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Medical Legal Appointments

Medical Legal Appointments

Medical Appointments in Personal Injuries Claims

This article is about medical appointments in personal injuries claims for the purpose of medical legal reports.  These appointments will involve attending your doctor or another medical expert who will then write a medical report for your Solicitor or for another.  The purpose of the consultation is to assist them in preparing their medical report.  Generally speaking, there are three different types of medical appointments that you will attend that will generate medical reports for personal injury claims.

These are as follows:

  1. Appointments with your own doctors or medical experts;
  2. Appointments with independent medical experts nominated by the Injuries Board;
  3. Appointments with medical experts nominated by and acting for the Defendant or his insurance company.

Your aim for all three appointments will be the same.  You will want clear and consistent medical reports outlining your medical history, the injuries that you have sustained and the reasons for those injuries, details of any treatment that you have received, your prognosis or outlook and any future treatment that may be required or recommended.  You will also want the report to outline the affect that the injuries have on you in terms of your working, domestic and social life.  The Injuries Board has a helpful precedent medical report template which can be found here.

Regardless of the type of medical appointment your aim is to assist the medical expert in writing the most favourable report he can about your injury – identifying your injuries, giving a precise statement of your current state of health and as accurate a prognosis as possible.  In order to assist in this you should be able to do the following for the benefit of the examining doctor:

  • Give a clear medical history.

This would include any previous injuries or medical conditions that would have a bearing on the injury in question or its impact on you.

  • Give an explanation of how the accident occurred.

The mechanics of the accident are relevant to the nature of the injury.  For example if you hit your head in a road traffic accident you sometimes have symptoms relating to concussion so the fact that you banged your head is relevant and should be explained to the doctor.  There is also a difference between the injury that you sustain if you are rear-ended versus frontal or side impacts so the mechanics of the accident, the way you fall or the way you were holding your body at the time of an impact are all relevant and will assist the doctor in explaining how the accident caused your particular injury.

  • You should set out how the injury developed since the time of the accident.

You should be able to explain what treatments you have received such as physiotherapy, injections or surgeries and whether these have helped or not as the case may be.  You should also be able to inform the doctor if there are any scheduled or planned treatments in the future that have been recommended for you.

  • You should describe the affect the injury is having or has had on your lifestyle including your work, family and social life.

In this you should include detail of any impact on your ability to sleep, to work, to exercise or to engage in normal family life such as picking up your children, doing household chores or carrying out your normal everyday tasks.  If you are not able to sleep in your own bed or have had to make other allowances arising from the injury then this to should be relayed.

  • You should be able to explain which injuries are continuing and are continuing to affect you and the ongoing impact they are having on you.
  • If the injury is having an impact on your mood or mental health then this too should be relayed to the doctor.

I always recommend that you take full advantage of medical consultations.  The doctor is after all being well paid for his work and is bringing an expertise to bear on your case.  The experts engaged are often consultants who have seen many hundreds of patients with your symptoms so they have very good experience and qualifications to assist you.  It is therefore worthwhile obtaining their advice on how best to deal with your injury and its side effects or what treatments might help you.  The doctors are always there to help and will often give recommendations, make referrals or even write to your GP with suggestions on how to manage your future care.

I do however have some caveats or warnings particularly when dealing with the defendant’s medical experts.  There are a minority of medical experts who typically act for insurance companies on an almost full time basis, who believe (wrongly) that it is there job to write a report seeking to minimize your injuries, to suggest that you are not being forthcoming or that your injuries are caused by pre-existing or alternative reasons.

These are the doctors who will say that a person who has had a limb amputated has made a spectacular recovery.  If you say you are “OK” when asked how you are, it will be suggested that you admitted to having made a full recovery.  These, albeit rare but biased medical practitioners, usually want you in and out in 5 minutes.  They ask questions solely to get you to say you are doing better than you are so that they can write a report saying that your recovery has progressed very well.  The more dangerous biased medical practitioners spend more time with you and interview you very carefully trying to find inconsistencies in your story and they will try to expand any inconsistencies as a means of suggesting that your injury was in some way unconnected with the accident in question.

In order to avoid falling into these traps you just need to be honest but meticulous in answering their questions.  You should try to avoid answering “yes” or “no” or short answers with these types of experts.  You should give complete explanations as to your injuries and how you were affected.  You should go into detail on points (a)-(f) above.  All doctors will ask these types of questions and they should be answered in full. If you are not given the time to answer those questions in full then you should inform the doctor that he may have over looked something.  Obviously there’s no point telling a psychiatrist about your back symptoms, but an Orthopaedic Consultant who focuses on your neck instead of your back should be courteously redirected.

It is your job to explain to the doctor what your injuries are and how you are affected.  Obviously if the doctor has seen you before, then they might have the information already and that should be taken into account.  You should have a clear mental list of your injuries and the affect they have on you and if at the end of the consultation one of those injuries has not been mentioned you should raise it.

In terms of what paperwork to bring with you to a medical consultation, this depends on who you are attending i.e. whether the medical practitioner is acting for you and your solicitor, the Injuries Board or for the Defendant / Insurance Company.  In nearly all cases you should bring your X-rays and MRI’s on disk to a medical consultation as they are very helpful.  If the medical practitioner is acting on your behalf, then your Solicitor is likely to have already provided them with any documentation that he considers necessary or relevant.

If the medical practitioner is acting for the Injuries Board, then they will already have the initial medical report for the personal injuries claim that was submitted to the Injuries Board with the Form A application.  It is unlikely that they will need anything other than the x-rays or MRI scans and, if they request further documents, you should check with your solicitor before providing them.  There is often a questionnaire that needs to be filled out and this is entirely normal but should be completed accurately and not rushed.

When you attend a medical appointment with an Insurance Company or Defendant’s medical expert, then you should not bring with you any previous medical reports.  You can expect the doctor to have the initial medical report that was submitted to the Injuries Board.  They will also have any medical report previously generated for the Defendant or his insurance company if the solicitor for the Defendant considers that helpful.  If you bring your medical reports with you, some biased doctors will actually copy these and send them to the solicitors for the Defendant.  That solicitor will then have an unfair advantage in that he will have most or all of your medical evidence while your Solicitor has none of their medical evidence.

So having outlined your aims in attending the medical appointment and having outlined what you should try to do, I will now outline what you should try to avoid.

Inconsistencies

Clearly your aim in attending medical appointments for your personal injuries claim is to have consistent medical reports outlining your injuries as fully as possible.  You want the Court that will eventually read these medical reports to see that you are a consistent and honest claimant.  If your neck is your main concern but your shoulder is also sore, it is not terribly consistent if the first time you mention your shoulder is 6 or 12 months after the accident.  To avoid this problem you should make sure to tell your doctor and all other medical experts about all of your injuries so that they have a complete history or your injuries from the outset.

It may be that your neck receives the priority treatment in the early stages of your injury and that your shoulder turns out to be a long term injury that later becomes the main injury in the case.  It would not be helpful if the shoulder had not been mentioned until 6 or 12 months post-accident.  If that does happen then the Defendant’s solicitors will try to portray this injury as a subsequent injury unrelated to the accident.

Exaggeration

This is a buzz word with all insurance companies at the moment who like to claim that injured parties are exaggerating.  My experience is that the risk of exaggeration mostly lies in the other direction.  The typical Irish attitude is to down play injuries and to say that you are doing better than you really are.  Just as a person with a minor injury should not portray themselves as being on death’s door, so too a person with a chronic and ongoing pain ought not to say that they are “grand”.  This reluctance to speak up can also lead to the injury not being properly investigated or treated as well as affecting the quality of the medical reports generated.

Follow advice and be open

If physiotherapy or some other form of treatment is recommended then within reasonable limits it should be followed.  If you are unable to undergo physiotherapy for example for financial or other reason, then you need to be frank with the medical expert and explain this them.  If you suffer an extra 12 months of pain because you did not go to physiotherapy, then that is your problem.  If however, the reason you did not go for physiotherapy is because you could not afford it, your GP will put you on a public waiting list.  You may well be on that waiting list for 12 months before you are seen but that delay was not caused by you and you will not be blamed for it. That 12 month delay and the additional pain and suffering during that period becomes the Defendant’s problem and not yours.  It is therefore important to be open and to let your doctors and indeed your solicitor know what is going on so that they can advise you properly.  The same can be said if you have a phobia of needles or medication.  Tell your doctor the problem and they may be able to find a solution.

Summary

So in summary, if you want to optimise your medical appointments for the purpose of your personal injury claim you need to do the following.  Be clear with the medical expert about your injury and how it happened.  Be clear about the impact of the injury on you in all spheres in your life including working, domestic and social life.  Be firm and try not to let the medical expert overlook areas that are of concern to you.  Be consistent and open.  Keeping a diary in order to record the areas of injury and how you are affected can be extremely helpful as memory can fade after a number of months and it is sometimes a couple of years before a case can come to court at which stage you might not recall whether it was your neck or your shoulder that was sorest at the start or how long it was until your arm started tingling.

I hope this article has been helpful.  If you have any queries regarding personal injuries claims please contact us by phone at 061 501100, email Thomas Dowling, personal injuries partner at tdowling@hdm.ie or get a call back by completing our contact form so we can provide you with further information or advice.