The only way the ICWA and its lawyers are able to gauge:
• What injuries you have suffered,
• How serious those injuries are,
• The likely prognosis for your condition,
is by what your doctor says. Your doctor will be asked to write reports on these matters. It is on the contents of these medical reports that your lawyer will advise you of the likely amount of compensation you will receive.
It is also on the contents of these medical reports that the ICWA and its lawyers will formulate any offers of settlement which they make to you.
Your doctor will rely on what you tell him/her, as well as their diagnosis of you independent of what you say. If you do not tell your doctor about a particular injury, it is not likely to be contained in a medical report.
You should neither conceal from your doctor any relevant matter relating to your injury, nor exaggerate any aspect of it.
You should avoid relying on medical reports which are other than a complete statement of all your injuries and the extent of them.
The ICWA will pay for your medical treatment from the time of the accident until the settlement of your claim. As part of settlement of your claim, an amount representing the cost of future treatment (if any) should be included. Should the accident be partly your fault, the ICWA will only pay, and be liable to pay, the percentage of medical bills that represents the percentage of the accident that was caused by the other party, eg, if the blame for the accident was 90% on the other party, the ICWA will only pay 90% of the medical bills.
The cost of treatment by physiotherapists is treated in the same manner as your other medical treatment. That is, if the treatment is related to your compensable injury and is reasonably required or desirable having regard to that injury it is treated as any other medical expense.
The ICWA's current policy in relation to the payment of physiotherapy is as follows:
As a general rule, the ICWA's payment of physiotherapy treatment is based on the comments of the Courts and the general policy of the Australian Orthopaedic Association (AOA). In general terms this is as follows:
The ICWA will not pay for physiotherapy treatment unless the treatment is "reasonable". Treatment will not be regarded as "reasonable" if the benefits derived are slight or of a short term duration and other alternatives are available. Further, the ICWA's policy in relation to "passive" physiotherapy treatments (i.e treatments which do not require any significant effort from the patient e.g. ice, local heat and electrical treatments) is that such treatment has a limited application and achieves maximal effects relatively quickly.
Generally the ICWA requires a review of the treatment by the referring doctor after a maximum period of six weeks and the ICWA may dispute its liability to pay for "passive" physiotherapy treatment after this six week period unless the referring doctor advises that its continuance is desirable.
The ICWA will only pay a set fee for physiotherapist's initial consultation and a lesser fee for subsequent consultations. Payment for any excess of these fees will be your responsibility. This excess should be the subject of negotiation during the settlement process.
Furthermore, you should be aware that the ICWA will not pay for "out of hours" consultation (if charged by your physiotherapist) unless there is a valid reason for attending after hours.
Upon accepting liability for your injuries, the ICWA's policy is that it will pay for these treatments, subject to such treatment being reasonable in the circumstances. This will depend, of course, on such things as the type of injury you suffer, the type and frequency of the treatment, the attitude of your doctor to you receiving benefits as a result of such treatment etc.
Unless the ICWA have accepted liability in full, the cost of medical reports is your responsibility. Generally, we would not require a medical report until the ICWA has investigated the accident and advised us of their decision on liability.
If the ICWA accepts liability in full, they will pay the costs of medical reports. If the ICWA accepts only partial liability, they will still pay for the cost of reports in full. Often the ICWA will request that you authorise them to obtain medical reports directly from your doctor.
Our policy is to recommend that this does not happen, and that medical reports are firstly obtained by us on your behalf, before disclosing them to the ICWA.
The reason for this is that medical reports obtained in contemplation of instituting legal proceedings are privileged documents. That is, you cannot be compelled to disclose them to the ICWA or anybody else.
If for some reason a medical report contains information which is incorrect or you do not wish to disclose, you cannot be compelled to.
If you choose, after receiving our advice, not to disclose the contents of such reports, you will have to meet the cost of such reports yourself.
The cost of medical reports can vary significantly between one doctor and another and to a large degree is dependent upon the detail which the report contains.
We at Stephen Browne Personal Injury Lawyers will often request your doctor to answer specific and detailed questions about your injuries and your prognosis, for the purpose of advancing your claim.
Usually the cost of reports from specialists e.g. orthopaedic surgeons, will be greater than reports from your general practitioner.