An assessment carried out for a report is not treatment. It produces an opinion for whoever commissioned it, and it does not create the ordinary relationship between a doctor and a patient.
For aviation matters, Dr Brown holds two CASA appointments alongside his addiction medicine fellowship: Designated Aviation Medical Examiner, and CASA-Approved Aviation Consultant.
To instruct, or to check whether a matter is suitable: Phone (07) 3180 6020 or email reception@drdouglasbrown.com.au.
Independent means independent
A fee pays for specialist time and analysis. It does not buy a favourable conclusion, preferred wording, or a recommendation decided before the material is read. An opinion is not altered to meet a preferred result.
If the person to be assessed is, or has been, a patient of this practice, say so when you instruct. A treating relationship is not automatically a bar, but it has to be disclosed, and it may mean the assessment is better done by someone else. It is easier to establish that at the outset than to have it raised later.
Reports and opinions provided
- capacity and impairment;
- relapse risk;
- adequacy of treatment and standard of care;
- fitness for safety-critical work;
- prognosis and future treatment needs;
- causation;
- reports for court in Queensland and other jurisdictions.
If what you need is not on the list above, ring reception and it can be discussed before anything is committed. Two of these areas come with their own published requirements and are set out separately below: driver licensing, and CASA assessments for pilots and controllers.
Driver licensing: the standard that asks for a specialist
Fitness to drive is assessed against Assessing Fitness to Drive, the national standard published by Austroads. Its substance misuse criteria were revised in June 2022 and cover regular heavy use of, and dependence on, alcohol and other substances, including prescription medicines.
A report of this kind is usually requested through the driver’s own doctor, although an employer, an insurer or a solicitor may commission one directly.
Commercial drivers
For commercial vehicle drivers, the opinion of a medical specialist is generally required before a conditional licence can be considered, reflecting the higher safety risk that comes with the licence class.
For a truck or bus driver, the licence is the livelihood. That makes these matters urgent in a way most medicolegal work is not, and it usually means an employer or an insurer is involved as well as the driver.
What a conditional licence report has to establish
The licensing authority is given the criteria that are not met, the evidence for those that are, and the conditions and monitoring proposed. Where there have been repeated relapses, the standard points towards a longer non-driving period or an alcohol interlock before a conditional licence is granted. A documented response to treatment and a well-evidenced period of abstinence can support a licence at the minimum period instead.
CASA alcohol and substance assessments for pilots and controllers
Where substance use including alcohol is in question, the Civil Aviation Safety Authority does not ask for a general medical opinion. Its clinical practice guidelines specify an assessment by a Fellow of the Australasian Chapter of Addiction Medicine, the qualification abbreviated FAChAM.
The aviation background
A CAAC is a specialist with additional training in aerospace medicine, appointed to advise both patients and CASA on the safety relevance of a condition or a treatment within that specialty. Before specialising in addiction medicine he served eight years as a permanent Royal Australian Air Force Medical Officer, with aviation medicine among the areas he worked in. The two CASA appointments are held alongside the addiction medicine fellowship, so the standards, the terminology and the certification process are familiar ground.
A stricter rule applies in aviation than the one set out under Independent means independent: a matter is not accepted where Dr Brown has examined the person as their DAME, or has already advised CASA on the same case.
If you are a pilot or an air traffic controller
The assessment covers the diagnosis, the history of use, your current clinical status and health, treatment and how you responded to it, and the plan from here. It does not decide anything: the certificate is CASA’s to grant, and the report is one of the things it weighs.
An assessment arranged early, with monitoring already under way, gives CASA more to work with than one arranged after a deadline has been missed. Failure to submit reports on time is treated by CASA as an indicator in itself.
Pilots, controllers, DAMEs, employers and solicitors with a CASA matter can phone (07) 3180 6020 or email reception@drdouglasbrown.com.au.
What this specialty can and cannot answer
Addiction medicine speaks to dependence and its course: whether a dependence existed and when, the risk in withdrawal, what treatment was reasonable, how a person responded to it, the likelihood of relapse, and prognosis with and without treatment.
It does not speak to forensic toxicology. Back-calculating a blood alcohol concentration, detection windows, and the interpretation of a particular assay belong to a forensic toxicologist or a clinical pharmacologist. Where a matter turns on those, it is better to know at the start.
Who instructs
Solicitors acting for plaintiffs and for defendants, insurers, employers, regulators and professional bodies. Work as a drug and alcohol expert witness in Queensland, and as an addiction medicine expert witness elsewhere in Australia, is undertaken on the same terms, and instructions are accepted from either side of a matter.
Reports written for court
A report prepared for a Queensland proceeding is written to comply with the Code of Conduct for experts in Schedule 1C of the Uniform Civil Procedure Rules, as amended in 2022. The expert’s paramount duty is to the court, not to the party who retained them, and an expert is not an advocate for either side.
Rule 428 sets out what the report itself must contain: the expert’s qualifications; all material facts and assumptions relied on, with the letter of instruction annexed; the reasons for each opinion; a statement where a question falls outside the expert’s expertise; the literature relied on; and details of any examinations or tests, including the qualifications of whoever carried them out.
A report that does not comply with rule 428 can be ruled inadmissible. Reports are prepared to that standard from the outset, not corrected afterwards.
Beyond the report
Where a matter proceeds, the work can extend to conferences with counsel, joint conferences with the other side’s expert, a supplementary report where further material arrives, and giving evidence.
How to instruct
Questions that produce a useful report
• Was a substance use disorder present, and if so, at what point did it begin?
• Was the treatment the person received reasonable and necessary in the circumstances?
• What is the prognosis with treatment, and what is it without?
• What is the risk of relapse, and what would reduce it?
• Did the substance use affect capacity to work in the person’s occupation, and over what period?
• What future treatment is likely to be required, and for how long?
Questions framed as a request for a conclusion the evidence cannot support will be answered as such, with reasons. That is what rule 428 requires and it is more useful to a matter than an opinion that does not survive cross-examination.
Send the letter of instruction with the questions you want answered, together with the material you want considered: medical records, test results, any previous reports, and the relevant statements or affidavits.
Instructions can be sent directly, or through Medicolegal Assessments Group or MLCOA. All three reach the same specialist.
Direct instructions go to reception@drdouglasbrown.com.au, marked for the attention of medicolegal so that they are not handled as patient appointments. Phone (07) 3180 6020.
The fee is a fixed amount for the report rather than an hourly rate. It is quoted for the particular matter, and it is agreed before any work begins, as is the turnaround.
Where the file is large or an examination is needed the report may take longer to complete and the timetable is agreed when the matter is accepted.
If you have been asked to attend an assessment
You may have been sent here by an employer, an insurer, a solicitor or a medical examiner. Three things are worth knowing before you come.
The appointment is an assessment, not treatment. The report goes to whoever commissioned it, and nothing is prescribed and no treatment is started on the strength of it.
Bring photo identification, a list of your current medications, and any recent test results you have. You may bring someone with you, although they will usually be asked to wait outside while the assessment itself is done.
An assessment of this kind is not the way to get help, and it is not meant to be. If help is what you are looking for, that is a different door and it is open: the what is an addiction physician page explains how that side of the practice works and how a referral is made.
Where to go next
• The physical side of stopping, and the point at which it becomes dangerous: alcohol withdrawal.
• Supervised treatment that does not require an admission: private outpatient treatment.
• The specialty itself, and how a referral is made: what an addiction physician does.
• If you have served in the ADF, or a matter concerns a current or former ADF member: veterans and DVA.
Support available in Australia
These services are free and independent of this practice.
None of them requires a referral, a report or a solicitor.
- HIMS Australia, aushims.org.au — confidential peer mentoring for pilots with alcohol or other drug problems, run by pilots. CASA guidelines name compliance with a CASA-approved HIMS-style program as an option within a monitoring plan.
- 000 — for a medical emergency
- Lifeline 13 11 14 — crisis support
- Adis Queensland 1800 177 833 — Queensland alcohol and drug support, twenty-four hours.
- Open Arms 1800 011 046 — current and ex-serving ADF members and their families.
Where this information comes from
The aviation, driving and court requirements described on this page are set by CASA, by Austroads and by the Queensland rules, not by this practice, and the registration details come from the national register. All were checked on 15 September 2026:
- Civil Aviation Safety Authority, clinical practice guidelines for DAMEs, Alcohol. Sets out the requirement that the assessment be made by a FAChAM, the circumstances in which another specialist may be accepted, and the period of demonstrated abstinence CASA looks for.
- CASA-Approved Aviation Consultants, Civil Aviation Safety Authority. What the appointment is and what it covers.
- Austroads, Assessing Fitness to Drive, Substance misuse. The national standard, the 2022 revision, the specialist requirement for commercial drivers, and what a conditional licence report must contain.
- Uniform Civil Procedure (Expert Evidence) Amendment Rule 2022 (Qld). The Code of Conduct for experts and the content required in a report.
- Register of practitioners, Australian Health Practitioner Regulation Agency. Registration and specialty.
Requirements change. Each should be checked against the current published version before it is relied on.
Reviewed by Dr Douglas Brown, MD FRACGP FAChAM, addiction medicine specialist, AHPRA MED0002140538. Last reviewed: 15 September 2026.