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Question about Workers’ Compensation Records

Occasionally we are asked questions about workers’ compensation records. Just last week, we responded to the following question by Rick W. in Texas:

What do you have to disclose to an employer who wants records from one of its employees who is getting workers’ compensation services from you?  Do employers have a right to see those records?

Healthcare Compliance Pros Response

Under the HIPAA Privacy Rule, covered entities are permitted to disclose protected health information to workers’ compensation insurers, State administrators, employers, and other persons or entities involved in workers’ compensation systems, without the individual’s authorization. In other words, a covered entity is permitted to disclose an individual’s protected health information as necessary to comply with and to the full extent authorized by workers’ compensation law.

Generally, the Privacy Rule requires covered entities to reasonably limit the amount of PHI disclosed under 45 C.F.R. 164.512(l) to the minimum necessary to accomplish the workers’ compensation purpose. When disclosing PHI as required by Texas workers’ compensation or other law, or pursuant to an individual’s authorization, covered entities are not required to make a minimum necessary determination 45 C.F.R. 164.502(b).

Based on the facts restated above employers do have a right to see those records. In the state of Texas, you are not required to make a minimum necessary determination.  HIPAA defers to State law, and in situations where employers are involved in workers’ compensation systems, they are entitled to see records for purposes to the extent necessary to comply with laws relating to workers’ compensation.  In addition, disclosures are permitted for purposes of obtaining payment for any health care provided to an injured or ill worker.

If you have any additional questions or require further assistance, please do not hesitate to contact one of our professional consultants.

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