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  1. #1
    Join Date
    May 2019
    Posts
    2

    Default Medical Files

    My workers comp case was filed in Oklahoma.
    I'm under the impression my employer has somehow gotten my FCE and or medical files. Are they supposed to have access to that? I thought hippa laws prevented the sharing of my files without consent. I dont have anything to hide but they are trying to play dr and Its the exact opposite of what my dr has ordered.
    Last edited by Seeker28; 05-17-2019 at 06:24 PM. Reason: Need to list state

  2. #2
    Join Date
    Oct 1971
    Posts
    4,992

    Default Re: Medical Files

    That FCE is to establish your physical limitations or capacity, they need that report to determine if they accommodate your restrictions.
    Also they do get the monthly doctor report stating your work status or retsrictions.

    Tony
    Last edited by tony; 05-20-2019 at 03:12 PM.
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    May 2019
    Posts
    2

    Default Re: Medical Files

    I guess I was under the impression that we needed to go by the Drs orders. The Dr stated that he uses the fce to decide what my restrictions are so I just dont see why they need the full fce report. I know I had to go down and show ID to get a copy.

  4. #4
    Join Date
    Oct 1971
    Posts
    4,992

    Default Re: Medical Files

    Quote Quoting Seeker28 View Post
    I guess I was under the impression that we needed to go by the Drs orders. The Dr stated that he uses the fce to decide what my restrictions are so I just dont see why they need the full fce report. I know I had to go down and show ID to get a copy.
    Technically, the carrier is excluded from the protections afforded by Hippa, they are entitled to all medical records needed to expedite your claim - they can share info needed to accommodate your restrictions to the employer.
    The doctor gives general restrictions, the FCE report gives specific limitations and capabilities to determine your job duties.

    HIPPA And Your Medical Records by Linda Nee
    March 30, 2012 by lindane
    The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996 and was intended to protect health insurance coverage for workers and their families when members changed jobs; and establishes security protections for the submission of electronic health care transactions involving health insurance plans and employers.
    Title II, known as the Administrative Simplification (AS) addresses the security and privacy of health data by setting standards for electronic submission of patient medical data.

    Unfortunately, the AS also specifically excludes disability insurers from being defined as “a covered entity” or “health plan” any policy, plan or program to the extent it provides or pays for the cost of, expected benefits i.e. coverage only for accident or disability income insurance.”
    Also excluded are:
    Coverage only for accident, or disability income insurance, or any combination thereof.
    Coverage issued as a supplement to liability insurance.
    Liability insurance, including general liability insurance and automobile liability insurance.
    Workers’ compensation or similar insurance.
    Automobile medical payment insurance.
    Credit-only insurance.
    Coverage for on-site medical clinics.
    Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.
    https://lindanee.wordpress.com/2012/...-by-linda-nee/

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  5. #5
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,745

    Default Re: Medical Files

    HIPAA does not apply to work comp claims. And in any legal proceeding, work comp, personal injury, etc., in which you put your medical condition in issue, the other party will be entitled to have all of your medical records. The only difference is how they go about getting them.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

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