Medical Information on Injured Workers Restricted

A new law requires California workers' compensation insurers and claim administrators to severely restrict access to injured workers' medical files.

As of Jan. 1, 2000, a new law requires California workers' compensation insurers and claim administrators to severely restrict access to medical information about injured workers.

Legislation signed by California's Gov. Davis last year, amends Labor Code Section 3762 to specifically prohibit claims administrators from providing medical information regarding an injured worker's claim to employers, agents, brokers and others.

Despite some misgivings, since enactment of the "Employers' Bill of Rights" statutes in 1993, it has become common practice for insurers and claims administrators to provide employers with almost unfettered access to information in claims files.

Increasingly, this information has been provided to larger employers and insurance brokers by electronic means, to the point that computer access to information in claims files has become almost routine.

Caught off guard by this amendment in the enacted legislation, many insurers are now scrambling to reprogram computer systems, establish new policies and to train claims personnel on what information can be shared, under what circumstances, and with whom it can be shared.

At the same time, insurers have begun to notify their customers of what changes they can expect in claims service because of the new statute.

Because of differing interpretations of the new statute, many companies are adopting temporary strategies until the dust settles and there is more widespread understanding and consensus on what the statute specifically entails, according to the California Workers' Compensation Institute (CWCI).

CWCI's general counsel is preparing a more complete analysis of the statute, which will be available next week to Institute members and bulletin subscribers on the CWCI Web page at www.cwci.org

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