WORKERS' COMPENSATION QUESTIONS

Q. Does an individual have a right under the HIPAA Privacy Rule to restrict the protected health information his or her health care provider discloses for workers' compensation purposes?

A. Individuals do not have a right under the Privacy Rule at 45 CFR 164.522(a) to request that a covered entity restrict a disclosure of protected health information about them for workers’ compensation purposes when that disclosure is required by law or authorized by, and necessary to comply with, a workers’ compensation or similar law. See 45 CFR 164.522(a) and 164.512(a) and (l).



Q. Won't the HIPAA Privacy Rule's minimum necessary standard impede the ability of workers' compensation insurers, State administrative agencies, and employers to obtain the health information needed to pay injured or ill workers the benefits guaranteed them under State workers' compensation system?

A. No. The Privacy Rule is not intended to impede the flow of health information to those who need it to process or adjudicate claims, or coordinate care, for injured or ill workers under workers’ compensation systems.



Q. Does the HIPAA Privacy Rule permit a health care provider to disclose an injured or ill worker's protected health information without his or her authorization when requested for workers’ compensation purposes?

A. Covered entities are permitted to disclose protected health information for such purposes as authorized by, and to the extent necessary to comply with, workers’ compensation law. See 45 CFR 164.512(l). In addition, the Privacy Rule generally permits covered entities to disclose protected health information in the course of any judicial or administrative proceeding in response to a court order, subpoena, or other lawful process. See 45 CFR 164.512(e).



Q. My State law says I may disclose records, relating to the treatment I provided to an injured worker, to a workers' compensation insurer for purposes of determining the amount of or entitlement to payment under the workers' compensation system. Am I allowed to share this information under the HIPAA Privacy Rule?

A. Yes. A covered entity is permitted to disclose an individual’s protected health information as necessary to comply with and to the full extent authorized by workers’ compensation law. See 45 CFR 164.512(l).