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10 Issues With Medical Reports That Make Third Parties Suspicious - Dr Mark Burgin

20/08/17. Dr. Mark Burgin BM BCh (oxon) MRCGP gives 10 examples of weaknesses in medical reports that defendant solicitors can challenge with a low value generalist re-examination.

Defendant solicitors are constantly looking for innovative ways to challenge the medical expert’s report such as re-examination by Orthos and more recently fundamental dishonesty. (1)

Re-examination by a low cost generalist is permitted although defendants must have the court’s permission to call an expert or put the report in evidence.

The defendant can however ask tough questions to the expert when a re-examination discovers an unexpected pre-existing condition or other inconsistencies. (2)

Ten examples of the types of problems in medical report that suggest that a generalist re-examination will be useful are given below.


The word severe raises the suspicion that the claimant is at best exaggerating their symptoms and is confirmed when there is an inconsistency between the level of pain and medical care.

The problem arises because many claimants use a five point scale mild - moderate – severe – very severe – extremely severe so that a moderate pain can be classified as severe.

The expert should avoid the use of the word unless it is supported by other evidence such as admission to hospital, investigations, strong painkillers or disability.

Loss inconsistencies

Disability that changes abruptly e.g. where the claimant returns on full duties after prolonged absence from work or returns to work and then after a delay goes off sick or retires.

Where the claimant has a sedentary lifestyle and was planning a large project but has to employ help or needs help with housework for many hours a week for several weeks.

The expert should further investigate with medical records review or offer a range of opinion rather than simply accepting the inconsistency without comment.

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