Remember in the olden days when preparing a brief would see the office junior at a photocopier for hours, brandishing a hole punch and colorful dividers! There was something inherently satisfying in seeing the neat lever arch files packed up ready to be couriered over. But with medical records now sent via hyperlink, paperless offices, and now that lawyers have moved to digital briefs, the poor trees must breathe a sigh of relief. Unfortunately, medical experts find themselves sighing in frustration as it appears that the use of digital briefs has led to a corresponding deterioration in the quality of the briefs they receive.
As medico-legal report providers we see the good, the bad and the ugly. So here we try to pass on our knowledge to ensure you get the best out of your medico-legal expert and the maximum success from your next medico-legal report.
There is no denying that the medical evidence in personal injury matters is expensive but also crucial to the success of a case. Be that for the Plaintiff or the Defendant. You do not want to get it wrong for your client. With the rules around full disclosure in QLD, rectifying a bad report can be costly in both time and money and potentially disastrous for a case.
As MLR providers the common mistakes we see are just throwing everything at the expert and hoping they will be able to wade through and determine the relevant bits!! The problem with this approach is that like you, the ML expert is a busy person, they have only a short time frame to understand your client’s case, examine them and then prepare a report.
Medico-legal experts are also human, and a badly prepared brief only leads to a badly prepared expert. This can lead to frustration when they are examining your client and writing the report. With a difficult to read brief, the risk is that things get missed. Crucial facts in the medical records can get overlooked when relevant records are not in order and the expert is unable to easily locate documents. A frustrated expert is also not the most efficient way to examine your client! Missed facts can lead to an incorrect opinion, which could be critical to your case.
Getting off to a good start with your expert, is the most efficient way to get the most out of them. Getting it right at the start will reduce unwanted additional costs and time, in rectifying mistakes in reports.
Here are Lex Medicus’ insights into how to get the best from your expert:
How to get right with a digital brief
- Provide your brief as early as possible but no less than a week prior to the appointment
This gives the expert sufficient time to review and prepare. It also allows for any missing material to be identified and provided or questions about the assessment to be addressed.
It means that the expert can approach the assessment with all the relevant evidence and their examination questions in mind.
- Make sure the material is relevant. Do not overload the expert with irrelevant material. Consider what the assessment is about. Does the expert need to see it all? It is unlikely an expert will need to consider a full Centrelink file, tax records or full WorkCover file to access an injury. For a medical negligence opinion on liability, it is unlikely an expert will need to see the full treating records.
Limiting the material to the relevant only, will also save costs as most experts will charge an “excess pages” fee once a brief gets too big.
Keeping it relevant also makes it easier for an expert to consider and find the relevant records.
- BUT Do not miss out relevant material. Consider – have you provided all the medical records that are relevant to the injury in question? Eg. investigations of the injury and treating records, records of pre-existing conditions or previous injuries, incident reports from the subject incident.
Consider – does the brief contain everything the expert will need to assess – causation, diagnosis and impairment?
If you do not have all the records, consider if you want to proceed with the assessment, as you will likely only require a supplementary report when it becomes available.
- Do get and provide radiology reports and imaging. This means the actual radiology images. The typed up report is not sufficient. These are crucial to the diagnosis of most orthopaedic injuries. Without radiological evidence an injury is at risk of being categorised as a 0% impairment.
- Make sure your brief is easy to read – You still need to format the digital brief (as you would a paper file with dividers!!). Do not give an expert one giant PDF that requires clicking in and out of. The expert will get frustrated and the risk is that relevant facts will be missed. It is also increasing the time they are spending reading the material and thereby the costs.
Make sure sets of records are identifiable and kept all together.
- Provide a useable index on the PDF file (not just in the letter of instruction). Rather concerningly, indexes appear to have all but disappeared with the advent of digital briefs! But for a busy medico-legal expert they can be critical to ensure all the material is fully considered.
Provide an index on the PDF file that is hyper-linked to the document location in the PDF. This makes it easy for the expert to move around the brief and return to material during the process without having to begin another search!
- Ensure the material is provided in the same order as the Index. Obvious but not always done.
Just because it is digital and not a visual thing, does not mean that you should not take pride in its creation. The expert is your friend, they want to work with you to get the best for your client. You can help them by providing a beautiful brief. You will be fondly remembered by the expert and the medico-legal provider if you do.
Success starts with the basics.