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MEDICOLEGAL ASSESSMENTS

Alpha Prolipsis  contains prominent specialists highly experienced in the provision of IMEs including Whole Person Impairment Assessments (WPI), Total & Permanent Disability Assessments (TPD) & Work Capacity Assessments.

Our team of expert physicians and doctors have over 10 years experience providing medico legal services to clients across every industry and our professional yet personal approach to both the assessment and the reporting of your case is guaranteed to impress.

With flexible appointments and the ability to arrange appointments at your place of work or home, we are committed to providing you with the highest quality medico legal assessments and reporting 

 

WE SPECIALISE IN

 

  • ADL’s – Activities of Daily Living Assessment
  • Compulsory Third Party Claims (CTP) Assessment
  • COMCARE
  • Department of Veterans Affairs
  • Early Intervention Assessment
  • (ECA) Earning Capacity Assessment (a dual assessment) AKA Work Capacity Assessment
  • File Reviews – Surgical, Occupational and Radiology Interpretation
  • Fitness for Work Assessment and Report
  • Fitness for Employment Assessment (work capacity)
  • Fitness to Continue Assessment
  • Functional Capacity Assessment
  • Functional Capacity Evaluation
  • Health Care Complaints Commission (HCCC) Reporting
  • Home, Hospital and Jail Visits
  • Impairment Assessment
  • Impairment Disability Assessment
  • IME’s – Independent Medical Examination
  • IMC’s – Injury Management Assessment
  • Independent Medical Assessment (Physical and Psychological)
  • Life and Disability Assessment
  • Life and Income Protection Assessment
  • Medical Negligence File Review
  • Medical Negligence Assessment and Report
  • MMPI2 (Psychological) Assessment
  • MAA (SIRA) – Motor Accident Assessment
  • Neuropsychological Assessment (Cognitive impairment)
  • Personality Assessment Inventory (PAI) – Psychological
  • Pre-liability Workplace Assessment
  • Pre-employment Medicals and Assessment
  • Psychometric Assessment
  • Psychogenic Movements Disorder Assessment (PMD)
  • Return to Work Medicals and Assessment
  • Radiology Interpretation and Appointments
  • Seminars – In House and On-Site to your office
  • Superannuation Entitlement Assessment
  • Victim’s Compensation
  • Vocational Assessment
  • Work Capacity Assessment
Health Tips 

MEDICO-LEGAL ASSESSMENT

A medico-legal assessment is used to settle disputes related to the medical health status of an employee. This evaluation provides an unbiased medical answer in cases of occupational injury, occupational disease or short and long term disability. It equally offers the opportunity to ask specific questions to a physician or a specialist regarding any type of case, whether absenteeism, disability, CSST, SAAQ, IVAQ, etc., such as:

Verification of the diagnosis
Date of consolidation or justification for the absence
Assessment of functional limitations
Evaluation of personal pre-existing condition and the possibility of cost-sharing
Assessment of permanent impairment to physical and mental integrity
Relevance of treatment
Possibility to perform simple tasks or temporary reassignment
Motivation of the employee to return to work

CUSTOMIZED APPROACH

The coordination of medico-legal assessments is done by qualified and trained personnel specialized in occupational health that will assist you in the procedure. You will thus obtain a personalized approach adapted to your needs.

With the support of our team, make the right decision in a timely manner and ensure the proper follow-up of your files.

HOW WE CAN HELP

ALPHA PROLIPSIS will tailor its services to meet your individual needs.

REPORTING

At ALPHA PROLIPSIS we only work with high quality specialists who can produce concise, accurate reports in a time frame that meets your needs. Our specialists are experienced, working in private practice and the medico-legal industry. All reports are written in plain English, with a clear, succinct history, and use accepted medical terminology.

We have a dedicated greek based team who transcribe your reports. Every report is proof-read before final approval and release and any discrepancies are highlighted, and the draft report is returned to the specialist to clarify.

You can rest assured your report will be of the highest standard and quality.

ACCREDITATION ACRONYMS

AMS Approved Medical Specialist for WCC (Workers Compensation Commission) for Dispute Resolution
CIME Certified Independent Medical Examiner
COMCARE COMCARE Trained Assessor of Permanent Impairment
GEPI QLD WorkCover trained assessor
IMC Injury Management Consultant - WorkCover Approved.
MAA Motor Accidents Authority - Trained Assessor Permanent Impairment Disputes Assessor
MAS Medical Assessment Service
VWA Victorian Worksafe Assessor
WCA WorkCover Approved
WIA WorkCover Trained Assessor of Permanent Impairment
WPI Whole Person Impairment

SPECIALIST DESCRIPTION

ALLERGIST/IMMUNOLOGIST Asthma, dermatitis, food reaction, drug and insect allergy reaction, hives, dust, mites. Immunodeficiency disorders.
ANAESTHETIST General anaesthesia issues, death related claims (med neg), pain management.
CARDIOLOGIST Stress related claims (work, assault, mva) viral disease, heart attack, angina, hypertension.
CRANIO-MAXILLARY (Head, Neck and Facial) Head, face and neck injury, cleft palate, jaw injury, eyes/eye socket, gun shot wounds to face, MVA and industrial injury.
DENTIST Teeth and mouth injury, jaw and bite problems, TMJ-clicking jaw, temporo-mandibular, loss of teeth, implants
ENDOCRINOLOGIST Hormonal imbalance typically in the gland and endocrine system. Diseases that are caused by problems with hormones, including diabetes, osteoporosis, thyroid problems.
ENT SURGEON (Otorhinolaryngology) Deafness (work related or trauma), diseases of the ear, nose and throat, surgical management of cancers and benign tumours – head and neck. Hearing aids, cochlear implants.
GASTROENTEROLOGIST Treatment of liver disorders, including, Hepatitis, gastroesophageal reflux, colitis, gall bladder, biliary tract disease, cancer/polyps, IBS - Irritable Bowel Syndrome, GIT (upper and lower gastrointestinal system), colon, rectum, spleen, pancreas, bowel.
GYNAECOLOGIST (Health of the female reproductive system) Gynaecology/obstetric issues, including vagina, uterus, ovaries and breasts. MVA/work related, med neg, loss of sexual function, endometriosis, vaginal surgery, pregnancy care.
HAND SURGEON Carpal tunnel, de Quervain’s tenosynovitis, epicondylitis, trauma, burns, trigger finger, Reflex Sympathetic Dystrophy, Dupuytren’s contracture, microsurgery.
NEPHROLOGIST A physician who deals with adult and paediatric study of the kidneys and associated diseases, renal replacement therapy, (dialysis and kidney transplantation), Hypertension, Renal cancer.
NEUROLOGIST Disorders of the central and peripheral nervous system; including all lumbar and neck injury. Headache disorders, migraine, radiculopathy, neuropathy, stroke, dementia, seizures, epilepsy, Alzheimer’s and Parkinson’s disease.
NEUROSURGEON (Neurological surgery) Neck and back injury; including brain injury. Diagnosis and surgical treatment of central and nervous peripheral nervous system. Congenital anomalies, trauma, tumours, ruptured discs, vascular disorders, infections of the brain, degenerative disease of the spine.
OCCUPATIONAL PHYSICIAN Musculo-skeletal injury to neck, back, upper and lower limbs, all soft tissue injury. Epicondylitis, hernia, ganglion, “Q” Fever, Ross River Fever, asbestos, duct and chemical issues, fitness for employment.
OCCUPATIONAL THERAPIST Worksite and Home assessment; Ergonomic and Functional Capacity Assessments
ONCOLOGIST Prevention, diagnosis and treatment of cancer. Medical, surgical and radiation are part of treatment.
ORTHOPAEDIC SURGEON Surgical and non-surgical treatment of musculo-skeletal trauma, neck and back injury, fractures, dislocations, osteoporosis, degenerative disease, bone infection, bone tumours, disc rupture, and congenital disorders.
OPHTHALMOLOGIST Injury and disease of the eye and visual system. Including cataracts, blindness, chemical injury, macular degeneration, trauma to the eyes.
PHYSICIAN Musculo-skeletal injury to neck, back, upper and lower limbs, all soft tissue injury. Epicondylitis, hernia, ganglion, “Q” Fever, Ross River Fever, asbestos, duct and chemical issues, fitness for employment.
PLASTIC and GENERAL RECONSTRUCTIVE SURGEON Facial and body disfigurement, reconstruction due to injury, craniofacial surgery, burns, scarring, skin cancers, melanoma, cleft palate, skin grafting, cosmetic enhancement, carpal tunnel.
PROSTHODONTISTS Dentistry for replacement of missing teeth (implants) and other related mouth or jaw structures by artificial devices.
PSYCHIATRIST (Can prescribe medication) Diagnosis and treatment of mental and nervous disorders including depression, PTSD, dementia, suicidal ideation, bi-polar and schizophrenic issues, stress-related claims, personality vulnerability, drug and alcohol dependence.
PSYCHOLOGIST (Cannot prescribe medication) Diagnosis and treatment of mental and nervous disorders including depression, PTSD, dementia, suicidal ideation, stress-related claims, personality vulnerability, neuropsychological reports for cognitive impairment due to brain injury.
REHABILITATION PHYSICIAN Conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. Pain management, treatment for stroke, and other rehabilitation plans.
RESPIRATORY PHYSICIAN (Thoracic Physician or Pulmonologist) Treatment of lung disease and conditions. Asthma, bronchitis, lung cancer, mesothelioma, pneumonia, tuberculosis, pleural effusion, sleep medicine.
RHEUMATOLOGIST Treatment of musculoskeletal and systemic autoimmune conditions (rheumatic diseases) that affect joints, muscles and bones.
SURGEON Surgical procedures to abdominal organs, blood vessels, surgery due to accidents (trauma), appendix, hernias, gall bladder, stomach and intestinal issues, amputations, fractures, crush injury, veins, haemorrhoids, some orthopaedic surgery, cancer surgery.
VASCULAR SURGEON Treatment of arteries, veins, DVT (deep venous thrombosis), cellulitis, phlebitis, arteries, capillaries, circulation problems.

Role of an Expert

The role of the expert is to educate those involved in the judicial system regarding the standard of care provided, taking into account all facts and variables relevant to the case including the practice setting. The authors have come across a number of cases of negligence to provide their valued opinion based on the facts of the case. The second author with a vast experience in the medicolegal field has provided expert opinion in various courts and also has drafted a number of opinions concerned with medicolegal cases. The ignorance of the judicial system toward the medical field was evident when the authors came across the questions put forward by the legal personnel in a number of cases. The general rule relating to evidence is that witnesses give evidence on the facts of the case, while the inference to be drawn from these facts is a matter for the judge. If the witness offers an opinion, the function of the judge is usurped [3]. There are, however, exceptions to this rule. The opinion of experts is admissible where competency to form and opinion upon subject can only be acquired by a course of special study, and where the judge could not otherwise form an opinion. In the Indian legal system, an expert is defined under Section 45 of Indian Evidence Act [4]. Accordingly, expert opinion is expressed by a person having specialized knowledge in a particular field based on his/her training, study, and experience. The opinion must be wholly or substantially based on his/her expert knowledge. Expert witness can be appointed either by the consent of both parties or by the court. Their opinion is useful in both civil and criminal cases. The physician called on as an expert physician should devote sufficient time to examine all the material provided to him/her on a particular case. In V. Kishan Rao versus Nikhil Super Specialty Hospital and another [5], the Supreme Court concludes that expert opinion is required if the case is complicated enough to require the opinion of an expert or that the facts of the case are such that it cannot be resolved by the members of the fora. The Court makes it clear that in these matters no mechanical approach can be followed by these fora. Each case has to be judged on its own facts. It is unwise for the expert physician to depend only on the analysis of documentation undertaken by other experts involved in the case. If possible, the expert can ask for the examination of the patient as it may substantially differ from the facts noted in the documentation and shed a different light on the case.
Whatever the purpose of the report, the expert should remember that opinion should be clearly differentiated from the facts on which the report is based. The opinion is the expert evaluation of the significance of these facts, together with a conclusion, which should include specific recommendations relevant to the issue in hand and, if appropriate, an assessment of risk or dangerousness and prognosis for the future. It is important to remember that negative findings are of much value to the judicial process as positive ones.

Who Can Issue an Expert Opinion?

The first and foremost thing to be looked into is that the expert physician should have relevant clinical expertise and familiarity with the issues in order to discharge the responsibility. It is inappropriate for those physicians who obtained their relevant qualifications recently to provide opinions on an event that occurred many years ago without declaring this potential discrepancy and without learning the practice patterns and standards of care existing at the time of the event as it takes many years for the litigation case to be tried in a court of law. Likewise it is also inappropriate for the physician who has stopped practicing in providing expert opinion in a recent case as the modality of diagnosis, treatment, and the standard of care may vary to a substantial degree. The best opinion that can be taken into account is the one provided by a physician with similar qualifications and practicing under similar circumstances.

The individuality for providing expert opinion differs from case to case. The lawyer for the plaintiff or the defendant may ask an individual physician to provide an opinion or the judge may ask an institutional head to provide an expert opinion. When the head of a medical institution is called on to provide an opinion, he/she in turn has to form a committee of experts and one among them should be a medicolegal expert who can draft and analyze the matter under purview taking medical, legal, and ethical issues into consideration. The medical superintendent or the director of the medical institution should chair the committee. Each fact of the case should be analyzed by the experts individually pertaining to their field of expertise and finally arrive at an opinion.

Structure of the Report

It is important to bear in mind that a medicolegal report is usually addressed to laymen who are not experts themselves. Although lawyers and judges who frequently deal with medical matters gain knowledge of medical terminology, it can often be inaccurate and no assumptions should be made. The report should be clear, understandable, with little application of technical words and professional jargon as possible [6].

It is often seen that the committee experts provide opinions in a single line without mentioning the list of documents which were scrutinized in order to conclude. The institution should have a format that enlists all the particulars required in a given case. The authors have tried to enlist the required particulars for providing an expert opinion.

The experts should identify themselves as a physician in good standing and are registered practitioners. The year of certification in their specialty with the Medical Council of India should be stated; identify any additional subspecialty interest and qualification.
The experts should state what their type of practice is at the time when the particular case under review occurred and what it is at present.
The experts should state the number of years of experience in field of their expertise.
The experts should state their affiliation to the hospitals and universities.
The experts should state that their clinical practices are relevant with the elemental facts under review of a particular case.
The committee should itemize the information provided to them to be reviewed.
The committee or the expert should provide a synopsis of the facts contained in the documentation using objective, nonslated language.
The experts should identify the issues pertaining to the standard of care of possible relevance to the clinical outcome.
For each issue identified in the report, the committee should opine whether standard of care was met.
If certain facts are missing or required any other additional information at the time of drafting the report and if the expert opinion is subject to change if other facts under query are provided, they should state clearly in the report.
The experts should provide reason for the basis of opinion with appropriate reference: a standard textbook, specific review article, and guidelines, widespread clinical practice in the expert’s jurisdiction or personal experience [7].
The experts should not stray beyond their expertise to provide an opinion on matters about which they are unable to demonstrate special qualification or experience.
The expert should provide the opinion in an unbiased manner.
The report should be comprehensive without being unnecessarily wordy and over-inconclusive. Its length should be dictated by the complexity of the matter under consideration. It is important to be clear at the outset what the issues in a particular case are. If the report has been requested from an outside agent, read the requesting letter from time to time to ensure that the issues are well in mind while writing the report and to check that they have been clearly addressed.
The expert giving opinion in a medicolegal case should be ready to be cross-examined by the defense lawyer in the court of law. Calling the expert to the court to give evidence on the opinion provided by him/her is a matter to be decided by the judge.
Once the report is ready, the experts should sign mentioning his/her designation, seal the cover, and it has to be sent to the requesting party at the earliest. The confidentiality of the report has to be maintained by the authority signing the opinion.