Your Rights Regarding Medical Records Authorization and Workers’ Compensation Claims
The skilled Delaware workers’ compensation attorneys at Silverman, McDonald & Friedman work to protect your right to fair compensation when you have sustained a workplace injury. You are welcome to a free consultation to review your case and answer any questions about your injury at work. Contact us in Wilmington, Seaford or Newark to learn more.
When you apply for Delaware workers’ compensation benefits after a workplace injury, your employer’s insurer will want access to all your medical records. When you are completing the paperwork for your workers’ compensation claim, you are not required to sign a blank medical records release form. This medical records release would allow your employer’s insurer to review all your medical records as part of its investigation, where it will determine if your injury qualifies for workers’ compensation benefits.
Can employers really see my entire health history?
No: your employer cannot see your health history. The insurance company handling workers’ compensation claims, however, can request authorization to your medical records – but only to those records that are relevant to your injury. Why would they need to have access to medical records pertaining to your gall bladder surgery when you injured your foot? They are entitled to all the medical records that pertain only to the workplace injury.
Under the Health Insurance Portability and Accountability Act (HIPAA), “Covered entities are required reasonably to limit the amount of protected health information disclosed under 45 CFR 164.512(l) to the minimum necessary to accomplish the workers’ compensation purpose.”
You can request that the insurer send a specific release which complies with HIPPA regulations, and is limited to requesting medical records which are relevant to your workplace injury and nothing else. The form directs the doctor or healthcare facility to release specific records when you sign it.
The Delaware Industrial Accident Board has the authority to address legitimate health-privacy concerns. So, your lawyer can appeal to the Board if your employer’s insurer is making unnecessary demands for records that exceed the scope required for your workplace injury.
Why does my employer’s insurer want authorization to see all of my medical history?
Ideally, so that they can find a pre-existing condition which would give them enough grounds to deny your claim. If your history indicates that you already had a medical condition, or that you engage in activities or behaviors that could exacerbate a condition unrelated to your work (i.e., if you develop mesothelioma after years of working with asbestos, but you were also a smoker during the time you worked), then the insurer will attempt to use that history to prove your injuries are not work-related.
However, under Delaware’s workers’ compensation laws, you can still claim benefits if your work aggravates a pre-existing condition. For example, if you have asthma, but your boss makes you work in a warehouse filled with dust (and maybe mold) without offering you the proper safety equipment, like face masks or air filters, then you can make a claim for benefits.
If you are encountering difficulties when dealing with your employer’s insurer, and they are demanding medical records that exceed the scope of your workplace injury, an experienced workers’ compensation attorney from Silverman McDonald & Friedman can help to protect your right to keep irrelevant health care records out of the hands of the insurer so that you can maintain as much privacy as possible.
Delaware workers face countless hazards just to do their work each day. The workers’ compensation lawyers at Silverman, McDonald & Friedman, are here to help you get the compensation that you deserve when are injured at work. Please call 302-888-2900 or fill out our contact form to make an appointment for a free consultation at our offices in Wilmington, Newark or Seaford today.
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Attorney Jeffrey S. Friedman joined Silverman, McDonald & Friedman in 2001. He graduated from Widener University School of Law, and is admitted to practice law in Delaware and Pennsylvania, and in several Federal Circuit courts. He areas of concentration include auto accident and workers’ compensation cases. Read more about Attorney Friedman here.