Overview

Any personal injury lawsuit involves seeking monetary compensation for the damages sustained by the claimant. For a successful personal injury claim, it should be proved that the negligent action of the at-fault party ended up in harm to the claimant. In this blog we would discuss the role of medical chart review in a personal injury lawsuit.

To claim a reasonable value for a personal injury, the first and foremost document the law considers is the medical records of the injured. Medical charts would mirror all the medical encounters of the claimant right from the emergency room visit till the case comes for trial. Medical records in layman’s terms are the medical database of an individual. It contains information like date and time of injury, diagnostics performed, treatments obtained, EMS report, accident report, etc.

Primarily, the evidence from medical records aid the attorneys to prove the proximity of the injury case.  It helps the legal community to understand the nature and extent of the injury, and suffering and pain experienced by the injured person. Moreover, medical bills and medical notes are essential tools to determine the compensation in most of the personal injury cases. This would help both the plaintiff’s attorney and the insurance claim adjusters to evaluate the injury claims.

Now with your understanding of medical charts and their importance in a personal injury lawsuit, it’s the perfect juncture to discuss medical chart review. Also called medical record review, it is the process of analysis and filtering out relevant data from the pre-recorded medical chart of a patient. A review of medical records by an expert medical record reviewer is valuable in a personal injury claim. A precise medical record review report reveals medical evidence that would shoulder the arguments of the personal injury attorney in the court. Sailing through this blog, you would understand how imperative a medical chart review is in personal injury cases.

Do you know what are the common injuries considered as personal injuries to claim insurance? We would go through some of the most common personal injury cases.

Common Types of Personal Injuries

The below-mentioned are the most frequently reported personal injury cases in the United States.

Motor Vehicle Accidents

Even with all safety measures and rules, motor vehicle accidents have been unavoidable through these years. As per NHTSA, fatalities in motor vehicle crashes for the first quarter of 2021 is estimated to be 8,730. If injured during a motor vehicle accident due to someone’s negligence, the victim is entitled to proceed with a personal injury claim.

Slip and Falls

The most common type of personal injury claim is slip and fall cases. They can be highly dangerous at times, as they mostly hurt the neck, spine, head, legs, and, arms. They may even lead to brain damages and hip fractures leading to catastrophic injuries in the victim. If you slip and fall in someone else’s property, it comes under personal injury case.

Dog Bites

A dog bite is one of the most common personal injury claims in the US. The personal injury law for dog bites differs from state to state but mostly the owner of the dog is liable to the injured person. If attacked by a dog, the victim is eligible for compensation via a personal injury claim.

Medical Malpractice

Medical malpractice is termed as the most complicated and dangerous of all the claims. This may be caused due to ignorance or negligence by any of the healthcare professionals, doctors, or nurses. This includes surgical errors, birth injuries, misdiagnosis, and medication errors.

Work Place Accidents

Workplace accidents also contributes to personal injury claims. This mostly happens due to defective equipment, hazardous materials or the carelessness of the worker. In this case, the individual can claim money for his or her treatment.

Product Liability

If the malfunctioning of a product ends up in in damages to the consumer, then the consumer is entitled for compensation from the manufacturer.

Premises Liability

Premises Liability is another common personal injury claim. These claims include accidents that occur on someone else’s property.

Defamation Claims

Personal injury cases do not need to involve actual physical injuries. They can be emotional at times. Disgrace, lost profits, personal humiliation and decreased earning ability are just a few of the injuries an individual could face.

Factors that Influence the Value of a Personal Injury Claim

No two personal injury claims would be the same before the law. The value of any personal injury lawsuit would vary depending upon the below-mentioned factors. A precisely tailored medical chart review would spotlight all these attributes. This would lend a hand to the client to acquire a deserving compensation for his damages. The most influential aspects that determine the fate of personal injury litigation are.

  • Severity of the injury
  • The defendant’s liability
  • Medical expenses
  • Time for recovery
  • Pain and suffering
  • The future effects of the injury
  • Loss of income
  • Disability
  • Death

Let’s now get into the sum and substance, the role of medical chart reviewing in personal injury cases. We would kick off with the process of a medical chart review.

Steps Involved in a Medical Chart Review Process

The medical chart review is a long and tedious process executed by professionals in the medical or legal backgrounds, most probably with the support of a medical record review company. Medical record reviewing is executed in the following steps

1. Collecting and Arranging Medical Records

This is the first step in reviewing of medical charts in which all the medical records concerning the claimant is collected. A personal injury attorney fetches the complete set of medical records of the claimant. The injured claimant needs to sign the HIPAA authorization form to get the medical records released from the healthcare facility.

2. Finding out the Misplaced Records

Once all the data is collected and arranged, misplaced records would be identified. After finding and gathering all the misplaced records, they are to be placed in order.

3. Preparation of Summarized Reports

In this step, the medical chart reviewer would analyze the medical records and draft a medical summary in a manner that could be accepted in the court of law.

4. Preparing Events Chronology

The events mentioned in the report are presented in chronological order. This is done for better awareness of the medical encounters of the claimant connected with the personal injury.

5. Analyzing the Present and Future Medical Expenses

The after-effects of the injury and the treatments required for the patient in the future is analyzed. The addition of this data plays a vital role in determining the value of the claim.

How does Medical Record Review and Analysis help Personal Injury Lawyers?

As you have got a grasp of the entire process, let’s check out how does a medical chart review helps the attorney involved in a personal injury claim.

  1. For a successful claim, the attorney must ensure that the medical records of the injured plaintiff are accurate and can serve their purpose. A medical chart review would support the attorney in this regard.
  2. Missing records if any would be easily be brought to light during the review of the medical charts. If medical record review services are outsourced, retrieval of missing records could also be simple as ABC.
  3. If any inconsistencies or hitches are discovered in the medical chart, they could be sorted out during a medical chart review. Accordingly, the attorney may have to give necessary directions to the claimant.
  4. The timeline of the subject injury plays a crucial role in a personal injury lawsuit. Medical chart review would assist the attorney in presenting a crisp and clear timeline of the injury.
  5. Medical chart reviews epitomize the damages sustained by the claimant and the pain and suffering he had experienced. The proof of the injury, as well as the treatments provided, would be clearly indicated in a medical chart review report which would strengthen the arguments of the attorney.
  6. Apart from the unintentional errors physicians and other healthcare providers make when making entries in the medical record, there is always the possibility of intentional tampering. Since the medical chart reviewers are proficient in medical chart review process, they can more easily spot medical record tampering.
  7. Medical records review would showcase the treatment provided to the claimant for the injury and also any treatment if required in the future.
  8. The most common argument from the defendant in a personal injury claim would be that the claimant had a pre-existing illness which could have contributed to the expense of the treatment of the subject injury. This argument could easily be ruled out with an expert medical chart review.
  9. Every medical data highlighted during medical record reviewing would help the attorney in strengthening his arguments and helping the claimant get a deserving pay-out.
  10. The expenses of the treatment connected with the subject injury could easily be projected with the help of medical chart reviews. Apart from the current medical costs, the estimate of the future treatment expenses could also be presented with the help of a medical record review report.

Final Thoughts

We are all prone to get injured in our day-to-day life. It is the need of the hour to be aware of personal injury claims and the role of medical chart review reports in them. Even if we think, the purpose of the medical charts are primarily to help monitor the patient’s health status, they are required for insurance claims and lawsuits.

Medical record reviews provide attorneys with the proof that acts as a building block for a personal injury claim. Authentic medical records are vital to prove economic damages such as income loss, hospital bills as well as non-economic damages such as pain, worsening of prior injuries etc. A legitimate medical chart review would mirror all the complications, medications, and treatment costs which would convince the judge of the required value of the claim.