Authorization for Release And Use of Medical Information

June 30, 2012 12:41 AM

What happens if I don't return the "Authorization for Release And Use of Medical Information" form for my Worker's Comp claim?

Recently I was injured at work. Nothing big - just a big ol' bruise. But I had to get it checked out.

Now I received a form that says "Authorization for release and use of medical information" from the Worker's Comp administrative company. I don't speak legal, but it sounds like they want access to all my past medical records, forever. It also has checkboxes for HIV, Psychiatric Information, drug/alcohol abuse.

I'm not comfortable returning this - but I also don't have the money to hire a lawyer to review what looks like a form letter.

The cover letter doesn't really say what would happen if I don't return this.

So... I know you don't have a JD, but what would happen if I don't return this?

posted by StrictlyVague to law & government (12 answers total)

Workers comp differs state to state. Can you specify where you are?
posted by amro at 3:23 AM on June 30, 2012

This is a HIPAA thing. Your health care providers aren't allowed to release your medical records to just about anyone without your consent. But your workers' comp carrier needs access to those medical records to figure out what the heck happened to you. They're not just gonna pay a claim because you asked them to; you need to prove the loss (1) happened, (2) happened at work, and (3) was related to your duties there. Without your medical records, you can't do that.

Further, they're not gonna just get one record. For all they know you went to the ED, got admitted, spent two days in the hospital, had images taken by two different labs and bloodwork done in three others. Each of those providers is going to want a release authorization. So rather than have you identify each and every one of your providers up front, they're just getting a blanket form they can use to figure out what happened without you having to spend a few hours on the phone, likely more than once. That's why it's this sort of blanket release: they don't know what they're going to need, and they can't actually find out until you say they can. Hence the form.

But it carefully. I'd bet there's language in there saying that they can't use your information for anything but adjusting your claim and that they can't share this information with anyone else without your consent. That's how these things generally work. My firm sends out these authorization forms every day of the week, and we've got boilerplate to that effect.

So what happens if you don't fill out the form? Odds are decent they deny your claim for refusing to cooperate with the investigation to which they are entitled.

IAAL, and even though IANYL, this is pretty basic stuff. Just fill out the damned form.
posted by valkyryn at 4:09 AM on June 30, 2012 [2 favorites]

Each person's history and each person's injury are different. In many cases, the history may be irrelevant to the injury. Yours may be one of them. But the insurer cannot tell until its claims people look at the records. And the form has to cover everyone. That necessarily means overinclusiveness.

JFOTDF.
posted by yclipse at 5:20 AM on June 30, 2012

You can always alter forms. They might or might not accept it, but you could create a limited time period, for example, like 6 months.

As valkyryn says, this is totally routine, but if you feel like altering it or otherwise asking for a limitation, you should.
posted by mercredi at 5:35 AM on June 30, 2012 [1 favorite]

I have a hard time buying that the worker's comp folks need to know the OP's HIV status, or whether he's sought psychiatric treatment, in order to confirm that he bruised himself.

This seems way overly intrusive to me, and I would not play ball. I've had good luck before with crossing out and initialing items on forms that I didn't consent to. I've done this in the home-buying/selling process and in employment contracts (with regard to drug testing). I'd do it here too. If they insist that they need carte blanche, I'd seriously question whether what sounds like a small amount of money is worth compromising my feeling of privacy and security.
posted by parrot_person at 6:13 AM on June 30, 2012 [2 favorites]

As stated above, this question can't be answered without knowing the applicable state; workers' comp law is statutory state law.

It is entirely possible [and, given the financial incentive of the insurer, likely] that a refusal to return the medical release or your alternation of the release will give the insurer an excuse to deny your claims. I'd find this out before you refuse to sign or alter the form. Why don't you call the administrative company handling the claim and ask them?
posted by seventyfour at 6:27 AM on June 30, 2012

Oh, I just noticed that the claim was for a bruise, not a major injury. In that case, getting your claim denied may not matter much. However, check and be sure that your employer doesn't have some clause requiring cooperation re workers comp claims.
posted by seventyfour at 6:30 AM on June 30, 2012

Sign the form. Just don't check those boxes.
posted by SMPA at 8:25 AM on June 30, 2012

I missed the part where there was any claim being made. No claim, why any questions, much less irrelevant intrusive ones like HIV status?
posted by Goofyy at 11:47 AM on June 30, 2012

If it has specific checkboxes, definitely leave the ones you don't want investigated unchecked.

If you aren't interested in pursuing a claim, don't return it.

But if you're worried you might need it investigated at a later point (depending on the size of the bruise?) you might want to check any boxes that are related to the work injury. If there's a note area, put a time limit on it, and maybe even include that they can only release information related to the injury that you saw your doctor for on X/XX/XX and follow-ups.
posted by Lt. Bunny Wigglesworth at 12:44 PM on June 30, 2012

>Workers comp differs state to state. Can you specify where you are?

I'm in California.


To provide more context, I've seen a doctor and gotten physical therapy for this injury. (I hit a joint :() So, there's definitely a claim.
posted by StrictlyVague at 3:27 PM on June 30, 2012

So, there's definitely a claim.

Well you know that, but until you fill out and return the form, your workers' comp carrier doesn't and can't.
posted by valkyryn at 7:30 AM on July 2, 2012