Why Employers/Insurers Need Employees’ Medical Records

MOS Medical Record Reviews 1­800­670­2809

Why Employers/Insurers Need Employees’ Medical Records Legitimate Reasons for Medical Record Release Workers’ Compensation process often requires the release of the claimant’s medical records to the employer or insurer. They will have to either provide the medical records on their own or sign a release form that will allow the payer/employer to make the request on their own. The medical records are needed to ensure: • That the worker is receiving the right treatment • That the worker is not abusing the privilege of receiving free medical treatment • That the independent medical evaluator has a complete medical history of the injury to provide the best evaluation as regards permanent or partial disability.

The insurer or employer has the right to ask for the claimant’s medical records provided that they are relevant to the workrelated injury. According to the Workers’ Compensation rules, each party has to provide the opposing party with copies of all relevant medical information that is currently in the possession of the party or subsequently received by the party. The claimant can also request for any medical information that may be in the possession of the payer or employer.

MOS Medical Record Reviews 1­800­670­2809

Issuing Subpoena for Release of Medical Information The claimant as well as the employer/insurer can issue a subpoena duces tecum through a lawyer to a physician that requires the physician to provide copies of the requested medical documents. When such a subpoena is received, the opposing party will have 30 days to note an objection. If no objection has been noted, the subpoena will be sent to the medical provider who must necessarily comply with the request.

For a smooth Workers’ Compensation process, the claimant must make sure that every doctor who treats his/her injury knows that the injury is a work related one. Moreover, he/she should also make sure that any pain/changes in the injury are brought to the notice of the treating physician so that they are well documented.

Decision Made on the Basis of Comprehensive Medical Record Review It follows that there is no need for an employee to get anxious when an employer/payer requests for copies of his/her medical records. They are making the request to perform a detailed review of the medical records to ensure that the claim is valid. It is important to understand that the request for medical details is not part of a plan by the payer/employer to extract confidential medical information. Workers’ compensation attorneys can help claimants fight for their rights. They also represent insurance companies and employers, helping them decide whether a claim placed is legitimate.