A medical case chronology is a summary of all the relevant medical records, provided in a proper timeline. It is a very important document in a personal injury case that clearly highlights all of the relevant medical facts. More importantly, you get to know the basic timeline of medical events, and can reference the pertinent facts over the life of the case. Information contained in a medical chronology include date and time and visit, healthcare provider, type of service, and outcome of medical event. Typically, page number and hyperlink of the referenced information are also provided. If medical chronologies are to prove useful, they must be clear, list all relevant facts without bias and offer insight into a case.
The attorney can build a convincing argument with a reliable case chronology and summary. All parties concerned can clearly understand the events that happened at particular points in time. Chronologies and medical summaries help attorneys understand the medical terminology and procedures relevant to the case, and be focused on the relevant points only. Any missing information will be highlighted in the chronology and summary.
Medical record retrieval is an important first step when preparing a case chronology. Here are some things to note to ensure an effective medical chronology.
- Start preparing the medical chronology at the earliest: This is to make sure that all events leading up to the present condition of the patient are included. Always, any delay in preparing the document can lead to confusion and significant medical events could be missed. When you start early, the chart review can be done effectively and the various events chronologically listed.
- Ensure clarity in the medical record chronology: This means that all medical jargon should be ideally avoided to make everything clear to the attorney and others with a non-medical background.
- Record all the facts meticulously: Even if some details appear irrelevant or disputable, they may prove to be significant at a later stage. So, it is vital to include all the important facts in a case.
- Note down missing documentation: Missing documentation can prove to be problematic. Therefore, it is important to highlight any documents that are missing. The missing documents should be requested from the patient or the treating organization.
Details a Medical Case Chronology Must Contain
- Date of injury (DOI): This is a very important element in the medical case chronology/summary. Even if the attorney needs details regarding a specific injury only, those who prepare the chronology must highlight all injuries related to that specific injury.
- Causation: This is to be documented as reported by the patient.
- Symptoms: All symptoms of the patient relevant to a case must be included. This requires interpreting all the medical records accurately so that the relevance of each medical event can be clearly understood.
- Diagnosis/diagnoses
- Providers, dates of treatment
- Treatment plan – this would include diagnostic reports, prescriptions and referrals
- Impairment, whether permanent
- Likelihood/prospects of recovery
- Whether future medical treatments are needed
- Details regarding earlier medical treatments undergone, even unrelated medical treatments
In a medical case chronology, common medical abbreviations are best expanded so that non-medical persons can also follow the details presented. The definitions of various medical terms can also be included for quick reference.
Medical Record Chronology – Benefits
- Helps evaluate the merit of a case and its strong points: Apart from enabling the attorney to judge whether a case is valid, a well-prepared chronology also helps identify all the strong points in the case.
- Provides an objective analysis of the medical records: Since medical chronologies are prepared by expert reviewers, they will contain an unprejudiced view of the medical records. This is important when it comes to determining the strength and value of a case.
- Provides clear details of diagnosis/diagnoses: This is an important component in the medical record chronology. Take the instance of a personal injury case filed against a healthcare organization where a wrong diagnosis led to adverse patient events. In such an instance an accurate medical chronology will provide clear details regarding the diagnosis and whether it was a wrong one.
- Helps avoid costly errors: An attorney or paralegal without formal medical training could easily miss out on important medical details. This may lead to fatal errors when arguing the case. On the other hand, a good medical chronology with all important medical aspects clearly outlined ensures that the attorney goes to court well prepared, and fully aware of all relevant events.
- Provides details regarding treatments given, and the organizations that provided the treatment. This is also very important in a personal injury case.
An accurate case chronology prepared by an experienced chart review company can be used to strengthen attorneys’ arguments, whether at settlement discussions or court trials. In the court setting, it can be used to provide the necessary information to the jury, and to emphasize relevant points. Medical record chronologies are not mere timelines of medical events; they are a solid source of information for personal injury attorneys and their legal staff.
