SIRA releases updated guidance on medico-legal examinations

The State Insurance Regulatory Authority (SIRA) has updated its guidance for insurers and injured people's legal representatives regarding medico-legal examinations amid the COVID-19 pandemic.

According to the updated guidance, the Public Health (COVID-19 Mandatory Face Coverings) Order 2021 applies to indoor areas of premises where medico-legal examinations are conducted. The regulator clarified that the rule does not apply to premises used for providing health services, but medico-legal assessments are not expressly included as “health services.”

Medico-legal assessors, claimants, and other attendees must wear a face mask during the in-person assessment. They should only remove their mask if it is necessary for the proper assessment of the claimant, and they must resume wearing the mask as soon as practicable after the aspect of the assessment ends, says the guidance.

Other rules include:

• If an in-person examination is determined to proceed, both the injured person and health practitioner should agree for the examination to proceed. Before a decision to proceed is made, consideration should also be given to whether the examination is likely to impact the injured person's safety, health, and wellbeing (see point 3 of the current SIRA Guidance) and the impact of any delay.
• No or limited in-person, psychiatric examination must occur in the Greater Sydney area until the Public Health (COVID-19 Mandatory Face Coverings) Order 2021 is amended or withdrawn.
• Medico-legal examinations could be postponed in instances where:
• the matter is not urgent (see point 1 of the current SIRA Guidance);
• an appropriate method of examination is unavailable;
• an examination is likely to cause unreasonable risk to the injured person or health practitioner's safety, health, and wellbeing; or
• where the injured person and insurer agree that the examination should not proceed.

SIRA also issued a reminder that masks would reduce non-verbal communication, so it would be difficult for the medical assessor and claimant to communicate properly.