If you have a medical problem which you have not been able to resolve yourself, your GP may refer you for a specialist opinion from a consultant.
Your GP writes a referral letter and you will receive an appointment for a clinic at a hospital in due course.
At the clinic, you may see the consultant or a more junior doctor. You have to rely on how well you can understand what you are told at the consultation. The doctor will write to your GP as a result of the appointment, which will be a sort of “report”. You will not automatically get to see that letter.
It can be difficult to get a clear idea of your diagnosis, prognosis and any further treatment proposed.
How personal injury claim medical reports are different
In the context of a personal injury claim, medical reports are different.
As part of most personal injury claims, your solicitor will refer you at some point for an expert opinion from a specialist such as a consultant. If your injury includes, say, a bone fracture, that specialist will probably be a consultant orthopaedic surgeon. Depending on the severity of your injuries, opinions may be required from experts in more than one field of medicine.
Lawyers refer to the opinions received from expert doctors in personal injury claims as medico-legal reports. This is because the doctor has to assess the medical position and then apply certain legal tests to the medical position, as he or she sees it, in order to provide the opinion which your solicitor requires to be able to value your claim for your injuries and other losses.
Personal injury claims are civil claims and the expert has to address the various issues on a balance of probabilities. In other words, the expert does not need to be certain what would have happened otherwise in the past, or will happen in the future; anything which is more than 50% likely, in the expert’s opinion, will be treated by the law as a certainty, if the opinion is accepted.
The main aim of a medico-legal meeting with an expert is to give them sufficient information to enable them to produce a report which will help in valuing your claim.
In every case, the expert is impartial. The expert’s duty is not to you or to your solicitor but, instead, to the court.
What does the expert want to know about?
When you attend a medico-legal appointment, the expert will want to know some or all of the following:
- What happened in the accident / incident and how did you come to be injured?
- What injuries or medical conditions were diagnosed and what treatment have you received from hospitals, GP, physiotherapists etc.?
- What recovery have you made by now and have you fully recovered?
- Are you still taking any medication and, if so, what is that?
- Have you ever suffered any similar injuries or medical conditions in the past?
- How much has the accident affected your social, domestic and work activities between the date of the accident and now?
Why do things which happened before the accident matter?
Sometimes we have medical conditions which we are not aware about and they are only brought to light when we have an accident. In some cases, such medical conditions may have gone on to cause you symptoms even if you had not had the accident.
The expert needs to take this into account in formulating the opinion. It may be, for example, that the accident has accelerated the onset of symptoms from a pre-existing (but previously symptomless) medical condition. This sort of thing is common in relation to back injuries.
What happens at the examination?
No two examinations will be the same but there will usually be some discussion of the circumstances of the accident and injury. The expert will want to know about your resultant symptoms, subsequent treatment, how well your recovery has progressed and any effect the injuries have had on your lifestyle.
Secondly, there will be a physical examination of you by the expert.
It may appear that the expert spends longer talking to you about the relevant events and in discussing your symptoms than in carrying out any physical examination. This is often because the expert is able to find out more about an injured person’s problems by careful noting of their pre- and post-injury history than by carrying out a physical examination.
What should you take with you to the appointment?
Your solicitor will arrange to recover and send the expert the relevant medical records. Usually, these come from your GP and from any hospitals you attended. The records will include copies of x-rays which will be on CD-ROM.
You might find it helpful to make a list of all the problems you feel you have had to deal with as a result of the accident or incident (e.g. details of symptoms and any problems with day to day activities) so that you do not forget to tell the expert to allow it to be taken into account in the formulation of the opinion.
Can you take someone with you to the appointment?
Yes, you can. It is generally okay to take a relative or partner with you. You should note that the accompanying person must not interfere with the consultation in any way, which includes answering questions on your behalf. They should really just be there for moral support.
Can the expert advise on further treatment?
The report is produced for the purposes of your claim. It is not the expert’s place to provide a specialist opinion on your condition for your GP. It is not for them to recommend specific treatment. Having said that, however, some experts will include advice in the report that your condition could benefit from further investigation and treatment.
It would not be up to them to refer you for that investigation and treatment; instead, the referral would have to come from your GP or the consultant who is in charge of your care.
Can you claim back your expenses for attending the appointment?
Usually, it depends who instructed the expert to provide the report.
If the instruction has come from your own solicitor, you will probably not be able to recover the costs of travel, subsistence and any accommodation.
On the other hand, if the expert has been instructed by the insurers for the third party or their solicitors, you can generally recover your expenses provided you keep vouching / receipts for the outlays you incur. You should give these to your solicitor as soon as possible on your return from the appointment.
Discussing matters with the expert
It is not a good idea to exaggerate. Experts, by definition, will have seen a lot of patients in their time. They will be able to spot situations where the symptoms claimed do not fit the expected pattern. Rather than helping to increase the value of your claim, it might raise suspicion about the truthfulness of the claim as a whole.
Try to tell the whole truth. Being selective will probably not help you. If you are asked about similar or related problems in the past, it is best to be honest. Do not try to filter out previous episodes of pain or problems you have had on the assumption that they are not relevant. That is for the expert to decide.
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