Diagnosis and referral concerns
A failure-to-refer concern examines the symptoms and results known at the time, whether specialist input was reasonably required, referral urgency, waiting time and whether the delay caused additional harm. A poor or unexpected outcome does not automatically mean that medical negligence occurred.
First reconstruct the care from contemporaneous records: what was known, what decisions were made and what happened next. The evidence must then address reasonable care, any departure, causation and the additional harm or loss attributed to that departure.
Start with the records made at the time, not hindsight. The review should identify the actual decision points, the information available to each provider and the response that followed.
A viable claim may require evidence that the care fell below the standard reasonably expected in the circumstances, that this departure caused or materially contributed to additional injury, and that measurable loss resulted. Each element needs evidence; concern or disagreement alone is not enough. For this topic, the review should specifically address: What symptoms were reported, when they changed and what was recorded at the time; When referral or escalation became reasonable and what happened after it was requested.
Request complete records from every relevant provider and keep the original files where possible. A clear chronology helps identify missing documents, conflicting entries and the point at which the outcome may have changed.
An independent expert in the relevant field may need to compare the care with accepted practice and explain causation. Different experts may be needed for the standard of care, the medical consequences and future needs. An expert review does not guarantee that a claim will be available. For this topic, the review should specifically address: Specialist assessment, interpretation, treatment plan, follow-up and communication with other providers.
Even if care appears to have been deficient, the evidence must usually address what probably would have happened with appropriate care. The underlying illness, recognised complications and other possible causes must be separated from any additional harm caused by the identified departure. For this topic, the review should specifically address: What probably would have happened with appropriate care compared with the actual outcome.
Preserve the clinical and practical timeline before drawing conclusions. Current treatment and safety should remain the first priority.
Continue clinically necessary care, write a dated chronology, identify each provider, preserve the complete records and note the additional treatment, work, care and expense impact. Early legal review may help identify whether specialist evidence or a time-sensitive step should be considered.
Send your medical negligence detailsClaim pathway
This is a general pathway only. The documents, decision-maker and timing can change depending on the facts and claim type.
Start with where and how the injury happened: road accident, workplace incident, public or private place, or a longer-term disability situation.
Get appropriate treatment and keep certificates, referrals, scans, reports and notes about how symptoms affect work or daily life.
Organise incident records, photos, witness details, wage records, claim numbers and correspondence in date order.
The pathway may involve a CTP insurer, workers compensation insurer, public liability insurer or superannuation trustee/insurer.
The insurer or fund may request material, assess treatment or work capacity, make a decision, or issue reasons that need a careful response.
The practical outcome may be approval, payment, treatment support, further evidence, review, dispute steps or another decision point.
Documents and records
Medical negligence enquiries usually turn on records, breach, causation, harm and expert evidence, not the poor outcome alone.
Common questions
Short general answers only. The right next step depends on the facts, dates and documents.
No. A poor outcome may occur despite reasonable care. The records and appropriately qualified expert evidence may need to address the expected standard, any departure, causation and additional harm.
Start with the complete clinical notes, referrals, results, original images, medication and observation charts, consent or procedure records, discharge material and later treatment records relevant to the concern.
Medical negligence questions often require a suitably qualified independent expert to explain the reasonable standard of care and whether the identified issue probably caused additional harm.
No. Urgent and clinically necessary treatment should take priority. A second opinion can be sought without abandoning current care, and records can be preserved at the same time.
General injury enquiry
Tell us where and when the injury happened, what has changed since, and whether an insurer, employer or super fund has contacted you. The enquiry can then be directed to the likely pathway.
