Monday, 7 August 2017

Areas of Medico-Legal Unreliability in Personal Injury Cases


Combining clinical and medico-legal analysis of any one particular civil case being litigated is an innovative approach devised by the first author and his colleagues to address both clinical/psychological and medico-legal aspects of complex personal injury cases [1-3]. This unique analysis ensures a comprehensive approach to understanding the key medicolegal processes in psychological assessment. This paper develops this innovative process further and highlights the application of key medico-legal postulates and develops these in respect of dispute resolution and the use of the Joint Statement process, uniquely developed and practiced in the UK (England and Wales).

Mr. D was a 29 year old man driving alone on a busy arterial road in Cambridge. He was stationary in traffic at an intersection, waiting to turn right. A car approaching from behind collided with the rear of his car at approximately 60 mph. At the time he felt very shocked and although he was afraid he was severely injured, he did not believe he was going to die.This assessment identified the psychological symptoms of stress, mood disturbance, situational travel anxiety as a driver and passenger, social and work disruption. Diagnosis of a Specific Phobia and multi-factorial Pain Disorder (Physical and Psychological aspects) were made with DSM-IV codes of 300.29 and 307.89 given [4]. At time of assessment, 12 months later, despite some improvement, there were residual symptoms of depressive and recreational drug use to help manage ongoing pain. Psychometric test data was consistent with this.

Throughout this case, careful scrutiny was made covering clinical aspects (diagnosis, severity, treatment requirements and likely resolution of symptoms) and medico-legal aspects (causation, multi factorial history, range of opinion, prognosis and material contribution to onset and course of symptoms). The case process was run efficiently by both claimant and defendant teams and the result was that the claimant was recompensed for his injuries, physical and psychological, and the disruption to and time off work. Despite the adversarial process, the use of reassessment, alternative expert assessment and subsequent joint discussion allowed for a professional, logical and comprehensive understanding of the genesis, development and likely resolution of the symptoms and case of Mr. D. In particular, dispute resolution is key to most, if not all, civil cases involving personal injury. The system operating in England and Wales of utilising Joint Statements is unique to the UK and a key characteristic of the ‘therapeutic’ or ‘positive’ approach to understanding and resolving apparent or real differences in opinion in the civil courts.

No comments:

Post a Comment