Medical Records – Proving Authenticity and Reasonableness


There are typically four distinct elements that a claimant must satisfy for the court to properly admit medical bills into evidence. First, the plaintiff must prove that the offered bills are authentic; second, the plaintiff must prove that the claimed charges are reasonable; and third, the plaintiff must prove that the services reflected on the bills were medically necessary to diagnose and/or treat the claimed injuries, and fourth, the plaintiff must prove that the claimed injuries were caused by the negligent act. See, e.g., McMunn v. Tatum, 237 Va. 558, 568 (1989).   This article will deal with the first two of these requirements.  


  1. Authenticity


The requirement of authentication or identification as a condition precedent to

admissibility is satisfied by evidence sufficient to support a finding that the thing in

question is what its proponent claims.   “Authentication is merely the process of showing that a document is genuine and that it is what its proponent claims it to be.” Owens v. Commonwealth, 10 Va. App. 309, 311 (1990). “The amount of evidence sufficient to establish authenticity will vary according to the type of writing, and the circumstances attending its admission, but

generally proof of any circumstances which will support a finding that the writing is

genuine will suffice.” Williams v. Commonwealth, 35 Va. App. 545, 556–57 (2001).


Generally, “authentication does not set a high barrier to admissibility, and is generally satisfied by any form of proof that supports a finding that it is what it purports to be.”  see  Charles E. Friend & Kent Sinclair, The Law of Evidence in Virginia § 17-1, at 1164 (7th ed. 2012).  Barring unusual circumstances, lay testimony is sufficient to establish authenticity.  


  1. Reasonableness of Charges


The McMunn Court defined “reasonable charges” in this context as medical billing 

“…not excessive in amount, considering the prevailing costs of such services”. McMunn v. Tatum, 237 Va. 558, 568 (1989).   Whether the claimed bills are reasonable is a question of fact for the jury or the judge in a bench trial. Walters v. Littleton, 223 Va. 446, 452 (1982)

the bills, but only to the fact that he had received them as a consequence of

the accident.


In McMunn v. Tatum, the Court made clear that, while not strictly necessary, proof of 

the reasonableness of medical bills proffered into evidence will typically require expert testimony if contested at trial.  The Court held that “where the defendant objects to the introduction of

medical bills, indicating that the defendant’s evidence will raise a substantial contest as to either the question of medical necessity or the question of causal relationship, the court may admit the

challenged medical bills only with foundation expert testimony tending to establish medical necessity or causal relationship, or both, as appropriate.  Id. at 569.  


As courts have subsequently made clear, a plaintiff may typically offer medical bills through the plaintiff’s testimony alone if he lays a foundation showing (1) that the bills are regular on their face, and (2) that they appear to relate to treatment, the nature and details of which the plaintiff has explained. If the defendant challenges the authenticity of the bills, they will be insufficient in themselves to create a jury issue, and independent proof of authenticity will be necessary.  This independent proof will most frequently require expert testimony as a medical malpractice lawyer in Arlington, VA, like those at The Law Offices of Ryan Quinn, PLLC can explain.