Win Orthopedic Injury Claims with Medical Charts Review

Orthopedic injuries are a common occurrence in our lives, affecting people of all ages and backgrounds. These injuries can range from minor sprains and strains to more severe fractures and joint dislocations. Every step, every reach, and every turn becomes an agonizing effort for people with orthopedic injuries.

When workers encounter orthopedic injuries in workplaces, it affects their ability to return to work and also the quality of their work. In addition to their struggle in dealing with their injury, discomfort and financial burden, they have to encounter the stress of proving their workplace injury.

In this blog, we dive into the causes of acute orthopedic injuries in workplaces and how to claim worker’s compensation with the support of expert chart reviews.

Are you in search of an expert medical chart review team? LezDo TechMed provides first-hand medical record reviews in orthopedic injury claims.

Understanding Orthopedic Injury & Their Types

What is an orthopedic injury?

Orthopedic injuries refer to injuries that affect the musculoskeletal system, which includes bones, muscles, tendons, ligaments, and joints. These injuries can result from various causes, such as accidents, sports activities, overuse, age-related degeneration and life styles.

The focus of our blog is workplace orthopedic injuries. In a recent survey done among the orthopedic surgeons, it is revealed that among the 2,700 plus orthopedic injuries reported to them, only 66% workers returned to work, while 34% retired from their work due to severe injuries.

Top 10 Orthopedic Injuries in Workplaces

Let’s take a closer look at some common orthopedic injuries, which occur in workplaces. These are the most common orthopedic injuries:

• Carpal Tunnel Syndrome: This repetitive stress injury affects the wrist and hand and is common among individuals who perform repetitive tasks, such as typing or using vibrating tools.
• Disc Herniations: Workers who engage in heavy lifting or undergo constant vibration during work, like truck drivers, may develop herniated discs, which can cause back and neck pain.
• Dislocations: Workplace accidents can lead to dislocations or damage to joints like the shoulder, knee, or hip.
• Meniscus Tear: Meniscus tear occur due to the sudden twist or turn to the knees damaging the rubbery cushion between the thigh and shin bones.
• Plantar Fasciitis: Workers who always stand throughout their work time, works on hard surfaces with ill-fitting footwear encounter plantar fasciitis.
• Rotator Cuff Tear: People engaged in overhead reaching works like construction, painting or decorations face rotator cuff tears.
• Sprains and Strains: These injuries happen when ligaments (sprains) or muscles and tendons (strains) are stretched or torn. They often result from overexertion, lifting heavy objects, or sudden movements.
• Fractures: Bone fractures can occur when there is a direct impact on a bone, such as in a fall or collision. These injuries may require surgery and immobilization.
• Tennis Elbow: Tennis elbow is found in people who overexert their wrist and arm like plumbers, butchers, carpenters, painters and so on.
• Tendonitis: Overuse or repetitive motions in the workplace can lead to inflammation of tendons, causing conditions like tendonitis or tennis elbow.

Causes of Workplace Orthopedic Trauma Injuries

• Overexertion

Workers involved in lifting heavy objects like boxes or bags suffer most painful orthopedic injuries to their knees, hips, backs and shoulders.

Truck drivers, movers, trash collectors, construction workers, and warehouse workers experience overexertion injuries to their joints and back. Herniated disc or slipped disc is common among these workers.

• Slip, trip and falls

Due to the debris or wet floors, workers may slip or trip during their work. Icy pavements, wet floors, cluttered or uneven pathways, and slippery roofs can contribute to these incidents. Construction workers, roof workers, window cleaners, and cleaning workers tend to face these kinds of incidents.

• Repetitive motion

Repetitive motion or repetitive strain causes injuries to people who do certain works frequently as it causes stress or strain to the body parts involved. The repetitive motion can develop injuries over time when muscles, tendons, and ligaments are overused without adequate rest, leading to inflammation, pain, and diminished function.

Common activities including typing, assembly line work, or any task that requires the same motion to be performed repeatedly can cause musculoskeletal injuries. When proper rest, physical therapy, chiropractic adjustments and suitable medical treatments, when combined gives proper result.

• Distractions

Distraction while doing high risk as well as normal work and neglecting one’s own posture can lead to musculoskeletal injuries. People accustomed to desk works may not pay attention to their sitting postures, like slouching can develop orthopedic injuries in the long run.

• Hazardous work environment

When the work environment becomes messy and cluttered, it would increase mental stress, elevate the chances of trip or slip and fall. In a cluttered workspace, workers may not have enough space to move freely. This can cause them to adopt awkward postures or movements, increasing the risk of strains.

Common Challenges in Orthopedic Injury Claims

Winning orthopedic claims are not an easy pie even for experienced attorneys. Identifying the strengths and weaknesses of the claim gains significance to plan the strategies. To do that, we should know the challenges involved in workers comp orthopedic injury claims.

• Efficiency of the legal representative: Workplace injury claims should be handled by an expert attorney who knows the nuances of workers comp law. Only then he/she can argue the case with vital evidences to support.
• No witness to the injury: Eye witnesses play a crucial role in supporting the victim of his injury in orthopedic injury claims. In the absence of witnesses, the insurance providers or the defense attorneys may argue that the victim’s injury is the result of life style issues or accidents at home.
• Accident reports and medical records contradictions: Details of the accident in the accident report and medical records should correlate with the victim’s injuries. Any contradiction in these would raise suspicion of the victim’s injury. This will guide the judge to decide against the victim.
• Dismissal from the job before the claim: A workplace injury claim should be filed while the victim is still in the same job. The claim pursued after the victim being expelled or fired from the company can be viewed as a claim filed to revenge the employers. These kinds of claims will most probable be denied.
• Difficulty in establishing causation: Repetitive strain injuries are hard to be established in a workplace scenario. Even in the case of other orthopedic injuries, the victim’s side will need the support of co-workers, supervisors, medical experts and testimony from orthopedic trauma expert witnesses to establish that the injury is work-related.
• Communication issues: When the victim fails to communicate the incident or orthopedic injury to his manager or supervisor, and get treatment on time, it will question the credibility of his injury. Any communication gap can have great impact in workers comp claims.
• Refusing to give recorded statements: Though it’s not mandatory or legal to give recorded statements, insurance adjusters might demand for such statements.
• Catastrophic accident case management: Catastrophic case management should be involved in the case as early as possible to get the maximum outcome in a workers comp claim. Delay in that might result in lesser reparation.

Role of Medical Charts in Orthopedic Injury Claims

Medical charts play a pivotal role in orthopedic injury claims, as they provide a detailed and objective record of a patient’s medical condition, treatment, and progress. When pursuing an orthopedic injury claim, whether for personal injury or workers’ compensation, these charts are instrumental in establishing the extent of the injury, the treatment received, and the impact on the patient’s life. Here are some key roles of medical charts in orthopedic injury claims:

Injury Documentation: Medical charts typically include detailed information about how the injury occurred, initial assessments, and diagnostic tests such as X-rays, MRIs, or CT scans. This documentation helps establish the cause and nature of the orthopedic injury.

Points out Diagnosis: Orthopedic medical charts provide the official diagnosis made by healthcare professionals. This diagnosis is essential for determining the severity of the injury and its impact on the patient’s life.

Treatment Details: Medical charts document the treatment plan, including surgeries, medications, physical therapy, and other interventions. These records are crucial in determining the extent of medical expenses and the effectiveness of treatment.

Progress Notes: Orthopedic injury charts include progress notes from healthcare providers, detailing the patient’s response to treatment and any complications or setbacks. These notes can be used to assess the overall course of recovery.

Functional Assessments: Orthopedic injury claims often involve assessing how the injury has affected the patient’s ability to perform daily activities, work, or engage in recreational activities. Medical charts may include functional assessments that help quantify these limitations.

Documentation of Pain: Pain range at the time of injury, during treatment and after the treatments undergone are crucial in determining the compensation. Medical charts often include pain assessments, which can be used to demonstrate to the court, the suffering experienced by the patient.

Evidence of Pre-existing Conditions: Medical charts may also contain information about any pre-existing orthopedic conditions or injuries, which can be important for determining causation and the extent to which the current injury exacerbated a pre-existing condition.

Vital Evidence: In legal proceedings, orthopedic injury-related medical charts can be used as evidence and may be referenced by medical experts who can provide expert witness testimony on the patient’s condition and prognosis.

Insurance Claims: For workers’ compensation claims, medical charts are often submitted to insurance companies to support the claim for compensation or damages.

Settlement Negotiations and Litigation: In the event of an accident claim or orthopedic motion lawsuit, the information contained in the medical charts is critical for building a strong case or negotiating a fair settlement. It helps attorneys and insurance adjusters assess the validity of the claim.

It’s important to note that accuracy and completeness in medical charting are vital. Any discrepancies or omissions can be used by the opposing party to challenge the claim. Therefore, it’s essential for plaintiffs and their legal representatives to thoroughly review medical records and, if necessary, consult with medical experts to ensure a strong orthopedic injury claim.

Benefits of Expert Chart Review in Orthopedic Injury Claims

Let’s know, how the plaintiff’s medical record review hold the key to success and how the reviewers plow out the hidden evidence from the medical records here. Expert medical chart review in orthopedic injury claims can provide several benefits to both the claimant and the insurance company or legal team involved in the case.

Here are some of the key advantages of medical chart reviews:

• Objective Assessment: Orthopedic injury claims often involve complex medical records, diagnostic images, and treatment histories. Expert chart reviewers can provide an objective assessment of the medical evidence, helping to ensure that the claim is evaluated based on the facts and medical science rather than bias or subjectivity.
• Medical Accuracy: Orthopedic review experts have the knowledge and experience to accurately interpret medical records, diagnostic imaging, and surgical reports. They can identify errors or discrepancies in the documentation and ensure that all relevant medical information is considered in the assessment of the claim.
• Causation Analysis: Orthopedic experts can determine whether the claimed injuries are consistent with the accident or incident described in the claim. They can assess causation and determine if the injuries are a direct result of the event in question, helping to prevent fraudulent claims.
• Analysis of Treatment Adequacy: Reviewing orthopedic charts allows medical record reviewers to evaluate whether the treatment provided to the claimant was appropriate and in line with established medical guidelines. They can identify cases where substandard care may have led to worsened outcomes or additional complications.
• Evaluation of Pre-Existing Conditions: Expert chart reviewers can identify any pre-existing medical conditions or injuries that may have contributed to the claimant’s current condition. This can help determine the extent to which the current injury is related to prior medical issues.
• Estimation of Future Medical Needs: In cases where orthopedic injuries result in long-term disability or ongoing medical treatment, experts can provide assessments of future medical needs and associated costs. This information is crucial for determining the appropriate compensation in a settlement or legal proceeding.
• Helps in Expert Testimony: If the case goes to trial, accurate medical chart reviews help experts in explaining complex medical concepts to judges and juries and providing credibility to the claimant’s case or the defense’s arguments.
• Efficient Case Resolution: Efficient chart reviews can expedite the claims process by providing a clear and expert-driven assessment of the medical evidence. This can lead to faster resolution and reduced legal costs.
• Reduced Risk: Insurance companies and legal teams can minimize their exposure to liability by ensuring that claims are thoroughly reviewed by experts. This reduces the risk of paying out on fraudulent or exaggerated claims and helps protect the financial interests of the insurer or defendant.
• Enhanced Decision-Making: Orthopedic expert opinions provide a solid foundation for making informed decisions regarding the settlement of a claim. They help both parties negotiate from a position of knowledge and clarity.

Do you want to dig out the strengths and weaknesses of your claim? Reach out to LezDo to get precise medical record reviews.

To conclude,

The importance of medical chart review in winning orthopedic injury claims cannot be overlooked. Medical chart review work a powerful tool for claimants, insurance firms, and lawyers alike in achieving better results. The orthopedic medical record review experts bring objectivity, precision, and credibility to the claims process through the diligent scrutiny of medical records, diagnostic imaging, and treatment histories, orthopedic medical record review experts bring objectivity, precision, and credibility to the claims process.

Medical chart review assists the parties involved in ensuring the accuracy of medical assessments, identifying causation, and evaluating treatment adequacy, documenting pre-existing conditions, estimating future medical needs, and expediting case resolution. Expert chart review not only enhances the decision-making process but also reduces the risks associated with fraudulent or exaggerated claims, ultimately safeguarding the interests of all parties involved.

LezDo TechMed’s medical chart review services work as an indispensable ally, offering clarity, fairness, and efficiency. It is the anchor in achieving successful outcomes and upholding the principles of justice within workplace orthopedic injury claims.

Get more insights by following us on Twitter.

1/6 Handling orthopedic injury claims? Need to unearth vital evidence?
Know how LezDo TechMed’s medical chart review services can assist you!#lezdomedlegal #orthopedicinjury #orthopedicinjuries #orthopedicinjuryclaim #medicalchartsreview pic.twitter.com/tfmhLSNh2t

— LezDo MedLegal (@LezDoMedLegal) October 10, 2023