In this series of articles, our Firm will shed light on the Courts’ thorough examination of injured workers’ medical records, which has led to the denial of Defense Base Act (DBA) claims due to what they deem as deficient and unreliable evidence. While the Courts have always shown great attention to a claimant’s treating providers’ medical records, recent years have seen a surge in claim denials solely due to insufficient detail in these records. There are several underlying factors contributing to the Courts’ growing skepticism of treating providers’ medical records.
First, we are aware that many employers and their recruiters concentrate their recruiting efforts in a limited geographical region, resulting in a significant number of civilians from that region working abroad. When these workers return home and experience psychological symptoms, they seek medical care. However, due to the employers’ narrow recruitment focus, there are only a limited number of doctors available to treat injured workers with psychological conditions in that region. Consequently, the Courts are repeatedly encountering the same doctors from the same area in each case. Regrettably, some of these doctors generate identical reports for many of their clients, leading to substantial challenges for injured workers when their cases come before the Court since the Court encounters the same report across multiple cases.
Furthermore, the Courts are intensifying their scrutiny of these medical records due to their lack of information specific to the injured worker’s claim. The judge’s focal points in this scrutiny encompass the following key areas:
- Detailed History: Courts are scrutinizing medical records because the records lack individualized details to the injured worker, including but not limited to no mental status examination documented, no mental illness history documented, little to no mention of Claimant’s work for Employer, amongst other evidentiary deficiencies.
- Detailed Explanation of Diagnosis: Judges are now emphasizing the need for treating providers to clearly explain how they arrived at their diagnosis. This includes providing a comprehensive assessment of the Claimant’s condition and its relation to the events experienced overseas.
- Discussion of Traumatic Events: It is crucial that medical records thoroughly discuss the specific events that led to the Claimant’s injury. Judges are assessing the level of expertise and knowledge demonstrated by your treating doctor. This additionally, provides evidence to the Court showing a connection between the traumatic, stressful, or war-risk hazards encountered during employment and the psychological injury suffered.
- DSM-V Criteria: Judges expect that any diagnosis made for a psychological injury aligns with the criteria outlined in the DSM-V. Make sure that your treating provider has properly referenced and justified the diagnosis according to these criteria.
Having your doctor specifically tailor your medical records to your specific claim with the facts above is essential in all DBA cases. This will not only bolster your credibility but your doctor’s credibility by providing the Court with evidence a through evaluation was conducted and your treatment is tailored to your specific case.