The Rehabilitation Code 2015
Details
The aim of the Code is to help an injured claimant make the best and quickest possible medical, social, vocational and psychological recovery. It is voluntary but the Personal Injury Pre-Action Protocol requires it to be considered in personal injury claims. To work, it requires the parties to work together to collaboratively use rehabilitation at an early stage in the litigation process, sometimes before liability has been determined.
Key points
The Code was first published in 1999. The biggest difference in the latest version is that it now includes lower-value claims (up to £25,000), recognising there may still be an early need for rehabilitation in less severe cases, but that a different approach is required to ensure proportionality.
The Code sets out the following:
The compensator needs to consider, on notification, whether the claimant would benefit from medical or rehabilitative treatment.
If the claimant’s solicitor suggests rehabilitation then a decision is to be made within 21 days confirming or rejecting the request.
If accepted, the claimant’s solicitor is to respond with 21 days, and thereafter the parties will work together.
Lower-value injuries:
Unless the medico-legal report deals fully with rehabilitation and both parties wish to adopt those recommendations then a triage report assessment should be undertaken by a person independent to a relevant medico-legal organisation and with no link to the claimant’s solicitor, and is prepared outside of the litigation process.
Compensators are to consider the recommendations and advise the claimant’s solicitor within 15 days of the extent of funds that will be made available for treatment, or justification for refusal of treatment recommended.
If further evidence is required then an assessment report will be prepared by the person carrying out the treatment, and a discharge report will summarise the treatment provided.
Medium, severe and catastrophic injuries:
An Immediate Needs Assessment will be undertaken by a case manager or a suitable rehabilitation professional, ideally agreed by both parties. They are to be independent from any relevant medico-legal organisation.
Consideration will be given by the assessor to factors such as the claimant’s employment, disability, costs and duration of treatment and anticipated clinical and return-to-work outcome of the intervention. The report is prepared outside of the litigation process.
The compensator confirms within 21 days as to the extent they will fund the treatment, or reasons for refusal. If there is an agreement to funding and the claim is subsequently unsuccessful then the funds cannot be recovered (unless there is fraud/dishonesty).
Comments
It must be remembered that the purpose of the Code is to try and put the claimant back into their original position, thus attempting to avoid the chance for injuries and symptoms to worsen or become chronic. However, compensators do not need to wait for a claim to be brought before considering offering rehabilitation, for instance shortly following the Alton Towers accident last year it was reported that interim payments were made to the victims to help with their rehabilitation. What is to stop employers offering an occupational health assessment and suitable treatment to an employee following a reported incident in work?
It remains to be seen how the new Code will be received and embedded in practice and how this will affect a claimant’s recovery in the long-term.
NB: The Code is published by the Rehabilitation Working Party which includes representatives from the IUA, the Association of British Insurers, Lloyd’s, primary insurers, legal groups, care providers and the NHS. It came into force on 1 December 2015. See the Code.
