What happens during a medical appointment for an injury claim?

Updated: September 8, 2020

A medical assessment is a critical part of the work injury claim process. Without a medical report, your solicitor cannot make an accurate assessment of your claim. But what can you expect during a medical assessment and how should you prepare?

What is the purpose of a medical?

The main purpose of the medical, or medical exam, is to get your injuries or illness examined by an independent medical practitioner.

The medical expert will write a report on:

  • What injuries or illness you have suffered
  • The seriousness of each injury or illness
  • What impact the injuries or illness has on your life
  • The cause of the injury or illness

Your solicitor will use the information in the medical report to help prove your injury or illness resulted from your work. The medical will also help ascertain how much compensation you should receive.

The medical will also:

  • Arrange for a referral to a specialist if a more detailed diagnosis is needed
  • Recommend further treatment such as physiotherapy
  • Provide a second opinion about your injuries

Where will the medical be held?

You should not need to travel far to attend your medical appointment. With the Work Accident Advice Centre, your medical appointment can be arranged for a convenient location close to where you live.

If you are too injured or ill to travel, a medical appointment can be arranged at your home.

Any travel costs you incur getting to your appointment will be included in the final compensation amount you receive, so keep any travel receipts or tickets.

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What should I do to prepare?

You don’t need to do anything to prepare for your appointment.

However, some preparation will help the medical specialist understand your condition in more detail, and will also help you cover everything you want to talk about.

Keeping a record

Before your appointment, you could keep a diary of how your life has been affected. The diary doesn’t have to be very detailed. A few updates about where and when you are feeling pain, and how bad the pain is, would be very helpful.

You could also write down how your injury has affected your normal life. Would you normally play in a Sunday league, or go to yoga classes, but now you can’t? Are you unable to cook, do housework or play with your children?

Write as much or as little as you want, but try to start as soon as you can. A diary that is weeks or months-long can be very useful when proving the full amount of the pain you have experienced, and the full impact on your life.

Questions to think about before your medical

You could write down your answers, or just use these questions to give you some idea of what to expect at the medical:

  • When did you first learn of your injury or illness? Was it immediately after an incident at work, or sometime later?
  • Have you been to your GP, or to hospital, for treatment?
  • Has your injury or illness been diagnosed?
  • How much pain are you in?
  • Where on your body is the pain? Is it more than one place?
  • Has the pain got better, or worse, over time?
  • Have you had time off work?
  • Have you been unable to do certain things, like lifting, running, or reading?
  • Have you needed any help or care?
  • Did you have any pain before you were injured?
  • Did you have any existing health conditions?

Should I bring any documents?

You can also bring documents and records, like a copy of your accident book report, to the appointment. You might not need other documents, but they can be helpful to refer to if you can’t remember certain details.

Filling out the pre-examination questionnaire

Some solicitors will ask you to complete a pre-examination questionnaire. This is usually a form of questions similar to the list of questions above and will help your solicitor and the medical expert understand more about your case.

If you have questions about the pre-examination questionnaire, your solicitor should be able to help.

What happens at the medical?

If you haven’t completed a questionnaire before the medical, you may be asked to fill one out when you arrive at your appointment.

During the medical appointment, a medical professional (often a GP) will ask about issues like:

  • Your injury or illness
  • The impact on your life
  • How the injury or illness was caused

They will also want to know about any medical treatment you have had or are going to have.

The medical professional may also ask you if they can carry out a physical examination, depending on the nature of your injuries or illness.

Be clear and accurate

You should answer all questions as completely and accurately as you can.

Don’t exaggerate anything. If your account changes later, or it is discovered that you have exaggerated, that could undermine your credibility when making a claim. You may have to accept a lower offer, or the claim could be rejected completely.

What if I don’t know the answer?

It’s fine if you are unsure about something. You could explain why you are unsure, and you can usually provide more information after the appointment, once you have had more time to think.

How long does the medical exam take?

The length of the appointment varies from case to case, but will usually take no more than 30 minutes. Complex or serious injury cases can take longer.

Don’t be offended if the appointment is quite short. The medical expert is not acting as your doctor and although they will likely discuss treatment options and your recovery, their main job is to gather the medical evidence they need to write their report.

You should be able to confirm beforehand, when booking the appointment, approximately how long it will take.

What happens after the medical?

The medical specialist who carried out your exam will prepare a detailed report. This report is sometimes called a 'medico-legal report'. The report will cover the topics and questions that you will have discussed during the appointment, along with relevant details from your medical records and other information.

You will be sent a copy of the report to read and sign, assuming you agree with the report’s contents. If you have any questions about the report, you can ask your solicitor or the medical professional for more information.

What if I don’t agree with the medical report's conclusion?

The report will not be used as medical evidence in support of your claim until you have confirmed you agree with the report’s findings.

If you don't agree with something in the report, or you think a mistake has been made, you should speak to your solicitor or the medical expert as soon as possible. Simple mistakes will be easy to correct.

Your solicitor will be able to advise you further regarding more fundamental disagreements, but in most cases, it will be straightforward to make appropriate changes so you can sign-off on the updated report.

What does my solicitor do with the report?

Your solicitor will read the report carefully and may follow up with you or with the medical expert if they need more information, The solicitor will also check whether the report supports your version of events, and will identify any possible issues.

Your solicitor will consider questions like:

  • Did the injury or illness document in the report match your account?
  • How long will recovery take, and will some symptoms be permanent?
  • How has the injury or illness affected your life?
  • Has the psychological impact on your life been considered?
  • What treatment has been recommended?

Mistakes in medical reports do happen occasionally, and the solicitor will take care to ensure all errors are corrected. It is particularly important that parts of the report that could affect the success of your claim or the amount of compensation you receive are as accurate as possible.

The solicitor will share the signed-off report with the other side, usually your employer’s insurance company or their solicitor. The medical report will be key evidence for agreeing on a total compensation amount and confirming that the employer was responsible for the accident or illness.

Recommended treatment

The main purpose of your appointment is for the medical expert to gather the information they need to write an accurate report. In addition, the expert will also discuss your treatment options with you.

The medical specialist may recommend further treatment, such as physiotherapy, to help ensure your injuries do not get worse, and to ensure that your recovery is as fast and as complete as possible.

The medical expert may also spot something that your doctor missed, or may recommend an alternative form of treatment. In these cases, you should discuss their findings with your own doctor.

Do I have to follow this recommended treatment advice?

If you have been injured in a work accident, you are responsible for “mitigating your losses”. Mitigating your losses means you must follow medical advice and do what you can to ensure your injury or illness does not get worse.

If your doctor recommends treatment, but you ignore your doctor’s advice and your injury gets worse, you cannot claim for this more serious injury. You can only claim compensation for the less severe injury you would have had if you had followed medical advice.

You should discuss any treatment recommended in the report with your own doctor.

Do I have to pay for this recommended treatment?

Not usually. In order to receive certain recommended treatments promptly, you may have to pay upfront. For example, some physiotherapy treatments are not routinely provided by the NHS.

If you choose to follow the recommendations, these treatment costs would apply regardless of whether or not you decide to proceed with a claim for compensation.

If you do decide to make a claim, the cost of any treatment recommended in your medical report usually can be recovered in your final compensation amount.

If the medical treatment is costly, your solicitor should be able to arrange an interim payment to cover the cost of this treatment. This interim payment is paid out by your employer’s insurance company and would be deducted from the total compensation you ultimately get at the end of the claims process.

Medical Exam FAQs

Will I have to pay for the medical exam?

No. Although there is a fee for the medical, you do not have to pay it and you will never be out of pocket. The cost of the medical exam will be covered, and is claimed back from the employer’s insurance provider when you win your claim.

Do I still need a medical if I have already been to the doctor?

Yes. A medical exam should be carried out by an independent medical specialist. The medical professional will also need information that may not be included in your GP’s notes, and they will be assessing your condition for the purposes of preparing a detailed report.

Do I still need a medical if I have fully recovered?

Yes. The medical expert is not likely to recommend treatment if you have fully recovered, but they will still need to discuss the questions listed above with you, to understand in more detail things like how the injury affected your life, and how long your recovery took.

Can I claim if the accident made an existing health condition worse?

Yes. You are entitled to claim for any negative health consequences caused by your employer’s negligence. This includes examples like:

  • Where the symptoms of an existing back injury have worsened
  • Where the worsening of a progressive condition like vibration white finger or hearing loss is accelerated
  • Where dermatitis becomes more painful or widespread

Can I keep my medical history private?

You can restrict access, yes. Although your records are confidential, if you do not provide access to these records, it will mean the medical report could be incomplete. The medical expert will not be able to say with confidence what impact your medical history has had on your condition.

If you have any questions, you could discuss these with your own GP first, or with your solicitor.

Will I need to attend several medical exams?

Not usually, no. In most cases, one medical exam will be enough to gather all the required information and to satisfy all sides that the medical evidence of your injury or illness is accurate.

The employer’s solicitor or insurance company may ask you to attend their own medical if they strongly disagree with something in the report. Also, in rarer or very serious cases, the first medical expert may recommend that you attend a further medical appointment with a specialist in your type of injury or illness.

What should I do if my injuries get worse later on?

After your medical report is complete, if your injuries seem like they are getting worse, you should contact your solicitor as soon as you can.

You cannot claim more compensation once your claim has settled. If your injury is more serious than expected, your solicitor may need to arrange for a second medical to have your condition reassessed.

The second report can then be used to argue that you should be awarded more compensation, but this must be done before the claims process completes.

Have you been injured at work?

If you have been injured at work in the last 3 years, you may be able to claim financial compensation.

Find out more about making a work accident claim:

  • Do you qualify?
  • How much compensation could you get?
  • How does No Win, No Fee work?

Read more: Work accident claim guide

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