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Releasing Medical Records in Chicago Workers’ Compensation Claims

Workers Comp Medical RecordsNo matter how safe we try to be in our daily lives, sometimes accidents happen anyway. We may be able to mitigate certain risks and avoid dangerous situations, but the nature of being alive and having imperfect, relatively fragile bodies means not everything can be prevented. Regardless of our occupations, those accidents can and do happen on company time — and many times, it is the company’s fault.

That is why workers’ compensation exists. It is a way for employees who have been injured or sickened on the job to make sure they do not have to pay for their employers’ negligence, in whatever form that took. These financial awards can be, quite literally, life-saving, but the process of getting them is infamous for being complicated, irritating, and — to the chagrin of most — exposing. Those who embark on workers’ compensation claims have to make peace with the fact that several strangers will be closely reviewing their personal medical records, and they may not even know when it happens.

Understandably, this can be very troubling to many victims. The good news is, a lot of your medical history is protected by the Health Insurance Portability & Accountability Act (HIPAA), so neither your employer nor their doctors can see your entire record.

How HIPAA protects your privacy

Patient-doctor confidentiality is incredibly important, and rightfully so. It is the basis of most healthcare and ensures that patients have as much control as possible over the most intimate details of their bodies. So, when victims find out that submitting a workers’ compensation claim means allowing for the release of their medical records to certain parties, there is usually some hesitation. How does HIPAA, famous for its Privacy Rule making confidentiality exist, allow this?

In simple terms, workers’ compensation is an exception. Medical documents are required to prove whatever injuries or illnesses a victim sustained are legitimate, caused by their job, and caused during the correct time frame — among other things. HIPAA’S disclosure for workers’ compensation is as follows:

The HIPAA Privacy Rule does not apply to entities that are either workers’ compensation insurers, workers’ compensation administrative agencies, or employers, except to the extent they may otherwise be covered entities. However, these entities need access to the health information of individuals who are injured on the job or who have a work-related illness to process or adjudicate claims, or to coordinate care under workers’ compensation systems. Generally, this health information is obtained from health care providers who treat these individuals and who may be covered by the Privacy Rule. The Privacy Rule recognizes the legitimate need of insurers and other entities involved in the workers’ compensation systems to have access to individuals’ health information as authorized by State or other law. Due to the significant variability among such laws, the Privacy Rule permits disclosures of health information for workers’ compensation purposes in a number of different ways.

Exceptions and disclosures like these are incredibly rare within HIPAA, and even as they are, you may notice only very specific entities are exempt. They are still incredibly careful and private with all medical records. In fact, while those entities may be able to see certain records, they are required to share and view as little as reasonably possible.

Can my employer see my medical records if I go on workers’ comp?

No, they cannot. Your employer is not entitled to see your medical records. They can’t even send your records to their insurer without your permission. But your employer’s insurance company can request authorization to look at your records. Luckily, you can legally ask to see the release form ahead of time, to make sure it complies with HIPAA.

Why releasing medical records is necessary in workers’ comp cases

As disconcerting as it may be to view your own health in such an impartial manner, it may help to consider your medical records and documents as pieces of evidence for your case. That is, after all, the role they serve in it. Your medical records include pertinent information such as official diagnoses, doctors’ notes, prescriptions, treatment plans, and more that can all legitimize your claim. Not only is it important to provide credibility, but it also shows what sort of compensation you are eligible for depending on the severity of your injuries and the treatments you require for them.

This carries an extra layer of importance when it comes to any disabilities you may now have as a result of the accident. Depending on your needs, you would receive disability benefits matching them. Typically, those benefits are divided into:

  • Temporary disability where you can ultimately return to work (but you would still receive some compensation for time missed and medical bills).
  • Temporary disability with restrictions, meaning you are able to return to work but require accommodations. Again, you would will receive most lost wages and compensation for your medical bills.
  • Partial permanent disability, where you would generally be entitled to 2/3 of your lost wages for a predetermined amount of time depending on your injuries.
  • Full permanent disability, meaning you are unable to work in any capacity at any occupation, garners 2/3 of lost wages for life.

Your workers’ compensation attorney can go over what you are and are not eligible for, and what you can expect to receive given your individual situation. Nothing is ever guaranteed, of course, but a professional in the law understands your rights and how to fight for them. Not only that, but they know who is liable and how to make sure they do not get away with it. It does not matter if it was an honest mistake if it was still borne from your employer’s negligence.

Do I have to sign the authorization release?

You do, but you can have a lawyer look at it first, if you’re unsure how much information the insurance company will have access to. They can’t ask for anything that isn’t pertinent to your job-related injury. So, if you had your tonsils removed when you were a kid and you break a leg at work in a fall, the insurer can’t ask for anything related to that tonsillectomy.

So if the insurer asks for your entire medical history? Say no, and call a Chicago workers’ compensation lawyer. We can help you with the records release authorization, so that you don’t agree to anything you’re not legally obligated to provide. Even if you are not sure if you would qualify, it costs nothing to talk to an attorney about the logistics of your case — no medical records required. The Chicago workers’ compensation attorneys at Gainsberg Law are here to answer your questions and give you honesty you can trust. For a free, no obligation consultation, call us today at 312-600-9585 or use our contact form.