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Personal Injuries & Medical Records Information

Medical Records For Car Accidents And Personal Injury Claims

Have you been injured as a result of negligent business practices? Were you attacked by a neighbor’s dog and hospitalized as a result? Did another driver rear-end your car, leaving you with whiplash or broken bones?

No matter the accident or injury you’ve suffered, filing a personal injury claim in California can be a tedious process. There are many state laws dictating your rights, including the statute of limitations stating that you must file your personal injury claim within two years of the accident.

One thing you will always need is your medical records for injury claims. In addition to the rights guaranteed you by HIPAA, there are laws specific to the state of California that you must take into consideration.

Read on to find out more about obtaining your medical records for injury claims in California.

Your Right to Your Medical Records as Dictated by HIPAA

Most health insurance plans and providers are covered by HIPAA. In other words, the HIPAA Privacy Rule applies in most (though not all) cases.

The HIPAA Privacy Rules dictate that you have a right to see or receive copies of your protected health information. This includes medical records or billing information. It also includes records that were maintained by or for your health insurance plan. Almost all records that were used, either in part or in whole, to make decisions about your healthcare or payment are covered by the HIPAA Privacy Rules.

You have access to documents such as Xrays, clinical case notes, and disease management program files. You do not have access to psychotherapy notes. You also do not have access to files that were compiled in lawful anticipation of a court case or action taken against the healthcare provider in question.

You may request medical records for anyone whom you are deemed by law to personally represent. This may include your children as well as any relatives whose medical care decisions have been legally put in your hands. 

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Your Right to Your Medical Records as Dictated by California State Law

In addition to the HIPAA Privacy Rules, California state law will determine how and when you can access your medical records.

Under California state law, your health care provider must show you your medical records within five days of reviewing your initial request. If you need a copy of your medical records, they must get those copies to you within fifteen days of reviewing your initial request. 

California state law determines what your health care provider can charge for requested copies. They may charge up to 25 cents per page for photocopies and up to 50 cents per page for copies taken of microfilm. They may also charge you for postage but they may not charge you for the time or effort it took them to make the copies.

If you feel that your medical record is not accurate or is not complete, you have the right to amend your record. This right is restricted in the case of certain mental health files. 

Finally, California state law guarantees you certain rights if you feel that your right to your medical record has been violated. You may file a complaint with the Office for Civil Rights. You may also sue for your medical records in the California Superior Court. 

Once again, these laws apply when you are trying to obtain your own medical records or the medical records of anyone whom you legally represent.

How to Get Your Medical Records for Injury Claims

There are several steps you should take to get through the injury claims process smoothly. Read on for a break down of this process.

What Must You Prove When Filing an Injury Claim?

In order to receive a settlement in your favor, there a number of things you must be able to prove. 

The first is that your injury is, in fact, the result of the negligence or recklessness of the person or business in question. The second is that these injuries required medical attention. (In other words, achiness or injuries that can be resolved with at-home or over-the-counter remedies do not qualify.)

You must also prove that the cost of your medical attention was high and that you were required to pay hefty sums out of pocket. You will also, in most cases, need to prove that your injuries led to an inability to work (and therefore a loss of income) and that you are experiencing on-going suffering.

When to File an Injury Claim

If you have been injured due to the negligence of another person or business, you may qualify for compensation. A personal injury claim is settled between you and, most often, the insurance company of the person or business at fault for your injury. Typically, the goal of your settlement is to receive compensation from the insurance company for medical bills associated with this injury.

If the injury is minor, you may be able to get through the injury claim proceedings without representation. However, moderate to severe cases should be handled by a personal injury lawyer. This is because the insurance company may push back harder against a case that requires high levels of compensation, which we will discuss in greater detail below.

If you’re not sure if you qualify to file an injury claim, request a free case evaluation.

If you are going to file an injury claim, let the insurance company in question know what you are doing as soon as possible. However, do not attempt to settle until your injuries have been addressed and you are well into the healing process. Otherwise, you may receive a settlement that covers only a portion of related medical bills.

How to Ask for Medical Records

Contact your health care provider and inform them that you need your medical records. It’s standard for health care providers to use specific forms for these requests, although not all of them do. If there are any specific requirements, such as an in-writing statement of the request via letter or email, they must inform you of this upon your initial request.

If they do not have any specific forms, you will need to put together your own written statement. This should include your full name, phone number, email, and address. It should also include your date of birth and, if you know it, your medical record number. Finally, you should include the date or dates of your medical services.

Next, include the information you need to see. Specify whether you need to see all or part of your medical record. Make note of any test results or records made with medical devices that you need to receive.

Note that you are allowed to request a viewing of original documents, copies of original documents, or both. Note, too, that your health care providers are allowed to ask for reasonable proof of identity, including your Social Security number or a photo ID.

It is often in your best interest to hire representation. Insurance companies may attempt to get you to agree to certain practices that will harm your case.

For example, the claims adjuster may ask you to sign a medical release form. What they’ll tell you is that they need to verify your medical records in order to make sure that the insured is at fault and that the accident required costly medical attention. What they will not tell you is that this form likely gives them the right to access your entire medical history.

If an insurance company is seeking access to your entire medical history, it is likely that they’re looking for a pre-existing condition that could have caused your current injury. You are not legally required to share information about your pre-existing conditions when filing a personal injury claim. A lawyer will be able to look over any documents and spot these kinds of discrepancies before you make the mistake of signing them.

Insurance companies may also request that you get an independent medical examination performed by a medical professional of their choice. This medical professional will often provide the insurance company with an opinion that favors the insurance company. In other words, this is an attempt to discredit the findings in your medical record. 

If an insurance company requests an independent medical examination, you should always consult with a lawyer before complying.

Hire a Lawyer to Help with Personal Injury Medical Records

If you’re in need of medical records for injury claims, you’ve got a lot on your plate. Not only are you suffering from your injury and the financial strain it has caused but the insurance company is going to do their best to settle in their favor.

Contact the Scranton Law Firm for professional legal advice and representation. 

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