Frequently Asked Questions
This page is designed for two overlapping audiences: insurers, statutory agents and legal practitioners who brief neurosurgical experts, and claimants who attend medicolegal assessments.
It brings together the questions that arise most often in TAC, WorkSafe, Wrongs Act, Comcare and TPD matters, and answers them in the same terms used throughout the broader Legal Spine site architecture.
The aim is clarity rather than simplification. Some readers arrive wanting to understand how a neurosurgical IME differs from an ordinary specialist letter; others want to know whether they may bring a support person, when a Wrongs Act Certificate should be obtained, or what happens if they disagree with a report.
What is a medicolegal assessment?
A medicolegal assessment is a formal medical examination undertaken for legal, insurance or statutory purposes rather than for treatment. It is used to assist insurers, lawyers, tribunals, courts and statutory decision-makers with questions such as diagnosis, causation, impairment, treatment needs, work capacity and future prognosis.
At Legal Spine, this means the appointment is not a treating clinic consultation. Dr Aliashkevich's role is to provide an independent expert opinion based on the history, examination, investigations and material contained in the brief, not to commence ongoing care or advocate for any party.
Is the assessment a treatment appointment?
No. The assessment is not a treating clinic consultation and does not create an ongoing treatment relationship. Dr Aliashkevich's task is to assess the claimant independently and provide an expert opinion for legal, statutory or insurance purposes, rather than to take over treatment, alter medications in the ordinary course, or manage rehabilitation.
That distinction matters because medicolegal reports are written to answer forensic questions and may later be tested in conciliation, tribunal proceedings or court. Treating practitioners and expert assessors may review the same injury, but their professional roles are fundamentally different.
What duty does the examiner owe?
The examiner's duty is to provide an independent, objective opinion within the field of neurosurgical expertise. In any court-related context, that duty is owed to the court or tribunal rather than to the party who has commissioned the report.
In practical terms, this requires the report to identify the material relied on, separate fact from opinion, explain its reasoning clearly and acknowledge any meaningful limits or uncertainties in the evidence. That approach underpins the practice's work across IMEs, JMEs, impairment assessments, conciliation reports and court-facing expert evidence.
What distinguishes a neurosurgical IME from a standard specialist report?
A neurosurgical Independent Medical Examination is commissioned as an independent forensic assessment rather than as part of treatment. The report is written for decision-makers and addresses specific questions about diagnosis, causation, impairment, work capacity and treatment within TAC, WorkSafe, Wrongs Act, Comcare or TPD frameworks.
Compared with an ordinary treating specialist letter, a neurosurgical IME is explicitly structured as evidence. It sets out the history, examination findings, imaging, guideline steps and reasoning in detail, anticipates challenge under cross-examination or Medical Panel scrutiny, and applies the correct impairment methodology where necessary.
The practical consequence is that the report is not simply informative; it is usable. It is designed to withstand adversarial testing in a way that routine clinic correspondence is not.
What is an IME?
An Independent Medical Examination, or IME, is an assessment carried out by a specialist who is not the claimant's treating doctor and who has been asked to provide an impartial opinion for a legal or compensation purpose.
The report is provided to the party who commissioned the examination and may later be used in conciliation, tribunal proceedings or court. Because the IME is not a treating appointment, the examiner does not usually prescribe medication, arrange routine treatment or form an ongoing doctor-patient relationship.
What is a JME?
A Joint Medical Examination, or JME, is a single medicolegal assessment arranged jointly by TAC and the claimant's legal representative so that one agreed specialist provides one shared report.
The process is intended to reduce duplicate examinations, minimise claimant fatigue and create a common medical foundation for decision-making and negotiation. Although both parties agree to the appointment, the examiner does not act for either side. The assessment remains independent, non-treating and directed to the proper medical issues arising under the claim.
When is a JME preferable to separate IMEs?
A JME is often preferable where both parties wish to avoid multiple assessments and the medical issues are complex but sufficiently discrete to be addressed by one agreed expert discipline.
This commonly arises where TAC and the claimant's legal representatives want a shared neurosurgical opinion on causation, impairment, serious injury or common law issues without creating the additional burden of duelling experts. Separate IMEs may still be appropriate where there is a genuine disagreement about discipline, scope or the need for independent advice outside the joint process.
How are reports structured?
Reports are structured as evidentiary documents rather than informal medical letters. They usually set out the referral context, the material reviewed, relevant history, examination findings, investigations, diagnosis, impairment methodology where applicable, work capacity or treatment opinions, apportionment where required, and direct answers to the specific questions posed by the referrer.
This structure allows claims managers, solicitors, tribunals and courts to see not just the conclusion but the path by which the conclusion has been reached. It also reduces confusion where the matter turns on technical issues such as guide selection, pre-existing pathology, maximum medical improvement, causation or statutory thresholds.
What documentation should accompany a neurosurgical IME or WPI referral?
High-quality neurosurgical medicolegal opinions depend on complete, organised documentation. A strong referral generally includes a clear letter of instruction identifying the legal context and specific questions, all relevant treating and previous medicolegal reports, operative notes and discharge summaries, imaging reports and, where possible, the image files themselves.
It is also helpful to include neurophysiological studies such as EMG or NCS where relevant, statutory notices, decision letters, conciliation or arbitration outcomes, and any Medical Panel material already generated in the claim. The more coherent the documentary foundation, the more precise and efficient the final opinion is likely to be.
What happens if the brief is incomplete?
If important material is missing, such as imaging, operative notes, prior reports or a clear accident chronology, the report should identify those gaps and explain how they affect the strength or scope of the conclusions.
A proper expert opinion cannot be built on assumption alone, and an examiner should not guess beyond what the available evidence can reasonably support. At Legal Spine, incomplete briefs are treated as a methodological issue. Further records may be requested where possible; where gaps remain, the limits of the opinion are stated openly.
Can the same neurosurgical report be used across TAC, WorkSafe, Wrongs Act and Comcare matters?
The underlying clinical findings, imaging and diagnosis may be the same, but each scheme applies different statutory tests, thresholds and impairment frameworks. TAC spinal impairment, WorkSafe matters, Comcare assessments and Wrongs Act significant injury questions all require the same clinical foundation to be translated through different legal lenses.
A report written for one regime may inform another, but a truly scheme-specific opinion will identify and apply the correct guide, thresholds and legal questions for each pathway. Where multiple regimes are in play, it is often preferable for the report to address each one expressly.
How does SIGMD change TAC spinal impairment ratings?
The Spinal Impairment Guides Modification Document is a TAC-specific instrument that modifies the way AMA4 Chapter 3 is applied to spinal injuries in eligible TAC claims. It applies only to TAC spinal injuries arising from accidents on or after 14 December 2016 and cannot lawfully be used for WorkSafe or Wrongs Act assessments.
Its practical effects include a more refined definition of fracture, a new table for assessing spinal fractures and surgery, and clarified categorisation of certain spinal procedures. For TAC spinal claims within its proper scope, SIGMD can change impairment ratings materially when compared with unmodified AMA4.
How does Legal Spine approach apportionment between degenerative and traumatic pathology?
Apportionment is approached as a reasoned clinical analysis, not an arbitrary percentage exercise. In complex spinal claims, the critical question is often not whether pathology exists, but what portion of the claimant's present impairment is properly attributable to the compensable event as distinct from age-related degeneration, prior injury or other non-compensable causes.
That analysis ordinarily involves comparing pre- and post-injury imaging, mapping the onset and evolution of symptoms against the accident or exposure, considering surgical outcomes and complications, and distinguishing age-appropriate degeneration from pathology that is unusually severe or anatomically specific.
When should a Wrongs Act Certificate of Assessment be obtained?
A Wrongs Act Certificate of Assessment is generally sought when a practitioner needs to determine whether the claimant meets the statutory significant injury threshold required to pursue non-economic loss in a relevant common law matter.
In practical terms, this usually means the matter has advanced beyond preliminary speculation, liability has been investigated sufficiently to justify serious consideration of proceedings, and the injury has stabilised enough for permanent impairment to be assessed meaningfully.
Because the certificate must be issued by an approved medical practitioner and rests on a properly reasoned impairment assessment, timing is strategically important. It should be treated as a threshold medicolegal evaluation with direct forensic consequences.
Can Dr Aliashkevich give evidence in court?
Yes, where required. Medicolegal reports may be relied upon in conciliation, tribunal proceedings or court, and an expert may be asked to clarify opinions or give oral evidence under cross-examination.
That is why reports are written with careful attention to structure, assumptions, methodology and evidentiary discipline. The purpose is not merely to express a view, but to produce an opinion that can withstand formal scrutiny in an adversarial setting.
Can a support person attend the assessment?
Usually, yes, provided the arrangement is reasonable and does not compromise the practical conduct or independence of the assessment. A support person may be helpful for claimants with significant pain, anxiety, mobility difficulties, language barriers or cognitive problems.
At times, the support person may be asked to step out during part of the interview or examination so that the history can be obtained directly from the claimant and the assessment can proceed independently. Where an interpreter is required, a professional interpreter is generally preferable to a family member.
What should a claimant do to prepare?
Preparation tends to improve both the quality of the assessment and the claimant's experience. It is sensible to gather previous imaging reports and, if possible, copies of scans, prepare a list of medications and treating practitioners, think in advance about pre-injury work, household activities and hobbies, and arrange transport so that the day is not rushed.
Where useful, a support person or interpreter should be organised in advance through the practice. Simple preparation often makes it easier to provide a clear, accurate history and reduces avoidable stress on the day.
Will the examiner treat the condition or change medications?
No. A medicolegal examination is not a treatment appointment. The examiner's role is to provide an independent opinion on diagnosis, causation, impairment, treatment issues and work capacity for legal and statutory purposes, not to prescribe medications or manage ongoing care.
The report may comment on whether further treatment options exist or whether surgery is likely to assist, but those opinions are directed to the referrer for forensic or decision-making purposes. Day-to-day treatment remains the responsibility of treating doctors.
Will the claimant receive a copy of the medicolegal report?
Not automatically. In a medicolegal setting, the report is usually provided to the party who commissioned it, such as an insurer, lawyer, tribunal or court, and its release is governed by the legal and procedural context in which it was obtained.
That is another reason the assessment should not be understood as a treating clinic appointment. The report is prepared as independent expert evidence, not as ordinary clinical correspondence to the patient.
What happens if the claimant disagrees with the report?
Disagreement can arise in any medicolegal process, particularly where the issues involve causation, impairment, work capacity or future treatment. A claimant who disagrees with the report would usually raise that issue through the relevant insurer, lawyer or statutory review process, rather than with the examiner as though the appointment were part of ongoing treatment.
Depending on the scheme, the issue may be addressed by clarification, supplementary comment, service of other medical evidence, referral to a Medical Panel, or testing the opinion through conciliation, tribunal procedure or cross-examination.
Will the examination be painful or make the condition worse?
A neurosurgical medicolegal examination is designed to be as comfortable as possible and is not expected to cause new injury. The examiner may need to test movement, strength, reflexes, sensation or range of motion, and those manoeuvres can temporarily increase discomfort, particularly where pain is already prominent.
Claimants are encouraged to say so immediately if any movement causes excessive pain, dizziness or distress, so that the examination can be adjusted. Short-term aggravation of symptoms can occur in chronic conditions, but sustained worsening should be discussed with treating doctors.
What happens if the claimant cannot attend or needs to reschedule?
If attendance is not possible, the practice should be contacted as early as possible. Late cancellation or non-attendance can delay the claim and, in some settings, may affect how the matter progresses.
Legitimate reasons such as illness, transport difficulty or caring responsibilities can usually be accommodated, particularly where notice is given promptly. If uncertainty arises, the claimant should speak with the organiser, case manager or legal representative without delay.