The differences between plaintiff and defence medico-legal reports primarily relate to who commissions the report and the legal purpose it is intended to serve, rather than the content or the standard it must meet. Plaintiff reports are typically prepared to establish that an injury, loss, or impairment has occurred and that it was caused by the actions or negligence of another party. Defence reports, by contrast, are commissioned to respond to those claims, often by examining causation, the extent of injury, and whether the alleged harm aligns with clinical evidence and accepted standards.
Despite these differences in focus, both plaintiff and defence medico-legal reports are governed by the same overriding duty to the court. Experts must provide an independent, impartial, and objective opinion, regardless of who engages them. Understanding where these reports differ, and where they are fundamentally the same, is essential when interpreting medico-legal evidence in Australian legal proceedings.
Plaintiff Medico Legal Reports Explained
Who Commissions Plaintiff Reports
Plaintiff medico-legal reports are typically commissioned by individuals who allege they have suffered injury, impairment, or loss as a result of another party’s actions or negligence. These instructions usually come via solicitors acting on behalf of the injured person.
Primary Purpose of Plaintiff Reports
The primary purpose of a plaintiff medico legal report is to establish injury, loss, and damage, and to demonstrate a causal link between the alleged incident and the resulting impairment. These reports are often used to support claims involving negligence, workplace injuries, motor vehicle accidents, public liability matters, and other compensation-based proceedings.
Plaintiff reports may also address the ongoing impact of injury, including future care needs, functional limitations, and the effect of the injury on daily living and independence.
Typical Areas of Focus
Plaintiff medico-legal reports often place emphasis on the individual’s lived experience of injury. This includes consideration of how the injury affects day-to-day activities, work capacity, and quality of life. Contemporaneous medical records are still critically important, but they are typically reviewed alongside the person’s reported symptoms and functional limitations.
The focus is generally on presenting a comprehensive picture of how the alleged injury has affected the individual, both immediately and over time.
Defence Medico-Legal Reports Explained
Who Commissions Defence Reports
Defence medico-legal reports are commissioned by defendants, respondents, or insurers involved in legal proceedings. This may include healthcare providers, employers, public authorities, or insurers responding to a claim.
Primary Purpose of Defence Reports
The primary purpose of a defence medico-legal report is to respond to the plaintiff’s allegations. This may involve examining whether the claimed injury occurred as alleged, whether there is a causal connection between the incident and the injury, or whether the extent of impairment has been overstated.
Defence reports may also consider whether alternative explanations exist for the alleged condition, including pre-existing conditions or unrelated medical factors.
Typical Areas of Focus
Defence medico-legal reports often focus heavily on detailed clinical documentation, timelines, and contemporaneous records. There is typically close scrutiny of consistency between medical notes, diagnostic findings, and the claimant’s reported symptoms.
In some matters, defence reports may also rely on evidence relating to accepted standards of care or peer professional practice, particularly in cases involving allegations of professional negligence.
Key Differences in Scope
Approach to Causation
One of the clearest differences between plaintiff and defence medico-legal reports is the approach to causation. Plaintiff reports are usually directed towards establishing that the alleged incident caused the injury or impairment. Defence reports, on the other hand, often explore whether causation can be challenged, qualified, or attributed to other factors. Causation is typically provided by a medical practitioner, with an occupational therapy report addressing the functional impact of injuries sustained in the alleged incident.
This difference in approach does not mean one report is less valid than the other. Rather, it reflects the different legal questions each party is seeking to address.
Treatment of Medical Records and Evidence
Both plaintiff and defence reports rely on medical records, but they may emphasise them differently. Plaintiff reports often integrate medical documentation with the individual’s account of their functional difficulties. Defence reports typically place greater weight on contemporaneous clinical records, objective findings, and documented observations made closer in time to the alleged incident.
Discrepancies between records and reported symptoms should be closely examined in both plaintiff and defence reports.
Interpretation of Functional Impact
Both plaintiff and defendant reports should highlight the practical consequences of injury, such as limitations in self-care, mobility, work tasks, or community participation; and should assess whether these reported limitations are supported by objective findings and documented evidence.
What Plaintiff and Defence Medico Legal Reports Have in Common
Addressing Questions Posed in the Letter of Instruction
The difference between plaintiff and defendant reports is often governed by the questions posed in the letter of instruction. This document is where the commissioning party outlines the information they want clarified. The body of a medicolegal report should outline the assessments undertaken, the objective findings, and discuss the impact of this on the claimant’s day-to-day functioning. However, the questions presented by the instructing party may differ as noted above.
Overriding Duty to the Court
Both plaintiff and defence experts owe an overriding duty to assist the court, not the party who instructs them. This duty is fundamental to medico-legal practice in Australia and is reflected in expert witness codes of conduct across jurisdictions.
Requirement for Independence and Impartiality
Experts are expected to provide opinions that are objective, fair, and impartial. Advocacy, selective reasoning, or alignment with the interests of the instructing party can significantly undermine the credibility of a report.
Courts are alert to perceived bias and may discount or reject evidence that appears partisan.
Examination and Evidence Standards
Regardless of who commissions the report, both plaintiff and defence medico-legal assessments require a thorough examination of the individual and careful consideration of all relevant medical material. Experts are expected to explain how they reached their conclusions and to acknowledge any limitations in the available evidence.
Compliance With Expert Witness Rules
All medico-legal reports must comply with relevant expert witness codes of conduct, court rules, and legislative requirements. These rules govern matters such as disclosure of assumptions, acknowledgement of instructions, and the requirement to remain within the expert’s area of expertise.
How Courts Assess Plaintiff and Defence Medico Legal Reports
When evaluating medico legal evidence, courts do not favour reports simply because they are labelled “plaintiff” or “defence”. Instead, weight is given to factors such as the expert’s independence, the logic of their reasoning, consistency with contemporaneous records, and the clarity with which opinions are expressed.
Reports that clearly explain how conclusions were reached, address contrary evidence, and remain within the expert’s scope are more likely to be persuasive, regardless of who commissioned them.
Why Understanding These Differences Matters
Misunderstanding the differences between plaintiff and defence medico-legal reports can lead to assumptions about bias or reliability that are not supported by law or practice. Both types of reports play a legitimate role in assisting courts in resolving complex medical and functional issues.
Understanding these distinctions helps ensure that medico-legal evidence is assessed on its merit, methodology, and objectivity, rather than on which party instructed the expert.
Need an OT Medico Legal Report?
If you require a medico-legal report prepared to court standards, it is critical to engage an expert who understands the importance of independence, objectivity, and clarity, regardless of whether the report is commissioned for a plaintiff or defence matter.
Independent OT Medico Legal has been providing comprehensive, timely, and evidence-based OT medico-legal reports in Australia since 1984. Our reports are prepared with careful attention to the brief, the relevant medical evidence, and the expert’s overriding duty to the court.
To discuss your medico-legal reporting requirements or to make a referral, please contact Independent OT Medico Legal.
We provide services across Australia, including:
- New South Wales
- Queensland
- Victoria
- South Australia
- Western Australia
Further Reading
How OT Evidence Supports Total and Permanent Disability (TPD) Claims
