Obtaining Your Medical Records for a Personal Injury Claim

Medical records in a personal injury claim are crucial. Thorough documentation of your injuries is needed to prove that you were harmed due to someone else’s negligence and that you are entitled to compensation.

As a rule, most people have little to no experience requesting copies of their medical records. They are unfamiliar with the procedures involved, as well as the information to which they have a legal right.

Whether you are looking to obtain your own medical records or records for a seriously injured or deceased family member, it is in your best interest to consult a personal injury lawyer. Knowledgeable attorneys can provide you with assistance in obtaining medical records and all other aspects of your claim.

At Burg Simpson Law Firm, we understand the critical role of medical records in a personal injury claim in Arizona. For a FREE and confidential case evaluation, call our Phoenix office at 602-777-7000 today.

How Do Medical Records Affect Your Personal Injury Case?

Medical records consist of a comprehensive history of your health. They include documentation concerning health conditions and complaints, any illnesses or injuries you have sustained, medications and treatments prescribed, and more.

Although complete medical records will contain your health history from when you were born to the present, personal injury lawyers are primarily concerned with recent information related to the accident. Medical records in a personal injury claim are important for the following reasons:

• They provide objective evidence of the existence of any injuries
• They help your attorney to establish what caused the injuries
• They document the physical and psychological symptoms of the injuries
• They illustrate how severe the injuries are and how they affect your life
• They provide a prognosis (i.e., will you be fully recovered in a few months, or will the injuries affect you permanently?)

Your medical records are also crucial for assessing the value of your personal injury claim. Based on the medical records, your attorney can determine the nature of your injuries and their extent. Medical and economic experts can provide testimony to help your lawyer quantify the damages you are due.

When Medical Records Are Required in a Personal Injury Claim

There are many reasons why you may need to obtain copies of your medical records in the course of a personal injury matter:

• If you are involved in a personal injury lawsuit, or you have a workers’ compensation claim, your medical records may be able to provide important information for you to prove your case.
• If you have filed a legal claim following a motor vehicle accident, it may be necessary for you to prove that the collision, and not a previous medical condition, was the cause of your injuries.
• If the extent of your injuries is in dispute, it is also important to have access to your medical records.
• If you are pursuing a claim for medical malpractice, medical records will be needed to show potential negligence on the part of a health care practitioner and the nature and extent of any injuries.
• You may need to provide your new doctor, or a specialist, with your medical records.
• If counsel later requests the records with your permission, they may get a different set of records which a jury may find questionable as to why different records were produced at different times.
• Medical records for a loved one may be required in a wrongful death claim.

Generally, you can obtain copies of your medical records by submitting a request in writing to the hospital, doctor’s office, and/or any other facilities where you have received care. You can also authorize a legal representative (such as an attorney) to do this on your behalf.

You Have a Right to Obtain Your Medical Records

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) was enacted by the United States Congress and signed into law by President Bill Clinton in 1996. The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information. It applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.

HIPAA gives patients the right to obtain a copy of their medical records from any medical provider, with a few exceptions.

What Records Can You Obtain?

HIPAA provides patients with the right to obtain copies of all of their medical records. These include:

• Information on your diagnosis, treatment, and medical history
• Medical imaging results
• The results of any laboratory tests
• Clinical notes
• Billing and payment records
• Information on health insurance coverage, enrollment in an insurance plan, etc.

Patients also have the right to view, usually at the medical provider’s offices, their original medical records.

Who May Obtain Medical Records?

According to HIPAA, you may request:

• Your own medical records.
• The medical records of another party if you are their legal guardian.
• The medical records of another party if you are their designated representative.
• The medical records of another party if they give you written permission to act as their representative.
  • For example, if your elderly parents designate you as their representative, and you request their records, the medical providers must comply with your request.
• Your children’s medical records, with some exceptions. Generally, parents and legal guardians have access to their children’s medical records; however, a parent may not obtain a child’s records if:
  • The child has consented to medical care and parental consent is not required under state law, or
  • The child receives medical care at the court’s direction, or
  • The parent agrees that the minor child and the medical provider have a confidential relationship.

Can You Get the Medical Records of a Deceased Person?

There are several situations where individuals can obtain the medical records of deceased persons:

• If you are the personal representative of an estate or are appointed by the court to settle a deceased person’s affairs, HIPAA will allow you access to the deceased’s medical records.
• If you are related to a deceased person and there is information in that person’s medical file pertaining to your own health, HIPAA will allow you access that information.
• In Arizona, a spouse, child, or parent may be able to obtain records of a deceased patient if the provider wishes to produce those records without a probate being set up.

Medical records of a deceased person may be disclosed to a surviving spouse, children, parents, and siblings. Non-family members who have been invested with legal authority (such as a personal representative, a trustee, or a guardian or conservator) may also request copies of the deceased’s medical records.

Can You Obtain the Medical Records of a Deceased Parent?

Adult children are often named the personal representative of a deceased parent’s estate. If you were named as the personal representative in a parent’s will (also known as an executor) or you have been appointed as the personal representative by the court (also known as an administrator), you have the right to request copies of your parent’s medical records.

If your parent died as a result of injuries suffered due to the negligence of another, your parent’s medical records will be needed to prove wrongful death. An attorney can help you obtain copies of the necessary records and build a strong case on your behalf.

Can a Spouse Request the Medical Records of a Deceased Spouse?

Married couples do not have an automatic right to one another’s medical records. In order to obtain your spouse’s medical records, your spouse must provide you with his or her consent in the form of a signed advance directive or power of attorney.

If a spouse dies without a will or the court has not yet named an administrator, the surviving spouse is given first priority for disclosure of a deceased spouse’s medical records; however, the provider may be obligated not to share the records if the patient “notified the health care provider in writing that the deceased patient opposed the release of the medical records or payment records” (see Arizona Revised Statutes § 12-2294(D)).

Requesting Medical Records

• If you are requesting medical records in person, you will be required to show a valid government-issued photo ID at either the time of your request or when picking up your records.
• If you are picking up another person’s records, the provider will require additional legal documents and information to demonstrate your right to access records on another’s behalf. Make sure to ask about these requirements in advance.

Can Certain Records Be Withheld?

HIPAA does allow health care providers to withhold certain types of medical records, including:

• Notes from a psychotherapy session.
• Information the provider is gathering and compiling for a lawsuit.
• Medical information that the provider believes could reasonably endanger your life, your safety, or the safety of another party.

Generally, if the provider denies your request for medical records, they must provide you with a denial letter. In certain cases, you may be able to appeal the provider’s denial.

When Will You Receive the Requested Medical Records?

• HIPAA requires that providers complete a record request within 30 days.
• It also allows a single 30-day extension, but the facility must explain to the requestor the cause of the delay.

Get Help with Medical Records in a Personal Injury Claim

Obtaining medical records is essential for your personal injury claim. Without complete records of the injuries you have suffered, it will be very difficult to prove your case and recover the compensation you deserve.

Burg Simpson Law Firm in Arizona is primarily focused on representing individuals and families in personal injury and wrongful death claims. We have achieved more than $2 billion in verdicts and settlements for our clients, and we will fight aggressively to obtain a favorable result on your behalf.

The key to our success is the comprehensive approach we take to preparing each case. Our attorneys and staff carefully review all medical records in a personal injury claim and any additional evidence to maximize your recovery.

Contact Burg Simpson for a FREE and confidential case evaluation. Our personal injury lawyers are based in Phoenix and serve clients throughout Arizona.