How is a medical examination carried out by the medical adviser in the context of an accident at work?

When a worker has had an accident at work and has suffered serious bodily injuries, the industrial accident insurer will ask him to report to his medical adviser.

During the medical examination

During the examination, this medical adviser will ask you about the accident and what you are still able to do and can no longer do. He will try to see to what extent the consequences of the accident at work interfere with your professional life.

• Most questions are obvious. Thus, the doctor will ask you how the accident happened and what you are suffering from. He will also ask you what treatments and operations you have undergone.
• In addition, he will ask you questions that, at first glance, may seem a little surprising to you. Yet they are important. It will ask you what training you have taken, what other jobs you have had, if you are married, if you have children, etc. Such information can be important in determining whether and to what extent you are still fit for work and should therefore be included in the medical report. 
• The medical advisor may also request additional examinations, but this is rather exceptional.

You can help the medical adviser by sending him the medical reports (scan results, blood test results, etc.) from your treating doctor(s). In principle, the patient himself chooses which information he communicates to the doctor and which examinations he wishes to undergo or not. However, you should be aware that the insurer needs the information to be able to make a correct compensation offer. So be sincere and give complete information without exaggerating.

After the exam

Based on the medical examination, the medical adviser will give his principal, ie the industrial accident insurer, an opinion on your state of health.

The work accident insurer can then determine to what extent you should be compensated for your injuries. It will do so according to the regulations that each occupational accident insurance is required to comply with. If a permanent incapacity is foreseen, the insurer will make you a proposal on this subject.

Bear in mind that the medical adviser does not have to comment on aspects that have no connection with your ability to exercise a professional activity.

Need help?

To obtain compensation from occupational accident insurance, you must go to the insurer’s medical adviser. However, you are free to contact a medical advisor of your choice to obtain a second opinion or to prepare for the medical examination described above.

Some legal protection insurance reimburses the costs of the medical adviser you call upon to assist you during the examination by the medical adviser of the occupational accident insurer.

If the work accident insurer has proposed to you concerning permanent incapacity, your doctor must agree with this proposal. The consultation for this purpose is reimbursed by the insurer.

When the opinion of the medical advisor of your choice does not correspond to that of the insurer’s medical advisor, an amicable or legal solution may be sought. This solution will be on the medical level and it is therefore important that the opinion of your doctor is communicated in writing to the workers’ compensation insurer.