Workers’ Compensation Coverage for Firefighters

by | Published on Mar 4, 2023 | Workers Compensation

Firefighters get injured in the line of duty on many occasions such as when rescuing people from burning buildings, in traffic accidents involving fire department emergency vehicles responding to or returning from incidents, from activities at a non-fire scene, and while participating in training activities. Workers’ compensation coverage is available for firefighters who are injured on the job. This is for the necessary medical care and wage loss benefits that are due to the injured worker. If the coverage is denied by the employer/insurance company, a case can be filed through a workers’ compensation attorney. In this case, it sets off processes such as medical record retrieval to gather all the diagnosis and treatment records related to the injury, and medical record review to study the medical components involved.

What Types of Coverage Are Available?

When it comes to workers’ compensation coverage for firefighters injured on the job, medical records have a key role to play in proving the injury and its impact. The injured or sick employee or their families/beneficiaries may be eligible for the following:

  • Coverage for medical care
  • Compensation for lost wages
  • Coverage for a new job role training, if the worker cannot pursue his firefighter profession because of the injury or illness sustained
  • Long-term disability benefits if the worker cannot return to wrk
  • Payment for funeral expenses, in case the employee dies because of the injury or illness.

Firefighter Injuries That Need Medical Records Analysis

There are many injuries that firefighters may sustain while performing their duties. Burns sustained while in a burning building, fractures and other injuries from structural collapses, injuries from other work activities such as building maintenance, training exercises, office work, traffic crashes while traveling to and from emergencies and so on. Workers’ compensation coverage may be available also for injuries and illnesses that develop over time as a result of the job. The relevant medical records will be reviewed for conditions including the following:

  • Burns
  • Lung damage because of smoke inhalation
  • Fractures
  • Hernias
  • Cancers (specific cancers related to the firefighting profession such as throat cancer, leukemia, pancreatic cancer, rectal cancer, prostate cancer, breast cancer due to contact with a toxic substance, non-Hodgkin’s lymphoma)
  • Heart conditions
  • Tuberculosis
  • Muscle tears and strains
  • Pneumonia

Medical records are vital to substantiate an injured firefighter’s claim. These include records from doctors, hospitals, and other healthcare facilities to show the diagnoses the workers have and the treatments they have received. Physical therapy records, MRI, orthopedic records, and pain management documentation are among these.

  • Admission records
  • Patient history and physical records
  • Progress notes by the treating physicians
  • Physicians’ orders
  • Consultation reports
  • Laboratory reports
  • Anesthesia records
  • Operative reports
  • Nursing records
  • Discharge instructions from attending nurses
  • Discharge summary

The medical records provide valuable evidence that can establish a causal relationship between their health condition and their work.

Medical Record Review for Workers’ Compensation Attorneys

  • The first important step is medical record retrieval, which involves obtaining the injured worker’s medical records including hospitalization records, medical history reports, laboratory results, and progress notes
  • Medical records organization and review to support or defend the clients in view of the workers’ compensation claim
  • Creating an accurate legal case chronology
  • Preparation of precise medical case summaries
  • Identifying missing records, and duplicate records

The following services can also be requested:

  • Bates stamping the records
  • Bookmarking
  • Highlighting keywords
  • Preparing plaintiff fact sheets

Why Attorneys Need Medical Review Services

The medical records are typically high-volume and unorganized

  • Attorneys may not have the medical expertise necessary to understand which documents are relevant and how they can be used to substantiate the claim
  • Lack of medical knowledge may also make it difficult for attorneys to clearly understand the injured firefighter’s complex treatment course
  • Reviewing medical records is a time-intensive, laborious activity
  • It may be difficult for attorneys to identify missing documents that could be useful for the claim
  • Attorneys may find it challenging to exclude other possibilities for client injuries to prove causation

Comprehensive analysis of the medical records helps the attorney or workers’ compensation insurer determine the validity of the claim and the compensation that may be due. Typically, firefighters are eligible for all the benefits other U.S. workers can access under the workers’ compensation system. Coverage may also be available if the firefighter develops an illness during retirement. A retired worker may get both workers’ compensation and retirement benefits up to a cap, or may receive only one of these benefits.

Are you looking for value-added medical record review services for your law firm?

As an experienced medical record review company, Managed Outsource Solutions (MOS) provides a full suite of services from sorting, organizing, and reviewing medical records to preparing accurate chronologies and timelines for workers’ compensation cases.

Get Started Now!

Workers’ compensation claims may be straightforward, or complicated. Workers’ compensation attorneys work to obtain the best compensation for their clients. In their efforts, the solutions provided by a medical review company help increase their efficiency, and ensure valuable time and cost savings.

Disclaimer: The content in this blog is for purely informative purposes, and does not constitute professional legal advice. It has been sourced from reliable online resources. For an expert legal opinion, contact a workers’ compensation attorney.

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

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