We know. We get it — and we agree with you. It’s absolutely ridiculous that the adjuster would demand this of you. Not only is it a huge pain, but it’s a huge invasion of your privacy. Nevertheless, the Industrial Commission routinely allows for this to happen. The question is why do you need to give your adjuster your medical records and is it truly necessary?
Why do adjusters request medical records?
Adjusters request medical records because they're required by law.
The reason they need them is first, they need to be able to verify that the person who was injured actually received treatment at the hospital where he/she claims to have been treated.
Second, they need to determine whether the injuries were sustained during work hours. This second point is important because most states require workers' compensation benefits to be paid only when the injury occurs during working hours.
If the adjuster determines that the injury wasn't work-related, he won't pay any benefits. So, it's important to keep track of injuries over the last ten years.
If the adjuster doesn't ask for medical records, there's no proof that the injury occurred. This means that the claim may not be paid out.
What happens if you don't turn in your records?
If you don't turn in your records, your adjusters may not be able to determine whether you're eligible for benefits. They won't know if you've had any work done since the last filing, or if you've been injured at work recently.
They won't know if you're currently receiving disability payments, or if you've filed for Social Security Disability Insurance (SSDI) benefits.
And they won't know if you were previously employed, or if you're self-employed.
All these things matter because they affect your eligibility for benefits. So, if you don't submit your medical records, you risk losing out on benefits.
What are the dangers of submitting medical records for the past 10 years?
The problem is, on paper, this sounds like a way for the adjuster to check for fraud. However, what the Industrial Commission fails to take into consideration is the human side of things. There’s no rule to prevent your adjuster from sharing your records with your coworkers. If this happened, it would be a huge invasion of privacy.
If you sustained a knee injury at work, why would the adjuster need to know if you’re taking birth control, or if you broke your arm five years ago, or if you have asthma? We do understand that they might need to know if you’d had a previous knee surgery before you were injured at work, but anything not related to your injury is unnecessary.
That’s why it’s important to us that we fight for our clients’ right to privacy. We make every effort to limit this horrible intrusion. Dealing with a workplace injury is difficult enough; you shouldn’t have to add worrying about your privacy.