Who reviews medical records for relevance to the claim?

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Multiple Choice

Who reviews medical records for relevance to the claim?

The person in charge of screening and judging which medical information actually matters for the claim is the claims adjuster or an authorized reviewer. They gather the medical records and sift through them to identify material that directly affects the injury, treatment, causation, and disability questions in the claim. This keeps decisions based on relevant medical evidence and helps protect privacy by excluding unrelated details. The treating physician provides care and writes the medical records, but their role is to treat, not to decide what information is pertinent to the claim. The court is involved if the case goes into litigation, reviewing records as part of legal proceedings rather than during routine claim processing. The employer isn’t the party responsible for determining relevance in the claims process.

The person in charge of screening and judging which medical information actually matters for the claim is the claims adjuster or an authorized reviewer. They gather the medical records and sift through them to identify material that directly affects the injury, treatment, causation, and disability questions in the claim. This keeps decisions based on relevant medical evidence and helps protect privacy by excluding unrelated details.

The treating physician provides care and writes the medical records, but their role is to treat, not to decide what information is pertinent to the claim. The court is involved if the case goes into litigation, reviewing records as part of legal proceedings rather than during routine claim processing. The employer isn’t the party responsible for determining relevance in the claims process.

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