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WC versus HIPPA Federal

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  • WC versus HIPPA Federal

    Hello - I'm a HR and EHS Manager and I'm in a disagreement with the attorney for the company I'm employed with. She states an employee must sign a release from the attending provider if I am to receive any workers compensation paperwork as a result of a work related injury due to HIPPA and I said this is workers compensation not standard medical treatment. Please advise if I'm incorrect.

  • #2
    "... In the case of workers compensation, HIPAA Section 164.512(l) provides that a covered entity may disclose protected health information “as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work related injuries.” As such, any disclosure would be subject to state law regarding workers compensation. There is no specific exception in HIPAA regarding disclosures for FMLA and ADA purposes. Therefore, covered entities usually require a valid patient authorization, pursuant to section 164.508, prior to disclosing employee protected health information to an employer for purposes of FMLA and ADA. - See more at:"

    Generally you are correct but you do need to look at state laws in each state (and your WC carrier should know this information), and I do think it is best business practices on both the side of the medical facility and on the side of the employer. It's better to have that authorization signed than not, even if not required by any law. So in reality I think many medical facilities will require it to protect themselves.

    I suspect your WC carrier(s) is going to deny claims if the doctor/facility fails to provide the documentation needed due to the failure to sign such an authorization by the employer. And the employee would have a hard time arguing they were denied benefits through no fault of their own. But there seems to be one who thinks the rules/laws/policies shouldn't apply to them.


    • #3
      It's HIPAA, not HIPPA.
      The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.


      • #4
        I don't do any work for clients in Florida but in all of the states where I do the form that is required by the State Workers' Compensation Commission for the employee to complete to notify the employer of injury has had as part of the signature statement that the employee allows release of medical information related to the claim. This dates back to before HIPAA was in place.

        Check you state's form.


        • #5
          Welcome to my world. Yes, HIPAA has a carve out for WC related medicals. However, it is not uncommon for medical reports to also reference other conditions which are not related to the work injury and those are not protected. It is also standard for many providers/insurers/employers to have it a policy not to share any medicals without a release from the patient. The extent to which those medicals can be required in the absence of a release vary by state (and sometimes circumstance and even hearing officer). Most states have a form which allows for the release of medicals for good measure.
          I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.