Handling employee medical records
State law allows employers to have access to injured employees' medical records so they can see the work restrictions ordered by the physician, which is typically documented on a "Report of Work Ability" form and the basis for them.
Access isn't without limitations, though. An employer must notify an employee in writing every time his physician is contacted to let him know when the doctor was contacted and what was discussed.
It's a good idea to call a physician to get clarification on work restrictions and transitional job tasks, but remember to document everything. You have a right to discuss an injured employee's progress and existing medical data with the physician. Just keep the employee in the loop.
- Keep a separate medical file for an employee. By law, you can't combine medical records with the personnel file.
- Never give medical information to a third party without the employee's written authorization.
- Do not use medical information as grounds to fire or discriminate against an employee. This violates the federal Americans with Disabilities Act, the Minnesota Human Rights Act and the Wisconsin Human Rights Act.
HIPAA's effect on workers' comp
SFM often gets questions from employers about the effects of the Health Insurance Portability and Accountability Act (HIPAA) on workers' compensation.
The general guideline for employers: You have a right to discuss an injured employee's progress and existing medical data, as it relates to the injury, with the physician.
Medical providers sometimes are unclear about the HIPPA law as it applies to workers' compensation and are reluctant to give you the requested information. If you're not getting needed information from a provider, please call your SFM claims representative.
Things to keep in mind about HIPAA and workers' compensation:
- For the most part, HIPAA privacy rules do not apply to workers' compensation claims. Some provisions apply, but only to the workers' compensation insurance company or the self-insured employer, not the general employer.
Prior written or other approval by any party to the claim is not required to obtain medical records and information related to a current workers' compensation claim.
HIPAA privacy rules authorize doctors, hospitals and other health care providers to disclose and release medical records and other personal health care information without a HIPAA authorization form to the extent necessary to comply with state workers' compensation laws.
Nevertheless, many providers will still require a HIPAA authorization form before releasing any records.
Medical records and information related to the current workers' compensation claim must be released to the employee, employer, the insurer and the Minnesota Department of Labor and Industry within seven working days from the date the provider receives a written request to release the information.
A treating physician may be consulted or called by any party to a worker's compensation claim to give testimony regarding a work injury with or without the patient's consent.
However, healthcare providers will generally not release any medical records to Wisconsin insurers or employers without a medical authorization form signed by the employee and in compliance with the "Disclosure of personal medical information" section in the Wisconsin Statute and HIPAA. Wisconsin Form WKC-9488 complies with the requirements of both laws.
Download form WKC-9488 "Voluntary and Informed Consent for Disclosure of Health Care Information" (pdf)
