North Carolina Workers’ Compensation and Privacy

Workers' Compensation Privacy

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that offers protections to individuals’ private medical information. This Privacy Rule applies to any data that contains your date of birth, gender, ethnicity, as well as your information on the diagnosis or treatment provided to you by your doctor. We want our clients to know that we make our own requests to your medical providers for copies of all records and bills. We don’t just rely on the other side to get everything. We do this by simply having our clients sign a HIPPA form and a medical authorization giving permission for us to get the records. It is as simple as that.

Medical Records

Federal and state law recognizes employers and insurance companies' rights to review patient medical records in Workers Compensation cases, but there are restrictions - Riddle & Brantley (1)

Most people do not realize just how thoroughly physicians’ offices document information. Each time you go to the doctor, nearly every person you interact with enters some piece of information into their system.

  • When you schedule your appointment, they note:
    • What is bothering you (your “reported symptoms”)
    • If you think you know what caused those symptoms (the “cause” or “mechanism of injury”).
  • When you arrive, and a nurse takes your weight and temperature, they record that in your chart and may even note how you are acting (for example, limping, exhibiting signs of pain, etc.).
  • The doctor will note your subjective complaints (what you say is bothering you) as well as your objective complaints (what they can objectively tell is wrong with you, like a muscle spasms).
  • Your records will also note any diagnostic tests performed, the diagnosis you are given, and any therapy or medications prescribed to you. They will also usually list any restrictions you are given (such as “no lifting”).

For this reason, your medical records and most of the data included in them is considered private medical information that is covered by and protected by HIPPA. But HIPPA’s protections are not absolute, and HIPPA specifically provides numerous classes of individuals that are allowed access to your medical data.

HIPPA and Workers’ Compensation Records

According to the United States Department of Health & Human Services, the HIPPA Privacy Rule recognizes the legitimate need of insurers and other entities involved in the workers’ compensation systems to have access to individuals’ health information as authorized by State or other law. Due to the significant variability among such laws, the Privacy Rule permits disclosures of health information for workers’ compensation purposes in a number of different ways.

North Carolina and Privacy in Workers’ Compensation Claims

North Carolina has its own version of HIPPA, which similarly provides that confidential information obtained in medical records shall be furnished only on the authorization of the patient, or upon order of a judge or other officer.

However, North Carolina has a separate law that specifically sets forth details of how medical information should be protected, or accessed, in the context of workers’ compensation claims. Under the North Carolina Worker’s Compensation Act, there is a system set up that is intended to balance the privacy interests of the employee, with the interests of employers and insurance companies in having access to relevant medical information, and with the interests of health care providers who wish to receive timely payment for their services without spending unreasonable administrative time determining what information can be shared with whom.

Under N.C.G.S. § 97-25.6:

“An employer is entitled, without the express authorization of the employee, to obtain the employee's medical records containing relevant medical information from the employee's health care providers. In a claim in which the employer is not paying medical compensation to a health care provider from whom the medical records are sought, or in a claim denied pursuant to G.S. §97‑18(c), the employer shall provide the employee with contemporaneous written notice of the request for medical records. Upon the request of the employee, the employer shall provide the employee with a copy of any records received in response to this request within 30 days of its receipt by the employer.”

Communication with Physicians’ Offices

An experienced workers' comp lawyer can help protect your Rights to Privacy when employers and insurance companies request your Medical Records - Riddle & Brantley

The statute also sets forth specific situations in which employers or insurance companies are entitled to communicate with physicians’ offices on billing issues, and when they may communicate with physicians in writing or verbally for additional information not contained in medical records. The statute also sets forth the manners and circumstances in which an employee or his or her attorney can object to such an authorization for release of medical records, or even move for a protective order.

If you believe an insurance company or your employer are inappropriately accessing or using your medical information, you should contact a North Carolina workers' compensation attorney to learn your legal rights.

Talk with a Workers’ Comp Attorney Today

Since 1985, Riddle & Brantley’s attorneys have fought for justice for injured North Carolina workers, recovering millions of dollars in compensation for our deserving clients (see disclaimer below).

In one recent case, we recovered $2.475 million in total compensation for an injured welder who suffered a debilitating head injury after falling from a platform while on the job (see disclaimer below). In another, our attorneys secured a $1.8 million total settlement for a truck driver who suffered the eventual loss of his left leg below the knee after he was hit by another truck while working (see disclaimer below).

If you’ve been injured while on the job, or you have questions concerning your right to privacy in a workers’ compensation claim, call our North Carolina workers’ comp lawyers today at 1-800-525-7111.

"I would recommend them to anyone who needs help with workers' comp."

-B. Fields, Riddle & Brantley client

The consultation is free and you won’t pay any attorney fees unless we win your case and you receive workers’ compensation benefits.

Justice Counts.


*** Disclaimer: The results mentioned are intended to illustrate the type of cases handled by the firm. These results do not guarantee a similar outcome, and they should not be construed to constitute a promise or guarantee of a particular result in any particular case. Every case is different, and the outcome of any case depends upon a variety of factors unique to that case.