The expert can still write a report. The harder question is whether a reliable opinion can be given.
Missing information should never be concealed by confident language or replaced with assumptions that fit the claim. The expert should identify what is absent, decide whether it is material and explain what effect the gap has on diagnosis, causation and prognosis.
Not every missing document matters.
A medical bundle is rarely a perfect record of somebody’s life. There may be administrative gaps, duplicate pages or unrelated consultations that add nothing to the issues under consideration.
The expert should distinguish information that would merely be useful from information needed to reach a safe conclusion. Earlier GP records may be essential where the claimant denies previous symptoms. Imaging may matter where the diagnosis depends upon structural findings. Occupational health records may be necessary where work capacity is disputed.
The question is not whether the bundle is complete in an abstract sense. It is whether the absent material could reasonably change the opinion.
The GMC requires medical experts to check whether they have received all relevant evidence and to make clear when there is not enough information to reach a conclusion or when an opinion must be qualified. Practice Direction 35 similarly requires experts to state when insufficient information prevents a definite opinion.
Identify the gap precisely.
A vague sentence stating that “further records would be helpful” gives the instructing party little assistance. The report should identify what is missing, the period concerned and why the material matters. For example:
The GP records supplied begin in January 2024. The claimant reports treatment for similar back symptoms during 2022. Those earlier records are required to establish the pre-accident baseline and may affect my opinion on causation.
The expert should also check whether the material genuinely exists. A claimant may refer to an MRI when only an X-ray was performed. The request should be specific enough for the instructing party to investigate without beginning an unlimited search.
Ask for the information early.
Missing evidence should be raised as soon as it becomes apparent.
Waiting until the report deadline to request records creates avoidable delay. A preliminary review can identify missing date ranges, referenced investigations and incomplete treatment records before the claimant is examined.
The claimant may clarify where treatment took place and whether records exist. Their explanation is not a substitute for documentary evidence where the distinction is material, but it may direct the request to the right source.
If the information is likely to affect the examination, it should ideally be obtained beforehand. An expert assessing psychological injury may need earlier mental-health records to ask informed questions about previous episodes and recovery.
Decide whether to pause or proceed.
Not every gap requires the report to be stopped, the expert may be able to answer some questions while reserving others. Diagnosis may be possible from the examination and current records, while causation remains provisional pending earlier notes. The report should distinguish firm conclusions from those dependent upon further evidence.
If the missing information goes to the centre of the instruction, the expert should pause and explain why. A final prognosis may be premature where relevant imaging, treatment outcomes or specialist recommendations have not been supplied.
The expert should not produce a finished-sounding opinion merely because an administrative deadline exists. Both current GMC guidance and Practice Direction 35 require limitations caused by insufficient evidence to be stated openly.
Use conditional opinions carefully.
Where the missing information concerns a disputed fact, alternative opinions may be appropriate.
The expert might state that if the claimant had fully recovered before the index event, the current symptoms are likely to represent a new injury. If earlier records show continuing symptoms immediately beforehand, the event may instead have caused an aggravation.
This shows how the absent evidence could alter the conclusion without privately choosing the factual version that appears most convenient. Conditional reasoning should remain focused. Alternatives should be used only where the factual difference is material.
Do not assume silence means absence.
A missing record is not proof that an event did not happen.
The absence of an early complaint may weaken a proposed chronology, particularly where the claimant attended medical appointments for other reasons and severe symptoms are later alleged. It does not automatically establish that the symptoms were absent.
Clinical notes are produced for treatment, not as complete transcripts. A symptom may be omitted because another problem dominated the consultation.
The expert should distinguish between no supporting record and a positive contradiction. An entry saying nothing about neck pain is different from one stating that the claimant denied neck symptoms or reported a later onset.
Do not fill gaps with summaries or AI.
Missing source material cannot be repaired by an AI-generated chronology, a solicitor’s summary or wording copied from another report.
Those tools may organise the information supplied, but they cannot establish what an absent document contained. A summary should be identified as a secondary source and checked against the originals whenever possible. MedCo has warned about report errors arising when experts fail to check the contents fully before signing. That risk increases where incomplete information is presented with the appearance of certainty.
Update the opinion when records arrive.
Further information may confirm the original view, require qualification or change it substantially.
The expert should review the new material rather than simply attach it to the file. If the opinion changes, the instructing party should be told promptly and the reasoning explained in a supplementary or amended report. Current professional guidance requires a material change of view to be communicated without delay.
A changed opinion is not evidence that the first expert was careless where the earlier report properly identified the limitation. The problem arises when an unconditional conclusion was given despite an obvious gap. The final report should state what was supplied, what remained unavailable and which conclusions were affected.
Important medical information may be missing for innocent reasons. The proper response is neither to abandon every incomplete case nor to proceed as though the gap does not exist. The expert should ask three questions: what is missing, could it change my opinion, and can I answer safely without it?
Where the answer to the final question is no, the most professional report may be the one that refuses to pretend otherwise.
