Do I Have to Sign the Medical Release the Workers Comp Adjuster Told Me to Sign?

Do I Have to Sign the Medical Release the Workers Comp Adjuster Told Me to Sign?

After reporting a work injury in Alabama, you may receive a medical authorization or medical release from the workers’ compensation insurance adjuster. You may even be told that you have to sign it before your claim can move forward.

But do you have to sign the particular release the insurance company gives you?

Not necessarily.

An injured worker does have important obligations to cooperate with reasonable medical examinations and the disclosure of medical information relevant to a workers’ compensation claim, but that does not necessarily mean that an insurance company is entitled to have you sign an unlimited medical authorization giving it access to every medical record you have ever had—including highly sensitive information having nothing to do with your work injury.

What Medical Information Is the Workers’ Compensation Carrier Entitled to Receive?

Alabama’s Workers’ Compensation Act gives employers significant rights to obtain medical information concerning an injured employee.  Under Ala. Code § 25-5-77(b), an injured employee must submit to an examination by the employer’s physician at reasonable times. If an employee refuses a reasonable request for an examination, or refuses medical services or physical rehabilitation the employer elects to furnish, the employee’s right to compensation may be suspended during the period of the refusal.

The same statute also addresses medical information. A physician who treats or examines the injured employee may be required to testify concerning information obtained during treatment or examination as it relates to the injury or the disability arising from it.

Section 25-5-77(b) further provides that, upon written request by either the employee or employer, a hospital, medical clinic, rehabilitation service, or other treatment provider must furnish copies of records, X-rays, and laboratory reports relating to the treatment of the injured employee.

In other words, filing a workers’ compensation claim does require you to give up some degree of medical privacy. The employer and its insurance company have a legitimate need to investigate questions such as:

• What injury did you suffer?
• Is the condition related to your employment?
• What treatment is reasonably necessary?
• Are your present symptoms related to the work injury?
• Do you have a preexisting condition affecting the same part of your body?
• What are your physical restrictions?
• When can you return to work?
• Have you reached maximum medical improvement?
• Do you have a permanent impairment or disability?

Those are legitimate workers’ compensation issues, but there is an important difference between allowing access to medical information that is relevant to your claim and signing an authorization that potentially opens your entire medical history to the insurance company.

Recommended Reading: Can I See My Own Doctor after Suffering a Job Injury?

What If the Release Is Much Broader Than Your Work Injury?

This is where injured employees should pay particular attention to what they are being asked to sign.

Some medical releases contain language specifically authorizing disclosure of records concerning matters such as:

HIV or AIDS testing and treatment; sexually transmitted diseases; psychiatric or psychological treatment; psychotherapy records or notes; alcohol or substance-abuse treatment; genetic information; or other particularly sensitive medical conditions.

Suppose you injured your knee at work. Does the insurance company automatically need records concerning HIV treatment from ten years ago?

Suppose you injured your shoulder. Does the adjuster automatically need the notes from counseling you received following a divorce years earlier?

Those are very different questions from whether the carrier is entitled to obtain prior orthopedic records showing that you previously injured the same knee or shoulder.  The fact that you filed a workers’ compensation claim does not mean that every aspect of your medical history automatically becomes relevant.

Doesn’t HIPAA Protect My Medical Records?

Yes—but HIPAA does not prevent workers’ compensation carriers from obtaining medical information they are legally entitled to receive.

The federal HIPAA Privacy Rule specifically recognizes workers’ compensation systems. Health-care providers may disclose protected health information without the employee’s authorization when the disclosure is authorized by workers’ compensation law and is necessary for workers’ compensation purposes. See 45 C.F.R. § 164.512(l). The U.S. Department of Health and Human Services explains that HIPAA was not intended to prevent employers, insurers, and workers’ compensation administrators from obtaining the medical information necessary to process and adjudicate workers’ compensation claims.

That is why simply telling the adjuster, “HIPAA says you cannot have my medical records,” is generally not correct, but the opposite statement—“Because this is workers’ compensation, HIPAA gives us the right to everything”—is also too broad.

HHS explains that disclosures made under the workers’ compensation exception are permitted to the extent authorized by workers’ compensation law and that, when applicable, covered health-care entities generally must limit disclosures to the minimum necessary for the workers’ compensation purpose.

What About Psychological or Psychiatric Records?

Psychological and psychiatric records deserve special attention because Alabama law provides them with protections beyond those generally applicable to ordinary medical records.

Under Ala. Code § 34-26-2, confidential communications between a patient and a licensed psychologist, licensed psychiatrist, or licensed psychological technician are protected by a specific statutory privilege. In fact, Alabama law places these confidential relationships and communications “upon the same basis as those provided by law between attorney and client.”

That is a significant protection.

The Alabama Supreme Court has held that the privilege extends to medical records created as part of the psychiatrist-patient relationship. Ex parte Western Mental Health Center, 884 So. 2d 835 (Ala. 2003). Here, the Court has also held that a person does not automatically waive this privilege simply by filing a lawsuit and claiming mental anguish or emotional distress.

So, if you injured your knee, shoulder, or back at work, the fact that you previously received counseling or psychiatric treatment does not necessarily give the workers’ compensation adjuster the right to obtain those records.  This is particularly important when reviewing a broad medical authorization.

If the authorization specifically states that you are consenting to the release of psychiatric, psychological, counseling, or other mental-health records, signing it could potentially authorize disclosure of information that the insurance carrier might not otherwise be entitled to obtain.

There may, of course, be circumstances in which mental-health information becomes relevant to a workers’ compensation claim. For example, an employee may specifically claim a compensable psychological injury arising from the work accident. Whether particular records are privileged, whether the privilege has been waived, and whether an exception applies can depend upon the facts of the particular case-but an injured worker should not assume that filing a workers’ compensation claim automatically gives the insurance company unrestricted access to his or her psychological or psychiatric history.

This is another reason to read a medical release carefully before signing it. There is an important difference between cooperating with the employer’s legitimate right to obtain medical information concerning your work injury and voluntarily signing a broad authorization that may waive important rights concerning highly confidential mental-health information.

Should I Simply Refuse to Sign Any Medical Release?

Usually, that is not the best approach either.

An injured worker has a duty to cooperate with legitimate medical investigation of the workers’ compensation claim. Alabama law expressly permits employers to obtain relevant treatment records and requires employees to submit to reasonable examinations. An unreasonable refusal to cooperate with an examination or authorized treatment can have serious consequences, including suspension of compensation under § 25-5-77(b).

The better question is often not: “Do I have to sign a medical release?”

Instead, it is: “Do I have to sign this particular medical release, written this broadly?”

Those are two very different questions.

Depending upon the circumstances, an employee may be able to provide an appropriately limited authorization that permits the carrier to obtain information reasonably related to the work injury while objecting to provisions authorizing indiscriminate access to unrelated and highly sensitive medical information.

Recommended Reading: What to Do If You Suffer a Work-Related Injury in Alabama

Don’t Sign Something You Don’t Understand

A workers’ compensation adjuster works for the insurance company—not for you.

That does not mean that every request an adjuster makes is improper. Insurance carriers have legitimate rights under Alabama law to investigate claims, obtain relevant medical information, and determine whether requested treatment and benefits are related to the work injury.

But you should understand what you are signing.

Before signing a broad medical authorization, look at what it actually permits the insurance company to obtain. Does it cover records related to the body part you injured and conditions that could reasonably affect your claim? Or does it authorize the release of virtually every medical record concerning every condition you have ever had?

Pay particular attention if the release specifically mentions HIV/AIDS, sexually transmitted diseases, psychiatric or psychological treatment, psychotherapy notes, substance-abuse treatment, genetic information, or other highly sensitive medical information.

The workers’ compensation carrier may have a legitimate right to some of that information in a particular case. But the fact that you suffered an injury at work does not, by itself, mean that every private medical condition you have ever experienced is relevant to your workers’ compensation claim.

Recommended Reading: Common Mistakes You Can Make in Your Alabama Workers’ Compensation Claim

The important point is not to obstruct legitimate workers’ compensation medical discovery. It is to make sure that the information being requested bears a legitimate relationship to the claim

At Powell & Denny, P.C., we have extensive experience representing injured workers-so if you have questions about your rights after suffering an on-the-job injury in Alabama, don’t hesitate to contact and speak with one of the experienced  attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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