Addressing Inconsistencies in PI reports - Dr Mark Burgin
03/06/22. Dr. Mark Burgin BM BCh (oxon) MRCGP explains why inconsistencies are a sign of a good personal injury report and the expert’s skill is in addressing them.
Inconsistencies can arise from an internal error in a report, a mistake by a claimant or a biopsychosocial phenomenon.
Errors in the report can occur when the claimant said that they had no previous neck pain and then said that they had whiplash following a previous RTA.
Claimant often make mistakes and I recommend that all material facts are checked at least once by reading the entry back to the claimant or rephrasing a question.
The commonest biopsychosocial inconsistency is despite LVI the claimant is injured, the expert should consider any explanations that the evidence suggests.
Severity of pain
Where the claimant has stated that their pain is severe any has not taken strong painkillers or attended for treatment further details of the pain may clarify the situation.
Some experts simply opine that the likely explanation is that the pain was not as severe as the claimant suggested and suggest that the claimant is unreliable.
Another approach is to give a range of opinion as possible explanations of the inconsistency and the expert’s own opinion.
Leaving the issue unaddressed makes the expert look either less than independent or sloppy and should be avoided.
Failure to recover
When the claimant states that they have not had any previous problems but is still suffering from significant disabling symptoms well after a reasonable recovery time.
The examination may indicate the cause is an untreated condition which explains the delay in recovery and offers an approach to recovery.
The medical records review may indicate that there could be a pre-existing condition is causing ongoing symptoms or has been worsened by the accident.
Extending the prognoses or referring to a specialist without reviewing the evidence does not assist the court resolve the inconsistency.
Time off work
Most claimants take a few days to two weeks off work as they recover from the psychological and physical stress of the accident although some take no time off.
As the amount of time off work increases there is a risk that it will be inconsistent with the other findings and require an explanation in the reasonableness section.
A logical and reasonable explanation of why the claimant was not able to return to their occupation including the possibility of light duties is key.
GPs sign their patients off sick for biopsychosocial reasons and give insufficient information in the sick notes meaning medical record review is usually necessary.
Conclusions
Inconsistencies can occur for many reasons and the expert must consider the evidence that supports and detracts from the claimant’s version.
Sometimes the inconsistency arises due to insufficient or inaccurate information from the claimant and should be considered as expert error.
More frequently the inconsistency is due to biopsychosocial phenomenon which is the main reason why medical experts are needed in personal injury.
Using range of opinion, medical records review, understanding GP and claimant behaviour can all assist the court in finding explanations for inconsistencies.
This is part of a series of articles by Dr. Mark Burgin. The opinions expressed in this article are the author's own, not those of Law Brief Publishing Ltd, and are not necessarily commensurate with general legal or medico-legal expert consensus of opinion and/or literature. Any medical content is not exhaustive but at a level for the non-medical reader to understand.
Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.
Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk
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