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Privacy Rule impacts the ability to obtain medical information

Self-insured business owners who are dealing with workers’ compensation matters must remember that they have to comply with the requirements of the Health Insurance Portability and Accountability Act. The HIPAA rules have been in place since 1996; however, the Privacy Rule of the act went into effect in April of 2003.

For the purpose of the Privacy Rule, employers aren’t considered covered entities. This means that you can use an employee’s medical information in a customary manner. You should have access to any health information about an employee who filed a workers’ compensation claim as long that information is necessary for the lawful process of handling the claim. Typically, you won’t need a signed authorization from the employee if you’re accessing this type of record but some information is still considered protected, so obtaining a release is often a good practice.

One thing to remember is that you must receive specific health information relevant to the employee’s claim if you’re going to pay the providers who are taking care of the injured worker. A provider who doesn’t hand over the required information won’t have to be paid.

If you need specific information to handle the workers’ compensation case but are unable to get it, you may need to get a subpoena for it. This step might be necessary if you receive the signed authorization for the release of medical information from the employee but are still unable to procure the information you need.

Understanding all the points you need to know about workers’ compensation when you’re a self-insured business owner can be complicated. Working with an attorney who’s familiar with these cases may be beneficial. This gives you the opportunity to have the case checked to ensure that you’re complying with all the laws you must.

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