Letters of Instruction (LOI) Explained

Referrals include a Letter of Instruction, and a brief of all records.

A referral to our medical experts must include two things, a letter of instruction on the reffering party’s letterhead, and the briefing documents.

The letter of instruction is the outline of the current situation, the type of claim, the specific questions, and a summary of the documents enclosed in the brief.

The brief includes all applicable medical records, including previous medico-legal assessments, hospital records, GP consultations, and any records that will give the medical expert a fuller picture.

Our experts work under the Expert Witness Code of Conduct and (where applicable) relevant court rules for civil proceedings. Our sample LOIs prompt the medical expert to confirm this in their report.

The Letter of Instruction sets the intention for the assessment.

The letter of instruction is the outline of the current situation, the type of claim, the specific questions, and a summary of the documents enclosed in the brief.

Key Information

Medical conditions, time/dates

Reported symptoms, time/dates

Undertaken treatments, time/dates

Brief Enclosures

Summary of documents and their date

Background

Detailed background relevant to the claim, including history of the illness/injury, treatment received, and employment details.

TIP – Break history into pre‑injury / at the time / post‑injury to clarify impacts on activities of daily living (ADL)s and work capacity.

Type of Accident

Where appropriate

Details of the Accident

How, when, injuries sustained and relevant circumstances and context.

Specific Questions

This is where a majority of the skill comes into writing a well crafted LOI. The questions asked will help the parties understand the nuance of the situation, the rehabilitation, diagnosis, prognosis, pain and suffering, impacts on the examinees occupation, impact on their recreation and domestic activities, and any other comments.

Questions tend to be heavily sub-questioned, to account for a range of possibilities when the expert is doing their interview.

The best LOIs have tailored questions, and account for a range of possibilities.

TIP – Some medical experts have limits, either explicit or preferred, on the quantity of questions asked. It’s best to speak to your member of Customer Experience to understand how your preferred Medical Expert tends to work in matters like you are referring.

The best LOIs are written anticipating where the investigation will go, so appropriate follow up questions can be drafted. Sub-questions that delve into matter important topics and general questions that highlight a range of considerations for the matter.

Our sample LOI for a personal injury matter covers the nature of the injuries, diagnosis, prognosis, current treatment and medication, permanent disabilities, pain and suffering, permanent impairment, occupational impact of the injuries, recreational and domestic impact, future treatment, and rehabilitation. Our other sample LOIs for different matters contain specific questions that relate to the general nature of those matters.

Report release considerations

Red Health recommends clarifying with the independent medical expert if reports, if requested, can be released to the examinee directly or if they can instead be released to treating physicians.