Remote examinations and treatment

COVID-19 has had a significant impact on the way that Road Traffic Accident claims have been presented and their progression through the courts. 

In a time when face to face social interaction has been restricted, medical examinations and the rehabilitation of claimants effectively stopped for the first few months of the pandemic.

However, as we learn to live with the pandemic, claimants have been using technology to bypass difficulties and  we are now seeing medical examinations and physiotherapy rehabilitation taking place remotely.

Remote physiotherapy can take place by:

• Video consultation on a mobile phone, laptop or tablet followed by video sessions
• Video initial consultation, followed by self-exercise programme
• Telephone conversation with guidance and advice on a self-exercise plan which is sent online with a condition questionnaire and completed online. The claimant then self-administers the treatment.

The ABI and ACSO (Association of Consumer Support Organisation) issued a statement of intent to provide guidance to claimant representatives on remote examinations. It is currently in place and has been extended to 15 January 2021. The associations are to meet on 11 January to consider further extensions. Although not binding on claimants or compensators, it provides guidance for the use of remote rehabilitation and medical examination.

The statement notes that one-off measures are required at this time as a temporary measure.

It states:

1. There is no requirement for agreement between the parties for a MedCo examination to take place remotely and the cost remains at £180 + VAT
2. Non- MedCo examinations for psychological injuries are encouraged, although the parties should agree what other types of medical evidence are acceptable prior to any examination if taking place remotely
3. Delivery of one on one physiotherapy is agreed for MedCo users and vulnerable road users
4. In respect of other cases the parties may agree to the above on a case by case basis
5. The number of sessions of physiotherapy will be restricted to no more than an initial assessment of 30 minutes and a maximum of six sessions of treatment if this is required, with each session being restricted to 20 minutes rather than 30 minutes
6. Any challenge to the method of treatment shall not be on the basis that it was delivered remotely
7. Each claim for remote physiotherapy needs to be validated on a case by case basis

What does validation mean?

In essence, claims for rehabilitation should be presented in the usual way, with confirmation that such examination or treatment has taken place remotely and include details of any technology used.

Medical examiners are still required to provide evidence of identification of the claimant and length of time spent in the examination.

Rehabilitation should provide a breakdown of initial consultation, triage, number of sessions and how the sessions took place. It is clear that any ongoing programme by self-help should be identified.

Difficulties faced by compensators

1. The above statement is not binding and not all claimant representatives have signed the agreement.
2. Within the portal, we are all aware that the provision of rehabilitation documents can be limited and further queries need to be raised. Validation of treatment, particularly whether such treatment has been carried out remotely, is a valid query but puts the compensator at risk of being “timed out” from making further offers should the claimant fail to respond. As such, it is important that any request for further evidence is set out fully at Stage 2 together with reasons for the request and an offer subject to that information being provided.
3. More serious injuries are unlikely to be suitable for remote examination, and claimant representatives should seek agreement prior to such examinations taking place. Whether claimants will seek prior agreement is one for the coming months. However, a compensator has to weigh up the costs of delaying examinations and treatment against the restrictions remote appointments place upon the examiner.
4. There is a likelihood of a claim for additional costs of provision of questionnaires and home exercise packs. It is questionable that these costs are recoverable and they therefore should be challenged.
5. Self-help programmes – given whiplash therapy would be standard across these types of injuries, the programme is likely to be generic and have little involvement by the therapist in terms of weekly advice. As such, a one-off payment for initial consultation followed by self-help guidance and final discharge maybe the best approach.

It is likely that remote examinations and rehabilitation will be with us for the foreseeable future, at least until the vaccination process is fully underway. Given the move to such examinations and treatment, it is also questionable whether, given its convenience to the claimant and reduced costs, this will continue after the pandemic is over. It is important that each claim is considered on a case by case basis, with reference to the suitability of whether remote access to treatment and examination is appropriate.  Additionally, compensators should closely monitor the impact the availability of such treatments and examinations has on rehabilitation frequency and overall claims inflation, before taking a final view on whether these new initiatives are appropriate in the long-term.

 For more information, please contact Sue Hampson.