If the injured worker brings medical records to the initial interview with their attorney, the attorney will be a step ahead. In any case, if the injured worker (“Petitioner”) does not have any medical records, it may be important to have the injured worker sign HIPPA compliant medical authorizations at the initial interview so the attorney can obtain the medical records necessary to prepare the case. The Rules governing procedure in the Division of Workers’ Compensation are listed at N.J.A.C.12:235 – 1:1 through 13:6. Under N.J.A.C.12:235-3.6 (c) the employer is required to furnish or make available for inspection and copying all records of medical treatment, examinations and diagnostic studies authorized by the respondent (“Employer”). The respondent shall have the same right when the worker is treated by his or her own physician. If either party fails to furnish this information within 30 days of receipt of demand for records, it may be responsible to reimburse its adversary for the cost of procuring same. In most cases this request is sent to the respondent when the petitioner completes authorized medical care. Attorneys for both sides have an ongoing obligation to provide each other with all of the medical records obtained in the case.
If the claim is denied, the petitioner’s attorney will have to immediately request medical records from the treating physicians to review for filing a Motion for Medical and Temporary Disability Benefits. This type of Motion is to force the workers’ compensation carrier to provide medical treatment and temporary disability benefits to the injured worker. If the petitioner had a prior injury to the same part of the body for which you are now filing a claim, it is important for the petitioner’s attorney to obtain those records so that the attorney has the proper information when negotiating a credit for prior loss of function at time of settlement and when filing a Motion.
When the medical records are received, whether from the respondent or the unauthorized treating physician, it is important for the records to be reviewed thoroughly to truly understand the nature of the claim. There are many nuggets of information contained in the medical records, and in some cases the workers’ version of events does not match what is written in the medical records. As we all know, not all of the histories contained in doctor’s records are accurate, and in many cases an inaccurate history is repeated throughout the medical records. It is important to know about the potential problems in the medical records as soon as possible to adequately prepare for any problems that may arise. In many cases the injured worker can discuss the discrepancies with the doctor and have the doctor correct the records so that they are accurate.