For claimants undergoing independent medicolegal examinations, attending multiple expert assessments by separate specialists is often an unpleasant and confronting experience. Unfortunately, many claimants must travel away from home to their nearest major city, where they are subjected to multiple back-to-back assessments over a two- or three-day period. While each medical examination serves a critical purpose in arguing a case, the cumulative toll on claimants is often overlooked, resulting in traumatisation and “examination fatigue.”

The Repetitive Cycle

In claims running over several years, individuals may be required to undergo multiple rounds of expert consultations and examinations. This process demands that they recount the same events, symptoms, and medical history multiple times—sometimes years after their injury occurred. This can lead to frustration, distress, and inconsistencies—not because the claimant is being deceptive, but because human memory and emotional responses naturally change over time.

A Psychological and Physical Toll

For individuals suffering from conditions such as Functional Neurological Disorders and Post-Traumatic Stress Disorder, reliving an injury through repeated questioning and physical examinations is known to exacerbate symptoms or even lead to withdrawal from the assessment process altogether.

Impact on Medicolegal Opinions

Examination fatigue often affects how claimants engage with their independent assessments. This is why experienced Independent Medicolegal Examiners must be adept at putting claimants at ease. They should adopt a nuanced communication style that considers the broader context of the case, prior assessments, and the natural effects of repeated questioning on recall and emotional response.

Lessening the Risk of Examination Fatigue

Examination fatigue can be mitigated by considering the following when booking your IMEs:

• Scheduling home assessments where appropriate and using experts willing to travel.
• Combining medical and allied health assessments (e.g. rehabilitation physician plus occupational therapist or pain medicine physician plus psychiatrist).
• Limiting IME scheduling to no more than two assessments per day.
• Utilising remote assessments with a surrogate examiner if needed.
• Forewarning the IME about an individual’s specific anxieties and requesting that an accompanying person be present.
• Choosing IMEs with recent clinical practice experience who are used to putting patients at ease in their everyday work.
• Engaging cross-skilled experts (e.g. a dual-qualified physician in both pain medicine and psychiatry or pain medicine and rehabilitation).
• Engaging firms or specialists that provide combined examinations using two or three individual experts, reducing examination fatigue while also lowering overall costs.

At INDEX Medicolegal, we recognise the importance of court-worthy and trusted assessments performed in a manner that respects each claimant’s individual needs. As civil procedure rules regarding the use of expert evidence shift away from adversarial processes, our approach to independent medical assessments should also evolve—balancing the needs of legal proceedings without retraumatising the claimant.