Assessments and Reports
Dr Aliashkevich has accomplished a Ministerially approved training program in the application of the American Medical Association Guides to the Evaluation of Permanent Impairment (4th and 5th Editions AMA Guides) for the spine and nervous system. He provides accurate and comprehensive medicolegal assessments for brain, spine, and nerve injuries and can be a trusted expert witness for all neurosurgical conditions.
Independent Examinations and Reports
Dr Ales Aliashkevich specialises in brain, spine and nerve injuries and has more than 17 years of experience in the provision of medicolegal services. He can offer independent examinations, comprehensive reports, thorough file reviews, teleconferences, consultations and expert witness opinions on a wide range of neurosurgical conditions. As an actively practising surgeon, he appreciates the value of advanced modern diagnostic modalities, such as state-of-the-art radiological and neurophysiological investigations.
His assessments are always in line with the current evidence-based treatment recommendations, considering the values of multidisciplinary approaches and availability of minimally-invasive and motion-preserving surgical techniques. The meticulous collection of history and great attention to the details of clinical presentation and investigations sets him apart from the majority of other medicolegal service providers.
Medicolegal Impairment Assessment
Dr Aliashkevich is certified by the Australian Medical Association (AMA) Victoria and the Personal Injury Education Foundation (PIEF) in Impairment Assessment using the American Medical Association Guides to the Evaluation of Permanent Impairment 4th Edition and other prescribed methods, as applied to relevant Victorian legislation. He completed courses to assess impairments for TAC, WorkCover and the purposes of Part VBA of the Wrongs Act 1958 (personal injury).
He is accredited for assessing the spine using both the methodology from Chapter 3 of the Guides and modification to those criteria by the Spinal Impairment Guides Modification Document (SIGMD). He can perform an expert apportionment to disentangle what impairment may or may not be related to a compensable event.
PERSONAL INJURY ASSISTANCE
Help to Recover from Injury
Our reports are prepared in accordance with the Expert Witness Code of Conduct and the guidelines specified by AMA (American Medical Association) TAC (Transport Accident Commission) and Worksafe. They can be used for a variety of legal purposes:
– assessment of injuries (e.g. related to work, transport accidents, public liability or medical negligence),
– assisting with insurance and compensation claims (e.g. WorkSafe, TAC, third party claims, medical indemnity or income protection),
– impairment assessments,
– estimation of work capacity.
INTELLIGENT AND ACCURATE
Our Range of Medicolegal Services
STANDARD MEDICAL REPORTS
Dr Aliashkevich can provide standard medical reports to TAC and Worksafe agents. Usually, such reports outline the claimant’s medical history related to an injury, current medical condition, its stability, treatment options and prognosis. Lawyers and solicitors may also obtain these reports on behalf of their client.
INDEPENDENT MEDICAL EXAMINATIONS (IME)
Independent Medical Examinations (IME) and reports may be provided to TAC, Worksafe, insurers, employers, lawyers and solicitors, regarding the nature and extent of a claimant’s injuries. They play a critical role in ensuring the right treatment and benefits are provided to injured persons.
JOINT MEDICAL EXAMINATIONS (JME)
Joint Medical Examinations (JME) are conducted on behalf of the TAC and the client’s legal representative. The process is designed to improve client experience and to minimise the number of examinations a client needs to undertake to decide on lump sum entitlements.
WHOLE PERSON IMPAIRMENT ASSESSMENTS (WPI)
Dr Aliashkevich is certified WPI assessments can be conducted based on the AMA or Comcare guidelines in matters where compensation is sought for the permanent impairment of part(s) of an individual’s body. The impairment is calculated in terms of the extent to which an injury impacts your whole person.
WRONGS ACT 1958 – SECT 28LN CERTIFICATE OF ASSESSMENT
The Wrongs Act is governing claims for damages for economic and non-economic loss arising from personal injury and death, as a result of negligence or fault. The Wrongs Act applies to cases involving claims for compensation such as slips or falls in public places, and harm as a result of medical treatment. The Certificate of Assessment is required to claim pain and suffering damages from a significant injury, i.e. meeting the threshold level under the Wrongs Act.
TOTAL & PERMANENT DISABILITY ASSESSMENTS (TPD)
TPD reports are required in insurance claims for compensation if an injury results in permanent incapacity for work.
WORK CAPACITY ASSESSMENTS
Dr Aliashkevich can help determine the injury impact on worker’s ability to perform pre-injury employment or suitability for alternate work duties. The reports may include return-to-work examinations and fitness-for-work assessments.
These reports are usually requested by the Accident Compensation Conciliation Service (ACCS) and help resolve disputes between injured persons and their insurers.
Dr Aliashkevich provides unbiased and evidence-based expert responses to questionnaires requested by TAC, Worksafe agents and insurers, to clarify the nature of injuries, required treatment, resulting impact on work capacity and prognosis for recovery.
EXPERT WITNESS OPINIONS
If required, Dr Aliashkevich can appear in court to provide an expert neurosurgical opinion.
In certain cases, Dr Aliashkevich can provide an expert opinion based on available medical records, imaging, neurophysiological testing results and other documentation.
In complex situations, personal discussions of the case can be very helpful to understand the circumstances. We are happy to arrange a conference to assist with claim evaluation and case assessment.
UNBIASED INDEPENDENT EXPERT REVIEW
Medical examinations form a crucial part of the personal injury and compensation claim assessment. Lawyers, insurers or other parties can request them. They should be performed by the unbiased independent experts who have appropriate qualifications, deep knowledge of the problem and are specifically trained to provide impairment ratings. As an expert witness and healthcare professional, Dr Aliashkevich has a duty to the court to provide an impartial opinion and is not influenced in his opinion by anything but his experience and expertise.
Medicolegal assessment is different from the usual medical or specialist consultation because no patient-doctor relationship is formed, no rereferrals for any investigations are provided, and no treatments are prescribed. The information collected during the appointment is not confidential and will be released to the lawyers and, if required, to the insurer and The Court. This assessment goes much deeper into the claimant’s history, vocational background, employment, accident circumstances and activities of daily living. This evidence is generally collected from the claimant directly and from the supportive documentation. The client or his legal representative is responsible for providing all relevant notes, reports, scans or X-rays before the appointment.
Accurate history is a crucial part of any report, and having just a single conversation with a client like many other examiners do is not sufficient. Clients often complain about memory problems, suffer from mental health problems, take regular opioids/antidepressants/benzodiazepines and may not always provide the same information when asked twice, in particular when feeling pressure form examiners.
Our history collection process involves five separate steps and is much more reliable than just a one-off personal chat:
1. Provided Dr Aliashkevich thoroughly reviews legal documents and analyses the background information. Every possible inconsistency will be identified to be double-checked before seeing the client. Hence it is important to have the documents at least three days in advance so that we have time to read them.
2. All available radiology providers are checked for relevant scans, and the dates of investigations/referrals are noted. The relevant images reviewed and selected for presentation in the final report.
3. Clients are asked to fill the forms with the details and dates of their injuries. If clients have difficulty writing/understanding questions, they are helped by assistants. We aim to send the forms to clients well in advance so that they can prepare them at their convenience and understand what questions will be asked during the appointment. The filled forms will be reviewed by Dr Aliashkevich and compared for consistency with the history obtained in steps 1 and 2.
4. The history is recorded from clients in a personal conversation, and any missing details or inconsistencies from steps 1-3 will be clarified. The history is summarised in the client’s presence so that they can make any amendments directly. The handwritten notes will be collected and stored in a file for further reference.
5. When clients leave, their history is again double-checked for consistency with available records, scans and examination findings. If any important pieces of information are missing or require verification, we will get clarification and updates before sending the final report to lawyers or insurers.
Hence, the clients are encouraged to take plenty of time to get prepared for their appointment and to collect all relevant documents, scans, list of medications and other supporting records. Depending on the type of assessment, the interview and examination may last a long time, and it is important not to feel any time pressure or be under stress.\
PREPARATION IN COMFORT
Before the Medicolegal Appointment
As many of our clients suffer from chronic pain and psychological problems form their injuries, we want to reduce the discomfort of the examination and collect as much information about the injury and its consequences well in advance. We understand that undergoing a medicolegal assessment and going through the details of the injury over and over again can cause additional distress. To reduce the pressure of prolonged medical examination and to allow comfortable preparation, our medicolegal assistant will provide a registration form, health questionnaire and consent form well in advance before the date of the actual appointment.
He/she can also help to answer some questions and make sure that all concerns are covered. We want to make our clients feel as comfortable as possible during their assessment and strive to help to fill the registration form and interview to persons with reading/writing problems. Having a structured questionnaire helps to focus even on the smallest details of the incident and resulting incapacity which may not be initially considered as necessary by the injured person.
The questions will cover various aspects of pre-injury activities, medical history, accident circumstances, treatment received, current medications and injury impacts on daily life, mobility, hobbies etc. Our medicolegal assistant will be delighted to take enough time and to provide guidance through all the fields in the form and to make sure that nothing is missed or overseen. Sometimes, a long time passes after the injury, and the dates or the events may be forgotten. We want to make sure that all the relevant information is recalled and provided during the interview to prepare a robust and comprehensive final report. We will be happy to provide a photocopy of the filled questionnaire on request.
For their comfort, the claimants are welcome to have a support person, carer or legal guardian. A professional interpreter can be arranged if required. Family or friends may not be considered as appropriate interpreters by lawyers or insurers. We can arrange for a chaperone to be present when Dr Aliashkevich performs an examination.
ATTENTION TO DETAIL
During the Appointment
We always aim to start the appointment on the specified time, but sometimes practising surgeons have to deal with emergencies that may cause delays. We apologise in advance for any inconvenience and appreciate the client’s understanding and patience.
The appointment usually consists of 4 parts:
– explanation of the purpose of the assessment;
– time for any comments and conclusion.
The interview includes a discussion of the following topics:
– a history of any relevant pre-existing medical conditions, including when and how they began, what treatment was required and was the outcome;
– if any medical tests and scans were undertaken before the injury;
– educational background and work history;
– the accident or circumstances that caused the injury;
– the investigations and treatment received after the injury;
– current complaints and symptoms;
– current work capacity;
– current medications;
– general health matters;
– the injury impact on basic mobility (standing, sitting, walking, driving), daily living (cooking, cleaning, laundry, shopping) and the ability for self-care;
– the effect of the injury on quality of life, personal, social and recreational activities, i.e. hobbies, sports, family life etc.;
The previously filled questionnaire will be discussed to clarify the answers and to expand on some points if needed.
The neurological examination is not expected to cause any additional pain. It involves measuring height and weight, the circumference of the arms and legs, testing reflexes, sensation, movement of various joints and identifying the affected body parts. The examination is focussed of the injured body part and doesn’t require to undress a client fully. Some clothes may need to be removed to visualise the injured area and note any scarring. The photographs can be taken to document any scars, injuries, deformities, movement restrictions or walking aids as discreetly as possible. The images will be included in the final report and may also serve the identification purposes. These images will be stored securely and deleted six months after the report has been finalised.
Some interviews can be conducted via phone or video conference using Zoom, Skype and similar applications. The report will state that and outline any limitations. A link to join the conference is provided either by email or text message. Parts of the videoconference may be recorded, and screenshots may be taken to include into the final report. All personal and confidential information is securely stored and deleted six months after the report has been finalised.
HIGHEST QUALITY REPORTS
After the Appointment
Medicolegal reports provide significantly more detail than the usual specialist’s letters. They are legal documents which can be used as evidence in courts. In some complex cases, reports can be 30-50 pages long. Analysis of literature and additional evidence (e.g. video footage, surveillance materials) may be required in some situations. Understandably, it may take several weeks to analyse all the evidence and to prepare a comprehensive report which can be presented to a judge and jury.
After the report is finalised, it will be sent directly to the requesting party. As a general rule, Dr Aliashkevich doesn’t mind for his reports to be forwarded to the claimants or their general practitioners if they help with future treatment planning.
Dr Ales Aliashkevich can assist in meeting your requirements timely and in a cost-effective manner. Our fees are based on the volume of the provided materials, the complexity of the injuries and urgency of the request. We can provide the cost estimate in advance, in particular for complex and time-consuming assessments. Our network of locations and flexible timetabling allow to arrange even weekend appointment for the most urgent cases and to respond to short-notice deadlines.
If you have any questions about our medicolegal services, please call our main office on 0390084200 or email us at firstname.lastname@example.org.
All medicolegal appointments are booked by our main office in Surrey Hills. It is located within 2 minutes walking distance from the train station and has plenty of on-street parking available:
miNEURO Consulting Suites
Suite 4, Ground Floor, 619 Canterbury Road
SURREY HILLS VIC 3127
Please call us on 03 90084200 and we will coordinate an appointment most convenient and accessible for your cllients.