What kinds of medical records do I need for my workers’ compensation claim?

hospital buildingMedical records represent an important part of the process of obtaining workers’ compensation in Illinois. Workers’ compensation is an entitlement to benefits, owed by the employer, when a worker is injured out of and in the course of employment. Any workers’ compensation attorney in Chicago knows that medical records help to ensure that the specific form and magnitude of compensation requested is appropriate.

The law with which actions by injured workers or liable employers must be consistent is the Illinois Workers’ Compensation and Occupational Diseases Act. Moreover, the Act addresses the role of medical records in the process of seeking workers’ compensation. Specifically, the role of medical records is addressed in sections 8 and 16 of the law.

Employers are entitled to obtain medical records

Section 8 of the Act states that hospitals, doctors and other medical professionals are obliged to allow employers of workers seeking benefits to inspect relevant medical records. However, there are nuanced here that are important for injured workers to understand. In context, employers and their insurers are financially motivated to use medical records to their advantage. In other words, they may try to frame them as evidence that workers’ compensation benefits are not deserved.

For this reason, injured workers need to be vigilant in order to not allow more access to records than what is required by law. For example, employers may seek authorization from the injured worker for what are called “ex parte” communications. This means that the employer’s attorneys are authorized to communicate with treating physicians, in addition to reviewing records, which a workers’ compensation attorney in Chicago might advise against.

On a related point, Section 8 of the Act also describes the necessity of medical records as evidence of deserved benefits. Evidence of the timing of treatment sought, relative to the alleged date of the injury, may be important. The specific diagnoses, recommendations or treatments received also constitute important evidence for a claim’s validity.

Admissibility of medical records

Section 16 of the Act describes how medical records are admissible as evidence in workers’ compensation cases. When verified by legitimate medical providers, they are presumed to be true, although they are rebuttable. What does broad admissibility mean for workers? Whatever is available to employers may be used against workers’ claims. Therefore, it may be important for injured workers or their representatives to be aware of all medical records that could form part of employers’ arguments.

The sensitive nature of medical records in workers’ compensation cases requires injured workers to tread carefully. For this reason, these individuals may wish to consult with a workers’ compensation attorney in Chicago.