Medical records not only serve as necessary documents for apt management of a patient, they are also legal documents. These records contain useful evidence for diverse litigations including personal injury lawsuits, criminal cases, workers’ compensation actions, disability determinations, and medical malpractice claims. It is important for medical practices and other healthcare facilities to properly maintain patient records, as proper record keeping helps in scientifically evaluating the patient profile, analyzing the treatment results, and thus planning treatment protocols and future medical care. In the same way, lawyers also require these medical records to develop their case. Medical records services can assist attorneys in identifying the strengths and weaknesses of the cases they’re handling. Up-to-date medical records generally include operative notes, medical history, clinical notes, investigation reports, diagnosis results, consultation reports, referral notes, discharge notes and more.
|How Are Medical Records Used In A Legal Proceeding?
What Are The 5 Cs In Medical Record Documentation?
Check out these 4 major reasons why lawyers require medical records.
Provide Clear Evidence – As the legal system relies mainly on documentary evidence to prove any sort of negligence in a lawsuit, health records are useful in such situations. They help determine whether the claimant’s injury or complaint is related to another person’s negligence or whether it was a past or pre-existing condition.
Assess Damages – Records can be used in legal proceedings to show the extent of the plaintiff’s injuries. This can help determine the damages that the plaintiff is entitled to. During the discovery process of a case, these medical records are produced to the defense counsel in the affidavit of documents as the clinical notes and records are relevant to the legal proceedings. Medical records are vital for both the plaintiff and defense attorneys to evaluate the physical injuries and estimate the damages.
Help Build the Case – Relevant medical records allow a lawyer to truly understand the impact of the injuries and how they have affected the quality of the plaintiff’s life. Records enable attorneys to look for specific acts of negligence.
Help Establish the Standard of Care Provided – These records serve as the backbone, particularly for medical malpractice litigation, as they provide details of every professional liability action and help establish whether the standard of care was met. Some of the common reasons for medical malpractice lawsuits are – diagnosis errors, surgical or medication errors and birth injuries. Medical records help to prove whether it was the doctor’s negligence that caused the injury, and whether the injury led to specific damages such as physical pain, mental stress, additional medical bills and more.
Clear records are useful for lawyers to determine if the lawsuit has a good chance of success. Providing documents on time reduces the amount of time victims have to wait for compensation. Professional medical chart reviews provided by experienced reviewers can help in identifying any missing details in the chart and get a complete medical record for evaluation purposes.