Top 10 Clashes in Medical Records Affecting an Injury Claim

The medical record of an individual is the repertoire of his entire medical data, which would reflect all his medical encounters. When the individual is involved in an accident or any other mishap, he may claim damages by filing a personal injury lawsuit.  

In such instances, his medical records would act as evidence to prove that his damages are connected with the accident. How? Medical record review and analysis are the processes used in such circumstances to use medical records as evidence in injury claims.

To begin with, the contradictions in medical records and their effect on a personal injury claim, let us explore how imperative medical records are.

Role of Medical Records in a Personal Injury Claim

Seeking medical care would be the most sensible thing you could do after being victimized in an accident. Never judge your injuries on the spot. Do not overlook the damage caused by the type of accident you encountered.

Documentation of the accident details and the injuries sustained would act as your first line of defense when proceeding with a personal injury lawsuit. Even minor statements of yours in the medical charts would be powerful enough to turn your claim upside down.

Let’s check out what are the details a medical chart would reflect:

• The signs and symptoms presented by the victim

• The nature of injuries sustained

• The details of the treatment providers with dates of treatment

• The intensity of pain

• Diagnostic tests suggested by the physician

• Treatment plan suggested by the physician

• The duration of treatment

• The connection between the damages and the accident

• The charges incurred by the patient due to the injuries

• Future medical needs of the patient due to the accident

Common Contradictions in Medical Records

In any personal injury litigation, the insurance carrier or the defendant’s attorney would attempt to avoid a potentially record-breaking payout. The defendant would try to dodge the responsibility of the accident through strong defense arguments.

Medical records are often the targeted evidence for both the plaintiff and the defendant. The claimant’s attorney would submit the medical records as proof of the damage incurred and to reflect the economic burden the claimant suffered.  

On the other hand, the defense attorney would try to dig out the loopholes in medical records. Any disparities in it would be utilized to deny the claim.

The below mentioned are common errors encountered in a medical record.

1. Date and Time of Injury

Documenting the date and time of the accident in the medical chart is very crucial in any personal injury lawsuit. Any error in the entry of the date of the accident could make the lawsuit weak.

Every personal injury lawsuit needs to be filed under a statute of limitations, which differs according to the type of injury and state. The statute of limitation begins from the date of injury, and any claim after the completion of the duration won’t be considered by the law. In this aspect, the date and the time of injury, as mentioned in the medical record, are very central.

2. Deployment of Airbags

Airbags, though they provide safety to the occupants of the vehicle during a crash, are not expected to deploy in every accident. The deployment of an airbag during a car crash depends upon certain factors like the speed of the vehicle, type, force of the collision, etc. This makes the deployment of airbags one of the most important queries after any road accident.

Statements about airbag deployment are considered vital evidence in accident claims. It is cross-checked by other evidence in the accident, like photographs, the direction of the vehicles during the collision, etc. Providing contrary statements about airbag deployment may negatively impact the consistency of the personal injury claim, thereby affecting the compensation.

‍3. Use of Seat Belt

Wearing a seat belt would safeguard the vehicle’s occupants during a collision. Some states in the US follow the doctrine that failure to wear a seatbelt can drastically affect the ability of the claimant to recover his damages.

Personal injury claims often face inconsistencies in the statement of the claimant about the use of the seatbelt. Insurance companies would try to minimize the compensation amount paid to the claimant. Not wearing the seatbelt during the accident may be seriously reflected in the litigation considering negligence in certain accident claims.

4. Loss of Consciousness (LOC)

Loss of consciousness is the state where an individual loses normal awareness. It happens due to an obstruction of blood flow to the brain as a result of an accident. It is an immediate indicator of the physical as well as mental trauma sustained by the victim.  

Hence, it is considered an important factor in a personal injury claim, especially in a brain injury claim. However, brain injury after an accident need not always be present as loss of consciousness.

In some cases, ambulance or emergency room records would state that the victim had no loss of consciousness (LOC). However, the victim may testify that he had a loss of consciousness immediately after the injury. This clash in the medical reports may adversely affect the litigation process.

The ambulance or emergency room staff being physically absent in the accident spot immediately after the misfortune cannot comment about LOC in the medical records. These records are not always reliable as they are hurriedly prepared.  

The complicated part is that even the victim may give inconsistent statements about LOC. This occurs mainly in the aftermath of the trauma.

Conflicting statements about the loss of consciousness in the medical charts may become hefty when presented by the defendant. This may even end up in denial of claims like that in brain injury litigation.

5. Initial Onset/ Severity of Pain

Unlike physical injuries, the pain and suffering of an injured are beyond measure. The victim often finds it difficult to express the intensity of pain he suffers.

Physicians use the pain scale method to assess the pain encountered by the patient. Instantly after the accident, there would be an adrenaline gush in the body, due to which the victim may not experience the pain.  

This may mirror the pain scale assessment. Even in major injuries, the victim may not feel intense pain. This would lead to differing pain scale ratings given to the physician and the insurance company. This, in turn, would result in a discounting of the damage caused by the accident.

The other side of the coin is that the victim may sometimes tend to exaggerate the pain and give a higher score during pain scale assessment. This stems from the thought that a high pain scale rating would result in a better payout. However, the bitter part of the story is that it ends up doubting the credibility of the claimant when the medical experts find the pain scale reading does not correlate with the symptoms presented by the patient.

6. Paradoxes in Reports

Police reports and collision reports are the official reports of the accident. It contains all the information about the accident, photographs, the contact and insurance details of the at-fault party, and also the witness information. The statements given in these reports would serve as a piece of additional evidence in a personal injury claim.

Often it happens that the details missing in the medical records would be extracted from these reports during the medical record review process. Therefore, statements provided in these reports should be unbiased.

The testimony of the claimant if these reports were filed also is very important in the claiming process. If these reports were filed after the accident yet missing in the records of the claimant, they could be easily retrieved and presented as crucial evidence to support the litigation.

7. Emergency Room visit

Immediately after any accident, the victim would be confused and clueless. A few days later, the victim would suffer excruciating pain. In some instances, like a car accident, delayed injuries like internal damage, concussion, or soft tissue injuries may occur, which may not immediately be noticed.

After an accident, the victim should seek instant medical care even if the injury appears minor. This would not only aid the victim in managing his injuries but also help him in battling the claim.  

Not reaching an emergency room after the accident would make your insurance company or the defendant claim that your injuries were not that serious. This may even question the credibility of your injuries.

Medical records of emergency room visits after the accident would reflect the seriousness of the damage you sustained. Seeking medical attention will ensure your injuries are documented and will benefit in substantiating that they resulted from the accident. This would give a good turn while going ahead with personal injury litigation.

8. Date of Hospital Visit

When proceeding with a lawsuit for your injury, the defendant’s attorney and his insurer will carefully dissect your hospital visits and follow-up records. The claimant should follow the treating physician’s recommendations and attend to all scheduled appointments.

The date of the hospital visit immediately after an injury reflects the intensity of your medical issues and the need for medical care. Discrepancies in your medical charts concerning hospital visit dates would negatively affect your claim. The defendant’s attorney may use these gaps in your medical records as an opportunity to question your injuries and pay you less than your case is worth.

9. Name and Specialty of the Physician

The name of the treating physician and his specialization is another pressing particular in the medical record of the claimant.  

There are two possibilities for errors in this aspect. Either the name of the physician may be stated incorrectly by the claimant, or there would be a typo error when entering the names and specialization of the physicians in the medical records.  

This would result in hassle while trying to retrieve missing reports during medical chart review.

10. Number of Hospital Visits/Therapy Sessions

Since the insurance adjuster may try to devalue the damages and reduce the compensation, the number of hospital visits or therapy sessions is also key to the potential success of your claim.

Frequent visits and follow-ups indicate the severity of the injury of the claimant and the need for prolonged treatment. The medical chart would indicate the hospital visits and the date of the follow-ups. Missing a follow-up would adversely affect the claim. It would make the defendant substantiate that the injuries are not as severe as presented in the claim.

The unparalleled way to tackle medical record controversies creating hurdles in the claim is offshoring the medical records review to an expert medical record review company. They would sort, organize, and index the medical records based on the timeframe, which helps to identify any mismatches.

Your sensible reasoning can become clouded after an accident. Never lose your mind. Collect as much evidence as you can. Medical records are double-edged swords as far as your claim is considered. They could well determine whether you receive maximum compensation or walk away empty-handed.

If you overlook hospital medical records, that will affect your claim. Reviewing medical charts through expert hands would minimize the discrepancies in your medical records affecting your claim. Outsourcing medical chronology services would make every minute data in the medical chart analyzed with high precision.

Any clash of data in the medical record, like treatment dates, names of the physicians, missing bills, etc., would be easily dug out by the medical record reviewer and communicated with your attorney.