Medical Evidence in Personal Injury Claims: CPR Part 35 Requirements

Introduction

In personal injury litigation, medical evidence is not merely important — it is indispensable. In most cases you will need medical evidence; where you rely on a medical practitioner's evidence you must attach the report (PD 16 para 4.3). You cannot claim future loss of earnings without a prognosis addressing your capacity to work. You cannot quantify future care costs without expert evidence on your ongoing needs.

Yet the rules governing medical evidence are more prescriptive than many claimants — and indeed some practitioners — appreciate. CPR Part 35 imposes specific obligations on experts, specific requirements for report content, and gives the court broad powers to control how expert evidence is presented. Failure to comply can result in the evidence being excluded or given reduced weight.

This guide explains the CPR Part 35 framework in practical terms: how to instruct an expert, what the report must contain, how single joint experts work, how to put written questions to the other side's expert, and how to present medical evidence effectively in your court bundle.

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The Purpose of CPR Part 35

CPR Part 35 exists to ensure that expert evidence assists the court rather than becoming a partisan tool for the parties. Before the Civil Procedure Rules came into force in 1999, expert evidence in civil litigation was widely criticised for being adversarial rather than objective — parties would instruct "hired guns" whose reports invariably supported the instructing party's case.

The overriding principle of CPR Part 35 is stated in Part 35.3:

It is the duty of experts to help the court on matters within their expertise. This duty overrides any obligation to the person from whom experts have received instructions or by whom they are paid.

This principle has practical consequences throughout the process of obtaining and presenting medical evidence.

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Instructing a Medical Expert

Choosing the Right Expert

The expert must be qualified in the relevant medical specialty. A GP should not be providing an expert opinion on orthopaedic surgery; a psychiatrist should not be opining on neurological damage. The court will assess the expert's qualifications and experience in determining the weight to give their evidence.

MedCo applies to soft tissue injury claims under the low value RTA Protocol (up to £25,000) and to whiplash claims (RTA Small Claims Protocol and PI Protocol para 7.12), including after the claim leaves the portal (PD 16 paras 4.3A–4.3B; PD 35 para 2.6). It does not apply to EL or PL claims. For other claims, the parties have greater freedom to choose their expert, subject to the court's directions.

The Letter of Instruction

The letter of instruction is a critical document. The Guidance for the Instruction of Experts in Civil Claims 2014 (PD 35 para 1) sets out what instructions should contain. In practice the party instructing the expert should provide:

• The identity of the party instructing the expert
• The issues the expert is asked to address
• All material documents and records the expert needs to review

Instructions are not privileged, but the court will order disclosure only if there are reasonable grounds to think the report's statement of instructions is inaccurate or incomplete (r.35.10(4)). Courts take a dim view of letters that attempt to lead the expert towards a particular conclusion.

What to Send to the Expert

Provide the expert with:

Withholding relevant records from the expert — particularly records that might undermine the claim — is improper and likely to be discovered. If the expert later learns of omitted records, their trust in the instructing party (and their willingness to support the case) may be damaged.

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What a Report Designed to Follow CPR Part 35 Must Contain

Practice Direction 35, paragraph 3.2, sets out the mandatory contents of an expert report. Non-compliance risks the report being excluded or given reduced weight.

Mandatory Contents

1. The expert's qualifications (para 3.2(1))

2. The literature or other material which has been relied on in making the report (para 3.2(2))

3. A statement setting out the substance of all facts and instructions which are material to the opinions expressed in the report or upon which those opinions are based (para 3.2(3))

4. Which of the facts stated in the report are within the expert's own knowledge (para 3.2(4))

5. Who carried out any examination, measurement, test or experiment which the expert has used for the report, giving their qualifications, and whether the test was carried out under the expert's supervision (para 3.2(5))

6. Where there is a range of opinion on the matters dealt with in the report, a summary of the range of opinion and the reasons for the expert's own opinion (para 3.2(6))

7. A summary of the conclusions reached (para 3.2(7))

8. If the expert is not able to give an opinion without qualification, a statement of the qualification (para 3.2(8))

9. A statement that the expert understands their duty to the court and has complied with it, and is aware of the requirements of Part 35, PD 35 and the Guidance for the Instruction of Experts in Civil Claims 2014 (para 3.2(9))

The report must be verified by the statement of truth in the PD 35 para 3.3 form: "I confirm that I have made clear which facts and matters referred to in this report are within my own knowledge and which are not. Those that are within my own knowledge I confirm to be true. The opinions I have expressed represent my true and complete professional opinions on the matters to which they refer. I understand that proceedings for contempt of court may be brought against anyone who makes, or causes to be made, a false statement in a document verified by a statement of truth without an honest belief in its truth."

Common Deficiencies in Medical Reports

Reports frequently fall short of Part 35 requirements in these ways:

• No discussion of range of opinion — The expert states their view without acknowledging that other qualified practitioners might reasonably disagree
• Failure to address causation — The report describes the injuries but does not link them to the accident
• Pre-existing conditions glossed over — If the claimant had pre-existing symptoms, the expert must address whether and to what extent the accident aggravated them
• Missing statement of truth — Without the statement of truth in the prescribed form, the report does not comply with Practice Direction 35
• Instructions not summarised — The substance of the instructions must be set out in the report

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Single Joint Experts

When Are Single Joint Experts Used?

Under CPR Part 35.7, the court may direct that evidence on a particular issue is given by a single joint expert — one expert instructed by both parties. Single joint experts are particularly common in:

• Small claims track personal injury cases
• Fast track cases where the medical issues are straightforward
• Lower-value claims where the cost of two experts would be disproportionate

In higher-value or more complex cases — particularly multi-track clinical negligence claims — each party typically instructs their own expert, with the court potentially directing the experts to hold discussions.

How Joint Instruction Works

When a single joint expert is directed:

1. Both parties agree on the expert — If they cannot agree, the court will select from a list provided by the parties
2. Both parties contribute to the letter of instruction — Each party may give instructions to the expert, sending a copy to the other parties at the same time (r.35.8(1)–(2))
3. Both parties are jointly and severally liable for the fees unless the court directs otherwise (r.35.8(5))
4. The report is addressed to the court, not to either party
5. Either party may put written questions to the expert under CPR Part 35.6

Challenging a Single Joint Expert's Opinion

If you disagree with the single joint expert's conclusions, your options are limited but not non-existent:

• Put written questions under Part 35.6 (see below)
• Apply for permission to instruct your own expert — The court may grant this if the joint expert's report raises issues that require further investigation, but this is the exception rather than the rule
• Cross-examine the joint expert at trial — With the court's permission

The court is generally reluctant to permit a party to instruct a second expert on the same issue after a joint expert has reported. You need compelling reasons — not merely that you disagree with the conclusion.

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Written Questions Under CPR Part 35.6

The Right to Ask Questions

Under CPR Part 35.6, a party may put written questions to the other party's expert (or to a single joint expert) about their report. This is a valuable but underused procedural tool.

Rules for Questions

• Questions may be put once only, must be proportionate, within 28 days, and only for clarification (r.35.6(1)–(2))
• Questions that seek to extend the expert's instructions or raise entirely new issues are impermissible
• The expert's answers are treated as part of the report

Effective Use of Part 35.6 Questions

Well-crafted questions can significantly strengthen your case:

Clarifying assumptions:

"In paragraph 14 of your report, you state that the claimant's symptoms are consistent with a grade 2 whiplash injury. Did you consider the GP records at page 47 of the bundle, which record persistent headaches and dizziness not typically associated with grade 2 whiplash?"

Exploring the range of opinion:

"You state that recovery from this type of injury typically takes 12-18 months. Are you aware of the literature suggesting that patients with the claimant's specific risk factors experience recovery times at the upper end of or beyond this range?"

Addressing omissions:

"Your report does not address the claimant's pre-existing lower back condition noted in the GP records. In your opinion, to what extent, if any, has the accident aggravated this pre-existing condition?"

What Happens If the Expert Refuses to Answer?

If an expert fails to answer questions within a reasonable time, the court may order that the party may not rely on that expert and/or may not recover the expert's fees (r.35.6(4)).

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Experts' Discussions and Joint Statements

Court-Directed Discussions

Under CPR Part 35.12, the court may direct experts to hold discussions for the purpose of:

• Identifying and discussing the expert issues in the proceedings
• Reaching agreement where possible
• Identifying what remains in dispute and why

The Joint Statement

Following discussions, the experts must prepare a joint statement setting out:

• The issues on which they agree
• The issues on which they disagree
• A brief summary of the reasons for disagreement

The joint statement is a powerful document. Where experts agree, the agreed position effectively becomes the evidence on that issue — neither party can easily depart from it. Where they disagree, the joint statement frames the issues for the trial judge with precision.

Important Safeguards

• Legal representatives may attend experts' discussions only if the court orders, or all parties and the experts agree (PD 35 para 9.4)
• Agreements do not bind the parties unless they expressly agree (r.35.12(5))

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Presenting Medical Evidence in Your Bundle

Organisation

Medical evidence should be presented in a dedicated section of the bundle, typically organised as follows:

1. Expert reports — In the order they were served (claimant's expert first, then defendant's)
2. Joint statement (if applicable)
3. Responses to Part 35.6 questions
4. Medical records — Chronologically, sub-divided by source (hospital, GP, imaging)
5. Rehabilitation and treatment records

Making the Evidence Accessible

Judges read bundles before the hearing. If the medical evidence is buried, disorganised, or difficult to navigate, the judge forms an incomplete picture before the trial even begins.

Practical tips:

• Tab and bookmark each expert report and each set of medical records
• Highlight key passages in the medical records that are referenced in the expert reports (if the court permits)
• Include a medical chronology — a timeline of treatment, separate from the general chronology, that the judge can use as a reference tool
• Cross-reference the expert reports to the specific pages in the medical records that support each finding

Electronic Bundle Requirements

For electronic bundles — now the norm in most courts — ensure that:

• The PDF is searchable (OCR processed)
• Bookmarks are set for each expert report and each set of records
• The index is hyperlinked to the relevant pages
• File size is optimised (avoid unnecessarily large scans)

BundleCreator.co handles these technical requirements automatically — generating searchable, bookmarked, paginated bundles from your uploaded documents with hyperlinked indices, so you can focus on the substance of your evidence rather than the formatting.

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MedCo and the OIC Portal

When MedCo Applies

MedCo applies to soft tissue injury claims under the low value RTA Protocol (up to £25,000) and to whiplash claims (RTA Small Claims Protocol and PI Protocol para 7.12), including after the claim leaves the portal (PD 16 paras 4.3A–4.3B; PD 35 para 2.6). It does not apply to EL or PL claims.

Key MedCo Requirements

• The first report must be a MedCo fixed cost medical report (PD 35 para 2.6)

Beyond MedCo

Outside those claims, parties have greater freedom to instruct experts of their choosing — subject to the court's directions and CPR Part 35.

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Common Scenarios and Practical Solutions

Pre-Existing Conditions

If you had pre-existing medical conditions before the accident, do not try to hide them. The defendant's legal team will obtain your GP records and any attempt to conceal pre-existing conditions will destroy your credibility.

Instead, provide the expert with full records and ask them to address:

• The nature and severity of the pre-existing condition before the accident
• Whether and to what extent the accident has aggravated the pre-existing condition
• The likely course of the pre-existing condition without the accident (the "but for" analysis)
• The prognosis for the aggravated condition

Multiple Injuries Requiring Different Specialists

Complex injuries may require reports from multiple specialists — for example, an orthopaedic surgeon for fractures, a neurologist for head injury, and a psychiatrist for PTSD. Each expert should address only their area of competence, but the reports should be consistent in their factual basis.

Ensure each expert has access to the other experts' reports where relevant, so that the medical evidence presents a coherent picture rather than conflicting narratives.

Deterioration After the Initial Report

If your condition deteriorates after the initial medical report, obtain an updated report. The court needs current evidence, not a snapshot from twelve months ago. The updated report should cross-reference the original and explain what has changed and why.

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Frequently Asked Questions

Can I choose my own medical expert for a personal injury claim?

MedCo applies to soft tissue injury claims under the low value RTA Protocol (up to £25,000) and to whiplash claims (RTA Small Claims Protocol and PI Protocol para 7.12), including after the claim leaves the portal (PD 16 paras 4.3A–4.3B; PD 35 para 2.6). It does not apply to EL or PL claims. Otherwise, you can instruct the expert of your choice, subject to the court's directions. The court may direct a single joint expert, particularly in fast track cases. In all cases, the expert must be qualified in the relevant medical specialty.

What happens if I disagree with the medical expert's report?

If you disagree with your own expert's conclusions, you should discuss the specific areas of concern with the expert before seeking a different opinion. If the expert has made factual errors or failed to consider relevant evidence, they may amend the report. You need the court's permission to rely on expert evidence (r.35.4), and "expert shopping" — obtaining reports until you find one that says what you want — is improper and may attract costs sanctions.

How long does a medical report take to prepare?

This varies considerably depending on the complexity of the case and the expert's availability. Complex cases requiring extensive record review — particularly clinical negligence cases — take longer. Always allow sufficient time in your litigation timetable.

What is the difference between a medical report and a medical record?

A medical record is the contemporaneous clinical documentation created during your treatment — hospital notes, GP consultations, test results, nursing observations. A medical report is an expert's retrospective analysis of your condition, prepared specifically for the court, which interprets the medical records and offers an expert opinion on diagnosis, causation, and prognosis.

Can the other side's solicitor ask my medical expert questions?

Yes. Under CPR Part 35.6, any party may put written questions to any expert who has provided a report. The questions must be for clarification of the report and must be put within 28 days of service. The expert's answers are treated as part of the report. This mechanism ensures transparency and allows both parties to test the expert evidence without the expense of a full hearing.

What is a joint statement from experts?

When the court directs experts to hold discussions under CPR Part 35.12, the experts must produce a joint statement recording the issues they agree on, the issues they disagree on, and the reasons for any disagreement. The joint statement is a particularly important document because it narrows the issues for trial and often resolves peripheral disputes, allowing the hearing to focus on what genuinely remains in contention.

How should medical evidence be presented in the court bundle?

Medical evidence should occupy a dedicated section of the bundle, with expert reports presented first (in the order served), followed by medical records organised chronologically and sub-divided by source. The index should include clear entries for each report and record set. For electronic bundles, each document should be bookmarked and the index hyperlinked. BundleCreator.co automates this formatting, producing paginated, bookmarked bundles with hyperlinked indices that meet court requirements.

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Next Steps

If you are preparing medical evidence for a personal injury claim, start by ensuring you have all relevant medical records and that your expert's report addresses every requirement of Practice Direction 35. Review the report critically — does it address causation? Does it deal with pre-existing conditions? Does it contain the mandatory statement of truth?

BundleCreator.co provides personal injury bundle templates with dedicated sections for medical evidence, expert reports, and Part 35.6 question responses. Upload your documents, organise them into the structured sections, and generate a professional, court-ready bundle with automatic pagination, indexing, and bookmarking — everything the judge needs to engage with your medical evidence efficiently and fairly.

Related reading

• How to Prepare a Schedule of Loss for Personal Injury Claims
• Multi-Track Personal Injury Trial Bundle: From Pleadings to Authorities
• Personal Injury Court Bundle: A Complete Guide for Claimants and Practitioners