In an interview with Attorney Ronca, I learned how medical record searches in NY became a part of their practice. As I learn about interesting new services and arrangements for my clients and other employers to lower their costs, I like to mention these services, so I recently sat down with Attorney Ronca who filled me in about their specialized document search services.
In 1993, Theodore Ronca, Esq. and Diane Kinslow, Esq. expanded their workers’ compensation services to include specialized searches for records, principally medical records for use in second-injury fund claims. Initially, these searches began as part of the handling of claims for self-insured employers where it was more effective in terms of time and expense to have the lawyers appearing at hearings pursue the searches between hearings.
The searches, done by subpoenaing group medical plan records of payments, quickly produced material that would have been many times more effective if used in the claim from the onset. The sheer amount of material on prior conditions, as well as prior comp claims, disability claims and lawsuits, if used in the comp claim would alter the way in which claims were presented and would radically change medical testimony. A federal publication on “Permanent Disability in the Workplace” bore this out with a finding that one worker in three had a permanent significant medical disability. This was the very group most likely to experience extended disability following a compensation injury, according to Attorney Ronca.
He said, " Our documentation of prior impairments for second-injury fund quickly quintupled the number of C-250s each employer presented with a good chance of success. Other employers, carriers and third-party administrators (TPA) began to use the service. For new clients we did not handle the hearings, confining our service to supplying useful documents. For these clients we included a one-page written analysis, placed above the records, of the contents useful to the claims examiner and the outside counsel. This was so that information would not be lost or overlooked by having each new person review hundreds of pages of medical records."
The addition of a condensed analysis by attorneys familiar with the nature of comp claims, legal issues and medical testimony brought many new benefits. Outside counsel could quickly present many new issues in a timely fashion, including apportionment with other claims, causal relationship and treatment for unrelated conditions, in addition to second-injury funds.
He said, "We never proposed to offer advice on the handling of the claim, nor did we appear at hearings, take testimony or write appeals. Outside counsel, normally uneasy about another firm handling portions of a file, quickly came to accept us as an unseen resource greatly adding value to their own services."
Since most of their work was done by phone, letter and fax (internet recently added) they could handle claims anywhere in the state of New York from one office. With new Health Insurance Portability and Accountability Act (HIPAA) regulations requiring a release, and such releases now being universal in comp and negligence claims, they can handle searches in any state on a file they are not working as attorneys.
He says, "We are attorneys who happen to have acquired the skills necessary to perform searches. In New York, we occasionally are required to issue subpoenas, in which case we become attorneys on a claim for the limited purpose of issuing a subpoena. This means we can lawfully perform services intended to assist in claims in other states where we do not have to issue a subpoena."
As they have become known to claims units, they have been asked to secure every manner of document in addition to medical. Among these are pleadings in lawsuits, bankruptcy records, police records, medical records from foreign countries, records of UI claims, Social Security disability records, news stories regarding a party, military medical records, death certificates, birth certificates, records of discrimination claims, bank records and signed purchases of material showing undisclosed business activity.
He also emphasized, "We have learned to be discreet with personal information and hold material that could be personally embarrassing to a party, or deleterious to their relationships, until contacts are made with a claims unit and opposing counsel to ensure proper handling. Such records, if not essential, are kept by us and are not revealed unless all parties agree."
And, they seldom bill for services on an hourly basis, unless asked to do so. Instead, they have followed a “DRG” system. Services have a fixed price regardless of the time spent so that claims units do not have to wonder about the accuracy of itemization of times. The two services accounting for 95% of the work are: (a) location and retrieval of a document and, (b) analysis of a document received together with a written summary of the contents.
In nearly all cases, mailing charges, phone calls and subpoena fees are built into a single charge. That flat fee is divided into two parts: a fee to locate and produce a set of records, usually starting with the group medical payment records, and secondly, at fee to analyze (including decoding of abbreviations used by many medical plans) and prepare a written report and mail the records.
Prior to mailing a subpoena or release they always speak to the people who will receive the release to make sure they understand what is being requested and see if there are any other matters that need to be resolved. These calls are built into the charge to locate and retrieve a document and do not result in additional expense. (workersxzcompxzkit)
They have been successful in having medical offices provide most sets of records for the subpoena fee. However, some hospital and medical groups insist on charging a statutory charge per page for copying. They will pay these but if they exceed the normal subpoena fee must add them to their charges.
I hope you agree, this could be a very useful service.
Author: [email protected]
Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers' compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.
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