The Birth Injury Case Acquisition Playbook

Part 1 — Decide whether the market is there

A birth injury acquisition programme is worth building when three things are true at once: enough births occur in a geography the firm can actually serve, the firm can review the inquiries that result, and the expected fee from a signed viable matter clears the all-in cost of acquiring it. Two of those are arithmetic. The third is the one firms skip.

The measured inputs are public and we publish them: births by county, hospitals confirmed to provide inpatient labour and delivery, and Offices of Lawyers establishment density. The whole layer is here, free, for all 3,144 U.S. counties.

The trap in part 1. Every market sizing you will be shown by a vendor multiplies births by a conversion rate they invented. The births figure is real and the rate is not, and the product inherits the worse of the two. Insist on seeing which inputs are measured and which are assumed. Our market opportunity tool labels its two assumed inputs on screen, in the result, not in a footnote.

Part 2 — Find the ceiling before you build demand

The number of birth injury cases a firm signs is set by how many inquiries it can competently review per week. Everything upstream should be sized to that number. This is the single most consequential idea in this document and it inverts how almost every agency engagement is scoped.

Review capacity is straightforward to compute and almost never computed: reviewer hours available per week, multiplied by a realistic utilisation, divided by hours per review. What makes it hard is that firms estimate all three inputs from job descriptions rather than from measurement, and all three estimates are optimistic in the same direction.

Part 3 — Rebuild attribution before optimising anything

Nothing in this document works if an inquiry cannot be joined to a signed matter. That join is the whole game, and in most firms it does not exist. Marketing lives in the ad platform, inquiries live in a CRM, and matters live in a case management system, and no identifier crosses all three.

The fix is mechanical and unglamorous: every inquiry carries source, campaign, landing page and timestamp from the moment it is created, those fields survive into the case management system, and signed-matter outcomes are pushed back to the ad platform as offline conversions. Without the last step, automated bidding optimises toward your cheapest, least viable inquiries — which is the failure mode described in part 5.

Calls are half of this and they are usually missing. A large share of inquiries in this category arrive by phone, and an untracked call is invisible spend. Call tracking with recording, where lawful, is not optional instrumentation; it is the only way to grade what happens on the call.

Part 4 — Buy demand against a derived ceiling

Birth injury and medical malpractice keywords are among the most expensive inventory in paid search. That is not a reason to avoid the channel. It is a reason to know your break-even before the first impression serves, and to derive it backwards rather than benchmark it sideways.

Start from the expected fee of a signed viable matter. Multiply by the share of clicks that become one — the product of six sequential rates. Subtract screening cost spread across every inquiry, including the ones that produce nothing. What remains is the most you can rationally pay per click. Apply a target margin and you have a bid ceiling that is defensible in front of a partner.

Part 5 — The failure mode, in detail

Here is how a birth injury programme deteriorates while every dashboard improves. It is worth reading slowly, because it is the most common way money is lost in this category and it looks like success the whole way through.

1. The campaign is set to optimise toward form fills, because that is the conversion the platform can see.
2. The bidding system does exactly that, and finds cheaper form fills — which are systematically the less qualified ones, because qualified searchers are more expensive to reach.
3. Cost per inquiry falls. This is reported, correctly, as an improvement.
4. The share of inquiries passing screening falls at the same time. This is not reported, because nobody joined the two systems.
5. Screening cost per signed case rises faster than media cost per inquiry falls, because you now screen more inquiries to find each viable matter.
6. Cost per signed case rises. Signed case count falls. The marketing report is a page of green.

The fix is in part 3: import signed-case outcomes so the bidding system optimises toward cases. Everything else is downstream of that one integration.

Part 6 — Screening as a marketing function

Screening is usually treated as an operations problem that happens after marketing ends. Treated that way it is a cost centre. Treated as part of the acquisition system it is the highest-leverage feedback loop available, because the reason an inquiry was screened out tells the marketing side exactly what to stop buying.

The last row deserves emphasis. Inquiries that die waiting for records are matters the firm already paid to acquire, already screened as promising, and then lost to a chase cadence nobody owns. Fixing it costs no media budget.

The full operational system is in the Medical Screening & Intake Manual.

Part 7 — The limitations question, handled correctly

In most states the limitations period for a child’s claim runs differently from an adult’s. The practical consequence for acquisition is large: a substantial latent population exists — parents of older children who assume it is far too late to ask anyone. They are not searching, most of them do not have a viable matter, and the ones who do are among the most valuable inquiries in the category.

This is also the single easiest place to cross a line. Content addressing this population must inform without advising. It can explain, generally, that limitation rules for a minor’s claim often differ and that only a lawyer looking at the specific facts and the specific state can say what applies. It must never tell a reader that their claim is live, that they have time, or that they should act — and it must never imply a value.

The compliance framework is in the compliance publication. The creative standard is in Video & Creative.

Part 8 — What to measure, and how often

The dashboard, the forecast model, and the meeting structure that makes any of this get acted on are in the Firm Operating Manual.

The one-page summary

1. Measure review capacity. It is the ceiling.
2. Build the joins so an inquiry can be traced to a signed matter. Nothing works before this.
3. Size demand to the ceiling, not to a budget.
4. Derive your bid ceiling backwards from expected fee, conversion, and screening cost.
5. Import signed-case outcomes so bidding optimises toward cases.
6. Categorise every screen-out and feed it back weekly.
7. Report cost per signed case at the top of every report, and cost per lead in the appendix.
8. Raise the ceiling deliberately, then let demand follow.