Call for compo claims to be suspended if medical exam refused

Injuries board obliged to continue handling claims despite absence of report

PIAB: Medical reports filed with claims often “do not provide us with adequate information” and have to be coupled with later examination. Photograph:  Thinkstock

PIAB: Medical reports filed with claims often “do not provide us with adequate information” and have to be coupled with later examination. Photograph: Thinkstock

 

Legal compensation claims should be suspended when claimants refuse to attend a medical examination, the Personal Injuries Assessment Board (PIAB) has urged the Government.

Currently, the PIAB is obliged to continue handling an injuries claim, even if a claimant fails to lodge details of “special damages”, such as medical bills or loss of earnings, or fails to attend an independent medical examination.

Medical reports filed with claims often “do not provide us with adequate information” and have to be coupled with later examination “when rehabilitation is more advanced”, it said.

The declaration was made by the PIAB in a submission to the Department of Jobs, Enterprise and Innovation, which has carried out a consultation into personal injury claims in Ireland for the last two years.

“However, going to the point at issue, where there is no compulsion for a claimant to attend such an examination, issues have arisen where we are under statutory obligation to proceed with an assessment,” it declared.

Submissions received by the Department of Innovation and Jobs about the operation and implementation of the PIAB Acts 2003 and 2007 have been released to The Irish Times under the Freedom of Information Act.

Special damages

The agency, which has nine months to deal with claims, wants to put applications on hold when a claimant refuses to attend for a medical examination or fails to return details of “special damages”.

The PIAB’s opinions about those who fail to supply documentary evidence, or with those who fail to furnish paperwork needed by claimants, was echoed by insurance firms, the Road Safety Authority and Dublin City Council.

In its paper, the injuries’ board said: “(S)pecial damages details are often not available from the various service providers/institutions at the application stage and again issues arise when we encounter same not being presented on request for a variety of reasons.

“Providing the board with the facility/option to put the statute ‘on hold’ supports the claimant as they seek out the required documentation and fosters engagement with the board where any reluctance is encountered.”

The State Claims Agency (SCA) said in its submission that the personal injuries body should review its rules dealing with “recalcitrant claimants” who refuse to attend independent medical appointments.

In its submission, Dublin City Council said there were “occasions” when a claimant did not attend independent medical appointments for which the council had paid.

“Such fee should be deducted from any award ultimately made in favour of the claimant,” it said.

Claimants should be prohibited from introducing new information or details of the claim that were available but not submitted to the board prior to assessment.

Medical negligence

The board should also be able to deal with medical negligence claims, which currently do not fall under its remit.

The Department of Health said it had no objection in principle to the board assessing clinical negligence cases where liability is not disputed, but said change must avoid “placing an unnecessary administrative burden on hospital staff”.

Its submission said: “The Department notes the risk of an increase in the number of claims, should persons be attracted to a fast-track and low-cost claims assessment system for medical negligence.

“An increase in the number of claimants could have significant implications for resource allocation within the public hospital system, as hospitals would be required to secure, copy and transmit copies of the medical records relating to each of these claims for the Injuries Board, when the same information might subsequently be required by the SCA.”

Similarly, the SCA said it would not object to the PIAB dealing with clinical negligence cases, but there are “special features” associated with these claims that indicates “they are best managed within the existing tort system”.

The SCA did, however, propose that the board should include needle-stick injuries in the classes of claims it assesses as well as those involving minor/moderate psychological sequelae.