Michigan lawyer discusses reasons why claimants are required to sign workers’ compensation medical records release.
Our job as workers’ comp lawyers is to protect individuals who are hurt. We do this through knowledge and experience. Understanding legal rights is the key to making sure the employer or its insurance company does not take advantage. A common question that we receive is about the workers’ compensation medical records release.
Many people get nervous when the insurance company starts digging into their medical background. It feels like a violation of their privacy rights. Does the insurance company really have the right to get all workers’ comp medical records? Keep reading below to find out some answers.
Workers’ Comp Medical Records
Michigan workers’ compensation law protects employees who get hurt on-the-job. All reasonable and necessary medical treatment must be paid by either the employer or its insurance company. This includes emergency room visits, doctor appointments, hospital stays, prescriptions, physical therapy, durable medical equipment, surgery, and even home medications.
Insurance companies review medical records to determine if treatment is reasonable and necessary. It provides a snapshot of how an employee got hurt and what medical treatment is needed. Bills should be paid 100% without any co-pays or deductibles being owed.
Sometimes an insurance company goes back even further. Medical records from years earlier are requested to determine if a person has any preexisting condition. Medical records can also be used to dispute workers’ comp benefits if they show a claimant has not been truthful.
Physician-patient privilege is generally waived if an employee is relying upon medical records/testimony to support his or her workers’ comp claim. Additionally, privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) generally do not apply to workers’ comp insurance claims.
Workers’ comp medical records are an “open book” for the insurance company but this does give them a blank check to speak with a treating doctor. It is important to have a lawyer to ensure that workers’ comp rules are being followed. This is especially true when a nurse case manager has been assigned to the claim. Watch out for attempts to change work restrictions or medical treatment plans.
Independent Medical Examination (IME)
Michigan law permits an insurance company to have a claimant examined by a doctor of its own choosing at the IME. Workers’ comp medical records will be obtained and shared for this purpose. These doctors are not independent and make careers out of testifying against disabled employees. Expect to be asked about prior injuries and preexisting conditions. Insurance companies refer to these examinations as second opinions, but they are not.
It is common to see IME reports that say no additional medical treatment is needed or disability was not caused by job in the first place. This happens months or years after the initial workers’ comp claim. Biased medical opinions should always be challenged in workers’ comp court. Deposition testimony from a treating doctor can be used to show a claimant needs additional medical treatment and/or is still disabled.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.