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Workers' Comp & HIPAA Rules

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    Workers' Compensation

    • Workers' compensation provides compensation for workers who have been injured on the job. However, employees who accept workers' compensation insurance waive the right to sue their employer for their injuries. Although workers' compensation coverage differs in each state, workers' compensation generally includes regular payments to supplement earnings, reimbursement for medical expenses, and restitution for past and future losses.

    HIPAA

    • HIPAA ensures that workers and their families remain covered by health insurance when the worker changes or loses his or her job. HIPAA also sets national standards for an individual's health care privacy.

    HIPPA Privacy Rule

    • The HIPAA Privacy Rule creates a national standard that protects the privacy of each individual's medical history. The rule applies to medical records and all health-related information. Under the HIPAA Privacy Rule, health information about an individual generally cannot be used or shared without the patient's clear authorization. However, there are a few exceptions to the rule, where an individual's medical information can be used or disclosed without prior authorization from the individual. The HIPPA Privacy Rule also gives patients an inalienable right to examine and possess copies of their medical records.

    HIPAA Workers' Comp Exception

    • Treatment obtained during workers' compensation that is directly related to the workplace injury may be exempted from the HIPPA Privacy Rule. If a covered entity treats the individual, that entity is permitted to disclose that individual's health information as necessary and to the extent permitted by workers' compensation laws. Covered entitles can also release information as necessary with the patient's explicit authorization to do so. Additionally, individuals cannot request, and do not have the right, to tell a covered entity not to share his or her personal health information if it is required to be disclosed as part of the workers' compensation law.

    Federal Workers' Comp Programs

    • In addition to state workers' compensation, four federal programs are also available. The Federal Employees' Compensation Act provides coverage for federal and postal workers who have been injured on the job or have developed a disease related to their occupation. Likewise, the Energy Employees Occupational Illness Compensation Program Act provides workers' compensation to employees at the Department of Energy, workers of atomic weapons employers and individuals qualifying under the Radiation Exposure Compensation Act. Moreover, the Longshore and Harbor Workers' Compensation Act provides compensation to injured longshoremen or their families in the case of death. Lastly, the Black Lung Benefits Act provides compensation to disabled coal miners and their survivors.

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