Guide to Medical Expert Opinion in Personal Injury Claims

What is a Medical Expert Opinion in a Personal Injury Claim?

A medical expert opinion is a critical professional-medical document in any personal injury claim involving bodily harm. It is a detailed professional assessment by a qualified medical expert who examines the victim's medical condition, diagnoses the injuries, evaluates the degree of disability and long-term consequences, and provides a scientific analysis of the connection between the incident (accident, negligence, injury) and the damage caused. This expert opinion is not merely a medical document — it is one of the main pillars supporting your legal claim.

In Israel, in personal injury claims for bodily harm (traffic accidents, workplace accidents, public negligence, insurance claims), a medical expert opinion is almost always required to support a compensation claim. Under the National Insurance Law and Tort Law, the court has authority to rely on expert opinions to determine the extent of disability, loss of earning capacity, and future medical expenses.

Why is Medical Expert Opinion So Important to Your Claim?

When you are injured in an accident or as a result of negligence, your damage is not limited to physical pain alone. It may affect your ability to work, your quality of life, current and future medical expenses, and special needs you may require. A medical expert opinion is the legal tool that translates that physical damage into the legal and economic language that the court understands. It:

• Establishes the type and severity of injury: A qualified medical expert will describe in detail the injuries, clinical findings, test results, and medical developments over time.
• Determines disability percentages: According to accepted medical standards (such as the AMA scale — American Medical Association), the expert evaluates what percentage of normal function is impaired or lost. This will directly affect the amount of compensation.
• Assesses loss of earning capacity: If the injury prevented you from working or reduced your ability to earn, a medical expert opinion will quantify that economic loss.
• Predicts future needs: The injury may require medical treatment, physical therapy, medications, or changes to the living environment. The expert opinion assesses these expenses.
• Strengthens your legal claims: In law, expert opinion carries significant legal weight. The court relies on it to determine the appropriate amount of compensation.

Who Can Issue a Medical Expert Opinion?

Not every doctor can issue a legal expert opinion in a personal injury claim. The Law of Evidence requires that the expert be qualified in the relevant field of expertise. That means:

• A physician specialist in the relevant field: If the injury involves the spine, an opinion from an orthopedic surgeon or neurosurgeon will be more relevant than an opinion from an ophthalmologist.
• Holding appropriate credentials: The expert must have formal training, certification from the National Health Council, and membership in a recognized professional body.
• With clinical experience: Generally, the court will prefer an expert who has years of clinical experience treating patients with similar injuries.
• Legal independence: The expert cannot have a conflict of interest with either party. If the expert regularly works for a particular insurance company or law firm, they may be considered biased.

In Israel, medical expert opinions in personal injury claims are frequently issued by physicians working in hospitals, private clinics, or specialists in specific fields such as neurology, surgery, psychiatry, or rehabilitation medicine.

Stages of the Medical Expert Opinion Process in a Lawsuit

Stage 1: Selecting the Right Expert

The first step is to identify an appropriate medical expert. In tort claims, the plaintiff (or their attorney) often seeks an expert with experience in assessing similar damages. Our firm, Mandelbaum, Gor, Witzman-Gor and Partners, will help you identify a suitable expert with the required credibility and qualifications, and who does not have a conflict of interest. This selection is critical, as an opinion from a recognized expert with legal standing will carry greater weight in the eyes of the court.

Stage 2: Collecting Medical Records

Before the expert writes the opinion, they must collect all relevant medical records. These include: emergency room reports from the date of the accident, test results (X-rays, CT, MRI), hospitalization reports, clinic visits, blood or cardiac test results, and treatment reports. All of these medical documents serve as the factual basis for the expert opinion.

Stage 3: Clinical Examination of the Injured Party

The expert typically conducts a direct clinical examination of the injured party. This examination includes: range of motion testing, muscle strength tests, sensitivity tests, pain assessment, functional tests (such as the ability to walk, lift objects, or stand for prolonged periods), and neurological assessment if relevant. This examination serves to verify previous medical findings and assess the current condition of the injured party.

Stage 4: Writing the Expert Opinion

After collecting the data, the expert writes a detailed report. This report typically includes: a description of the medical history, a description of the injuries and diagnoses, an analysis of test results, an assessment of the degree of disability (often using standard scales), an assessment of future medical needs, and an evaluation of the causal relationship between the accident and the injury. The opinion should be written in clear and scientific language, so that even a judge who is not a doctor can understand it.

Stage 5: Submitting the Expert Opinion to the Lawsuit

The expert opinion is submitted to the court as part of the plaintiff's evidence. Often, the defendant's attorney (the other party) will also request a counter-expert opinion from their own expert to argue a different version. In this case, there may be a need for a legal discussion between the two experts, or even a court hearing in which both experts testify under oath.

Comparison of Types of Medical Opinions in Tort Claims

In various tort claims, the types of medical opinions vary depending on the nature of the injury and the claim. Below is a table comparing common types:

Each type of claim requires an expert in the relevant field to ensure that the medical opinion carries full legal weight.

How Does a Medical Opinion Affect the Amount of Compensation?

A medical opinion is one of the central factors in determining the amount of compensation in a personal injury claim. The court uses the medical opinion to determine:

1. Disability Percentages: The disability percentages established in the medical opinion directly affect the compensation amount. Each percentage of disability is translated into a monetary sum according to accepted legal tables. For example, if a disability of 30% is determined, the compensation may be within a certain range; if a disability of 60%, the compensation will be significantly higher.

2. Loss of Income: If the injured party cannot return to work due to the injury, the medical opinion determines the loss of income. This includes past loss (from the date of the accident until the evaluation) and future loss (if the disability is permanent). This loss is translated into a substantial monetary amount in the claim.

3. Medical Expenses: The medical opinion evaluates current medical expenses (treatments already performed) and future expenses (treatments that will be required in the future). These include surgeries, medications, physical therapy, and special arrangements at home.

4. Pain and Suffering: If the medical opinion describes chronic pain or significant suffering, the court may award additional compensation for pain and mental suffering.

5. Impact on Quality of Life: A medical opinion that describes in detail the impact of the injury on the injured party's quality of life (inability to engage in activities they enjoy, impact on family relationships, etc.) may affect the compensation amount for non-pecuniary damages.

In practice, a high-quality medical opinion can increase the compensation amount by tens of thousands of shekels, or even hundreds of thousands, depending on the severity of the injury and its impact on the injured party's life.

Common Challenges in Medical Opinions

Conflicting Medical Opinions: Often, the defendant's counsel will submit a contradictory expert medical opinion from their own expert, claiming a different version of the injury or its severity. In this case, the court must evaluate both medical opinions and decide which one is more credible. To succeed in your claim, your medical opinion must be detailed, scientific, and based on strong evidence.

Incomplete Medical Records: If medical records are missing or incomplete, the expert may be forced to work with partial information. This may weaken the medical opinion. It is important to ensure that all relevant medical records are collected before the expert writes their opinion.

Time Between the Accident and the Evaluation: If a long time has passed between the accident and the medical examination, it is more difficult to assess the original damage. This may weaken the medical opinion. To avoid this, it is important to consult with an expert as soon as possible after the accident.

Issues with Expert Independence: If there is suspicion that the expert is biased or has a conflict of interest, the court may reduce the weight of the medical opinion. It does not matter how good the report is — if the expert does not appear independent, your claim may be damaged.