A medical evaluation is a process where a health care provider examines the patient for signs of injury, illness, or disease. Sometimes third-party physicians are requested to verify formerly diagnosed medical issues from a primary care provider. Medical evaluations ordered by insurance companies, or employers, usually target previously diagnosed conditions. For instance, a worker’s compensation claim which is a claim of a work-related injury by an employee is usually examined to assess the injury's existence or severity. In addition, the medical evaluation is used to rate the severity of injury or illness to determine a financial award or disability payment duration.
Most medical evaluations begin with a complete medical history. The patient will be asked a variety of details about medications that have been prescribed and are currently being used; current and past medical conditions; past surgeries, and any illnesses that have occurred. The physical exam will include vital signs, including blood pressure, heart rate, and body temperature, testing physical reflexes, examining the eyes, nose, and throat, or visually checking injuries. Based on symptoms and examination findings, further tests may be ordered. Gender-specific tests are typically included in a general medical evaluation. The medical evaluation results are recorded and provided to the requesting party.
Some medical evaluations are ordered to support a plaintiff or defendant in a specific lawsuit. When this happens, the existence and probable cause of a specific injury or illness are evaluated. In some cases, the evaluating physician is required to testify in court as to his or her findings and expert opinions regarding those findings. It is not uncommon for an insurance company to pay for a medical evaluation as a preventative health care measure. Policyholders are encouraged to schedule a medical evaluation to detect illnesses or injuries. Such evaluations usually involve a complete physical examination. This way they can be detected and treated in their early stages. Insurance companies order medical evaluations to assess customer insurance eligibility. Denial of eligibility or a higher premium can result from the evaluation results.
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