Workers Compensation

I was asked to evaluate an employee for a worker’s compensation claim. Is information from that visit protected by the doctor-patient privilege?

No. An employee who reports an injury alleged to be work-related waives any physician-patient or psychologist-patient privilege with respect to any condition or complaint reasonably related to the condition which the employee claims was caused by the work-related injury.  Absent employee consent, the privilege still applies to conditions or complaints not reasonably related to the work injury.

What if the employee was my patient before the alleged injury occurred? Is information from prior visits still protected by the doctor-patient privilege?

Yes, to the extent that information is not reasonably related to the condition which the employee claims was caused by the work-related injury. For example, take an employee who hurt her leg in a slip and fall in the course of her employment. You treated the same employee previously for chronic UTIs from which the employee no longer suffers. The information about this employee’s UTIs is protected by doctor-patient privilege because it is unrelated to the leg injury in that the UTIs did not cause nor are a symptom of the injury which is the basis of the worker’s compensation claim. You should not disclose information about the UTIs absent consent from the employee.

The employee signed a form from the Department of Workforce Development titled, “Voluntary and Informed Consent for Disclosure of Health Care Information”. Does this mean I am authorized to tell his employer, insurer or the Department everything?

Not necessarily. Review the consent form to determine the scope of the employee’s consent.  The form allows the employee to limit certain disclosures (e.g. physical evaluation only or physical evaluation and mental health, drug or alcohol abuse and HIV tests).

Who can obtain information about an employee’s health information related to a work injury and in what form?

In response to a written request for information, the employee, employer, worker’s compensation insurer, or the Wisconsin Department of Workforce Development or its representative is entitled to any information (may be oral) or written material reasonably related to the injury for which the employee claims was the result of a work accident. If the request is for copies of the electronic health record, that request should be forwarded to health information management for the hospital or clinic where the employee was treated as you are not the custodian of the medical record.