How Can A Medical Review Company Help Evaluate The Merit Of A Medical-Legal Case?

by | Published on Dec 8, 2021 | Medical Record Review

A medical record review company can help attorneys determine the merit of a medical-legal case. In medical malpractice and personal injury cases, attorneys need to work with evidence that can make their case compelling. To find crucial evidence, they need to review the medical records, and clearly understand their content. To know the medical facts, better understand the nature of the case, better represent their clients, and save valuable time and effort, attorneys can rely on a medical review company. The merit of this partnership is that attorneys receive a well-researched, fastidiously prepared medical case summary report or evaluation report. This report provides them the authenticated facts that will help them make their case.

What Type of Medical Records Are Reviewed?

Typically, attorneys may need to review any medical record created for a patient for the past several years. Older records are usually reviewed to find out if there is any pre-existing condition. The medical record set may be voluminous and each record needs to be thoroughly reviewed to determine the merit of the case. Medical records requested for review include:

  • Patient history
  • Admission records
  • Consent forms for specific treatments
  • Nursing notes
  • Physicians’ notes
  • Flow records
  • Physicians’ orders
  • Laboratory reports
  • Radiology reports
  • Discharge instructions
  • Discharge summary

Medical records are reviewed for reasons such as:

  • Creating a timeline of medical events
  • Understand what treatment was actually provided. Many patients are confused about what treatment they received, and a medical record analysis can clarify this.
  • To identify missing records that may contain key information or medical facts.
  • To determine the outcome of the treatment and care provided to the patient.

A well-drafted chronology enables attorneys to have a clear understanding of the sequence of events, the actual facts of the case, and thereby determine whether the case has merit. If the attorney accepts the case, these chronologies enable them to be better prepared to conduct effective depositions for the treating physicians and other defendants.

In general, medical records review involves the following components.

  • Screening to determine the strengths and weaknesses of the case
  • Evaluating the alleged injuries and damages
  • Medical case chronology and medical case summary preparation
  • Distinguishing liability and causation
  • Identifying treatment gaps
  • Identifying missing medical records
  • Elucidating the significance of past medical histories and co-morbidities
  • Defining standards of care

Determining the Merit of the Case with Medical Review Support

Medical record review for attorneys is provided by medical review companies that employ legal nurse consultants, physicians, and trained documentation specialists to provide the required solutions. Since these are professionals trained and experienced in their individual fields, they can easily understand the medical facts and put the records in an order that even laymen can easily understand. Importantly, concise analysis of the case can explain the strengths and weaknesses associated with causation, liability, and damages. A causation analysis of the records helps understand whether there is sufficient reliable information available to establish a causal relationship between the plaintiff’s injury and the alleged negligent act. Screening the case for merit helps ascertain the legality of the claim. In injury cases, proving liability is the most important requirement and for this, professional medical record reviewers would analyze the medical treatment provided to the plaintiff, evaluate its effectiveness, while also determining compliance to acceptable standard procedures of care for the particular condition. This analysis reveals if there has been any deviation from the standard of care.

All aspects of the medical review process – medical record organization, medical chronology, review and analysis – are significant when it comes to representing the facts of the case and determining case merit. An experienced medical record review company can help the attorney and the legal team to quickly evaluate the merit of the case at a very early stage itself. Unlike legal staff who may be untrained in medicine, professional medical reviewers use clinical judgment, standard of care evaluation, and data-driven processes to evaluate an injury case. This preliminary assessment of the merit of the case enables the attorney to re-evaluate his/her strategy without wasting valuable time and money.

Discover our medical record review solutions and partner with us for your next case.

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