What You Need to Know About Releasing Medical Records for an Injury Claim

pen on clipboard with stethoscopeIf you file a claim for compensation for personal injury damages, you must provide proof that you suffered an injury that resulted in damages. That means you are going to need medical records from one or more of your doctors that diagnose your injuries and their severity.

While you will likely need to disclose some of your records, you only need to release the records relevant to your claim. You have the right to keep everything else private.

The problem is insurance companies are working against your interests. They are on the hunt for any information they can use to question the validity or value of your claim. That is why they often ask victims to authorize the release of all their medical records, even ones that are not relevant to the claim.

It is important to work with a licensed attorney when releasing medical records so you can protect your claim and your privacy. Below, TSR Injury Law’s experienced Minneapolis personal injury lawyers discuss the release of medical records in an injury claim.

If you have questions about your injury claim, give us a call today to schedule a free consultation. (612) TSR-TIME.

What to Do When Insurers Request Medical Records

Although you need to provide relevant medical records to validate your claim, you should talk to an attorney first. For example, if you meet with the insurance company and they provide you with a form authorizing the release of your medical records, you should review it with an attorney. You want to make sure you are protecting your privacy and only providing the relevant information.

Some standard authorizations allow the insurance company to speak with your doctor, request mental records, seek birth records, speak with your employer, review your tax returns and many other intrusive private unrelated requests.

Legal documents are often confusing and difficult to read if you do not deal with them on a regular basis. At TSR Injury Law, we have been helping injury victims for decades and are well-prepared for obtaining medical records and taking other necessary steps to build a strong case. We can manage the legal paperwork and filings while you deal with your injuries.

Authorizing the Release of Your Records

You will be required to provide some medical history via records. For example, if you claim your neck was injured in a crash, the insurance company has a right to know if you were treated for neck pain before the crash.

Any lawyer representing you for an injury will have you sign their medical authorization so they can retrieve related records. The requests are covered under attorney-client privilege, so they may not always be shared with the insurance company. It also allows your representation to learn about potential pitfalls in your medical history.

In some cases, you or your lawyer can obtain records from an online portal used by the medical provider. In some cases, the request may need to be mailed or faxed to the provider.

It is always best to obtain the records yourself or have your attorney do so on your behalf. It is never a good idea to authorize an insurance company to obtain records because they will try to obtain records for the last several years to find evidence of a preexisting condition.

Signing Your Rights Away

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects the privacy of your medical records. Generally, HIPAA restricts access to your medical records to you and anyone you authorize. Those who are not authorized cannot gain access to your records, with rare exceptions.

HIPAA allows you to request records for yourself, your child (unless you are not the custodial parent or legal guardian), anyone who has appointed you their personal legal representative, or a deceased person if you were appointed to represent their estate.

That is why it is so important not to sign your rights away. HIPAA is a federal law that severely restricts access to your records. You have control over them and should not give that up without a good reason.

Even after your attorney submits a demand letter, the insurance company may request more records. Sometimes this is a legitimate request. For example, maybe they want imaging test results for tests done to diagnose your injuries.

Your lawyer can ask the insurance company to explain why these records are necessary and explain your options. Unlike the insurance company, the attorneys at TSR are focused on your best interests throughout the process.

In some cases, a request for certain medical records can be fought in court, if your case makes it to that point.

Doctors Have Discretion

It is important to note doctors have discretion to hold onto some records under HIPAA, such as:

  • Information provided by other doctors
  • Information the doctor believes could cause riots or a public panic
  • Information the doctor thinks could cause you or others significant harm
  • Information you told doctors not to disclose
  • Information the doctor does not want released relating to the treatment of a minor
  • Notes from a mental health professional
  • Personal notes taken by the doctor

What if the Insurance Company Requests an Independent Medical Exam?

Even if you provide detailed medical records documenting your injuries and treatment, the insurance company may dispute the severity or even the existence of your injuries. This often happens with permanent or long-term injuries, as insurance companies do not want to pay the full value of these claims.

Often, disagreements about the severity of an injury are resolved through the negotiating process. Unfortunately, that is not always the case, and the insurance company may request an adverse medical exam (AME).

The insurance company will say they want to do this to determine the extent and severity of your injuries. However, their true goal is to get an opinion from a doctor that lines up with their interests. The doctors who conduct these exams often reach conclusions that favor the insurance company.

You should not agree to an AME without discussing it with a lawyer. You may not be required to undergo an AME, despite what the insurance company says. If the exam is not required, you should discuss it with a lawyer to determine what you should do.

If the exam is required, an attorney can explain how to prepare for it to protect your rights. Your lawyer can give tips on answering questions without oversharing and providing detailed descriptions of your injuries and symptoms. Even if the AME doctor reaches different conclusions than your treating doctors, it is important that documentation of the exam shows you describing your injuries in a way that is consistent with your claim.

Call TSR Injury Law Today to Discuss Your Claim

Are you unsure how to respond to the insurance company’s questions?

Do you need assistance with your claim?

At TSR Injury Law, we have been securing compensation for injury victims for decades. We have obtained $1 billion on behalf of our clients.

We charge no upfront fees so there is no risk in talking with us to find out how we may be able to assist you.

Call today to schedule a free consultation. Call (612) TSR-TIME.