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Do I Need to Disclose My Medical Records in a Workers’ Compensation Claim?

May 31, 2018

Workers’ compensation claims can be confusing and frustrating. We have worked with a lot of clients in the past that didn’t know the exact route to take once they had filed a claim. It gets even more complicated when your claim is denied and you have to file an appeal. Over the thousands of workers’ compensation cases that we have reviewed, one of the most frequent questions that we get is “Do I need to disclose my medical records in a worker’s compensation claim?”

When initially filing a claim, you may be required to disclose medical records from your doctor (or doctors) to your company’s workers’ compensation insurance company. Obviously, this can feel like an invasion of privacy, and can lead to distrust between you and your company. That being said, your company will typically ask for these records simply to validate the symptoms in your current claim are not pre-existing.

Do I need to disclose my medical records?

The short answer is yes. You will need to disclose medical records to your employer if you file a workers’ compensation claim.

Luckily, there are federal laws in place to help protect your privacy as an employee. While your employer can request the medical records related to your claim, they cannot force you to disclose sensitive medical information beyond that. We work with these laws all the time and have referenced them in many cases. For your own benefit, it would be good to familiarize yourself with the basics.

The Health Insurance Portability and Accountability Act (HIPPA)

You’ve likely heard of this law before because it governs patient privacy and medical records disclosure for all health organizations. This law places restrictions on how medical records are distributed, however, workers’ compensation claims are exempt from HIPPA rules. The HIPPA Privacy Rule permits the disclosure of health information for workers’ compensation without individual authorization, however, covered entities are required. This means that the request for medical records only needs to meet the minimum required information to satisfy your claim.

The Drug Abuse Treatment and Rehabilitation Act and the Comprehensive Alcohol and Alcoholism Prevention, Treatment and Rehabilitation Act, protect employee privacy related to substance abuse treatment.

It’s important to keep in mind that your employer’s access to your medical records is vital when validating your workers’ compensation claim. We certainly understand how the request can create tension between the two parties, but medical reviews are necessary when getting a claim approved on first pass. When working with an experienced attorney, these options will always be presented to you to make sure you can maximize your benefit.

At Tabak Law, we have many years of experience helping individuals obtain the workers’ compensation benefits they are entitled to. For a completely free evaluation of your situation, please call us at 844-432-0114 or fill out the simple form below.







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