By Blake J. Howell, Attorney at Law
Our goal at Reinisch Wilson is to avoid costly and burdensome litigation whenever possible. One area of increasing frequency relates to attending providers filing medical disputes for Department penalties alleging a failure to timely receive a medical file after requesting the records or an IME report by the mandatory deadline.
- OAR 436-010-0270 (2)(b) governs obligations to provide prior medical records to a new attending provider. OAR 436-010-0270 (2)(b) states: “Within 14 days of receiving a request, the insurer must forward all relevant medical information to return-to-work specialists, vocational rehabilitation organizations, or new attending physician or authorized nurse practitioner.” These requests for the prior medical file are often “buried” within chart notes, or the attending provider may simply check the tiny box on the Form 827 requesting the entire medical record.
- OAR 436-010-0265(11)(c) governs obligations to forward IME reports to the attending provider. OAR 436-010-0265(11)(c) states: “The insurer must forward a copy of the signed report to the attending physician or authorized nurse practitioner within three business days of the insurer’s receipt of the report.”
Though requests for the worker’s medical file or an IME report may be found in just one sentence in a chart note, or an unassuming box on a Form 827, failure to adhere to the timelines above can result in penalties if not properly addressed in a timely manner. Please carefully review correspondence and chart notes for record requests, and always send an IME report to the attending provider within three days of receipt—regardless of whether you plan to seek agreement with the IME findings.
As always, please do not hesitate to contact the attorneys at Reinisch Wilson P.C. with any questions or concerns related to this information or if any similar disputes arise in your cases.