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  1. #1
    Join Date
    Aug 2019
    Posts
    2

    Default Legal Question Regarding Records

    My workers compensation claim was made in the State of: Virginia

    When the the insurance carrier denied my claim to see a doctor for my hip (my neurosurgeon (workers comp insurance used) referred me to a specialist) my lawyer suggested I use my personal health insurance. I have since seen 4 doctors using it. I find out today that she has been sending all of these documents from the doctor to opposing counsel when each one of them are going to hurt the case. Each doctor doesn't know whats wrong and came up with things to write down versus what my neurosurgeon says is the problem. She has bullied for a settlement since the very beginning which was over 2 years ago and has left out portions of information about what a settlement would include and what I would lose. I had in advance looked up settlements and when called on her leaving out this information she stopped talking about the settlement for the remainder of that phone call. By law is she required to send these documents even though I am being seen by a private doctor under my personal health insurance and not under workers comp? I also need some options on how I could get a new lawyer as my current one has done very minimal work and I believe is intentionally trying to get a settlement out of case versus helping me get the treatment I need.

  2. #2
    Join Date
    Oct 1971
    Posts
    5,032

    Default Re: Legal Question Regarding Records

    By law is she required to send these documents even though I am being seen by a private doctor under my personal health insurance and not under workers comp?
    Comp is entitled to all medical records necessary to expedite your case, you can't hide or cherry pick records that support or damage your claim.

    Not sure of what "looking up settlements" would have to do with your claim.
    All claims are unique to the facts of that claim - there are no averages.
    Also, I'm confused as to why your attorney is talking settlements on a denied claim, you're no where close to the settlement phase.
    It might be a good idea to first determine your injury, win your claim, have a final impairment rating, determine your loss of earning capacity then proceed from there.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Aug 2019
    Posts
    2

    Default Re: Legal Question Regarding Records

    I have benefits on my back however my neuro also believes that my pain, that has stayed current after surgeries, is causes by my hip which he believes was also injured in my fall. The carrier denied me seeing the specialist he wanted me to see for my hip so she had me see him on my own insurance. What I meant by looking up settlements was what is generally included and what you give up. She told us that I would still have my medical benefits even if we settled the claim. However when I brought it up again when she tried to settle the second time she said I would be giving up my right to benefits. My main question is if by law she has to provide all medical records even if seeing the doctor was not under the workers comp insurance.

  4. #4
    Join Date
    Oct 1971
    Posts
    5,032

    Default Re: Legal Question Regarding Records

    My main question is if by law she has to provide all medical records even if seeing the doctor was not under the workers comp insurance.
    The carrier has a right to all records that are "relevant and material" to your claim.
    Like I said, you can't cherry pick what benefits or damages your case.

    Effective July 1, 2013, it is hereby Ordered:
    1. Without leave of the Commission, the parties shall not file with the Commission or designate as evidence any of the following medical records, unless the specific record is accompanied by a written statement explaining its relevance and materiality, which statement may be provided at the hearing:
    http://www.workcomp.virginia.gov/sit...signations.pdf
    http://www.workcomp.virginia.gov/doc...d-designations

    As a rule, comp won't settle with open medical, it defeats the purpose of settling which is to get you off the dough and close your claim.
    Listen to your lawyer even if you don't like what you hear, she knows the laws of your state and has no reason to undermine your claim.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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