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HIPA law clarification

Washington |

My workmans compensation case manager wants to acompany me to my next doctor visit. Is this legal?

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Attorney answers 8


It is "legal" in the sense that it is allowed to occur and it happens quite often. However, you don't have to allow it. In my practice, I always inform the case manager that there is to be no contact with client or the treating doctors without my express approval. I do this just because the case manager is an agent of the insurance company/employer and is ultimately not your side.


If you allow them to, they can go to the appointment. And, they do have an ultimate right to get the record for the visit. However, I would not allow them to go to the appointment. Be courteous to the claim manager, however, when saying no. This is a person you do not want to be on the bad side of because they can greatly influence how your claim is handled. If you hire an attorney, you can ask not to be contacted (this is the norm) and your attorney will get all contact from the Department and pass it on to you. Good luck!


In Mass law, when a workers' compensation insurance company assigns a nurse case manager (NCM) to a particular file, the injured worker must provide his or her consent. Provided that the injured worker authorizes the NCM to work on his or her file, then yes, it is perfectly legal. However, if you revoke the authorization, or refuse NCM services, which you are within your rights to do, then the NCM services will end.


I do not practice in your State, so this response is only general information. This situation happens often in my State. A case manager or rehab nurse will show up at your medical appointments to discuss your case with you and the doctor. I advise my clients to tell the case manager that their attorney has advised that they are to inform the case manager that they are not permitted to enter the examination room with you but that they may certainly discuss your case with the doctor on their own. It's hard enough to have time to ask your questions of the doctor without a case manager manipulating the doctor's time during your appointment. There are positive aspects of the involvement of a case manager, such as, they can help schedule appointments sooner at times. I also advise clients that I do not have a problem with their talking with the case manager and they should continue to do so as long as the case manager remains professional in their contact. If a problem arises, usually involving the feeling of harassment or inappropriate opinions expressed, then I have my clients let me know and I notify the case manager that all further communication must go through me.


You do not have to agree to this. To do so constitues a waiver of the doctor-patient privilege because a third party was present during the consultation. Don't do it.


In Florida, this is allowed by statute and rule. You can, in Florida, and at your own expense, hire a court reporter to attend with you to record everything that is said, although often the doctors try to charge for this additional trouble.


HIPPA LAW- requires the patient ,you to sign consent before nurse case mgr. or others review your med. records , or attend your dr. visit . in Georgia, there is a requirement for you to consent to employer /insurer receiving copy of med records, more than 10 days prior to hearing. if no hearing has been requested , then I believe you can refuse to sign consent for co. mgr. to visit with you & dr. further it may be contested whether the HIPPA law ,federal pre-empts the state law ,soon ,in federal court. recommend consult expereienced comp lawyer, member of your state trial lawyer group & a workers comp claimants lawyer ,with trial experience . there may be strategic advantages in consenting & denying consent to be evaluated.


You don't want a camel peaking under your tent! You are entitled to patient - doctor confidentiality.

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