Most people generally trust that if they are injured during work, their employer will step up and support them while they recover, particularly when it comes to workers' compensation benefits. Unfortunately, that doesn't always happen, and it then falls upon the injured employer to advocate for him- or herself.
Under a recent California Supreme Court ruling, a woman, whose employer tried to bar her from using medical records from an out-of-network doctor in her workers' compensation claim, will indeed be able to use those documents in her workers' comp proceedings.
The case involves a woman who was injured while working for Warehouse Demo Services. Initially, she was seen by an in-network provider, but was ultimately unsatisfied with that care. Later on, she saw a physician recommended by her attorney, but who was not in her network. Medical records from that doctor were then used in an application for temporary disability workers comp benefits.
Her employer tied to argue that those records were inadmissible in workers' comp hearings, but that argument was rejected by a California judge. After being appealed, that initially decision has been upheld by the state's highest court. According to the court, there is no general rule of exclusion regarding which providers medical records come from. And why would there be, as long as the records are accurate and fulfill all other requirements?
It is important for those facing claim issues to work with an experienced advocate. Doing so will help facilitate the process.
Source: Business Insurance, "Out-of-network medical records OK as evidence in Calif. work comp cases," Sheena Harrison, November 15, 2013.