When a worker is injured on the job, the natural result of such an injury is a worker’s compensation claim. Whether or not it was an accident, a result of negligence or some other factor, it’s important for the legal courts to review the information in order to decide who was at at fault and how much, if any, of the medical costs should be covered by the employer. Of course, the court can’t make this decision without proper evidence that shows who or what contributed to the injury at hand. And the only way the court can make this sort of decision is with the use of a medical summary.
What is a Medical Summary?
A medical summary is a compilation of all of the documents and information that relates to a specific case or claim. When someone is injured, the subsequent medical treatment creates a rather involved paper trail. This paper trail includes things like test results, x-rays, lab work, doctor’s notes and other pieces of documentation. This information all goes together to create a thorough and complete medical summary. A well-written medical summary can often be the difference between a win or a loss in a workers compensation claim, because often the court’s decision is based in part on the information found in the summary. For this reason, it’s important to have a medical summary that is as complete and accurate as possible.
How Can A Medical Summary Help or Hurt a Case?
When an employee suffers an injury, there are a lot of possible ramifications that can affect both the employer as well as the employee. Determining who was at fault is only one small part of it, although that is important in determining how much liability the employee has. If the company is indeed liable, then a medical summary becomes crucial in dealing with things like loss of pay and treatment.
For example, If a worker can not return to work for a while he or she will be expecting for workers compensation to pay for the wages being lost while he or she is out and unable to work. You can bet the company’s insurance company is going to review the workers compensation claim very carefully to make sure that they are indeed required to cover the worker’s loss of income and inability to work while recovering. If medical documentation is not there to prove the extent of the injuries and the long-term prognosis, the insurance company will have a strong case to deny the claim.
As another example, consider treatment: if the injured worker has to undergo costly medical procedures, the company’s medical insurance company is going to expect there to be medical documentation that supports the necessity of these treatments.
Of course, medical summaries can also be used against the worker as well — for instance, if a treatment or medication was prescribed, and the worker has not followed through and done the required exercises or taken the prescribed medication, then the insurance company can argue that they are longer liable to cover the medical costs for someone who is not doing their part to speed up recovery.
In short, a medical summary is a necessary element of any successful workers compensation claim, but like a double-edged sword they can cut both ways. They can work either for or against the worker, which is why it’s important for them to be thorough and accurate, and it’s important for the worker to listen to and follow any and all medical advice.
If you would like to know more about medical summaries and how they can affect a workers compensation claim, please don’t hesitate to contact us today.