Medical Release Forms: What Do You Have To Give Your
Employer When You Make A Worker’s Compensation Claim?
By Lester Pines and Genny Gibbs-Benesh
Cullen Weston
Pines & Bach LLP
Increasingly, the WPPA is seeing employers demanding medical information from employees in a variety of situations. In particular, employers are demanding more records than they might be entitled to see in Workers’ Compensation cases. Wis. Stats. § 102.13(2)(a) provides that an employee alleging any work-related injury waives the practitioner-patient privilege. In other words, employers and their insurance carriers1 can gain access to an injured employee’s medical records, even without a signed authorization from the employee.
An employe who reports an injury alleged to be work-related or files an application for hearing waives any physician-patient, psychologist-patient or chiropractor-patient privilege with respect to any condition or complaint reasonably related to the condition for which the employee claims compensation. Notwithstanding ss. 51.30 and 146.82 and any other law, any physician, chiropractor, psychologist, dentist, podiatrist, hospital or health care provider shall, within a reasonable time after written request by the employe, employer, worker’s compensation insurer or department or its representative, provide that person with any information or written material reasonably related to any injury for which the employe claims compensation. [emphasis added]
Despite what the statute says, most health care providers require signed authorization forms to release an employee’s treatment records. Consequently, when an injured employee files a claim for worker’s compensation benefits, it is a common practice for the employer to ask an injured employee to sign an authorization form which authorizes the release of that employee’s medical records so it can analyze the claim and determine if there are any defenses to it. If an employee refuses to provide a signed authorization, the employer can deny the claim alleging that it doesn’t have the information it needs to process the claim. An administrative law judge would more than likely uphold the employer’s denial of benefits on that basis because of 102.13(2)(a).
However, just because an employer has the statutory right to collect the medical records that are reasonably related to the work injury, it does not have carte blanche access to all of an injured employee’s medical records for an indefinite period of time. In an attempt to find defenses to a claim, employers often overstep their right to medical information by requiring an injured employee to sign a “blanket” authorization form that authorizes the release of information not even remotely related to a work injury, e.g. mental health records. Under the statute, an injured employee has the right to limit that access to those medical records that are reasonably related to the injury.
But just how does an injured employee go about restricting access to his/her medical records without interfering with the employer’s right to investigate his/her worker’s comp claim? The key is that an employer has the right only to those medical records that are reasonably related to the claim. Consequently, no employee should ever sign a medical release form that is not addressed to a specific medical provider or one that allows the employer to receive all of the employee’s medical records. Nor should an employee sign a medical release form that gives an employer the names of all of the medical providers with whom he/she has ever consulted.
For example, if the employee suffered a shoulder injury, the employer does not usually have the right to review her mental health records. The employee should restrict the employer’s access to those records having to do with the current injury and any other shoulder or orthopedic injuries. This might require the employee actually to strike out and initial language on the release form provided by the employer or provide her own authorization form. The model authorization form that accompanies this article is a good one to use for this purpose because it protects against the release of “sensitive” records by requiring the employee to give her specific consent for release for these records. The employee also needs to be very specific about which doctors’ records she will release and she should write the individual doctors’ names on separate release forms to prevent authorizing access to an entire clinic or hospital’s records. By following these guidelines, the employee is cooperating with the claims process while still protecting her privacy.
If a dispute arises about the scope of a medical release, it can be resolved through a hearing before an administrative law judge with the Workers’ Compensation Division of the Wisconsin Department of Workforce Development. An employee can request a hearing by filing a Request for Hearing form and attaching a letter to the form describing the dispute. Generally, these kinds of disputes can be negotiated and resolved without a hearing.
As a general rule, WPPA members who suffer work related injuries, including injuries they suffer in automobile accidents, should consult with an attorney, such as those at the WPPA’s retained law firm Cullen Weston Pines & Bach LLP (www.cwpb.com). There are many interrelated issues involving workers’ compensation, duty disability, and personal injury claims that should be handled by lawyers and paralegals who regularly represent law enforcement officers.
1. For purposes of this article, the terms “employer” and “its insurance carrier” are synonymous and will be referred to collectively as “the employer.”
Attachment: Medical Relase Form
