Any treatment the insurance company paid for must be provided to the injured worker’s attorney and any unauthorized treatment must be provided by the injured worker to the insurance and carrier. However this does not mean that the worker not entitled to copies of his or her records. Under the New Jersey Administrative Code, they may obtain copies of their records upon written request. See NJAC 8:43G-15.3(d).
Medical discovery is limited in New Jersey Workers’ compensation and is governed by R. 12:235-3.8(c),
“The employer shall be required to furnish or make available for inspection and copying all records of medical treatment, examinations and diagnostic studies authorized by the respondent. The respondent shall have the same right when the worker is treated by his or her own physician. If either party fails to furnish said information within 30 days of receipt of demand of records, it may be responsible to reimburse its adversary for the cost of procuring the same.”
If an employer or their insurance company has a reasonable basis to believe that an injured worker has suffered a prior injury to the same body part alleged to be injured in a claim petition, they are entitled to receive those records. A reasonable basis can be established by providing evidence of a prior insurance claim, reference to a prior injury in the records, or a prior workers’ compensation claim all involving the same area of the body.
However a blanket request for ten years worth of personal medical records without any basis is not permitted. An injured worker does not give up their right to privacy when injured at work and a prior injury is not a bar to receiving benefits under the workers’ compensation statute. A recent unreported decision from the Camden District Office, April 15, 2013, upholds this proposition. However a worker cannot intentionally hide a prior injury either. Such an intentional act would subject a petitioner to fraud charges under the workers’ compensation statute, N.J.S.A. 34:15-57.4. If the worker is found guilty of fraud, penalties may include both civil and criminal. Civil penalties could include forfeiture of future benefits and an obligation to repay benefits obtained fraudulently. It should be noted that either party may request additional discovery upon motion with notice to the opposing counsel.