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About WC, doctors and supervisors (Virginia)

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  • About WC, doctors and supervisors (Virginia)

    Quick question.

    In Virginia, do you have to give permission for your supervisor (or employer rep) to be present in the examination room with you and the doc?

    I understand that they have the right to the information/records. I have no issues with that.

    My issues are with the individual that was sent with me to the doctor. He kept interrupting and redirecting the doctor. For instance, he informed the doctor that I was not allowed to have a prescription (in an attempt to keep the injury from being an OSHA recordable.)

    I am due to go back for a follow up, and would prefer that he not be there.


  • #2
    No, you do not have to permit anyone with you and your Dr in the exam room with you during the evaluation.

    After you are finished with your Dr, you should remain with the NCM/Nurse Case Manager while they discuss your Dr recommended treatment plan. You may not have any input at that time, but you should be aware of the issues discussed.

    At your follow up, politely notify the individual of your preference. If s/he insists, have the Dr make the request. If there is still difficulty, ask for the authority the person is relying upon to make the interference with your treatment/exam. (just don't laugh when s/he turns red, and begins to stutter...)

    Please don't ask about a ''law'' that covers this issue, I don't have it. But I have never seen a law in any state that requires you to permit this either. You do have patients rights however. I'd have to find the link to those.
    your supervisor (or employer rep) to be present
    If your employER is self insured, there should be one person handling your claim. As a rule, that would NOT be your immediate supervisor, but a rep from the HR dept who generally handles WC claim. Only that person, an no others would be privy to your medical records, or information in this claim, other than any restrictions placed upon you by your treating physician. Self insured ER generally have one dept/representative of the company handle claims, or a TPA/Third Party Administrator under contract for this purpose.

    If your ER is covered by a policy issued by a carrier providing WC insurance in VA, then a CA/Claims Adj would handle your claim, and NO ONE from your ER would be involved at all. (other than the job restrictions you may have. Your Dr would provide a form for you to give to your ER if you are released to a light/modified duty job)

    You are correct about the ER/IC being entitled to your medical records, they are paying the bills and have a right to know what/why they are paying.
    HIPAA is expressly exempt from WC. Only to the point of being a qualified entity.

    You can find the VA statutes governing the provision of benefits here

    If you are being delayed/denied benefits you should consult with an attorney handling primarily WC claims. No fee for consult, and if there is one, it would be awarded by a WC judge when your claim is resolved.


    • #3
      Thank you for your time and the link.


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