Reviewing medical records

Medical Records
A doctor is a key for good Medical Records.

Hospitals can show your medical records upon requests. In traffic accident injury cases, there are two main cases where someone requests your medical record: a voluntary insurance company who is in charge of paying your medical expenses, and GIROJ which is in charge of the evaluation of your residual disability.

The Voluntary insurance company’s request to disclose your Medical Records

Their purpose is to figure out the total amount they have to pay for you in the future. Besides, they sometimes review medical records so they can know the necessity of your absence from work, a causal relationship between your injury and the traffic accident, and how long treatment will be needed for your injury.

They have two ways to review your Medical Records: seeing the treatment record by paper or having an interview with your doctor. They prefer the direct interview, especially when they’re in a hurry.

In many of cases their request is made after about 6 months pass since the accident. But sometimes, they exceptionally start to review the medical record just after the traffic accident. In this case, they might have special needs to figure out the expected amount of payout. For example, lost wages of your absence of work are much higher than they initially expected. They do it also when they can not figure out the victim’s condition only by the name of the symptoms.

Let’s say you got cervical spine or lumbar sprain in a traffic accident, and you only have subjective symptoms. If the voluntary insurance starts to review your medical records after about 6 months pass since the accident, it might mean they seek ways to stop paying for your medical expenses.

In the case where you got fracture in a traffic accident, the voluntary insurance company might request disclosing your Medical Records. Their purpose might be stopping to pay your medical expenses, however, their review of Medical Records does not always result in the stop of their payout. If your doctor insists, you’re still in need of treatment, they never stop payout. So, whether they stop payout or not depends on your doctor’s answer.

GIROJ’s review of medical records

By the way, how did you apply for the special compensation for your residual disability? If you apply for it by yourself, GIROJ might ask some questions to your doctor as one of the ways of reviewing your Medical Records, so they can know what grade of residual disability is adequate for your symptoms. However, if your doctor cannot answer for their questions in a proper way, you might not be able to get the grade you wish.

For example, as a typical question, GIROJ asks your doctor

“Does the patient have objective symptoms?”

Many doctors answer “He/she doesn’t have objective symptoms” despite they conduct only one or two examinations. If he hasn’t executed all the possible examinations to see if you have objective symptoms, the answer should be “I didn’t execute all the examinations.” Only with the doctor’s easy answer, GIROJ will conclude you don’t have any objective symptoms.  

Besides, in your Medical Records, your doctor has to describe detail about time-dependent changes of your symptoms. However, many doctors tend to fail describing all the information. Sometimes they don’t describe one of your symptoms just because it’s too obvious for them. If it happens, GIROJ might not admit your symptoms as residual disability.   

So, it’s a bit risky only relying on your doctor to attend to the request of disclosing your Medical Records. The most prudent way to attend to these problems is to get Medical Records by yourself.

Getting your medical records by yourself

To submit persuasive and logical Medical Records for getting the intend grade of residual disability, you need to describe all the information on your symptoms including some examination results. However, doctors don’t always get used to making the proper Medical Records especially in traffic accident cases.

So we recommend you to be actively involved in making reasonable Medical Records.

One of our service is to accompany with a car accident victim visiting the doctor. Sometimes we hold a meeting with your doctor, and help you to effectively tell your symptoms to the doctor. Sometimes we ask doctors to include the important information which works to get the intended grade of residual disability.

GIROJ regards doctor’s indication as very important. It always influences the grade they designate to you. So our first recommendation is to get the Medical Records by yourself with the help of experts trying car accident cases in Japan.