Medical Examination for Injury Claims in Ireland: What Happens, How to Prepare, and Your Rights

This is general information, not legal advice. Every case depends on its specific facts. Consult a solicitor for advice on your situation.

There are three distinct types of medical examination in an Irish personal injury claim, and the rules, rights, and consequences differ sharply for each one. Most guides lump them together as "the medical exam." That's a mistake. Your treating doctor's Form B report, the Injuries Resolution Board (IRB, formerly known as PIAB until 2023) [1] independent panel examination, and the defendant's Defence Medical Examination (DME) are governed by different bodies, different protocols, and different legal protections under the IRB's claims process rules and the Law Society of Ireland's Practice Notes on medical examination [2] [4]. Knowing which type you're attending, and what the examiner can and can't ask, is one of the most practically important things in the entire claims process.

Contents

Form B: The IRB's standardised medical report, completed by your treating doctor. Required with your application. Form B template (PDF) [5]

IRB panel SLA: Appointment within 4 weeks, report within 2 weeks, per the IRB's Medical Professionals guidance ³.

"Usual terms": Law Society/IMO agreement. Defendant's doctor cannot ask about liability. ²

Non-cooperation: Section 51C can trigger costs penalties even if you win more in court. Citizens Information (March 2026) [6]

Three types of medical examination in an Irish injury claim

Under the IRB's published claims guidance ¹ and the Law Society's Practice Notes on medical examinations ^{2 4}, a personal injury claim in Ireland can involve up to three separate medical examinations, each controlled by a different party and governed by different rules. One detail that catches many claimants off guard: what you should bring, say, and expect changes depending on which type you're attending.

Comparison of the three medical examination types in an Irish personal injury claim

	Treating Doctor (Form B)	IRB Independent Panel	Defendant's DME
Who arranges it?	Your solicitor	IRB (via MedLaw agency)	Defendant's insurer/solicitor
Who selects the doctor?	Your solicitor, from approved providers	IRB from its Independent Medical Panel	Defendant's side
Who pays?	You initially. May be partly reimbursed via Section 44	IRB covers the cost	Defendant pays all costs including your travel
What do they assess?	Full injury documentation for IRB application	Verification of injuries and prognosis	Injuries, prognosis, consistency with records
Who sees the report?	IRB + respondent's insurer	IRB + both parties	Defendant's legal team (then shared)
Can you object?	N/A (you commission it)	Technically yes, but non-cooperation has consequences	Refusal risks costs orders and stayed proceedings
Key protections	You review before submission	Panel doctors bound by IRB SLA	Law Society/IMO "usual terms": no liability questions
Typical duration	30 to 60 minutes	20 to 40 minutes	20 to 45 minutes

Sources: IRB claims process guidance ¹, IRB Medical Professionals page ³, Law Society Practice Notes on medical examination ^{2 4}.

Your treating doctor's report: what's in Form B?

Form B is the IRB's standardised medical assessment form that must accompany your application. Raw hospital files, GP notes, or discharge summaries aren't sufficient. The IRB's ⁵ template requires your treating doctor to capture highly specific data points that directly influence the financial valuation of your claim under the Personal Injuries Guidelines (adopted March 2021, commenced 24 April 2021) [7].

Here's what the form covers:

Demographics and occupational impact. Height, weight, BMI, your occupation, total length of absence from work, and whether that absence is medically reasonable.

Dominant injury classification. Your doctor identifies the single most significant injury using the WHO International Classification of Diseases (ICD) coding system.

Clinical findings and functional assessment. Range of movement measurements, photographic evidence of scarring, and disability ratings across mental health, vision, manual dexterity, stair climbing, and lifting capacity.

The whiplash supplement. For soft-tissue cervical injuries, the doctor completes the Quebec Task Force (QTF) classification, grading from WAD 0 (no physical signs) to WAD IV (fracture or dislocation), and a Neck Disability Index (NDI) producing a percentage score based on interference with personal care, concentration, driving, and sleep.

Pain self-assessment. You'll mark a Visual Analogue Scale (VAS), a 10cm line from "no pain" to "pain as bad as it could possibly be."

Pre-existing conditions. If a prior condition was aggravated, the doctor documents the extent and duration of increased symptoms. This is where the legal principle known as the "eggshell skull" rule becomes relevant. Under Irish law, the defendant takes the plaintiff as they find them. If you had mild arthritis before the accident and the crash made it significantly worse, the examiner documents the aggravation, not the underlying arthritis. The defendant can't escape liability simply because you were more vulnerable than average. The examiner's job is to separate what the accident caused or worsened from what was already there, but the claim covers the full extent of the aggravation.

Prognosis and future needs. Anticipated recovery timeline, residual symptoms, whether specialist referral is needed, and estimated future treatment costs. The Guidelines require this prognosis to be specific. The IRB uses it to determine which severity bracket applies to your injury. All of the above fields are documented in the IRB's Form B template ⁵ and assessed against the Personal Injuries Guidelines ⁷.

The IRB independent medical examination

According to the IRB's own claims process guidance ¹, after your Form B is submitted and the respondent consents to assessment (they've 90 days to decide, per Citizens Information ⁶) the IRB may arrange a separate independent examination. The IRB doesn't do this in every claim. Where injuries are straightforward and the Form B is comprehensive, the board may rely on your treating doctor's report alone. But in most claims, an independent examination is arranged.

The IRB maintains an Independent Medical Panel, as described on the IRB's Medical Professionals page ³, comprising registered consultants including orthopaedic surgeons, neurologists, and psychiatrists. Panel doctors must hold a qualification recognised by the Medical Council of Ireland and operate under a strict Service Level Agreement: appointment within four weeks of request, report within two weeks of the appointment.

A detail that surprises many claimants: the appointment letter often comes from MedLaw, a medical agency contracted by the IRB to arrange panel appointments and coordinate reports. Receiving an unfamiliar letter isn't a cause for alarm. It's a standard part of the process.

The examination itself typically lasts 20 to 40 minutes. The panel doctor reviews your medical records, cross-references your current symptoms against the Form B, and conducts a focused physical assessment. This isn't a treating relationship. The doctor won't prescribe medication or recommend ongoing therapy. The purpose is verification and prognosis confirmation.

What physical tests will the examiner perform?

No guide tells claimants what the examiner will actually do during the physical portion. The tests depend on the injury, but knowing what to expect removes the mystery. For cervical (neck) injuries, expect Spurling's test (the examiner presses down on your tilted head to check for nerve root compression) and range of movement measurements in rotation, flexion, and extension. For lumbar (lower back) injuries, the straight leg raise is standard: you lie flat while the examiner lifts each leg to check for disc herniation indicators. For knee injuries, expect the Lachman test (ACL assessment) and McMurray's test (meniscus check), both involving controlled manipulation of the knee joint. For shoulder injuries, the Hawkins-Kennedy test checks for impingement by rotating your arm at specific angles. None of these tests are painful when performed correctly, though they may reproduce your symptoms briefly. That reproduction is actually the point: it confirms the injury is genuine and measurable.

Objective vs subjective: what the examiner can measure vs what you tell them

The examiner separates everything into two categories. Subjective findings are what you report: pain levels, sleep disruption, difficulty concentrating, how far you can walk before the pain worsens. Objective findings are what they can measure independently: range of movement recorded in degrees using a goniometer, muscle wasting measured in centimetres by comparing both limbs, reflex responses, grip strength, and imaging results. Courts and the IRB weight objective evidence more heavily than subjective reporting. A claimant with measurable range of movement restriction (say, 30 degrees lost in cervical rotation) carries stronger evidence than one who reports severe pain but demonstrates full movement on testing. This doesn't mean subjective symptoms are irrelevant. It means the strongest reports combine both: "the claimant reports ongoing pain rated 6/10 on the VAS, consistent with the objective finding of 25% reduction in lumbar flexion."

What are the "usual terms" for the defendant's medical examination?

If you reject the IRB assessment, or the respondent declines consent, the claim moves to the court track. At this point, the defendant's insurer will arrange their own medical examination: the Defence Medical Examination (DME). This is governed by a protocol set out in two Law Society Practice Notes ^{2 4} that most claimants have never heard of but that offers significant protection.

The Law Society of Ireland and the Irish Medical Organisation (IMO) agreed a set of rules known as "the usual terms" that strictly govern how the defendant's doctor must conduct the examination. The full protocol is published in the Law Society's Practice Note ². Here's what they require:

No liability questions, full stop. The defendant's doctor cannot question you on anything that doesn't have a direct bearing on the medical aspects of your case. Under no circumstances may the examiner ask about liability. No questions about whether you were wearing a seatbelt, whether you were on your phone, or whether you saw the other vehicle. That boundary is absolute.

Liability statements are inadmissible at trial. Even if you inadvertently mention something about how the accident happened, the Northern Ireland ruling in McDowell v Strannix [1951], adopted in Irish practice and referenced in the Law Society's Practice Note on independent medical examinations ⁴, established that no evidence of any such statement can be given or admitted at trial.

Your doctor is consulted beforehand. The defendant's doctor must consult with your treating doctor before the examination. Formerly, the plaintiff's doctor attended in person. The Law Society acknowledges that practice has "largely been departed from." Now, consultation typically happens by telephone or post, with your doctor furnishing notes.

The defendant pays everything. The defendant pays the consultation attendance fee to your doctor (whether by phone, post, or in person), all your travel and subsistence expenses, and the examination itself. For examinations involving a child, expenses must include at least one parent or guardian, and transport must account for the child's medical condition.

Evidence confined to damages. At trial, the defendant's medical evidence from this examination is confined to damages only. No liability evidence arising from the examination is admissible.

Which specialist examines which injury?

The type of medical specialist who examines you depends on the nature of your injuries. The IRB selects from its Independent Medical Panel ³ based on speciality, and solicitors match specialists for claimant-side reports in the same way. Here's how common car accident injuries typically map to specialist type:

Common injury types and corresponding medical specialists in Irish personal injury claims

Injury type	Specialist
Fractures and broken bones	Consultant orthopaedic surgeon
Back injuries, neck injuries, shoulder injuries	Consultant orthopaedic surgeon or spinal specialist
Knee injuries	Consultant orthopaedic surgeon
Whiplash / soft tissue (cervical)	GP (straightforward) or orthopaedic surgeon (complex)
Head injuries, concussion	Consultant neurologist
Psychological injuries, PTSD	Consultant psychiatrist or clinical psychologist
Nerve damage	Consultant neurologist or neurosurgeon
Chronic pain, CRPS	Consultant in pain medicine
Tinnitus / hearing loss	Consultant ENT specialist
Scarring and disfigurement	Consultant plastic surgeon

In complex multi-injury claims, you may need examinations with several specialists. The defendant may also instruct parallel specialists. If two experts disagree in a high-value claim, they may prepare a joint report setting out areas of agreement and disagreement.

Psychological injury examinations follow a different protocol

Where PTSD, anxiety, or depression is claimed alongside physical injuries, the examination process is different. A consultant psychiatrist or clinical psychologist conducts a structured clinical interview rather than a physical assessment. The examiner typically uses standardised screening instruments: the PHQ-9 for depression, the GAD-7 for anxiety, and the PCL-5 for PTSD. Each produces a numeric score that maps to the Personal Injuries Guidelines' ⁷ standalone categories for psychiatric injury. The Guidelines now include separate brackets for post-traumatic stress disorder and other psychiatric conditions. This is a relatively recent development. Before 2021, psychological injuries were rarely assessed by the IRB. A common mistake is treating the psychological examination as less important than the orthopaedic one. In practice, a well-documented psychological injury with ongoing symptoms can carry significant weight in the overall valuation.

How should you prepare for each type of examination?

Preparation differs depending on which examination you're attending. The IRB's Form B template ⁵ and the Law Society's Practice Notes ² set different expectations for each type. The timing matters more than most guides suggest: reviewing your records the night before, rather than weeks ahead, keeps details fresh.

When to schedule the examination

Your solicitor coordinates the timing deliberately, and there's an important reason. Attend too early, before you've reached what doctors call maximum medical improvement (MMI), and the examiner records you as "still recovering" with a positive trajectory. That can push your prognosis into a lower severity bracket under the Guidelines. Attend too late, and the defendant argues you've already recovered. The optimal window is when your condition has stabilised enough for the examiner to give a definitive prognosis, but not so late that your symptoms have fully resolved. For most car accident soft-tissue injuries, this is typically three to nine months post-accident. For fractures or surgical cases, it can be twelve months or longer.

For your treating doctor's Form B examination

Bring: your symptom diary (dates, severity, fluctuation of pain since the accident), a chronological list of all treatment (A&E, GP visits, physiotherapy sessions, medications), X-rays or MRI scans on disc, and details of how the injury has affected your work, daily life, sleep, and family responsibilities.

Be specific: "I can't lift my child out of the cot" is more useful than "I'm in pain." Describe your worst days and your best days. Accurate range helps the doctor write a precise prognosis.

Check the referral letter. If you're seeing a specialist rather than your GP for the Form B, your GP writes a referral letter that frames the examination. A thorough referral that mentions all affected body areas, psychological impact, and functional limitations leads to a thorough examination. A one-line referral ("please assess re RTA") leads to a narrow assessment that may miss secondary injuries. Your solicitor should review the referral letter before it goes, or provide the specialist with a separate letter of instruction covering everything the GP referral missed.

Early records carry outsized weight. Courts give more evidential weight to medical notes recorded close to the accident date than to accounts given months later. Your A&E attendance record, the first GP visit, and early physiotherapy notes matter disproportionately because they weren't created for litigation. If there's a gap between the accident and your first medical visit, the examiner will note it, and the defendant will use it. If you delayed seeking treatment for a legitimate reason (shock, caring for a child, or believing the injury would resolve), make sure the treating doctor records that context in the Form B.

The snapshot problem. Every examination captures a single snapshot of your condition. If you're having a relatively good day, the range of movement measurements, pain responses, and functional observations may understate your typical condition. If you're having a bad day, the reverse. The examiner sees you for 20 to 45 minutes and forms conclusions that affect thousands of euros. This is precisely why the symptom diary matters so much: it provides the daily range that a single-day snapshot can't capture. Claimants who maintain a dated diary give the examiner the context to write something like "the claimant reports good and bad days, with the examination conducted on a day the claimant describes as average." That sentence in the report protects you against the snapshot problem. Without the diary, the examiner has no choice but to treat the day they saw you as representative.

For the IRB independent panel examination

Bring: X-rays and MRI scans on disc. The panel doctor will already have your Form B. Check with your solicitor before bringing anything else. The IRB examiner shouldn't need additional documents beyond what's already been submitted.

Expect: 20 to 40 minutes. A discussion about your current symptoms followed by a focused physical examination. The doctor isn't providing treatment and won't discuss findings with you afterward.

For the defendant's DME

Do not bring your own medical reports. Experienced solicitors warn that some defence doctors will copy claimant reports and share them with the defence legal team, giving the other side all your medical evidence while your solicitor has none of theirs. Your solicitor controls disclosure.

Know the boundaries: if the examiner asks about how the accident happened, about fault, or about whether you were wearing a seatbelt, you don't have to answer. Those questions violate the usual terms.

Be consistent: the examiner will cross-reference what you say against your medical records. Review your own records beforehand to ensure your account of dates, treatments, and symptoms is accurate.

You can bring someone with you. A friend, relative, or support person can attend. For a child, at least one parent or guardian must be present.

How does your medical report affect compensation?

The medical report is the single most influential document in valuing your claim. Under the Personal Injuries Guidelines ⁷, the IRB and the courts use a bracket system based on injury type, severity, recovery timeline, and permanence. Your examiner's assessment of where you fall (substantially recovered, not fully recovered, ongoing significant symptoms, or serious and permanent) directly determines which compensation bracket applies.

What "substantially recovered" actually means. Claimants often misunderstand this term. Under the Personal Injuries Guidelines ⁷, "substantially recovered" doesn't mean pain-free. It means your functional capacity has returned to near your pre-accident baseline, even if some symptoms persist. A person with ongoing low-level neck stiffness who can work, drive, sleep, and exercise is "substantially recovered" even though they'd say they haven't fully recovered. The difference between "substantially recovered" (lowest bracket, lower award) and "not fully recovered" (next bracket up, significantly higher award) can be worth thousands of euros. The examiner's choice between these two phrases is often where the real money is, and it hinges on whether your residual symptoms are affecting your daily function or are just noticeable nuisances.

How multiple injuries interact. If you've sustained more than one injury in a car accident, you cannot simply add the individual bracket values together. The Guidelines are explicit on this point. The examiner identifies the single most significant injury first. That injury determines the primary compensation bracket. Secondary injuries then adjust the award within that bracket, not on top of it. This means the examiner's choice of which injury is "dominant" directly affects the overall valuation. A claimant with a moderately severe back injury and a minor knee injury will be valued differently depending on whether the back or the knee is classified as the primary injury.

The Guidelines shifted emphasis toward accurate prognosis. The IRB's assessors and judges now weigh the examining doctor's recovery prediction heavily when setting the award. A vague prognosis ("the claimant may improve") produces a different valuation than a specific one ("the claimant will retain a 15% reduction in cervical range of movement, requiring annual physiotherapy review").

One aspect that catches clients off guard: prognosis often carries more weight than diagnosis. A severe-sounding diagnosis with a good prognosis (say, a fractured ankle with full recovery expected within 12 months) will typically produce a lower bracket than a moderate diagnosis with a poor prognosis (persistent soft-tissue injury with ongoing limitation and no clear endpoint). What the examiner writes about your future matters more than the label they put on your injury today.

Three phrases in the report that produce completely different outcomes

As required under the Personal Injuries Guidelines framework ⁷, the examiner must state whether your injuries were "caused by," "contributed to by," or "coincidental with" the accident. These phrases aren't interchangeable, and the difference is measured in euros. "Caused by" supports full compensation for that injury. "Contributed to by" opens the door to apportionment, where the court divides responsibility between the accident and another factor (a pre-existing condition, a subsequent event), reducing your damages as a result. "Coincidental with" means the examiner believes the accident didn't cause the injury at all, which can collapse the claim on that specific injury. When you receive your medical report, check which of these phrases the examiner has used for each injury. If the wording is wrong or unsupported by the evidence, your solicitor can raise it with the expert before the report is finalised.

Between assessment and settlement, the sticking point is usually the medical evidence. If the defendant's DME report downgrades your injury severity or predicts faster recovery than your own expert, the gap between offer and expectation widens. More on the decision to accept or reject: how settlement offers work and whether to settle or go to court.

The real cost of your Form B report

Here's an aspect the official guidance doesn't cover in full. Under Section 44 of the Personal Injuries Assessment Board Act 2003 [8], the IRB can direct the respondent to pay fees "reasonably and necessarily incurred" by the claimant. But the practical reality is less generous than the statute suggests.

Analysis published by the Law Society Gazette (November 2025) [9] found that 49.5% of claimants were reimbursed less than the actual out-of-pocket cost of their Form B report. The IRB's internal guidelines cap reimbursements at roughly €120 to €175 for a limited report, while GPs and specialists commonly charge €350 to €400 or more (sometimes with additional VAT). The shortfall is absorbed from your general damages award, reducing your compensation for pain and suffering.

With the average IRB assessment timeline currently around 11 months from respondent consent, you'll be out of pocket for nearly a year before even receiving the assessment.

What are the most common mistakes during medical examinations?

Volunteering liability information to the defendant's doctor. If the examiner asks about the crash circumstances, politely decline. Under the Law Society's "usual terms" ², they're not entitled to ask. Even if you answer, McDowell v Strannix [1951] means the answer shouldn't be admissible. But why risk it?

Bringing your medical reports to the defendant's examination. Don't give the other side free access to your medical evidence. Your solicitor controls disclosure.

Downplaying symptoms. Saying "I'm managing" or "it's not too bad" gives the examiner grounds to downgrade the severity assessment. Describe your symptoms as they actually are, on your worst days and your best days.

Exaggerating symptoms. Under Section 26 of the Civil Liability and Courts Act 2004 [10], giving misleading evidence can result in your claim being dismissed entirely. Experienced examiners detect inconsistencies between what you report and what the physical tests show.

Hiding pre-existing conditions. Concealment will be discovered through your medical records and will destroy your credibility. Be upfront. The examiner documents the aggravation caused by the accident, not the pre-existing condition itself.

Forgetting travel receipts. Travel to any medical examination, including the defendant's, is claimable as special damages. Keep every receipt, bus ticket, and parking stub.

Describing injuries that don't match the accident. The examiner assesses whether your reported injuries are biomechanically consistent with how the accident occurred. A low-speed rear-end shunt producing catastrophic multi-level disc damage raises red flags. A high-speed head-on collision producing only mild whiplash raises different questions (possible underreporting or delayed onset). If there's a mismatch between the described mechanism and the clinical findings, the examiner will note it, and the defendant will use it to challenge credibility. Be accurate about both the accident and your symptoms, and let the medical evidence speak for itself.

Not considering that you may be observed outside the clinic. Insurance companies sometimes conduct video surveillance in the days around a scheduled medical examination. If you tell the examiner you can't walk more than 100 metres, but surveillance footage from the same week shows you carrying shopping bags across a car park, the credibility damage is severe. Under Section 26 of the Civil Liability and Courts Act 2004 ¹⁰, that inconsistency could be treated as misleading evidence. The point isn't to avoid normal activity. It's to ensure that what you describe to the examiner accurately matches your actual capacity. Overstating your limitations is the single fastest way to lose a claim.

What if you disagree with the medical report?

If your solicitor's own expert produces a report that contains errors (wrong dates, incorrect treatment history, or a prognosis you believe is inaccurate) the report can be returned for correction before it's shared with anyone. Under the Law Society's Practice Note on medical examinations ², the claimant reviews the report before it is disclosed.

If the defendant's DME report significantly downplays your injuries, your solicitor can commission a supplementary report from your own expert specifically addressing the points of disagreement. In high-value claims, the two experts may be asked to prepare a joint report identifying where they agree and where they don't. If the case goes to trial, both experts typically give evidence and can be cross-examined.

The IRB statistics don't capture how often assessment values shift based on competing medical reports. But in practice, a well-evidenced supplementary report can meaningfully change the negotiation outcome.

What if the examiner finds something you didn't know about? This happens more often than people expect. The independent examiner sometimes identifies a condition the claimant wasn't previously aware of: a disc protrusion visible on imaging that the GP hadn't flagged, early signs of CRPS developing after a fracture, or a rotator cuff tear masked by general shoulder pain. The examiner has a duty to document what they find, not just what was expected. When this happens, it can actually strengthen the claim by establishing an injury that wasn't part of the original case. Your solicitor can then arrange further specialist assessment to confirm the new finding and factor it into the valuation.

Your obligation when things change. If your condition changes materially after the examination, the medical evidence needs updating. This cuts both ways. If you deteriorate (new symptoms develop, existing symptoms worsen, you need surgery that wasn't anticipated), an updated report strengthens your claim and may move you into a higher bracket. But if you improve significantly, you have a disclosure obligation. Relying on the original pessimistic prognosis at trial when you've actually made a good recovery risks a Section 26 challenge for misleading evidence ¹⁰. Your solicitor manages the timing of updated reports strategically, but you need to communicate changes promptly. Don't wait for your solicitor to ask. If something gets meaningfully better or worse, tell them.

What does a medico-legal report actually look like?

When the examiner finishes, they produce a structured written report. The IRB's Form B template ⁵ provides the standardised format for treating doctor reports, and independent and defendant reports follow a similar structure. Understanding the standard layout helps you review it for accuracy and understand the defendant's report when your solicitor shares it. Most Irish medico-legal reports follow the same format:

Instructions received. Who commissioned the report and for what purpose.

Documents reviewed. A list of every medical record, imaging report, and previous expert report the examiner was provided before the appointment.

History of the accident. The accident as reported by you during the examination. This is why accuracy matters: this section becomes part of the legal record.

History of injuries and treatment. A chronological account of your symptoms and every medical intervention since the accident.

Previous medical history. Relevant pre-existing conditions. The examiner should confine this to conditions that have a bearing on the current injuries.

Current complaints. What you told the examiner about your symptoms on the day of the examination.

Examination findings. This is the core of the report. It begins with general observations (posture, gait, how you moved during the appointment) and then details system-by-system findings: range of movement in degrees, tenderness, muscle wasting, reflex responses, and results of specific clinical tests.

Diagnosis. The examiner's clinical conclusion about what injuries you have.

Opinion on causation. Whether the injuries were caused by, contributed to by, or coincidental with the accident.

Prognosis. The anticipated recovery timeline and any expected residual symptoms.

Recommendations. Whether further treatment, specialist referral, or future review is needed.

Your solicitor reviews the report before it's shared. If you spot factual errors (wrong dates, treatments you didn't receive, symptoms attributed to the wrong body part), flag them immediately. Corrections are routine and expected.

Can you refuse a medical examination? What happens if you do?

You can refuse, but the consequences escalate depending on which examination it is.

Refusing the IRB independent examination. There's no specific obligation under the Personal Injuries Assessment Board Act 2003 ⁸ to attend the IRB's panel doctor. You can object and provide your own medical reports instead. However, Section 51C of the Personal Injuries Assessment Board (Amendment) Act 2019 imposes penalties for non-cooperation: if you fail to attend an IRB-arranged examination without reasonable cause, a court may penalise you on legal costs even if you eventually win a higher award in court. That penalty follows you into litigation.

Refusing the defendant's DME. The consequences are more severe. The defendant will argue that refusal prevents proper assessment of damages and frustrates settlement. Irish courts have established through cases like McGrory v ESB that they possess inherent jurisdiction to stay (suspend) proceedings indefinitely until the claimant complies. In practice, refusal weakens your negotiating position and can trigger costs orders.

Consequences of non-cooperation with medical examinations in Ireland

Situation	Legal mechanism	Consequence
Missing IRB examination without cause	Section 51C (PIAB Amendment Act 2019)	Court may penalise you on costs, even if you win more in court
Refusing defendant's DME	Inherent court jurisdiction (McGrory v ESB)	Proceedings stayed indefinitely until you comply
Rejecting IRB assessment, then failing to beat it in court	Section 51A (PIAB Act 2003 as amended)	You don't recover your own costs and may pay the defendant's costs
Giving misleading evidence during examination	Section 26 (Civil Liability and Courts Act 2004) 10	Claim may be dismissed entirely

Can the defendant request a second medical examination?

According to the High Court's ruling in O'Donovan v Cork County Council [2024] IEHC 33 [11], a defendant can request a second examination in limited circumstances. In that case, the defendant had two experts with conflicting views on whether the plaintiff had developed chronic regional pain syndrome (CRPS). The defendant applied to have a third orthopaedic surgeon examine the plaintiff, one day before the listed hearing.

Mr Justice Holland permitted the second examination, finding the defendant had a "genuine difficulty" arising from its experts' conflicting views. He noted that "there is no rule that a party is bound irrevocably by the opinion of the first expert consulted" and that "litigation is adversarial and, within bounds, legitimately tactical." But he also emphasised that the essential test is fairness: a plaintiff, by prosecuting proceedings, waives certain privacy rights, but only to the extent of the defendant's reasonable requirements.

The practical takeaway: defendants can request a second examination where there's a genuine diagnostic dispute, but the court won't permit it as a fishing exercise or as a way to shop indefinitely for a favourable opinion.

Common questions

References

1. Injuries Resolution Board, Making a Claim (March 2026)
2. Law Society of Ireland, "Personal injury cases: Medical examination on the usual terms" (Practice Note, current as of March 2026)
3. IRB, Medical Professionals and Independent Medical Panel (March 2026)
4. Law Society of Ireland, "Independent Medical Examination of Plaintiffs" (Practice Note, current as of March 2026)
5. IRB, Medical Assessment Form (Form B) template (PDF, current as of March 2026)
6. Citizens Information, Injuries Resolution Board (March 2026)
7. Judicial Council, Personal Injuries Guidelines (adopted March 2021)
8. Personal Injuries Assessment Board Act 2003 (irishstatutebook.ie)
9. Law Society Gazette, "Insult to Injury" (November 2025)
10. Civil Liability and Courts Act 2004, Section 26 (irishstatutebook.ie)
11. O'Donovan v Cork County Council [2024] IEHC 33 (courts.ie)

This is general information, not legal advice. Every case depends on its specific facts. Consult a solicitor for advice on your situation.