Determining your Medical Needs- Physical and related injuries
As part of our investigation of your medical needs following an accident or injury, we conduct a comprehensive interview with you by completing a number of forms that inform us of your injuries before obtaining and reviewing your medical records. The forms that we have developed over thirty years of providing successful legal services to injured persons in Howard County and surrounding Maryland counties are as follows:
- Client Information Form
- Client’s complaints of injuries
- Physical record
- Wage Verification and Documentation of Lost Time
A. Client Information Form - Our Client Information Form is a valuable tool providing essential information about the accident such as our client’s contact information, work background, medical history (that includes the current physical complaints as well as medical history), military background, and any previous claims and lawsuits. It also provides us with information with regard to the opposing party (ies), including the identification of the other driver and of the owner of the vehicle he/she was driving, the make and model of the other party's car, and of his or her insurance company. Information is also gathered concerning the insurance claim number and adjuster’s name, details of the accident such as where it happened, the license tag number of both vehicles, the damage to the vehicles, the rental company from whom a rental car was obtained, and related information sufficient to identify the driver and where he or she resides, passengers in the client's car with their addresses and where they were seated, whether the car was towed and by whom, witnesses and contact information, statements made either to the police insurance companies, whether recorded statement was made or put in writing and to whom, and contact information of the person who received the written statement of the client. It also includes details of our client’s automobile policy, including the name of the insurance company, the claim number and/or policy number, and what coverages are included on their policy such as personal injury protection, medical benefits, and property damage and liability coverage. Damages from the accident; names of hospitals and medical providers who provided the client with treatment after the accident, with detailed contact information; descriptions of activities hindered since the accident; lost wages; dates of time lost at work or profession, time lost from school or confined at home, and time lost to attend medical appointments—this information is also recorded. This form is essential as an organizing strategy to be used by the attorney as well as staff members and should be completed in its entirety. Simply stated, when the form is completed, we are then ready to perform the next step which may be making sure that our client receives appropriate medical treatment. Unfortunately, many physicians do not wish to be involved in accident cases or do not have adequate training to understand how what is said in medical records may help or hurt the client. Therefore, it is very important that the client communicate all his or her injuries and symptoms and complaints to the physician at each visit. Our next form entitled Client’s Complaints of Injuries is a checklist that we complete with the client at the first interview. See below. Letters of representation are sent to all involved insurance companies. Insurers will not even discuss the claim on the telephone until they have received a letter of representation from the attorney. We fax the letter of representation at the first office visit with the client.
B. Client’s Complaints of Injuries - This form has many purposes, including but not limited to making sure that both the attorney and the client have a clear, definite, and certain understanding of all the client’s physical and related injuries. It is completed at the first interview and updated by completing the same form as the client’s condition improves or worsens. It's also used, in addition to medical records, for purposes of negotiation in an attempt to settle a case as well as to prepare a legal document called a complaint if and when suit is filed. In addition, it is used to prepare the client for trial and to respond to discovery which requests specific details of the client’s injuries. We encourage clients to call us or come into our office before each follow-up medical appointment so that both we and the client have a clear understanding of what the client is going to tell his or her treating physician.
C. Physical Record - This form is used to make sure that all areas and locations of pain and injury are covered. It also covers severity of pain and there is a printed picture of the front and back of the body on which the attorney can mark up affected physical areas. On the drawing, we can also indicate the location of other factors such as tenderness and swelling, lacerations and abrasions.
D. Employment - This form identifies the type of job that the client performs and the duties of that job. Under the description “Other” on this form, we inquire whether or not the client is required to perform lifting, bending, squatting, range of motion, and other important functional activities that relate to the client’s work and his or her injuries, particularly with regard to back and neck injuries.
E. Wage Verification and Documentation of Lost Time - Under their own automobile insurance policy, many clients has personal injury protection coverage with the minimum benefit of $2,500 and possibly up to $10,000. In order to obtain lost wages or compensation for loss of income, the treating physician must specify, in writing, the fact that the client needed to be off from work as a result of the injuries suffered from the accident. After the client authorizes this form to be completed, the employer completes the form by providing requested information about the client’s earnings and time missed from work.
F. Other Forms - We use many other forms which we will reference here but of which a sample is not provided. These other forms include our HIPAA-compliant medical release form and assignments of benefits forms which are often provided to us by medical providers. Howard County General Hospital has their own authorization for release of health information (HIPAA medical release) which we have available for our clients who are treated there. Before we begin our representation, we and the client both sign a retainer agreement, which is a contingency agreement, meaning our fee is based on a percentage of the recovery of the bodily injury aspect of the claim. We resolve property damage issues without charging a fee unless suit is filed as part of personal injury lawsuit or there is no personal injury but a dispute over the amount of property damage.
We utilize these forms in our practice. Often the information helps both the attorney and the client manage their communication as well as establish a foundation for the management of the case. With the exception of two of these forms, these forms have been developed by this office over the past 30 or more years. To one of these forms, the Client Information Form, we have made some additions, however that form was received at a seminar for attorneys who were establishing their own law office.
We provide you with these forms so that you may know before coming to our office what information we will be requesting of you. We don't expect at the first visit to have all the information as additional information may be provided at a later date. However, we do appreciate receiving as much information as possible at a first meeting.
Fred Antenberg has been providing quality legal services to injured persons for over 30 years. Sharon Chapman has been in the office for over 30 years in various roles including legal secretary and now office manager. Call Fred today and you will most likely initially speak with Sharon. Please call Fred at 410-730-4404 to set up a free initial consultation.