Accessing Medical Records for a Personal Injury Claim

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 What are Medical Records?

When you file a personal injury claim, understand that your medical records and medical history will be a main focus since you’re asking for compensation for injuries caused by the at-fault person or entity.

Any hospital or healthcare facility where a claimant sought medical treatment will have records of the care provided and the cost of that care. At some point, when a personal injury lawsuit is filed, the at-fault person or business will attempt to acquire those medical records through their insurer or attorney.

Medical records are the documents and files covering a person’s medical history. They inform doctors and other medical personnel of current and past medical conditions, ailments, and additional important information. Medical records can contain information such as:

  • The types of medication the person is taking;
  • Whether the person has any allergies or contraindications or interactions with other medications;
  • Records of previous surgeries, therapy, and other occurrences;
  • Records of illnesses and congenital conditions, if any; and
  • Various additional medical information.

Personal injury law involves a plaintiff being injured by another person or entity. When the plaintiff’s injuries are physical, medical information may be needed to prove that the defendant’s actions actually did cause the physical injury. Often, attorneys will request potential clients to have medical records with them during the initial consultation to see if the client even has a claim pursuable in court.

Medical records can also be used for other purposes in a lawsuit, such as determining whether a person has a pre-existing medical condition at the time of their injury.

A pre-existing medical condition can sometimes affect the outcome of the damages award calculations. For example, suppose a person was in a car accident and injured their neck. In that case, they may receive fewer damages if the courts show that the accident only aggravated a previous neck injury.

Can I Obtain a Copy of My Medical Records?

According to the Health Insurance Portability and Accountability Act (HIPAA), individuals can receive copies of their medical records from any provider. There are a few exceptions where a person cannot obtain their medical records.

According to HIPAA, patients have the right to view original medical records, except:

  • Psychotherapy notes;
  • Medical information a provider believes could endanger the health and safety of others; and
  • Information that is being gathered and compiled for a lawsuit, such as records that are being gathered during the discovery process. Such a request would need to be made through the court.

Besides individuals seeking their own medical records, other people who can request them include:

Can I Receive the Medical Records of a Deceased Individual?

Whether you can receive the medical records of a deceased individual depends on several factors. Generally speaking, the only person who can obtain a copy of a deceased individual’s medical records is the estate’s personal representative.

The personal representative may be appointed by the court or through the deceased person’s will. Other people, such as a family member or a close friend, will need to ask the representative or petition the court to obtain a copy on their behalf if they want one.

It usually takes about 30 days to receive copies of a person’s medical records. Some states, such as California, have a quicker turnaround. In California, it may only take about 15 days to receive medical records.

Authorization for Release of Medical Records

If you’ve decided to sue for personal injury, your attorney will ask you to authorize the release of your medical records. This request will include your name, social security number, date of birth, patient account number, and address. This request may also ask for specific records, records during a certain time range, or all records in the care provider’s possession. In some states, requests for medical records must include the law or statute that allows for the release of medical records to patients or authorized third parties.

Your attorney can request records on your behalf after you give written, signed, and dated permission. The request can be sent via mail or fax. Many large care providers allow patients to request their medical records through an online portal. If you fax or mail the request, call the medical provider to confirm their receipt if you fax or mail the request. Many healthcare providers charge a fee to release records and to cover postage when they mail records out. Depending on the medical provider, you may have to pay the fee before the records are released.

A request for the release of medical records may be denied for several reasons. One reason for denial is lack of patient consent.

In a civil lawsuit for assault and battery, the person being sued may want to obtain the injured person’s medical records to use in court proceedings. The alleged batterer may want to request the release of medical records. A doctor’s office can deny the request. If a request for medical records is denied, a medical records subpoena may be pursued.

Privacy Concerns

Each state has specific standards for acquiring medical records for legal purposes. When drafting a medical records subpoena, be aware of state laws and the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements.

For example, in some states, both the HIPAA Privacy Rule and state law give you the right to access medical records. The HIPAA Privacy Rule sets standards for records across the nation. State law sets standards for records for providers within the state. Where HIPAA and state law conflict, the most protective rule or law governs the situation.

What is the Process of Obtaining Medical Records?

Each state and healthcare provider has its own rules on how one must go about requesting their medical records. However, a person must usually:

  • Contact the medical provider to find out where the request should be sent;
  • Make a written request;
  • Include the name, telephone number, address, date of birth, email address, and medical record number in the request;
  • Complete a release form; and
  • Indicate whether the request is for originals or copies of the medical records.

If you are unsure of the legality of obtaining a certain batch of medical records, then you may need to consult with a lawyer. An attorney in your area can inform you of your rights and capabilities when obtaining medical records, especially in preparation for trial.

What Are Reasons for Releasing Medical Records?

There are advantages to obtaining all medical records relating to a personal injury case. Having all medical records relating to a personal injury case allows both sides to assess the injuries and viability of a case. It provides details on the nature and extent of the claimant’s injuries and helps to calculate damages sustained by the injured person.

Do I Need a Lawyer to Help Me Request My Medical Records?

If you have suffered a personal injury, you do have the right to obtain copies of your medical records, and you have the right to appeal any denial of your request for those records. These records may be necessary to prove that you were injured or to prove that the injury was not a pre-existing injury. Contact a personal injury lawyer near you to get help with this task.

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