Why are Separate Medical Records Necessary for Workers’ Compensation?

Workers’ compensation is often responsible for covering the cost of medical care when a worker suffers from an injury on the job.

The workers’ compensation process is intended to make it easier for injured employees to get the medical attention they need. It alleviates financial concerns so they can focus on recovering and returning to work. It also alleviates significant financial concerns for employers. Employers must pay for workers’ compensation insurance coverage, but they do so in exchange for not having to pay the significant cost of medical care for injured workers.

Receiving workers’ compensation once you’re injured can be a simple process, but this isn’t always the case. Often, questions arise about a worker’s injuries. They’re forced to prove they deserve the benefits to which they’re entitled. In some cases, this requires providing separate medical records.

Why might separate medical records be required?

Legal Issues

Separate medical records serve as legal documentation of a worker’s injuries, diagnosis, and treatment. Workers’ compensation claims can lead to litigation and become the subject of a lawsuit. If a worker does not have separate medical records, it can be challenging to prove their case.

Separating medical records ensures that the information provided is accurate, relevant, and would be recognized legally.

Privacy

Separate medical records for workers’ compensation claims protect the worker’s privacy. The records used in workers’ compensation cases tend to focus on the aspects of the work-related injury or illness only.

Insurance companies and employers are not entitled to the worker’s medical records from before the accident. When medical records are not separated, there is a risk of sensitive information about an employee being accessed by the wrong person.

Insurance

Insurance companies receive separate medical records as evidence needed to approve or deny a workers’ compensation claim. The insurer requires proof of the injury and documentation to ensure that medically necessary treatment is being provided.

By separating medical records, workers’ compensation insurance companies and employers can properly evaluate the injured worker’s injury and condition.

Speeding Up the Claim

Having separate medical records available for workers’ compensation claims can potentially speed up the decision-making process. Separating medical records improves the odds that the information will be organized, relevant to the work-related injury, and easy to evaluate.

Improving Communication

When medical records are separated for workers’ compensation claims, communication between the injured worker, the health care provider, the employer, and the insurance company can be more fluid. Separating medical records ensures that everyone involved in the claim process is on the same page. With fluid communication, employees can easily check on their workers’ compensation claim status and have better peace of mind while recovering.

Separate medical records for workers’ compensation claims serve many purposes. It not only protects the injured worker’s privacy and legal rights, but it assures they receive the medical attention they need promptly. Furthermore, having separate medical records ensures that information on relevant medical treatment is accurately documented.

For more information about workers’ compensation or to speak to someone about the medical information you must provide for workers’ compensation, contact Livingston DiMarzio Brown, LLP at (973) 943-4961.