Hippa and work comp

[Erin RN]

Hi

I recently had a situation which I would like some input on:

I was referred a "possible" comp claim by an employer who lives out of state

The claimant had, had either a stroke while driving long haul or he had a brain tumor. When I initially spoke with the employer she wanted me to go to the ICU (he was vented) and obtain any notes which would determine diagnosis. She gave me the impression that an injury rep would be filled and a claim also filled.

I did as she asked and faxed his notes to her. The notes indicated CVA..this guy had a high risk hx including uncontrolled DM.

When I spoke to her the following week I asked if an injury report had been filled or a claim started and she laughed saying that this injury was not work related but that she wanted more information. I told her I would not be able to do that for her, she became angry and told me to close the file, which I did.

In WA HIPAA does not apply to workers comp and the employer does have the right to any and all med records that relate to the injury which occurred during work hours. I think it is that way everywhere since I have several claimants that have moved here with open claims from other states. I know that MOST MDs would not find a causal relationship between this injury and his job but who knows I have seen stranger things like people who develop chronic illness such as MS or other autoimmune things that even though they would have probably of developed it is concluded that "but not for" their job the symptoms would not be so bad. I would assume that is why the employer didn;t want to file any paperwork. I told her that if it was filed I could get her anything she wanted and that even tho the paperwork was filled it does not mean the claim would be determined to be legit and it would be denied...guess she didn't want to take that chance since the guys prognosis is pretty bleak... so i basically siad if there is no claim you nor I have any right to this gentlemans records period..That really pissed her off

I told my boss about it and educated him to the fact that not only did the hospital breach Hippa by giving me the records I breached it by giving the records to the employer. His take was that I am a middle man so I would not be held accountable..I let him know I did not thnk that would be the case since I am a registered nurse and it is my resp to protect confidentiality. I mean now this guys employer knows he has several chronic illnesses.

My solution was that I told my boss that I would never again take a referral where the initial injury report had not been filed..he was okay with that.

Any comments as to how I handled it or how I could have done it better??? Erin

[Erin RN]

All of those "filled"s..I mean "filed"..oops too early!!

[Sharon]

Erin,

A similar discussion about another CDL driver is occurring on the Duke OEM list serv. The employee was having his post offer physical when elevated blood pressure was noted. The EE was sent to his treating provider the VA, which not only addressed the elevated B/P but also his active substance abuse. Here is the site link http://list.mc.duke.edu/archives/occ-env-med-l.html

In the Dec 2003 list look up the Disclosure of Medical Information wit the most responses.

It was bad of the hospital to disclose the information but by now it maybe a matter of public record. Since he probably held a CDL his medical records will be in the NTSB investigation report. (Remember the Louisiana fatal bus accident in which the driver had a diabetic crisis a few years ago?)

The practical matter is what physician cleared him to drive with all of those disqualifying conditions? Because of the falsification of paperwork (which appears to be criminal) the employer will have more of a right to know but will need to use appropriate methods.

I would be very surprise if any HIPPA violation investigation occurred before all criminal investigation and prosecution as well as the NTSB investigation report was published. Since these usually take over a year, if the injured driver is able to communicate I wouldn't be surprise if the statues of limitations were up before a possible HIPPA incident investigation was done.