Medicolegal pain practice: What to expect from a medicolegal assessment

Written in association with: Dr Rajiv Malhotra
Published: | Updated: 09/01/2025
Edited by: Karolyn Judge

A medicolegal assessment plays a vital role in cases where chronic pain impacts a patient’s ability to work, perform daily activities, or maintain their quality of life following an injury or incident. These assessments are conducted by specialists in medicolegal pain practice, who evaluate and document the nature, cause, and extent of pain-related conditions for legal or insurance purposes.

 

Woman doing medicolegal pain practice.

 

What is the purpose of a medicolegal assessment?

 

The goal of a medicolegal pain assessment is to provide an objective, evidence-based opinion on pain-related issues. This can be used in various contexts, including:

  • Personal injury claims: Determining the extent of pain and its impact on the claimant’s life following accidents or injuries.
  • Workplace compensation cases: Assessing pain resulting from occupational injuries or conditions.
  • Medical negligence claims: Evaluating pain caused by alleged clinical errors or delayed diagnoses.

 

The assessment also informs legal proceedings by offering clarity on the diagnosis, treatment, and prognosis of pain-related conditions.

 

What happens during a medicolegal pain assessment?

 

During the assessment, the medicolegal pain specialist will undertake the following steps:

  1. Review of medical history:
    • Previous medical records, imaging, and diagnostic reports are reviewed to understand the patient’s health before and after the injury.
    • Details of the incident or circumstances leading to the pain are examined.
  2. Comprehensive physical examination:
    • A physical assessment is performed to evaluate the location, intensity, and functional impact of the pain.
    • Specialists assess for any associated symptoms, such as reduced mobility or weakness, and examine areas that may contribute to the pain.
  3. Functional and psychological evaluation:
    • An assessment of how the pain affects daily living, work, and quality of life.
    • Evaluation of the psychological impact, including anxiety or depression linked to chronic pain.
  4. Expert opinion and report:
    • A detailed medicolegal report is prepared, outlining the diagnosis, the causal link to the incident, and recommendations for ongoing management or rehabilitation.

 

 

What should patients prepare before a medicolegal assessment?

 

  • Medical records: Gather all relevant medical documents, including reports, scans, and prescriptions.
  • Accident or injury details: Provide a clear description of the incident that caused the pain, including timelines and any treatments undertaken.
  • Pain diary: Document the frequency, intensity, and impact of the pain on daily activities to support the evaluation.

 

 

How does a medicolegal assessment benefit patients and legal proceedings?

 

For patients, a medicolegal assessment can validate the legitimacy of their condition and guide future treatment options. For legal professionals, it provides an independent and comprehensive analysis of pain-related issues to support claims or defend against them.

 

By offering detailed, unbiased medical evidence, medicolegal pain assessments ensure that the patient’s pain is appropriately acknowledged, and the legal process is informed by expert insight.

 

 


If you or your solicitors wish to use Dr Malhotra as an expert witness, please contact his PA directly: [email protected]

By Dr Rajiv Malhotra
Pain medicine

Dr Rajiv Malhotra is a highly respected Consultant in Pain Medicine and Anaesthesia based in Liverpool. He is renowned for his expertise in the management of long-term pain conditions and acute exacerbations of pain conditions, including back painneck pain and osteoarthritis. He also specialises in sciaticadegenerative diseases and epidural/nerve injections, and undertakes medicolegal work.

Dr Malhotra qualified in medicine from the University of Liverpool, as well as obtaining a Bachelor’s  degree with honours in pharmacology before going on to qualify in medicine from the University of Liverpool in 2006. He achieved the Fellowship of the Royal College of Anaesthetists in 2011, winning the Macintosh Prize for his exceptional academic achievement. Dr Malhotra then went on to complete an advanced fellowship in pain medicine at the Royal Liverpool and Broadgreen University Hospital NHS Trust, where he currently serves as a Consultant in Pain Medicine and Anaesthesia . In 2016, he was appointed as a fellow of the Royal College of Anaesthetists’ Faculty of Pain Medicine, and was once again recognised with an award for his top scores in the examinations. With extensive clinical expertise in a wide range of pain conditions, Dr Malhotra is dedicated to improving patients' quality of life through his comprehensive approach to pain management. He sees private patients at Spire Liverpool Hospital.

Throughout his esteemed career, Dr Malhotra has held a number of senior positions, and currently serves as the Regional Advisor in pain medicine (Mersey) for the Faculty of Pain Medicine of the Royal College of Anaesthetists. He is also a member of the British Pain Society’s Patient Education Group and acts as chair for the Vascular Anaesthesia Society’s research and auditing group.

Dr Malhotra's dedication to pain management goes far beyond clinical practice. He actively contributes to the field through his research and publications, having published numerous papers which appear in peer reviewed journals. He is also a leading name in education, having completed a Masters in Medical Education in 2015. He supervises trainee doctors and serves as lead consultant on a number of training courses. Dr Malhotra also holds several key roles with Health Education North West, acting as an Educational Supervisor and as a Consultant representative for the Mersey Pain Medicine Training Group. In addition, he regularly speaks at key conferences of fellow specialists on topics related to pain medicine. He also does medicolegal consultations, and you can contact him on 01514525555 for that.

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