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Medical report stage — England and Wales

The medical report — what it contains and why it matters

The prognosis period in the medical report determines the tariff band. The tariff band determines the settlement value. Everything downstream — the offer, the negotiation, the final figure — is calculated from this single document. The report records the injury and the expected duration of symptoms. It forms part of the evidence used to assess the claim. The review window before approval is the only point at which errors can be corrected.

General guidance only. Not legal advice. The medical report is reviewed before it is approved and submitted.
The claims process
Eligibility Liability Medical evidence Valuation Resolution

The medical report is not a formality. It is the point at which the claim is effectively defined. The prognosis period it records places the injury within a tariff band. The tariff band determines the settlement value. Everything that follows — the insurer's offer, the negotiation, the final figure — flows from what the report says.

Once approved, the report cannot be changed through the standard OIC process. The review window that exists before approval is the only opportunity to raise a factual concern. This page explains what the report contains, what to check before approving it and what to do if something is wrong.

Where this fits
01 Accident
02 Liability decision
03 Medical report ← You are here
04 Settlement offer
05 Negotiation & resolution

The steps below show how the process works at the medical report stage — what the options are, what each path produces, and what is typically considered before the report is approved.

Medical report stage — how the process works 1 of 4

A medical report has been provided.
Here is what that means.

This is the point where the injury and the expected duration of symptoms are recorded. The report can be reviewed before it is approved and submitted.

Medical report — for review
Draft report received
Records the injury, prognosis period, and impact on daily life
Review window open · Approval not yet confirmed

The prognosis period recorded in this report determines the tariff band. The tariff band determines the settlement value. The report can be reviewed before it is approved and submitted as part of the claim.

At this stage, the process
allows different responses.

The response given at this point affects how the claim proceeds.

The report is reviewed before it is approved and submitted. The review window closes permanently on approval.
Option A
Approve the report

The report is accepted as accurate. It is submitted as part of the claim evidence. The review window closes.

Option B
Raise a concern

The report is reviewed and concerns can be raised. Amendments may be made before it is submitted.

The report becomes part of the claim.
The review window closes permanently.

1
The prognosis period is fixed. The period recorded in the approved report is used to determine the tariff band. It cannot be amended through the standard OIC process after approval.
2
Later stages rely on this information. The insurer's offer is calculated from the approved report. The tariff figure in the offer reflects the band the recorded prognosis period produces.
3
The review window does not reopen. If something in the report is inaccurate, there is no mechanism within the standard process to correct it after approval.

Before approval, these factors
are typically considered.

Factors that affect the outcome
  • The description of the injury in the report
  • The recorded duration of symptoms (prognosis period)
  • Whether all symptoms reported at examination are included
  • Whether the report reflects the condition at time of examination
Common issues at this stage
  • Symptoms are missing or recorded incompletely
  • The prognosis period does not reflect the duration of symptoms
  • The report is approved without being read in full
  • The content is not checked before submission

Once the report is submitted, it forms part of the evidence used to assess the claim. The offer that follows is calculated from what the approved report records.

What this page covers

Four aspects of the medical report are covered below.

1 What the report contains The examination, the prognosis period, the injury classification and the impact section — and why each matters
2 What to check before approving Specific points that are reviewed before the report is submitted
3 How to raise a factual error The distinction between a factual error and a clinical opinion — and how the query process works
4 Preparing for the examination What an accurate and complete account looks like — and why preparation is not the same as exaggeration
01

What the report contains

The independent medical report is prepared by a MedCo-accredited examiner with no connection to the insurer or to the claimant. It records four things — each of which plays a different role in how the claim is valued.

The examination

The examination is typically conducted in person and takes 20 to 30 minutes. The examiner will ask for an account of the accident, a description of symptoms at the time and since and an explanation of how the injury has affected daily life. A physical assessment is also carried out.

The report is based on what is said during that appointment and what the examiner observes. It is not a review of GP notes — it is an independent assessment conducted on the day. What is said, and how fully, directly shapes what the report records.

Information can be prepared before the examination — including a full account of symptoms at their worst and all the ways the injury affected daily life, not just how things feel on the day.
The prognosis period

The prognosis period is the direct input into the tariff calculation — the tariff determines the settlement value.

The tariff is structured in bands: up to 3 months, 3–6 months, 6–9 months and so on up to 24 months. The band the prognosis period falls into determines which tariff value applies. The prognosis period is particularly important because even a small difference at the boundary of a band can affect the value of the claim by several hundred pounds.

If symptoms were still present at the examination, the examiner will give a future prognosis — an estimate of when full recovery is expected. If they had already resolved, the report records the actual duration.
The injury classification

The examiner classifies the injuries present. Whiplash injuries — soft tissue injuries to the neck, back or shoulders — attract tariff values set by government regulation. Non-whiplash injuries, such as a knee or wrist injury, follow a different valuation route. Claims involving both types are known as mixed injury claims.

The classification matters because the valuation basis changes depending on what type of injury is recorded. If the report classifies an injury incorrectly — for example, grouping a separate shoulder injury within the whiplash entry — the basis on which the claim is valued changes.

The impact section

The report includes an account of how the injury has affected daily life — sleep, work, driving, household tasks, childcare, exercise and social activities. This section is based almost entirely on what is said during the examination. If an effect is not mentioned at the appointment, it is unlikely to appear in the report.

Effects that seem minor — difficulty lifting, disrupted sleep, reduced driving confidence — can be included. They form part of the overall picture of how the injury affected the claimant's life.

What happens while the report is being prepared →

02

What to check before approving

Before approving the report, a small number of points are typically checked. This is the only point at which concerns can be raised through the standard OIC process. Once the report is approved, that window closes permanently.

The review window

The OIC portal notifies the claimant when the medical report is ready to review. On average, this happens around 29 days after the examination. There is no requirement to approve it immediately. The process provides a review window before approval. Factual concerns are raised at this stage.

The prognosis period

The prognosis period is the direct input into the tariff calculation. Compare what the examiner has written about prognosis duration against the actual experience of symptoms. If symptoms lasted longer than the period stated — or if they were still ongoing at the examination and the future prognosis appears too short — that is a factual matter that can be raised before approval.

The test is not whether you disagree with the examiner's opinion. It is whether the report contains a factual inaccuracy — something that does not correctly reflect what was said at the examination, or that contradicts documented medical history.

The financial consequence of band movement is material. A prognosis of two months and three weeks falls in the up-to-three-months band. A prognosis of three months and one week falls in the three-to-six-months band. The difference in time is two weeks. The difference in tariff value is £290. At every band boundary, a similar step applies.

Check the tariff table below. Understanding which band the stated prognosis places the claim in — and which band a corrected period would produce — shows exactly what is at stake in the figure.
The injury description

Read how each injury is described. Does it match the experience? Are all affected areas recorded? If a specific injury was mentioned during the examination and does not appear in the report, that is a factual omission. If the injury classification does not seem to reflect what was actually described, that can be queried before approval.

In particular, check whether injuries beyond the primary whiplash — a separate shoulder problem, a knee injury, a psychological reaction — are recorded as separate entries. If they are not, the valuation basis may be affected.

The impact section

Does the impact section reflect what was said during the examination? Significant effects that are missing — time off work, inability to drive, disrupted sleep over an extended period — can be raised before approval if they were mentioned at the appointment but are absent from the report.

Financial losses are assessed separately, but an accurate impact account supports the overall consistency of the claim.
Basic factual details

Confirm that the report correctly records the name, date of birth, date of the accident and the account of how the accident occurred. Errors in these details are less common, but a discrepancy that contradicts other documents within the claim can create complications later in the process.

The review window is the only point errors can be corrected

Once the medical report is approved through the OIC portal, it becomes a fixed part of the claim. The insurer's offer will be calculated from it. There is no mechanism within the standard OIC process to amend the report after approval — even if information later comes to mind that was not mentioned at the examination.

What this means concretely: if the prognosis period understates the actual duration of symptoms, and the report is approved, the offer will be calculated from the lower band. There is no correction route after that point. The tariff figure in the offer will be what the approved report produces, not what an accurate report would have produced.

The review window exists before approval. After approval, there is no route within the standard process to correct what the report records.

How the prognosis period maps to the tariff

Compensation for whiplash injuries is based on fixed tariff bands linked to the prognosis period in the medical report. The band the prognosis falls into determines the settlement value for the injury itself.

Whiplash only — accidents from 31 May 2025
Up to 3 months£275
3–6 months£565
6–9 months£965
9–12 months£1,510
12–15 months£2,335
15–18 months£3,445
18–24 months£4,830

A report recording a prognosis of 2 months and 3 weeks produces a different tariff value to one recording 3 months and 1 week — even though the real difference in time is small. Between the first two bands alone, the difference is £290. Figures last verified March 2026. For accidents before 31 May 2025, different values apply — see the full tariff reference.

Medical report fees

What they are and who pays them

A medical report carries a fixed recoverable fee. It is a separate disbursement — paid by the insurer, not deducted from what you receive.

The current fixed fee for a first report from an accredited MedCo expert is £226 (exclusive of VAT), set by the Civil Procedure Rules. This applies to claims where the claim is submitted on or after 6 April 2025.

If you are using a solicitor, they arrange the report and recover the cost from the insurer. If you are managing the claim yourself through the OIC portal, the report is arranged through the portal and the fee is recovered after settlement — it is not usually paid upfront.

What this means in practice: the medical report fee does not reduce what you receive. It is paid by the insurer separately from your compensation.

03

How to raise a factual error

The query mechanism addresses factual corrections — not clinical opinion.

Factual error versus clinical opinion

The portal provides one opportunity to raise a concern about the report before it is approved. That opportunity is for factual corrections only.

The distinction between a factual error and a clinical opinion determines what the process can address.

— incorrect accident details, an injury described at the examination that does not appear in the report, or a prognosis period that does not reflect what was discussed. A clinical opinion is the examiner's professional judgment — for example, their assessment of expected recovery time.

The query process is for factual corrections. The examiner cannot be instructed to reach a different clinical conclusion. They can be asked to correct something that is factually inaccurate.

If uncertain whether something is a factual error or a clinical opinion, the question to ask is: did I say this at the examination, and has it been recorded? If something was said and is absent from the report, that is more likely a factual matter than a clinical one.
The query process through the portal

The OIC portal allows a query to be submitted before the report is approved. The query is routed back to the examiner, who reviews it and either amends the report or explains why they have not. The examiner is not required to change the report because it has been queried — but they are required to consider it and respond.

Being specific is more effective than being general. Rather than stating that the prognosis period is wrong, explain what the symptoms were, for how long and why that differs from what is recorded. If GP records, prescription history, or a symptom diary support the correction, reference them.

If the examiner does not amend

The portal provides one opportunity to raise a concern before the report is approved. If the examiner reviews the query and declines to make an amendment, that response is the end of the process through that route. The report can then be approved and submitted to the portal with the challenge and the examiner's response included — making the compensator aware that a concern was raised and not resolved. That is not the same as resolving the error, but it is a documented record within the claim.

04

Preparing for the examination

The examination produces the report. What is said in it shapes what the report records. Preparation means making sure an accurate and complete account is given — not presenting the injury differently from how it actually was.

Accuracy, not presentation

Preparing for the medical examination means thinking through the experience completely and accurately — not inflating it. Exaggeration is usually counterproductive: an examiner who suspects it will note that in the report and it can affect how the report is written. The goal is a full and accurate account — including the effects that are easy to understate because they have become familiar.

Describe symptoms at their worst, not just on the day

Examinations often take place months after the accident, by which point symptoms may have reduced from their peak. The prognosis period is an assessment of the injury's duration — not only its severity on the examination day. Describing how symptoms were in the weeks immediately after the accident, when they were likely at their worst, is part of giving an accurate account.

If there was a period of significant pain in the early weeks followed by gradual improvement, say so. The trajectory of recovery is relevant to the prognosis assessment.
Think through all affected areas

Accidents can affect more than the obvious primary injury. Consider whether the accident caused headaches, disrupted sleep, anxiety about driving, reduced ability to exercise, difficulty with household tasks, or effects on work. If any of these apply, mention them. If they do not apply, do not mention them. The goal is accuracy — not a comprehensive list of every possible effect.

The examination is the only opportunity to get these effects into the report. If an impact is not mentioned at the appointment, it will not appear in the document. Once the report is approved, there is no route back to add something that was omitted. Completeness at the examination is the only protection against a gap in the record.

Bring a symptom diary if one was kept

A record of symptoms — even informal notes made in the weeks after the accident — helps provide a more accurate account of how the injury progressed. It also gives the examiner something specific to reference if the report is later queried.

The medical report is not just a formality

The medical report is used to assess the claim. Once approved and submitted, it becomes part of the claim evidence. The prognosis period it records determines the tariff band. The review window before approval is the only opportunity to raise a concern about what the report records.

The prognosis period recorded in the report is used to determine the tariff band. This is then reflected in the settlement offer. Once the report is approved and the offer arrives, the next decision is whether to accept it. What that means — and what to check before confirming — is covered on the settlement offer stage page.

The medical report forms the basis on which the claim is assessed — but it sits within a wider process. For guidance on your role at every stage, from submission through to settlement, see the complete action guide.

The medical report sits within the OIC portal process. For a full explanation of how the portal works — what it is, how each stage runs, and what it does not handle well — see the system guide.

What happens next
Should I accept the offer? → Compensation tariff → Problems With Your Claim →

Last reviewed: 16 April 2026

Please note

ClaimTalk provides general guidance only. Not legal advice. Not affiliated with the Official Injury Claim portal or any government body.

ClaimTalk cannot respond to questions about individual claims. If you need advice specific to your situation, a regulated solicitor is the appropriate route.