According to a recent article in The New York Times, new guidelines issued this month will remove barriers that in the past prevented patients from gaining access to their medical records. The new guidelines say that doctors and hospitals have to provide medical records to patients, and even set a time frame – within 30 days from receiving the request.
That means doctors and hospitals can’t require you to explain why you need your records, or deny access because you might not like what you see in those records. They can’t deny your records because you owe money or because they don’t want to pay for postage. They can charge you a fee for making copies but they have to provide them.
It sounds great – but there are some significant issues that anyone with a disability claim has to keep in mind. For anyone in the middle of a battle with their insurance company, who is about to file a claim or who is currently on claim and receiving benefits – which, from our perspective, means that person is likely to face a battle someday – those are more than medical records.
Your medical records are an important part of your ability to fight back against your disability insurance company. They are treated as legal documents, evidence, which will be part of an ERISA appeal, federal litigation or settlement negotiations.
One thing that we have seen over and over again is that not all physicians or medical providers understand that it is not the diagnosis that makes someone eligible for disability from their disability policy at work or the one they purchased privately. It is their inability to perform the specific and material tasks of their occupation. This is often the lynch pin that makes an appeal a success – or dooms a claim.
Our concern is that patients may start gathering up their medical records and sending them directly to the disability insurance companies without understanding the grave consequences that such an act may have on their claim.
Not all medical offices know that they are required to provide medical records when asked by a patient or a legal patient representative. You may end up in a struggle with the office manager that takes the full thirty days. Here’s the problem: ERISA appeals have a very firm and strict time guidelines. By the time you get those records, you may have lost valuable time that may cause you to lose the right to file an appeal.
Also, you may not know what you are looking at when you review your medical records. As disability insurance attorneys practicing in this area for many years, we understand the role that your medical records play in your claim, and we know what the insurance companies and the third parties claims companies are looking for when seeking to deny a claim that they view as questionable or overly costly.
Before you call your doctor, hospital, or other health care provider to demand that they send you your entire file, if you are in the midst of a dispute about your disability claim or if you anticipate filing a disability claim, call our office at 877-LTD-CLAIM (877-583-2524). Your medical records may be very important, and you don’t want to put your claim in jeopardy by losing valuable time arguing with your physician’s office over your right to get the records.