Medical Releases and Workers’ Compensation
Every workers’ compensation claim requires medical evidence. If you were injured while working at your job, you will need medical evidence to verify:
- That a workplace accident occurred
- That you sought timely treatment for your injuries
- That your injuries prevent you from working
- That the doctor’s bill for medical services is accurate
- That you saw your doctor on specific dates
- Your medical diagnosis
- Whether you can return to work with restrictions – and what those restrictions are
- If you’ve reached medical maximum improvement
- What treatments are required to improve your health
Each medical provider that you see must document their care. Medical providers include:
- Hospitals
- Emergency room physicians
- A general physician
- Any specialists or chiropractors that you see
- Any therapists, such as physical and occupational therapists, that you see
- Any psychologists or health care counselors that you speak to
- Any pharmacy prescriptions and medical device orders
The key concerns about medical authorizations that you should review with your Delaware workers’ compensation attorney
It’s critical that you review your medical condition with your lawyer. The attorney will explain which doctors you can treat with and when and why you can treat with doctors of your own choosing. The lawyer will explain what you need to explain to the doctor and what information you can keep private.
Insurers for the employer will always ask for a medical authorization so they know what bills to pay and so they know what your medical problems are. Your lawyer will review the following factors:
- The medical records. Your lawyer may need his/her own medical authorization to review the medical records. Often, the medical records aren’t accurate. Many times, the reports omit key information or come to medical conclusions that are inaccurate. Remember, the initial doctors work for the employer, so it’s critical that your lawyer review the medical records for these omissions and inaccuracies.
- That the medical request is only for relevant information. Insurers aren’t your friend. They’re looking for more than just a record of your bills and treatment. They’re looking to deny your claim and limit your treatment by:
- Searching to see if you have a pre-existing medical condition
- Looking for any inconsistencies between what your doctor says and what you say, which can be used to show lack credibility
- That the medical records comply with HIPAA (Health Insurance Portability and Accountability Act). Generally, medical providers can release medical information to workers’ compensation insurers – provided that the information is reasonably limited “to the minimum necessary to accomplish the workers’ compensation purpose.”
If your lawyer thinks the medical release is too broad or has other defects, the attorney will seek to have the Delaware Accident Review Board assess the release.
At Silverman, McDonald & Friedman, our experienced Delaware workers’ compensation lawyers have more than 100 years of combined experience. We’ve helped many workers in Wilmington, Seaford, and Newark obtain just workers’ compensation settlements and awards. We understand the tricks and strategies insurance companies try to defeat your claim – and we are quite successful at countering these strategies. If you’ve had a workplace accident or suffer from a workplace illness, please call us at 302.888.2900 or fill out our contact form as soon as possible to discuss your right to benefits.
