Factual Errors and an Incomplete History.
Incorrect dates, seating positions, injured areas or treatment histories can undermine confidence in the report and create unnecessary disputes.
The report should distinguish between the claimant’s account, the expert’s findings and information supplied in the instructions. It should record all material injuries and state whether each has resolved or remains symptomatic. Omitting an injury or giving inconsistent recovery dates may require correction before settlement. Factual errors left uncorrected before the report enters the Portal may affect valuation and credibility.
An Inadequate Account of the Accident.
A diagnosis cannot be assessed properly without understanding how the alleged injury occurred. A report that merely states that the claimant was involved in a collision and later developed pain provides little meaningful causation analysis.
The expert should record the claimant’s position in the vehicle, the direction of impact, whether the vehicle was moving or stationary, seatbelt use and the approximate onset of symptoms. Vehicle damage does not determine whether an injury occurred, but the mechanism should still be considered against the nature and distribution of the symptoms. An unusually prolonged recovery should be supported by identified clinical features and consideration of other causes.
Diagnosis Without Clinical Reasoning.
A list of injuries is not enough. The report should explain how each diagnosis was reached by reference to the history, examination and relevant clinical testing. Treating pain in several areas as separate injuries without analysing the mechanism or findings adds length rather than value. In mixed-injury claims, the expert should distinguish qualifying whiplash injuries from separate non-whiplash injuries and should not rely blindly on software classifications or templates.
The report is also unsatisfactory if it uses diagnostic language outside the expert’s competence. A physical injury expert may describe minor shock or travel anxiety but should not diagnose a psychiatric disorder without appropriate expertise. Where more significant symptoms are present, specialist evidence may be required.
Weak or Circular Causation.
A report may state that symptoms are “consistent with” an accident without answering whether the accident caused them. Consistency establishes possibility, not causation.
The expert should consider onset, mechanism, examination findings, previous symptoms, subsequent injuries and alternative explanations, while distinguishing the claimant’s account from facts supported by records.
Where causation is disputed, the expert may need to explain how the diagnosis and prognosis would be affected if either factual version were accepted. The expert does not decide which account is legally correct but should explain the medical consequences.
An unsatisfactory report assumes that every symptom beginning after the collision resulted from it. A satisfactory report identifies the facts on which the opinion depends and acknowledges when the evidence does not permit a firm conclusion.
An Unsupported Prognosis.
The prognosis is central to valuation because the statutory tariff depends on the duration of a qualifying whiplash injury. It should state clearly when recovery is expected and whether the period runs from the accident, examination or report date. A prognosis becomes vulnerable when it appears arbitrary, contradicts the claimant’s recovery history or is longer than usual without explanation. A longer prognosis may be justified, but the report should identify relevant factors such as continuing symptoms, examination findings, treatment history or pre-existing vulnerability.
Where recovery occurred before examination, the expert must still decide whether the reported symptoms were accident related. Repeating the claimant’s stated duration is not an expert prognosis.
Failure to Handle Medical Records Properly.
Medical records are not required for every first report, and their absence does not automatically make the opinion inadequate. The expert must recognise when records are necessary, particularly where there is a significant pre-accident history, uncertain chronology, disputed treatment or difficult-to-explain symptoms.
When records are reviewed, the report should identify the relevant entries and explain their effect. Copying a chronology without analysis, or ignoring an unresolved causation issue, leaves the opinion without a proper foundation.
Unjustified Recommendations for Further Evidence.
Because one report is expected to be sufficient, recommendations for additional evidence must be reasoned. A further report may be justified where treatment remains ongoing, recovery has not occurred as expected or an issue falls outside the first expert’s expertise.
A referral should answer a defined clinical question. A vague recommendation for orthopaedic, psychological or pain-management evidence, unsupported by symptoms or findings, may add cost and delay without improving the evidence. Failing to recommend further evidence where it is clearly required can be equally problematic. The expert should identify the unresolved issue and explain why another discipline is needed rather than attempting to provide an unsupported opinion.
Fixed Cost Does Not Mean Formulaic.
The first fixed-cost report does not need to be long, but it must be individualised, accurate and reasoned. Templates can support consistency, yet they become dangerous when irrelevant wording remains, classifications are inserted automatically or conclusions conflict with the history. The best report allows the reader to identify the injuries, understand how each diagnosis was reached, see why the accident caused them and follow the reasoning behind the prognosis. It should also make any limitation or need for further evidence clear.
A first fixed-cost medical report is unsatisfactory not because it is brief or because one party dislikes the outcome. It is unsatisfactory when its factual basis is unreliable, its reasoning is missing or its conclusions cannot safely perform the task for which the report was obtained.
