From time to time all of us have been required to review a claimant and prepare a further report. This often leads to a dilemma, how much to include in this report from the original report? Some assessors make no mention of the original report or their initial opinion. Others virtually reiterate their initial report.
Confounding the situation is the provision of other reports, some predating the initial report. How to deal with those?
My general view is that my report should tell a story. Accordingly I weave into my report information provided from other reports according to their chronology. I find this far more readable than having a summary of other reports provided in one section after the examiner has written about the incident, treatment and current situation. I find it frustrating to have to read backwards and forwards relating other reports to the timeframe provided by the examiner.
When I have been cross-examined, having written a report and then a review report the usual way of dealing with the review report is that I am asked to pick up the story from when I last saw that person. So why don’t I simply carry on from where I left off.
On a number of occasions I found that a review report is the only report I receive and the type of report carrying on from the last interview I mentioned above gives no background and to that extent is not informative.
Accordingly I provide a brief account of the incident and its aftermath and of any pre-existing relevant matters. I deal with the other medical reports by interweaving them into this narrative.
One note of caution. I saw a man for a WorkCover claim who was a carpenter working for his father’s construction company. His father and older brother were directors of the company. The company failed and his father and brother abandoned it. He was left to pick up the pieces. He had no training in management but felt committed to doing what he could for the subcontractors for the company, many of whom were his friends. It was in that context that he became severely anxious and depressed and ceased work 3 months later.
I saw him initially and then six more times for review. Every time I saw him for review, my focus was on what had happened since I had last seen him. I failed to go back to the events surrounding his psychological collapse. When I was cross-examined the barrister took me to my description of the events surrounding his breakdown. I was surprised to realise how scanty was my description and embarrassed to realise that the two or three sentences I had written were largely taken from a psychological report written at about that time. I had checked with him and he had agreed that what she had written was correct. Nevertheless it was clearly inadequate and my failure to ask him further about this at the six subsequent visits left me with egg on my face.
As usual, when I have stuffed up like this, I go through 24 hours of managing my wounded ego and then focus on “how do I make sure this never happens again”. So when I see somebody for review I always make sure that my description of the initial event is accurate and if any further questions are in my mind I use the occasion to clarify these.
One last point, if the event for which I’m seeing the claimant occurred only 6 to 9 months previously or if the claimant is about to have surgery or to commence psychological or psychiatric treatment or attend a pain management program then I recommend that the claimant be sent back to see me after another 6- 12 months when the situation is likely to have stabilised.