Minnesota Workers’ Compensation and Medical Records

One aspect of a Workers’ Compensation claim for benefits which causes concern for many workers who become injured on the job revolves around the release of medical records in Minnesota. We often hear questions such as: What information can the Workers’ Compensation carrier get from my doctor? How far back in my medical history can they go? Do I have to give Workers’ Compensation all of my medical records? What are considered related medical records?

The answer to these questions is fairly straightforward. The standard of discovery under Minnesota law is that employees who file a claim petition must divulge information “for injuries or conditions identical or related to those alleged in the petition.” In theory, it would seem this rule limits access to your medical records strictly to those dealing directly with your work injury. In practice, however, insurance carriers have managed to stretch the definition of “related” to encompass nearly your entire medical history. In other words, if it is in a medical record somewhere, chances are your Workers’ Compensation carrier will eventually gain access to it.

The rationale advanced by the insurance industry – and adopted by the courts – for their thorough and intrusive approach is that insurance carriers are entitled to your entire past medical history to ensure that your work injury is, in fact, their liability. In other words, insurance companies want to make sure that no other cause exists for your injury, which would ultimately relieve them of any liability. To that extent, Workers’ Compensation insurance carriers have convinced the courts that access to basically your entire medical record is the only way to ensure they have all the information they need to defend a claim.

Your Right to Protect Your Medical Information

You do have the right to protect your medical information under federal HIPAA laws, and certain types of medical information are more privileged than others in a Workers’ Compensation claim. The medical privilege doctrine generally provides that no patient is required to disclose any medical information to third parties without that patient’s consent. And your treating doctor is also prohibited, by law, from disclosing any information without your written consent.

Even if you have been receiving Workers’ Compensation payments, the insurance company may ask for a release of medical information and have you sign authorizations giving them access to your medical records. Most injured workers sign the authorizations.

However, some injured workers choose not to sign. You can do that, simply deny the insurance company access to your records at any point. They are your records, after all, and they are protected. But this type of blanket denial of access to the insurer almost certainly will result in your Workers’ Compensation benefits being denied, either through the insurance carrier’s claim denial or a judge’s dismissal of the claim petition for failure to comply with discovery.

A more practical approach is to limit the scope of information disclosed to the carrier. In many cases, sensitive information contained in your medical records will not be considered relevant to a Workers’ Compensation claim. Say you injured your knee at work, for example; absent any other facts, there is no reasonable basis for the carrier then to go digging through your records involving issues like chemical dependency, mental health, or genetic testing. Such sensitive and personal information is simply not relevant – or “related,” to use the statutory language – to the knee injury, and a judge likely will not compel its discovery in this circumstance.

Workers’ Compensation and Disclosure of Medical Records

Most medical authorizations that Workers’ Compensation insurance carriers impose upon employees are either blanket authorizations allowing access to all medical records at a certain provider, or an itemized authorization that explicitly includes access to sensitive and personal records.

You can cross off the sensitive areas on medical authorizations that you want to remain protected – like mental health, chemical dependency, genetic testing, etc. On blanket authorizations, amend them to clearly indicate that you do not want these types of records released. Usually, that is the end of it. The carrier gains access to your relevant past and recent records for your knee injury, the sensitive information remains protected by medical privilege, and the claim moves forward.

Often, insurance companies still want access to sensitive records, and they sometimes will go to great lengths to get them. The main reason insurers want this information is to dig up the “dirt” on the employee so they can try to undermine the employee’s credibility and seemingly strengthen their defense against the claim. Other times, carriers will have a legitimate, related reason for acquiring these records, such as in determining whether a course of prescribed narcotic pain medication should be approved.

Whatever the reason, the default for insurance carriers is always to request the sensitive information, and not the opposite. Remember whom your adjuster is working for and be as vigilant as possible. This may be the point where having a Workers’ Compensation attorney by your side becomes crucial. We can help you understand your legal options and what you can do to protect your private medical information.

Sometimes, disclosure of sensitive records will be impossible to avoid if you wish to maintain your Workers’ Compensation claim. Some medical providers do not accept “redacted” authorizations, which then requires the employee to sign a blanket authorization for all records at the provider.

The most common circumstance where employees will be required to waive their medical privilege on sensitive records is when the claim brings into issue exactly the types of treatment the employee would normally protect from view. Any claim involving traumatic brain injury or post-traumatic stress disorder, for instance, will invariably require the employee to release mental-health records. A good-faith defense arguing against the reasonableness and necessity of pain medication will likely require the release of chemical dependency records.

Can Workers’ Compensation request medical information directly from my doctor?

One thing insurance carriers cannot do is personally contact your doctor. If done without your permission, this conduct violates the confidential physician-patient relationship and can result in serious consequences for the violator. Carriers and adjusters attempt to subvert this privilege, however, by slipping language into authorizations that allow them to contact your treatment providers personally.

Do not sign forms with, or otherwise agree to this language. Because the courts recognize the necessity of maintaining the inviolability of the physician-patient privilege, almost never would your doctor be compelled to speak to an insurance adjuster in a Workers’ Compensation claim. So for the last time: seek out this language in that pile of authorizations and get rid of it. Nothing good can come from a carrier talking to your doctor.

What if I choose not to give Workers’ Compensation all of my medical records?

While you can prevent Workers’ Compensation from accessing certain medical records, you should be cautious about asserting your medical privilege. For example, say you had an MRI on that injured knee and it came up negative. It would not make much sense to grant access to the doctor’s notes that said you had a knee injury, but then try to prevent access to the MRI results that indicate you may not. A judge would compel disclosure in this instance and would not look too kindly on an employee who used an obstructive tactic like this. In the long run, it would not pay off.

The bottom line on your medical records, and the advice we give our clients, is not to worry about it too much. If you are trying to claim Workers’ Compensation benefits, the insurance carrier will ultimately gain access to most of the records they want because most of your records are deemed “relevant” to your injury anyway.

It does not pay to block that access, particularly on a denied claim, because it just delays payment to you for a longer period of time, if not entirely. Much of the time medical records and authorizations are not an issue at all in Workers’ Compensation claims. You have an injury, and the insurance carrier has a right to see your records before they pay for treatment and benefits.

If you are still unsure or have questions about access to medical records, please contact the attorneys at Fields Law. It always pays to know your options, and we are happy to offer a free Workers’ Compensation case review and answer any questions you might have.