Exploring the Legalities of the Blank Medical Release Form

As a public safety officer, you put your life on the line each day to ensure our safety. By doing so, you understand that sustaining an on-the-job injury is always a possibility. If you happen to be among those in your same profession who have filed a Workers' Compensation claim, you've undoubtedly received a blank medical records release form from your employer's insurance adjuster.

Don't be fooled by such a request for your signature on a medical records release form that leaves the doctor/facility entry blank. You are not required to complete such a form.

In order to discover prior injuries or pre-existing conditions, the adjuster will try to use this blank form to acquire all your medical records from every doctor you've ever seen, even if those records are entirely irrelevant to your Workers' Compensation injury.

"However, this doesn't mean that the insurance company does not have a right to obtain relevant records in your case," explains David Goldstein, an attorney with Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP (GEK). "They are legally allowed to do so once you have filed a claim. And, the sooner they have the relevant records to review, the sooner they can make a determination on whether they will accept your claim. The key here, though, is relevant records; they can't go on a hunting expedition."

In fact, the Health Insurance Portability and Accountability Act (HIPAA) set forth federal regulations that govern disclosure of medical records, including the essential features of a valid medical disclosure authorization form. These "core elements" include the following:

  • A description of the information to be disclosed and the purpose for the disclosure.
  • A particular expiration date upon which the disclosure form becomes invalid.
  • The name of the person to whom the disclosure may be made.
  • The name of the doctor or facility authorized to disclose the information.

As outlined by HIPAA, an authorization is not valid if it has not been filled out completely. "It must include the particular doctor or facility authorized to release records. Writing in the doctor or facility after you've signed the disclosure form is illegal.

"In addition, a medical facility is not legally permitted to disclose protected health information unless the authorization form is valid."

HIPAA clearly states that a doctor or medical facility may not disclose protected health information without an authorization that is valid." In other words, even if an injured worker signed the blank medical record release form, the insurance company could not (legally) acquire any medical information with it.

Falsifying a medical authorization form by adding the doctor/facility name after the form has been signed  is a crime under federal law; if prosecuted and convicted, an insurance adjuster that does so can be subject to a fine of up to $250,000 and/or imprisonment for not more than 10 years. Even though the law is clear regarding using such blank forms, and there are severe penalties for violating it, insurance companies continue this practice.

"You are not required to complete such a blank form, but it is imperative that you communicate your objection to it so there is no adverse effect on your case. Unfortunately, if you're not represented by an attorney, failing to sign one of these release forms can result in the denial of your claim."  

The attorneys at GEK have more than 30 years of experience fighting for Justice for the Injured®. If you would like to speak to a GEK attorney about your legal options, including the appropriate release of your medical records, please call 213-739-7000 or click here.


Do I have a case? Free Case Evaluation.

Click Here

Main Office

3580 Wilshire Blvd #1800,
Los Angeles, CA 90010


816 Camarillo Springs Road,
Suite I,
Camarillo, CA 93012

Santa Ana

Xerox Centre
1851 East First Street,
Suite #900,
Santa Ana, CA 92705

Inland Empire

3602 Inland Empire Blvd.,
Suite C-160,
Ontario, CA 91764
Geklaw Best Lawyers
Geklaw Super Lawyers