workerscompjudgeDo I have legal access to the medical records used in my workers’ compensation case? How do I obtain my medical records from the insurance company, the doctor, or third party according to New Jersey state law? These are questions we often hear from our clients. The good news is, claimants in these cases do have the legal right to request their medical records as explained in New Jersey Workers’ Compensation Act and by the New Jersey Medical Society.

It is unlawful for any employer, insurance company, third party, or treating doctor involved in the case to withhold medical information from the requesting individual according to the New Jersey Workers’ Compensation Act (NJSA) 34:15-128.4. In addition, the requesting individual may not be subject to costs higher than the cost to send the record copies. However, medical providers may not charge for a copy of records if the physician has chosen to terminate the patient care according to NJAC 13:35-6.22.

When it comes to requesting your records from the treating medical provider, the same laws apply as if you were making the request to your chosen family doctor. Gaining access to your medical records does not become more difficult simply because the physician was appointed and paid by your employer’s insurance company.

The New Jersey Medical Society provides even more specific parameters regarding this issue: The treating medical physician involved in a workers’ compensation case must provide the records to the patient within 30 days of the request according to N.J.A.C. 13:35-6.5. The records are required to objective data, such as test results. In addition, when an authorized third party requests the information, written permission must be obtained from the patient.

Another authority on this issue is The Board of Medical Examiners. The Board states that cost of providing records to the patient may not be more than one dollar per page or more than $100 total (whichever is less). However, if the medical records total under 10 pages, the physician may charge $10 to account for postage or other costs.

Medical Records & StethoscopeNote that there is a difference between the treating physician and medical examiner. A medical examiner is considered independent and not bound to the doctor-patient relationship. A physician that is simply performing an examination and not treating the patient is not required to furnish medical records to the patient. This physician will probably only provide the results of the examination to the insurance company or third party that requested it.

In the case that your lawyer requests your medical records from your employer’s insurance company or lawyer, these must be furnished within 30 days of the request according to N.J.A.C. 12:235-3.8 C. This rule works both way, so that if the employer’s lawyer requests medical records from your lawyer, these must be provided within 30 days as well. If the request is not fulfilled in a timely manner, a motion may be filed with the Division of Workers’ Compensation.

If you have any questions regarding your medical records or workers’ compensation case, we welcome you to contact The Hayes Firm today. We will review the details of your case as soon as possible and answer any questions completely for free. If we find that your situation could benefit from a skilled New Jersey lawyer, we can connect you with one also free of charge.