HIPAA and the Release of Workers’ Compensation Records
June 2012By definition, The Health Insurance Portability and Accountability Act (HIPPA) of 1996 Privacy and Security Rules provide federal protections for personal health information. However, medical providers are frequently confused by the requirements when it comes to the exchange of medical records for workers’ compensation treatment.
(1) Standard: Disclosures for workers’ compensation. A covered entity may disclose protected health information as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.
Colorado law, Colo. Rev. Stat. §8-47-203, further explains:
Access to files, records, and orders. (1) Notwithstanding the provisions of section 8-47-202, the filing of a claim for compensation is deemed to be a limited waiver of the doctor-patient privilege to persons who are necessary to resolve the claim.
A medical provider is not required to obtain a medical release in order to provide medical information related to the workers’ compensation claim to persons who are necessary to resolve the claim. In general, the persons necessary to resolve the claim and to whom medical records should be released when requested are:
- The patient/injured worker
- The payer or insurance carrier
- The employer as stated on form WC-164 (mental health records should not be released)
- Attorneys representing the injured worker
- The Division of Workers’ Compensation
- Other medical advisors or medical examiners
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