Medico-Legal assessments are an integral part of personal injury claims. A medical report is used as medical evidence to decide the impact the injury has on the injured person. The content in a medico-legal report has a direct impact on how much a personal injury claim is worth. If you have been requested to attend a medico-legal assessment, please read this before you attend.
Table of Contents
- What is a medico-legal assessment?
- Medico-legal report meaning in compensation claims
- Medical-legal report vs. GP report
- Medico-legal assessments – Don’t be the tough guy
- Medico-legal assessments – Stick to the facts
- Medico-legal assessments – Take it seriously
- Medico-legal assessments – Be cooperative
What is Medico-Legal Assessment?
A medico-legal assessment is a one off assessment by a doctor for the purpose of your workers compensation claim. It is for the purpose of preparing a medical report, the doctor completing the report ordinarily will not undertake any treatment.
Medico-Legal assessments are called many different names, including:
- Independent Medical Examinations (IME);
- Medical-legal assessments; or
- personal injury medical examinations
Medico-legal examinations are often requested by your lawyer, the insurer, or the insurer’s lawyers for the purpose of your ongoing injury compensation claim. This assessment is usually conducted by a medical legal doctor (i.e, medico-legal doctor), or other medico-legal experts. These doctors are often known as workers’ compensation doctors, AMS doctors, or accident injury doctors. Unlike your GP or your treating doctor, medical-legal doctors are often not of your choice. They are chosen by the lawyers or the insurance company to assess your level of disability or impairment ratings.
Medico-Legal Report Meaning in Compensation Claims
A medico legal report in a personal injury claim is a comprehensive medical report requested so that a party to a dispute can obtain expert evidence from a doctor, as an expert witness, as to the nature and extent of a person’s personal injury.
As an expert witness, the District Court consolidated practice directions state that the doctor conducting the medico legal review is not an advocate for a party. An expert witness’s paramount duty is a duty to the Court and not to the person retaining the expert.
Insurers, such as workers compensation insurers and motor vehicle insurers (such as the Insurance Commission of WA) will usually obtain medico legal reports to improve their case by showing:
- The injured person’s condition has recovered;
- The injured person’s condition is due to something else such as a disease they had before (e.g. natural degeneration of the body or arthritis) and not due to the accident;
- That the injured person is not telling the truth about the extent of their condition.
Compensation Lawyers who act for injured people will very often pay for medico-legal reports helping the injured person to prove their case and show that their injury happened due to an accident or incident (such as car crash claims or work injury claims) and the extent of their injury.
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Your lawyer will take you through this arrangement in more detail including any terms and conditions in your obligation free first initial consultation.
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Medical-Legal Report Vs. GP Reports
Medical legal reports from expert witness doctors and GP reports can both be used as medical evidence in personal injury claims. Insurers use medical legal assessments to plan the way they approach a personal injury claim. Insurers will use the information in a medical legal assessment to determine:
- What benefits are likely to become payable in your case (e.g. extent of medical expenses and time off work);
- How much they should pay to settle your case;
- Is there any further treatment required; and
- Is it the right time to consider the overall settlement of your claim.
Medical legal reports contain information that impacts your injury compensation payout amount. The medical legal doctors chosen by the insurance company and their lawyers may not agree with your chosen doctor. The reports provide significantly more detail than General Practitioner Progress Medical Certificates.
If there is a dispute between your General Practitioner’s report and the medical legal assessment report, a judge or WorkCover Arbitrator will consider both your doctor’s medical report and the report from a medico-legal doctor and then make a decision about your claim. It is important to make sure you do the right things at all medico-legal exams. Mistakes can get your compensation payout amount reduced.
Foyle Legal works with injured people on accident injury claims. In this work, they have witnessed lots of mistakes that injured people make with medico-legal exams. Here is a list of common mistakes to avoid when dealing with medical evidence in a personal injury claim:
- Failure to report to a doctor soon enough
- Failure to report all your injuries
- Failure to attend medical appointments on a regular basis
- Failure to truthfully report the severity of the injuries suffered
- Failure to cooperate with a medical doctor
- Failure to follow doctor’s advice
Don’t be THE TOUGH GUY
No one wants to seem weak and be seen as a complainer, a whiner or a wimp. However, medico-legal assessments are not the time to play the tough guy. If you are attending a medical-legal doctor, it is important to speak up so that your injuries are properly understood. Remember, medico-legal assessments are a form of independent medical examination. The doctor doesn’t know you. If you play the tough guy, they just assume you are fine and no further treatment is required.
We have seen some clients, who stay quiet about their pain and suffering. They fail to report their pain accurately and swiftly which results in getting their compensation cut or reduced. If you are working with a personal injury lawyer and you are unsure what to do, please be sure to seek advice before completing medical-legal assessments.
Not Seeing a Doctor Soon Enough
After your injury, if you are in any pain go directly to the doctor. Trying to tough it out can reflect badly on you in court. The inference can be made that you did not have an injury. The dates of both your accident and the first doctor’s visit will be on file. For example, if you suffered an injury from car accident, waiting too long will make it look like you were not in pain at the time. Or it can be alleged that your injury was not caused by the accident.
Stopping Seeing your Doctor Too Soon
It’s understandable that you want to get back to your life. But any significant breaks in your treatment will be factored into your compensation payout. The insurer is likely to argue that the fact you did not continue to seek medical assistance is evidence that you do not need medical assistance and have recovered. In moderate to severe injuries, a significant part of the claim is for:
- Loss of earning capacity and superannuation in the future;
- Medical expenses in the future; and
- Care expenses in the future.
A lack of medical evidence of an ongoing injury is likely to adversely effect all of these claims and therefore your overall compensation payout.
Not Bringing Up All of Your Medical Issues
Medical examinations usually commence with a discussion of your biggest and most pressing problems. However, everything you say to your accident injury doctor goes on the record. If you don’t mention the pain you are having, then the insurer is likely to say that you have provided an inconsistant history and imply that you have recovered from the injuries that are not mentioned in the report.
It is important to mention all of your medical problems, this includes mentioning if your pain or injuries make work impossible. Remember, the medical practitioner needs to produce a comprehensive medical report for your claim, it is important that you bring up all your medical issues.
Stick to THE FACTS
Honesty is the best policy when it comes to medical legal examinations. Everything you say can go into the doctor’s report and come up in litigation. So stick to the facts. There are two key common mistakes about stating the facts.
Making Overblown Statements – Don’t Exaggerate
On the opposite side of trying to tough things out, don’t exaggerate. Doctors have a lot of medical evidence to evaluate. They can typically tell if you are exaggerating and it will show up in their reports.
Speculating on the Facts — Don’t Guess
You will be asked about your accident during a medical-legal exam. Be factual. If you don’t know the detail, don’t embellish. Guessing can be used to discredit you as a witness later. Don’t speculate on things like the amount of damage done, speeds, or weights. Only speak to the facts that you know. Your medical records will do the rest.
Take it SERIOUSLY
No one is going to take your personal injury claim seriously if you don’t. Together with your personal injury lawyer, your job is to prove the severity of your injuries. And there are some ways to undo your efforts in this direction.
Missing Doctor’s Appointments
Nothing says you aren’t really concerned about your recovery like missed doctor’s appointments. Just don’t do it. Show up to every appointment and don’t try to put appointments off. This history is something that can be seen when judging your claim.
Dwelling on Legal Over Medical
Your car accident doctor, AMS doctor, or workers’ compensation doctor, usually doesn’t want to hear about your personal injury claim. This is partly because their focus is your health, and they think yours should be too. It is also partly because many doctors don’t like dealing with the courts. Either way, you should focus on their medical advice. If they think you are trying to milk the system that will show up in the medico-legal exam report. Your compensation lawyer and your medical-legal doctor don’t need to interact at this stage.
If you have a reason to doubt a doctor, or medical-legal doctor, do speak up calmly with an explanation of the reason why you disagree. It can be difficult to disagree and be cooperative at the same time. The best way to deal with it is to seek advice from your lawyer on how to handle situations like this. If you found yourself facing a tricky situation like this, please be sure not to do:
Don’t Argue with Your Doctors
Arguing with the doctor can reflect badly on your claim. You may not agree but always remain respectful. Remember, doctors, respond much better to reasons than emotions.
Don’t Ignore Medical Advice
Nothing kills a claim faster than if it’s discovered you are not following your doctor’s orders. It makes a statement that you don’t care about your recovery. Or worse, you may be regarded as fully recovered and needing no further compensation. Don’t give the opposing side this kind of ammunition. If you disagree with your doctor, you should voice it to your lawyer and follow their advice promptly. If you disagree it also makes sense to see another doctor for a second opinion.
Beyond these common mistakes, there is one prime thing you can do to help your personal injury claim – Work closely with your personal injury lawyer to avoid mistakes in your medical-legal reports. They know the process of independent legal examinations. Finding the best personal injury lawyer in the Perth area can be the best thing you do for your personal injury claim. At Foyle Legal, we deal with injury claims just like yours every day on a no win no fee basis.