medical EVIDENCE

If you’ve been involved in an accident and have commenced your own claim for personal injuries, one of the easiest and cheapest ways to get evidence that you have been injured is from your regular GP.

This evidence will be in the form of your regular GP’s notes. 

They’ll have those notes stored on a centralised system making it easy to gain a copy of records for your claim.

Your GP will have notes of your attendances prior to the accident, and afterward. You can use these notes to show the insurer that:

For example, if you’ve attended your GP for regular illnesses/concerns over the last few years and then you injure your neck in an accident, your GP notes should demonstrate that you’ve not complained to a GP of neck pain prior to the accident, but after the accident you have.

This can be used as medical evidence to show the insurer you truly did injure your neck in the accident.

Once you have a copy of your GP records, don’t forget to send that information on to the insurer.

The next step in proving the impact of your injuries is to have a specialist medical assessment.

A medico-legal report is a document completed by a medical specialist in the area of your injury (i.e. Orthopedic Specialist for back or knee injury).

The specialist acts as an independent source of information on the extent of your injury.

The insurer will usually insist you have one completed by their ‘independent’ specialists, so it’s a good idea you have your own done too (just so you –and the judge – know the true impact of your injuries).

You should use the specialist’s report to prove things such as:

Medico-legal reports are an essential piece of evidence in your claims.

We recommend that you wait just shy of one year after your accident to book in a medico-legal appointment to gather your own evidence.

This is because your injuries will not have had enough time to recover unless you have waited one year.

Don’t wait too long.

We specifically recommended that you book just shy of one year as these specialists typically have long waiting lists. You ideally want to book so your appointment falls at one year or just over.

Wait too long and the risk is you delay your claim further.

You need to pick a Doctor that is qualified to assess your injuries and provide a medico-legal report, remember all doctor’s are not qualified for this.

For example, if you have a sore neck and get headaches as a result of your injury you need to engage a neurologist, if you have been suffering psychological symptoms since the accident you need to engage a psychiatrist.

Use your common sense to determine which specialist you need. You may need more than one.

Google ‘medico-legal specialists in your area’ to find a list of doctors that are qualified to give medico-legal opinions.

When you phone the specialist’s office to enquire about making an appointment, ask them who the doctor traditionally does work for.

A good idea is to also ask whether the doctor does any work for self-represented plaintiff’s (that’s you). At this time you should also tell the specialist’s office a little bit about your injury just to make sure they can definitely report on those injuries.

If you can find a specialist who will report on your injuries, who usually does work for plaintiff’s and who has dealt with self represented plaintiff’s, then you are on the right track.

Note you will need to have your Notice of Accident Claim Form completed and include your GP’s medical notes.

When you attend a medico-legal assessment, or an Independent Medical Examination (IME) as they are commonly referred to, either one of two parties has requested the appointment. You, or the insurer. Whoever requests the appointment will be responsible for paying for it at the time. The final burden of the cost will be determined at the end of your claim.

We have curated a list of common questions asked by medico-legal doctors, as well as spaces to write your answers. These will help you prepare for the appointment. 

It’s up to you to make sure the Doctors know about all of your injuries. Just because you’ve not been provided with the opportunity to give certain information, doesn’t mean you can’t provide the information.

If you leave the IME thinking the specialist hasn’t asked the right questions – write this information down and date it.

This could come handy later down the track when the doctor provides their report and it hasn’t adequately explained your difficulties.

Similarly if the doctor was inappropriate, overly rude, dismissive of your symptoms or made you upset, note that down as well. If you can provide a record of your thoughts at that time and it’s dated right after the appointment, you are more likely to be believed by the insurer rather than if you raise the issue when it comes time to negotiate a settlement for your claim.

In the absence of a legitimate reason for not attending, the medical specialist will issue a non-attendance fee (usually in the order of about $250 - $500). Another difficulty which arises is that the
specialist usually will not be able to examine you again for a number of months (they have lengthy waiting lists).

This means your whole claim is put on hold while you wait for that rescheduled appointment.

Arrive early – it gives the doctor a good first impression and shows you are serious about your claim.

Doctors will often comment in the report if the claimant is late.

It is important to note that although the medical experts the insurer has asked you to see are theoretically independent, they are regularly engaged by the insurer.

So you can draw your own conclusions as to where you might expect their sympathies to lie in that situation. Of course the doctor is not permitted to lie, however they could review the evidence in the light most favourable to their client’s interest.

In practical terms, one of the things these specialists will try to do is examine other possible causes for
your ongoing symptoms.

They can do this by:

Obviously it is in the insurer’s interests to find evidence which suggests your current problems are not caused by the motor vehicle accident. So there will be a real focus by their experts on that.

The Doctor cannot treat you.

They are there to provide an opinion to whoever has engaged them about your injuries and how they affect your life. They can’t refer you to anyone or try to treat your injuries during your assessment with them.

The doctor is also not able to provide you with an opinion about your medical condition or about the treatment you have received or are considering, such as surgery – you need to ask your own doctor for advice about your condition and treatment.

Don’t forget to bring your original scans or x-ray films to the appointment.

For the reasons above, you can expect there to be wide ranging questions, some of which you may find intrusive.

Even though it may seem that some of the questions you are asked bear no relevance to your injury or  its effects upon your life, it is still in your interests to answer them.

The most important thing is to be honest and open. As with the examinations with the experts we arranged you to see, just “tell it as it is”.

That means it is essential to:

It is also not uncommon for the insurer’s specialists to treat you with disrespect or even disdain.

They can be abrupt and rude at times.

It may be used as a means of making you agitated and saying things you don’t actually mean.

The best way to proceed is to simply be prepared for the fact you may be treated that way and to ignore it.

If you are treated inappropriately there is nothing wrong with asking the specialist to speak to you civilly. Alternatively, the specialist may treat you civilly and politely and even appear to be sympathetic or friendly.

Don’t be fooled by that.

That sort of approach can be used as a means of disarming you and making you say things in a more
informal context that you might not ordinarily say (which then leaves things open to misinterpretation).

For example, if you were to respond saying that you are “ok” or are “better” the specialist will probably directly quote you as saying that, without further explanation (even though you probably meant that you were better by comparison to how you were immediately after the accident, but still having  problems).

If you leave the IME thinking the insurer hasn’t asked the right questions – write this information down and date it.

This could come handy later down the track when the insurer’s doctor provides their report and it hasn’t adequately explained your difficulties.

Similarly if the doctor was inappropriate, overly rude, dismissive of your symptoms or made you upset,
note that down as well.

If you can provide a record of your thoughts at that time and it’s dated right after the appointment, you
are more likely to be believed by the insurer rather than if you raise the issue when it comes time to negotiate a settlement for your claim.

The insurer’s experts will attempt to find some other possible explanation for your current symptoms.

Another feature of their reports is comments they make about your credit or honesty.

They will have a close look at your medical records dating back prior to the accident. They will also look
at what you have told other medico-legal specialists.

If you do not tell them about other injuries, accidents or symptoms you have suffered they will note that.

For example, they might record “the patient denied any history of prior complaints” and then also point out the fact there have been complaints noted elsewhere in the medical records/reports (if that’s
applicable).

That will then be used as a means of suggesting that you are not being entirely honest. It is not uncommon for people to forget about previous ailments or injuries. Often they may seem insignificant at the time. But in the context of a claim such as this they can take on a whole new relevance and meaning.

The doctor and their staff will observe you not only in the examination, but also:

The doctor will typically be on high alert for any sign of deception or exaggeration of symptoms, and can be expected to report any impression that the patient is intentionally or unintentionally exaggerating any symptoms.

For example, don’t move freely in the waiting room but then complain of restricted movement during the examination – chances are the doctor or staff have made notes about your movement while you’re not in the doctor’s room.

Similarly doctor’s will often make notes about how a claimant moves their body when they are being interviewed compared with when the doctor asks them to move that part of their body.

They may also try to trick you – by asking you to look at something in their room for a seemingly innocent reason whereby they are actually measuring your ability to turn your neck without alerting you to the fact they are doing so.

Wear appropriate clothing – you will be asked to perform exercises and the doctor will want to be able
to see your body moving.

Try to dress comfortably but presentably, as the doctor could also comment in the report about that.

The doctor will also observe your weight and personal hygiene.

Do not be offended, this is to determine whether your injuries or condition have affected the way you present yourself.

If you are unsure about something – phone the doctor’s rooms. The doctor should be able to speak to you about this, that’s why you’ve paid a lot of money for this report.

Once you have the report you are happy with, you need to serve this report on the insurer. If they haven’t had you assessed for your injuries yet, now is the time to put some pressure on them to do that by showing them you have your medical evidence and are ready to start negotiating a settlement for them.