The risks of accepting medical opinion at face value were exposed last year in the West Australian case of Robertson v Chase [2012 WADC 131] in a judgment which cautions practitioners against a casual assumption of the integrity of the medical evidence they put before the court.

Mrs Robertson's claim for damages followed a car accident in 2007 and came before the District Court last year. It illustrates plainly:

  • the need for an evidential basis upon which to offer an expert medical opinion;
  • how to approach injury claims where the only evidence to support the claim comes from the claimant.

There was agreement that a collision occurred but its force was apparently so mild that it failed to produce any objective evidence of physical trauma. All of the medical evidence was therefore based upon the claimant's subjective complaints of pain and suffering and the existence of pre-existing medical conditions.

The treating doctors and independent medical examiners essentially accepted that she had continuing accident-related symptoms and their views were never properly challenged. In the absence of a dispute between the parties on that issue, the court was effectively compelled to award damages.

However, His Honour made the point that in order for expert medical evidence to be of reasonable value, the primary evidence on which the opinions are based (including the plaintiff's own detailed testimony), should be heard in court. In this case, there were numerous gaps and inconsistencies in the evidence and therefore scope to challenge the conclusions drawn from it.

His Honour said that it was "...not uncommon...for litigants to conduct trials on the basis that what a medical witness reports of what he or she has been told by the plaintiff may somehow supplement the plaintiff's evidence of the effects of the...injuries. Formal objection is rarely taken to medical evidence of opinions based on the plaintiff's history, even when the history has not been proved by the plaintiff (emphasis added)."

On the apparent unquestioning acceptance by a senior orthopaedic surgeon of the claimant's complaints of unrelenting symptoms, His Honour commented: "I am not at all persuaded...that the plaintiff will have symptoms...indefinitely. Moreover, common sense dictates the contrary".

The duty practitioners owe both to clients and the court in effect compels them to test and evaluate the evidence they put before it, including the evidence of fellow professionals.

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