Focus on medical expertise – Part.1 (1/2)

The purpose of medical expertise is to assess the bodily injury suffered by a victim following an accident, an assault or an act of terrorism. It aims to determine the after-effects retained by the victim and all the resulting damages.

The appraisal is carried out by a medical expert, usually qualified in personal injury compensation, who may be appointed by an insurance company, a guarantee fund or a court. There are different types of expertise, depending on the context in which they are carried out. Expert appraisal may be amicable. This is particularly the case when the medical expert is appointed by an insurance company. It may be contradictory. This means that the expert doctor’s conclusions can be discussed by the victim or his or her counsel.

Lawyer and referral doctor. Expert appraisal may be carried out by a court. In this case, it is usually requested by the victim, who bears the costs, and the expert doctor is appointed by the court. He will draw up a pre-report enabling counsel for the parties to formulate observations in the form of statements. Finally, after the parties have exchanged views and responded to each other’s comments, the expert will draw up his final report, which he will submit to the court hearing the case.

In addition, it is also possible to request a counter-expertise, either amicably or judicially, to criticize the conclusions reached at the end of an initial expert appraisal.

It’s important to stress that expert appraisal does not begin on the day of the medical examination itself, but is prepared in advance. The assistance of advisors, referral doctors and lawyers is therefore very important. This is particularly important when it comes to preparing your application.

In practice, the first stage of expert appraisal is the mission entrusted to the medical experts commissioned by a company, a court, etc. A summons will then be sent to the victim. The next step is, of course, the expertise itself. Finally, the expert will draw up his report, a copy of which will be sent to the parties.

To ensure that the appraisal goes as smoothly as possible and that the expert doctor’s conclusions are as accurate as possible.

The file must be complete. It must include all the victim’s medical records, including the initial certificate of injury, operating reports, images (CT scans, MRI scans, X-rays, etc.), prescriptions, psychological follow-up certificates and records of physiotherapy or osteopathy sessions.

The file should also include any work stoppages, occupational medicine opinions, invoices and out-of-pocket healthcare expenses. Naturally, depending on the case, it will also be necessary to attach to the file letters, decisions and pensions received from the Social Security Fund, as well as letters from the employer concerning the adaptation of the victim’s workstation or dismissal.

In general, any other useful documents relating to the accident, in order to provide the expert with details of the victim’s medical, professional and situational history in relation to the accident.