Medical Records for DIME
What the Medical Records Unit Does
The Medical Records Unit works alongside the Division Independent Medical Examination (DIME) Unit to implement Rule 11 by collecting, organizing, and sharing medical records. The goal is to keep the DIME process fair, fast, and smooth for everyone.
Under Rule 11, both parties submit medical records to the Medical Records Unit. The Unit then utilizes a new system to create a clean packet of medical records based on criteria established by the Division of Workers' Compensation (DOWC). Each party will receive three files: a cleaned-up packet, the original records, and any unused documents.
Key Benefits
Faster Process
Reduce delays by managing records efficiently.
Consistent Packets
Reduce variability and potential errors by standardizing packet criteria and formatting.
Easier Physician Review
Doctors receive clear, complete, and relevant information to review.
The Medical Packet Process
The Medical Records Unit maintains strict security protocols to ensure all data and medical information is handled in compliance with relevant privacy laws and by authorized personnel only.
1. Record Upload
After receiving a secure link, the insurer has 30 days to upload all medical records relevant to the claimant’s case.
2. Proposed DIME Packet
After the insurer’s 30-day window, the Medical Records Unit will create a proposed DIME packet.
3. Claimant Review (10 days)
The claimant has 10 days to review the proposed DIME packet, identify errors, and submit medical records that were not included in the initial upload.
4. Joint Review (10 days)
Both parties have 10 days to jointly review the proposed DIME packet and identify errors or omissions. Once both parties agree on the packet, it becomes the final DIME packet.
5. Distribution
The DOWC distributes the final DIME packet to each party and the DIME physician at least 14 days prior to the scheduled DIME appointment.
6. Changing the Final Packet
Once approved, any changes to the final DIME packet require a prehearing order from the DOWC.
File Requirements Checklist
Use this file formatting checklist when submitting medical records to avoid delays and mistakes.
- All records are in PDF file type.
- All scanned documents are clear, easy to read, and submitted as PDFs.
- Each submitted PDF is under two gigabytes (2GB) in size.
- All file names follow the format of “Workers’ Compensation Number, claimant’s last name, claimant’s first name - original file name”.
- Example: “5-123-456, Lee, Bruce - Medical Report 1 of 3”
- Example: “5-123-456, Lee, Bruce - Medical Report 1 of 3”
Criteria for Record Inclusion
The Medical Records Unit will apply fixed criteria to compile focused, effective, and consistent DIME packets. The packet review and supplementation process ensures that both parties will have a chance to approve the final DIME packet. View and download a copy of the medical record criteria.
Inclusion Criteria
All records related to the evaluation and treatment of related conditions and contributory factors will be included.
- All workers’ compensation notes, WC164, QPOP
- ATP, NP, PAs, all PT/OT PTA/OTA, ED notes
- Operative and hospitalist notes
- Specialist Notes (any PA, NP, MD, or DO note)
- Primary care notes- (if relevant pre-existing condition(s), injury(ies), or disease(s))
- Impairment Ratings, Independent Medical Exams, Record Reviews
- Psychological assessments, EMDR, biofeedback, cognitive therapy
- Functional capacity exams
- Admission and discharge summaries (inpatient)
- Work status summary, work restriction
- First and last passive therapy notes (chiropractic, massage, acupuncture)
- Controlled substance medication logs
- EMG/NCS diagnostics, procedure notes, critical events inpatient (rapid response/ CODE blue/arrest/resuscitation), pre-hospital (ambulance) care report
- Diagnostics & radiology (other than inpatient blood tests), discharge blood work or last blood work done inpatient, first and last vestibular & visual therapy notes
- Outpatient labs including drug screens, genetic drug profile labs, etc.
Exclusion Criteria
Certain components of the chart may be removed but will remain in the original record.
- Duplicates
- Irrelevant pages (empty pages, all cover pages, fax covers)
- Commingled documents (other patient documents)
- Billing and Administrative correspondence (HIPAA paperwork, consents, instructions, invoices, EOB, patient’s rights)
- Case Management reports (Demographics, Medical Record requests, notes, Patient home exercise program instructions, including stretching and strengthening)
- Orders/Admissions (Referral scripts/ orders, Patient discharge instructions/After Visit Summary)
- Depositions, Surveillance recording
- Auxiliary records (Pre-anesthesia records/ anesthesia medication administration log, Pharmacy records inpatient)
- RN inpatient notes (medical administration, vitals, and daily notes), Physician orders
- Non treating case manager records
- Lab/ Radiological requisitions, Inpatient labs
- Other (Vocational rehabilitation reports, Prior authorization requests, Surgery scheduling forms)
- Passive therapies (massage/acupuncture/ chiropractic daily notes only keep initial evaluation/ discharge
Contact the Medical Records Unit
Division of Workers' Compensation
Medical Records Unit
633 17th Street, Suite 400
Denver, CO 80202
303-318-8678