In the 1990s , the College of Physicians and Surgeons and the Law Society of Manitoba issued joint guidelines on the preparation and fees for medical-legal reports. While these guidelines are no longer current, they provide useful direction to both physicians and lawyers.

Medical-legal reports are essential to the legal process of adjudicating claims for personal injury. A well-prepared medical-legal report will contribute significantly to the proper and just resolution of a claim for personal injury, expedite the process, reduce cost, and may avoid the necessity of a court appearance by the physician.

If asked to provide a medical/​legal report, first ensure that the lawyer provides a written consent to release the information signed by your patient or former patient (or the patient/​decision maker). The release should be specific enough to allow you to confirm the patient fully understands the nature and extent of the information to be provided. If you are uncertain whether your patient has this understanding, you should discuss it with them before providing the information.

Physicians and lawyers use different language and approach the ​“case” differently. While a physician is generally concerned with the patient’s current condition and the appropriate course of treatment, a lawyer acting on a personal injury claim may ask the physician to comment on the likely cause of the injury or condition (Slip-and-fall? Motor vehicle accident? Workplace effect of noise or chemicals?) and may ask for a prognosis of future and permanent limitations on employment or recreation. It is important to understand why the lawyer is asking for a report and specifically what information is required. If the lawyer’s request is unclear, you should contact the lawyer to seek clarification; it is not unreasonable to provide a draft report.

The letter from a lawyer requesting a report from a physician should make the request in writing. The request should usually include:

1. A clear statement as to whom the lawyer represents.
   
2. A clear statement of the nature of the matter in issue (e.g. motor vehicle accident, workplace injury, etc.).
3. A clear statement of the specific type of information requested by the lawyer for example:
   1. a brief summary of the circumstances of the injury;
   2. the nature of the injury;
   3. the extent of the injury; 
   4. the treatment prescribed;
   5. the severity and location of pain;
   6. a prognosis as to the duration of the injury;
   7. the degree of the present and residual impairment;
4. A clear statement of any specific questions the lawyer wishes the physician to address;
5. An undertaking to pay the fee promptly upon receipt of the report or a clear statement as to the alternate arrangement proposed. Where an alternate arrangement is proposed, the physician is not obliged to prepare the report until an agreement as to payment is reached.

It is recommended that before preparing your medical report, you obtain from the lawyer who made the request a written acknowledgement that they have been advised how your fee will be calculated.

It is recommended that you base your fee on your effective hourly rate for performing other productive work. Be sure to account for the time you spend reviewing the request for the report, conducting a review of the patient’s chart and any other relevant materials, researching, preparing, proof-reading and editing the report, and where necessary, reviewing/​discussing the report with the lawyer who made the request and/​or your patient.

Where a lawyer has given an undertaking to pay for the report or where a request for a report is silent as to payment for the report, the lawyer is personally obligated to pay the account.

If a lawyer fails to pay the physician’s fee, the lawyer can be reported to The Law Society of Manitoba. 

For additional information on the preparation of medical/​legal reports, including the determination of an appropriate fee, or any difficulty with billing or collecting your fees, please contact us.

For guidance on providing reports and forms in a timely manner, click here.