation issues that properly require clinical case management input.

Case management should be considered where the claimant’s needs are active, changing, complex or not being properly coordinated.

What can case management add?

Good case management is not simply an appointment arrangement. In catastrophic and complex cases, it can create structure around a situation that is otherwise becoming reactive.

A case manager can help identify current function, immediate risks, therapy priorities, family pressure, care needs, equipment issues, housing barriers and practical steps required to stabilise the claimant’s position.

That work can also assist the evidential picture. Case management records may help show what was recommended, what was available, what was delayed, what family members were doing, what risks existed, what interventions helped and what needs remained.

For solicitors, this can turn general concern into a clearer rehabilitation chronology. It can also support decisions around interim payments, expert instructions, care evidence, accommodation issues and future case management claims.

Immediate Needs Assessments (INA): useful when the case is still moving

An Immediate Needs Assessment can be particularly useful where the claim is at an early stage, but the practical problems are already visible. The value of an INA is not merely that it identifies treatment. Its value is that it brings order to a live situation. It can help clarify whether the claimant is receiving appropriate rehabilitation, whether family support is sustainable, whether equipment or housing is blocking progress, and whether further input is needed before the position deteriorates.

The 2015 Rehabilitation Code supports early, collaborative consideration of rehabilitation within the claims process. Its purpose is to help the injured claimant make the best and quickest possible medical, social, vocational and psychological recovery.

For serious injury solicitors, the practical point is straightforward: rehabilitation should not wait until quantum is fully developed. In many cases, the rehabilitation picture helps shape quantum.

Keep case management and expert evidence separate

A case manager is not a Part 35 expert. The distinction remains important.

The case manager coordinates rehabilitation and support. The expert witness provides an independent opinion for the court. Both may comment on function, care, therapy, equipment and future needs, but they do so from different positions.

Wright v Sullivan [2005] EWCA Civ 656; [2006] 1 WLR 172 is commonly cited on the role and status of the clinical case manager in litigation. The practical point is that case management evidence can be valuable, but it should not be treated as a substitute for independent expert opinion where the court requires it.

For solicitors, this affects how records are used, how expert instructions are framed and how the evidence is presented. A case manager may show what is happening in real time. Expert evidence may still be required to analyse what provision is reasonable, necessary and likely to be required in the future.

Brain injury: apparent independence can mislead

Brain injury claims often show why case management may be needed before the problem is obvious on paper. A claimant may be physically mobile but unable to manage fatigue, planning, appointments, medication, emotional regulation, cooking, finances, childcare or safe community access. Family members may be quietly prompting, supervising and managing risk. The claimant may appear independent during short assessments but fail to function reliably across an ordinary week.

Case management can help coordinate neurorehabilitation, psychology, occupational therapy, support worker input, family education and risk management. It can also help reveal the difference between apparent independence and reliable independence.

That distinction is often central to care, supervision, case management and future support evidence.

Spinal injury, amputation and complex orthopaedic claims

In spinal injury, amputation and complex orthopaedic claims, case management often becomes important around discharge, transfers, equipment, pain, fatigue, personal care, carer availability, transport and housing.

A claimant may be medically fit for discharge but not practically safe. Equipment may not be in place. Accommodation may be unsuitable. Family members may be absorbing care because no proper package has been arranged.

Case management can help identify and coordinate practical steps that directly affect independence and rehabilitation progress. Where accommodation, equipment or long-term care are likely to be disputed, early case management records may also help explain the practical barriers that formal expert evidence later needs to consider.

Clinical negligence claims

In clinical negligence claims, case management may be particularly valuable where the claimant’s pathway has already involved fragmented treatment, delayed intervention or avoidable deterioration.

This may include neurological injury, amputation, pressure damage, infection, birth injury, surgical injury or prolonged loss of independence.

The solicitor may be focused on breach, causation an

d condition and prognosis evidence. Case management addresses the parallel practical question: what does this person need now, what is blocking recovery, and what support is required to prevent further decline?

That distinction can be important. The litigation may take time, but rehabilitation needs may already be immediate.

Family care: the evidence that often disappears

One of the clearest reasons to consider case management is unrecorded family care.

Relatives may be managing medication, transport, supervision, personal care, meals, prompting, childcare, household tasks and emotional support without describing it as care. Over time, this can make the claimant appear more independent than they are.

Case management can help identify what family members are actually doing, whether it is sustainable, what risks exist and what formal support may be required.

For solicitors, this is both a human and an evidential issue. Family support should not disappear from the claim simply because it has become routine.

Helpful Resources

• The Rehabilitation Code 2015
  Framework for early rehabilitation and collaborative working in personal injury and clinical negligence claims.
• A Guide to the Conduct of Cases Involving Serious Injury
  Best-practice guidance for complex personal injury cases involving serious injury, significant value and likely future continuing loss.
• APIL Best Practice Guide on Rehabilitation
  Guidance addressing rehabilitation in personal injury claims and the importance of considering rehabilitation as part of the litigation process.
• BABICM
  Professional body focused on case management for people with brain injury and complex needs.
• CMSUK
  Professional association for case managers in the UK.

How Harrison Associates supports solicitors

Harrison Associates provides Expert Witness and Case Management services for solicitors handling serious injury, catastrophic injury, complex personal injury and clinical negligence claims.

Our Expert Witnesses provide independent opinion on function, rehabilitation, care, therapy, prognosis and future needs. Our Case Managers coordinate rehabilitation, support injured people and families, liaise with professionals and help ensure practical needs are identified and addressed.

Where a claim requires clear evidence, structured rehabilitation input or a better understanding of future provision, Harrison Associates can help solicitors identify the right expertise at the right stage.

To discuss expert witness evidence or case management support for a serious injury claim, contact us today.  

Contact