A workplace injury can leave you with mounting medical bills and uncertainty about your ability to return to work. Workers’ compensation benefits help cover your medical expenses and offset a portion of your lost wages, but you will need solid medical evidence to support your claim.
Why Medical Evidence Is Crucial for Workers’ Compensation
When you file a workers’ compensation claim, the insurance company will not simply take you at your word. Medical evidence serves as the foundation of your case, helping to:
- Establish that your injury is work-related.
- Demonstrate the severity of your condition.
- Show the need for ongoing treatment or work restrictions.
- Support disability claims if you cannot return to work.
Insurance companies often scrutinize claims for inconsistencies or missing details—the more comprehensive your workers’ comp medical documentation, the stronger your case.
Types of Medical Evidence for Workers’ Compensation Claims
Your medical records should paint a complete picture of your injury, its impact on your ability to work, and the treatment required. Providing multiple sources of evidence strengthens your case and minimizes disputes over whether your injury qualifies for workers’ comp benefits. Here’s a run-down of some of the types of medical evidence your claim might include.
Doctor’s Reports and Treatment Records
Your doctor’s notes should explain your injury, treatment, and work limits. Regular check-ups help your claim and stop disputes. If you skip treatments, the workers’ comp insurer might argue that you’re not that hurt or it no longer needs to cover your care. Staying consistent with treatment improves your prognosis and proves your injury is real.
Diagnostic Tests for Workplace Injuries
Objective medical tests strengthen your claim by confirming the extent of your injury. Standard diagnostic tools include:
- X-rays for fractures and joint injuries
- MRIs and CT scans for soft tissue and spinal injuries
- Nerve conduction studies for carpal tunnel syndrome or nerve damage
These tests also help doctors develop appropriate treatment plans, further supporting your claim.
Functional Capacity Evaluations (FCEs) for Workers’ Comp
A Functional Capacity Evaluation (FCE) measures your physical abilities after an injury to determine if you can safely return to work and under what conditions. It includes lifting, bending, and walking tests, helping decide if you need modified duties, accommodations, or time off to recover.
Independent Medical Examination (IME) Reports
Insurance companies may request an IME from their chosen doctor to assess your condition—a doctor who likely favors the insurer’s interests over yours. If the report disputes your claim, your doctor can counter it with a second opinion or additional tests. You should also consider getting legal help to assert your rights if the insurer asks for an IME.
Causation Reports in Workers’ Comp Claims
One of the biggest hurdles in many workers’ comp cases is proving that the injury is work-related. Your doctor can support your claim by writing a causation report—a supporting document that attests to the work-related nature of your injuries. Causation reports may include:
- Employer incident reports describing how the injury occurred
- Statements from coworkers who witnessed the accident
- Medical expert opinions linking repetitive stress injuries to job tasks
Gathering Evidence for Workplace Injury Claims
Building a strong case requires taking the proper steps from the beginning. Here’s how you can gather and present compelling medical records for workers’ comp benefits:
- Seek immediate medical attention – Delaying treatment can give the insurer reason to question whether your injury happened at work.
- Follow your doctor’s orders – Ignoring medical advice may be used against you to claim that your injury is not as severe as stated.
- Request copies of all medical records – Keep a personal file with test results, treatment plans, prescriptions, and work restrictions.
- Keep a symptom journal – Documenting pain levels, mobility issues, and the impact on daily activities adds another layer of evidence.
- Get statements from specialists – If your condition requires a specialist, their opinion carries significant weight.
- Communicate with your employer – Inform your employer immediately about your injury and follow company protocols for reporting workplace injuries.
Your claim may be denied or disputed without timely, consistent medical evidence. A workers’ compensation attorney can gather and present the necessary proof to support your case.
Protecting Your Workers’ Compensation Claim
Insurance companies love finding ways to deny claims, even those backed up by solid medical evidence. A good attorney can help you fight back. If your claim got denied or you need help with evidence, Robert Wilson & Associates has your back. Don’t wait—contact us online or by calling (612) 334-3444.