Medical Privacy is Your Concern - Keep It That Way

Saturday, August 3, 2002 | 0

While most people think that only medical information that is relevant to the condition for which workers' compensation benefits are being provided are discoverable by the insurance company, in fact the standard is much broader.

Once you bring a workers' compensation claim, any medical information that may lead to the discovery of relevant medical information can be discovered and obtained by the insurance company. Thus, the standard is very broad. What this means is that records from a doctor's visit for a cold or the flu may be discovered by the insurance company even though your work comp claim is for a back injury. Why? Because a common symptom for the flu is back aches (even though this is misdiagnosed and is typically kidney pain from dehydration).

You must understand that what's said inside a doctor's office will leave the room unless you're paying for the visit with cash. In order for a doctor to get paid by the insurance company (work comp or general medical) he has to transmit your personal medical information to the insurance company because the insurance company has to decide whether the condition and the treatment are covered by the insurance policy. Thus, your office visit typically includes a consent form for billing purposes. At that point, doctor-patient confidentiality is compromised. The doctor must disclose information about the visit so that the health insurer will cover the costs. Further, once the information goes to the insurer it leaves the protection of federal rules and regulations and becomes the domain of state law.

While the Equal Employment Opportunity Commission has brought charges in a public way against businesses that asked for a worker's medical history on job applications, kept employee medical records with personnel records or denied a person a job because of a disability, more often than not illegal discrimination under the Americans with Disabilities Act and other laws the protect injured workers against adverse employment decisions can and will happen.

A University of Illinois study in 1996 found that 35 percent of 84 Fortune 500 companies surveyed accessed medical records to make employment decisions. Businesses can legitimately review employees' medical records if it's necessary for screening to ensure physical ability to perform a job and public safety. For example, aircraft pilots are usually required to take psychological exams. Police officers are often required to have physicals. Truck drivers may have to take vision tests. The Americans with Disabilities Act requires that medical exams for employment be required of all workers in order to be legal.

Health care privacy is an extremely difficult area because it necessarily requires a compromise between the patients privacy rights, and the need to ensure public safety and make public health care as effective as possible. What this means is that it is up to you, the patient, to safeguard your medical privacy by disclosing to the physician only what is absolutely necessary for the evaluation and treatment of your condition, be it industrial or other causation.

Frankly the best way to protect your medical information is to see a doctor not covered under your company's health plan and pay for the visit with cash. If this isn't an affordable option, you can also edit the consent form to specify what information can be passed to whom. Unfortunately the problem with editing the consent form is that most medical office personnel don't know what to do with an edited form and it may be ignored anyhow.

Some other tips for protecting your medical information are: - Get your medical records and check them for mistakes, which unfortunately are way too common.
- Review your company's privacy policy.
- Find out who in your company has access to your medical records.
- Ask your employer if medical records are stored with personnel files (it's illegal under the Americans with Disabilities Act.)
- Ask your health care physician about his or her privacy policies.
- Ask to review the medical information on file with your physician. - Request the same information from the health insurance companies.

Your privacy is your concern - keep it that way.