Help!Do I have to disclose my medical records?what about hippa?

nursecat64 · Jan 19, 2012

I need to know ASAP as the test is this Friday. Thanks!!

Esme12, ASN, BSN, RN · Jan 19, 2012

I would talk to a disability, employment lawyer ASAP. There are very fine lines they need to walk without discriminating.

The Americans with Disabilities Act (ADA) is a federal law that prohibits discrimination against individuals with disabilities. Title I of the ADA covers employment by private employers with 15 or more employees as well as state and local government employers of the same size. Section 501 of the Rehabilitation Act provides the same protections for federal employees and applicants for federal employment.

The ADA protects a qualified individual with a disability from disparate treatment or harassment based on disability, and also provides that, absent undue hardship, a qualified individual with a disability is entitled to reasonable accommodation to perform, or apply for, a job or to enjoy the benefits and privileges of employment.

The ADA also includes rules regarding when, and to what extent, employers may seek medical information from applicants or employees. The U.S. Equal Employment Opportunity Commission (EEOC) enforces the employment provisions of the ADA. http://www.ada.gov/ Most states also have their own laws prohibiting employment discrimination on the basis of disability. Some of these laws may apply to smaller employers and provide protections in addition to those available under the ADA.

http://www.eeoc.gov/facts/health_care_workers.html

Then it's HIPAA Health Insurance Portability and Accountability Act of 1996. It's all about permission. If you are bringing them your records you are giving permission. So HIPAA is not an issue here.

:loveya:I hope this helps.

nursecat64 · Jan 19, 2012

Thank you for the reply and the links:) What I want to know is what will happen if I don"t bring my records to the appt. and ask for an evaluation based on what they see. When I called and asked that question, they said records were required for an evaluation. I feel like I'm wearing a tag! I know for a fact that MD's do much of their judging based on history. I know even I do- you paint a picture of your patient in your mind based on past history and current medications. I have a lot of stamina and a strong work ethic (despite a disability) I worked 12 hour shifts on a busy med/surg floor until 2 days before I gave birth at almost 40 years old!(not easy) but if you look at my health history and medication list you would be doubtful on whether I could do the job. The question I had about HIPPA is that the results of my drug screen are negative, but since the same company that does the drug screen is also the one that recommends and does the 'fit for duty" testing- they know some of my medications because I had to list them for the drug screen. It seems to me I should be able to have an evaluation that is completely unbiased. My stomachs in knots about this:uhoh3:

CrunchRN, ADN, RN · Jan 19, 2012

I would thnk at this point you have to disclose as they know you take some meds even though they aren't the ones on the alert list.

Just emphasize that you take the meds when not on duty and that you are physically and mentally able to perform as per job description.

If you lie or omit now it will come back and bite you in the butt when you least expect it and you will always have to worry about it until it does.

morte, LPN, LVN · Jan 19, 2012

This is why the drug list should not be submitted with the testing. If they find something, then provide script for med.

And I think that another entity should be doing the "fit for work" testing....what ever the heck that is, over and above an ordinary physical.

llg, PhD, RN · Jan 19, 2012

You were right to be honest from the beginning. That's the only way you will ever have a leg to stand on should you run into problems later. To lie or hide only guarantees that you will lose in the long run should your lie ever be discovered. Lying shows that you can't be trusted -- and no employer would ever want to hire someone they can't trust.

So sleep well knowing you have done the right thing -- and let the situation evolve as it will.

If you really want the job, comply with their requirement to allow your medical records to be reviewed. If you don't, you'll forfeit the job -- and send them a message that you have something to be ashamed of -- something so bad and so compromising of your abilities that you wouldn't even let them know about it. They will be happy you took yourself out of the running and that they won't have to deal with anything complicated or sensitive. What good will that do anybody?

morte, LPN, LVN · Jan 19, 2012

but it shouldn't have come up in the first place...

Esme12, ASN, BSN, RN · Jan 19, 2012

Thank you for the reply and the links:) What I want to know is what will happen if I don"t bring my records to the appt. and ask for an evaluation based on what they see. When I called and asked that question, they said records were required for an evaluation. I feel like I'm wearing a tag! I know for a fact that MD's do much of their judging based on history. I know even I do- you paint a picture of your patient in your mind based on past history and current medications. I have a lot of stamina and a strong work ethic (despite a disability) I worked 12 hour shifts on a busy med/surg floor until 2 days before I gave birth at almost 40 years old!(not easy) but if you look at my health history and medication list you would be doubtful on whether I could do the job. The question I had about HIPPA is that the results of my drug screen are negative, but since the same company that does the drug screen is also the one that recommends and does the 'fit for duty" testing- they know some of my medications because I had to list them for the drug screen. It seems to me I should be able to have an evaluation that is completely unbiased. My stomachs in knots about this:uhoh3:

Disability & Medical Exams During Employment Application & Interview Stage The law places strict limits on employers when it comes to asking job applicants to answer medical questions, take a medical exam, or identify a disability.

For example, an employer may not ask a job applicant to answer medical questions or take a medical exam before extending a job offer. An employer also may not ask job applicants if they have a disability (or about the nature of an obvious disability). An employer may ask job applicants whether they can perform the job and how they would perform the job, with or without a reasonable accommodation.

Disability & Medical Exams After A Job Offer For Employment After a job is offered to an applicant, the law allows an employer to condition the job offer on the applicant answering certain medical questions or successfully passing a medical exam, but only if all new employees in the same type of job have to answer the questions or take the exam.

Disability & Medical Exams For Persons Who Have Started Working As Employees Once a person is hired and has started work, an employer generally can only ask medical questions or require a medical exam if the employer needs medical documentation to support an employee's request for an accommodation or if the employer believes that an employee is not able to perform a job successfully or safely because of a medical condition.

The law also requires that employers keep all medical records and information confidential and in separate medical files.

Available Resources

In addition to a variety of formal guidance documents, EEOC has developed a wide range of fact sheets, question & answer documents, and other publications to help employees and employers understand the complex issues surrounding disability discrimination.

http://www.eeoc.gov/laws/types/disability.cfm

Disclosing, Assessing, Using, and Disclosing Medical Information The ADA strictly limits an employer's access to and use of medical information about applicants and employees.[41] How much information the employer may obtain, and under what circumstances, depends on the stage of the employment relationship. The ADA rules regarding "disability-related inquiries" (questions that are likely to elicit information about a disability) and medical examinations and the confidentiality of medical information, apply to all applicants and employees, whether or not they are individuals with disabilities.[

http://www.eeoc.gov/facts/health_care_workers.html

You really need to seek legal advice or contact the ADA/EEOC itself. I wish you the very best!! PM me with specific questions if you wish.....I have an auto-immune disorder that has me disabled but I forught for years to remin employed.

fiveofpeep · Jan 19, 2012

They are only going to want to see that you can do the job. You can leave your records in the car, so you don't have them with you but can access them if you must. From my experience, they just wanted to make sure I could meet the lifting requirements and I had percocet on my drug test and we all know how that looks.

nurseprnRN, BSN, RN · Jan 19, 2012

i don't see anything in the material esme posted that should give you pause. in particular, this should reassure you:

"the ada rules regarding "disability-related inquiries" (questions that are likely to elicit information about a disability) and medical examinations and the confidentiality of medical information, apply to all applicants and employees (my emphasis), whether or not they are individuals with disabilities."

the only report your employer will see from the physician/np who looks at your records and examines you is whether you are fit for duty at the position for which you have been conditionally accepted. your employer will not see your medical records per se; your coworkers or supervisors will not konw what medications you take or what your medical history is unless you choose to tell them.

wooh, BSN, RN · Jan 20, 2012

It sounds like you TOLD them you took a prescription drug, you tested positive for this drug and now you have to PROVE that you have a PRESCRIPTION. They can't just take your word for it. Because if they did just take your word for it, and you WERE obtaining the drugs illegally, then wouldn't you just say before the drug test, "Oh yeah, I'm on marinol and oxy."???