Fishing Through Your Medical Records: The Dreaded Blank Medical Release Form
If you've filed a Workers' Compensation claim, you've undoubtedly received a blank medical records release form from your employer's insurance adjuster. 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.
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.
"This is not to say, however, that the insurance company does not have a right to obtain relevant records in your case," explains Aaron Sussman, an attorney with Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP (GEK). "They do have this right 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 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 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, and, most importantly, 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. The practice of 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.
"Although you are not required to complete such a blank form, failing to communicate your objection to the blank form can have an adverse effect on your case. Even though the law is clear regarding using such blank forms, and there are severe penalties for violating it, insurance companies continue this practice. 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.