Facilitating access to medical treatment for an injured worker is the goal of workers’ compensation laws in Oregon and other states. Employers and their administrative staff must know their role in the process and procedures associated with a worker filing a claim due to a work-related injury or health issue. It is also important for them to be aware of the role they play in ensuring the employer is in compliance with federal OSHA and HIPAA regulations as they pertain to workers’ compensation claims and workplace injuries.
HIPAA regulations and individual privacy
The Health Insurance Portability and Accountability Act was enacted, in part, to protect the privacy rights of individuals regarding their health care records. The law establishes standards and guidelines for the handling and dissemination of health information by what the law refers to as “covered entities.” Examples of covered entities include:
- Health insurance companies.
- Medicare and Medicaid.
- Employer-administered health plans.
- Nursing homes.
The law recognizes the need to allow the sharing of an individual’s health information between health care providers and other entities in the normal course of providing treatment and care to a patient. HIPAA seeks to balance patient privacy in the sharing of health data with the need for information to provide proper treatment. One area in which this comes into play is workers’ compensation claims.
Complying with HIPAA in connection with workers’ compensation claims
Employers are specifically excluded from HIPAA regulations as to employment records and limited access to employee medical information. Privacy laws pertaining to health information access do not apply if an employer needs it for the following reasons:
- Sick leave.
- Wellness programs.
- Health insurance matters.
- Workers’ compensation.
For example, an employer has the right to ask a worker for a note from a doctor to explain days missed from work and claimed under a company’s sick leave policy. If an employee is injured on the job and files a workers’ compensation claim, HIPAA permits the employer or the workers’ compensation insurance company to access the health information needed to process the claim for the injury.
Even though the HIPAA law allows employers and workers’ compensation insurers access to employee information, it does not mean health care providers who are bound by the privacy rules will furnish it without a records release from the employee. This is not an issue in Oregon, where the form an injured person uses to report a job-related injury or illness contains an authorization for the release of information by the worker’s health care providers.
OSHA compliance and workplace injuries
Employers might be exempt from HIPAA privacy regulations, but worker exposure to substances in the workplace require compliance with Occupational Safety and Health Administration regulations pertaining to record keeping. Employers with more than 10 employees must maintain logs of workplace injuries and illnesses requiring more than first aid in the way of medical care.
OSHA requires employers to document a worker’s exposure to hazardous substances. Those records must be kept for at least 30 years after the worker ceases to work for the employer. Included in the records should be findings and diagnosis of the provider specific to the workplace exposure for which the employee was treated.
Preventing workplace injuries and illnesses through OSHA compliance
Compliance with OSHA regulations can help prevent or lessen the severity of workplace injuries. Employers and their administrative staff should implement a program to identify and remedy hazards in the workplace. Actions a safety program should focus on include the following:
- Establishing a schedule for regular inspection and maintenance of equipment used in the workplace.
- Providing workers with protective equipment suitable to their specific job, and ensure each employee is trained how to use it.
- Preparing workplace safety procedures, and implementing a program to train all existing employees and future new hires in how to comply with them.
- Creating a system for employees to report workplace hazards.
- Ensuring employees receive proper training on equipment and machinery they use.
Compliance With Oregon OSHA
An Oregon attorney is probably the best source for information and guidance about HIPAA and OSHA compliance for employers within the state, particularly because Oregon is one of 22 states with an OSHA-approved state plan in place. This means OSHA regulations in the state are administered and enforced by Oregon OSHA, so an attorney can help employers and their administrative staff ensure compliance.