Medical Report

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Medical Report
Medical Report
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The medical report

The medical report is the basis of a legal decision and is initiated by the client if medical expertise is required to assess a situation. A medical opinion is a scientifically based conclusion that a doctor makes about a person's state of health or functional limitations or other medical circumstances. This conclusion is the essential feature of an expert opinion, which distinguishes it from a findings report.

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  • Who can issue a medical certificate?
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In the majority of cases, an expert opinion is based on the taking of the anamnesis, a clinical examination, existing medical documents and findings as well as any objectifying examinations initiated in the course of the expert opinion, such as X-ray or laboratory findings. This process is called medical fact finding. Subsequently, all of this information is evaluated on the basis of medical-scientific knowledge and medical experience, and medical conclusions are drawn, the expert opinion in the narrower sense. In rare cases, an investigation is not necessary or possible, then the report is reimbursed based on the files.

Note There is no generally applicable legal definition of the (medical) report. Usually one understands this as a reasoned - oral or written - statement on subject-specific questions, whereby concrete conclusions are drawn from certain determined circumstances. Depending on the scope of the question and the conclusions to be drawn from it, the legal system uses different terms. The spectrum ranges from medical certificates, medical certificates, medical confirmations to medical reports.

Who can issue a medical certificate?

According to the Doctors Act (Section 2, Paragraph 3), every doctor authorized to practice the profession independently is authorized to issue medical certificates and to issue medical reports.

Proof of special qualification is required from the client for individual special questions. Some examples: Experts in court proceedings must be entered in the list of court-sworn and certified experts, which requires at least 5 years of professional experience and completion of an expert examination. Experts for assessment according to the Federal Care Allowance Act must be certified by the Austrian Academy for Medical and Nursing Assessment (ÖBAK). Appraisers who carry out examinations of the driving license are appointed by the governor.

Subject connection

The limits for medical professional authorizations apply to medical experts in the same way as to other medical activities. According to this, the general practitioner is generally allowed to work as an expert in the entire field of medicine - provided that it is not an expert activity that is explicitly reserved for specialists. Specialists, on the other hand, are limited to the special subject or subjects for which they have been trained and entered on the list of doctors.

Types of expertise

There are different ways in which an expert opinion can be drawn up:

  • Form reports: In this form, the expert writes the results of the anamnesis, the clinical examination and the objectifying findings in the categories specified by the client and summarizes his / her scientific conclusions.
  • Free expert opinion: The expert determines the scope and content of the statements himself.
  • Medical certificates: Such certificates can be limited to very limited findings, such as the presence of illness, sick leave, a ban on gymnastics, etc.

Who can commission an expert opinion?

Medical experts are commissioned by courts, authorities, social security agencies, insurance companies, lawyers or private individuals, among others, to comment on questions of the state of health, illnesses, bodily harm, etc. of those affected. Appraisal assignments come from almost all areas of law, such as:

  • Social law: e.g. statutory health and accident insurance, pension insurance;
  • Labor law: e.g. employer;
  • Criminal law: e.g. public prosecutor's offices and criminal courts
  • Civil law: e.g. questions of liability, compensation for pain and suffering
  • Disability law: e.g. severity of a disability,
  • Family law: e.g. custody proceedings, visiting rights.

The medical expert supports the client (authorities, courts) through the assessment and the resulting expert opinion in the decision. The most important task of medical experts is to present complex medical relationships at the interface between medicine and law in a form that is understandable even for medical laypeople. For this it is necessary that reviewers are not only medical experts, but also have a certain understanding of the respective legal background and that the client ask clearly formulated questions to the expert. The reports must be scientifically sound, medically conclusive, comprehensible and understandable.

Note Private individuals also have the right to hire an expert. However, such private reports do not have the same status in court as the report of a court expert. They can, but do not have to, be admitted as evidence by the court. In such a case, the court expert will be asked for an opinion on the private opinion.

A judicially appointed expert is obliged to take over the expert opinion. The appraiser is to be released from the assignment if the questions asked lie outside his / her area of ​​competence and specialist area, if the appraiser cites reasons for bias or if the appraiser is unable to complete the appraisal due to lack of time to be reimbursed in a reasonable time.

Note The expert is not authorized to transfer the contract to another person or to initiate additional subsidiary reports.

When is a medical certificate necessary?

Medical reports are prepared, among other things:

Before issuing a driving license: the basic requirement for driving a vehicle in Austria is fitness to drive. Only those who are physically and mentally "fit" are allowed to drive a car or motorcycle. You can find detailed information at www.help.gv.at

When applying for care allowance: The expert opinion is an essential basis for the pension insurance institution's decision on granting care allowance. You can find more information at www.sozialministerium.at

  • Application for disability / occupational disability pension: Medical reports are also used to assess pension applications. The basis for the decision as to whether there is disability / occupational disability or whether medical or occupational rehabilitation is expedient is a medical assessment in which the applicant's ability to perform in his / her job is determined. More information at www.sozialministerium.at.
  • For measuring pain compensation, e.g. after a traffic accident.
  • To take a cure or rehabilitation.
  • To clarify liability issues after medical treatment.

Whom can I ask?

There is a separate list from the judicial authorities and also from the main association for judicial experts in which every registered expert can be called up.

How are the costs going to be covered?

The costs for the preparation of a medical report are usually borne by the client. There are also statutory provisions and the Austrian Medical Association's own guidelines.

If someone appoints a private expert, he has to reckon with costs that are regulated in the autonomous fee schedule of the Austrian Medical Association and are also available there.

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