Can the workers’ comp insurance company’s lawyer talk to my doctor without me?

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Wondering if your employer or workers’ comp representative can talk to your doctor when you’re not present? The short answer is: yes. According to O.C.G.A. § 34-9-207 , when “an employee has submitted a claim for workers’ compensation benefits or is receiving payment of weekly income benefits or the employer has paid any medical expenses, that employee shall be deemed to have waived any privilege confidentiality concerning any communications related to the claim or history or treatment of injury arising from the incident.”

Is it legal for my employer or workers comp to talk to my doctor?

In Georgia, HIPAA’s Privacy Rule allows workers’ comp insurance companies, third-party administrators and some employers to obtain the necessary medical information to manage workers’ compensation claims. The workers’ comp insurance company has a responsibility to pay your medical bills and benefits, so they may use your medical records to decide whether they are going to pay. Georgia workers’ compensation law requires you to allow the workers’ comp insurance company to get medical records that are relevant to your injury.  If you have been injured at work in Georgia, the workers’ comp adjuster or nurse case manager will probably ask you to sign a Form WC-207.

What is Form WC-207?

Form WC-207 is an authorization form that allows the release of some of your medical records. You will be required to let the insurance company get two types of medical records:  medical records for your injury and medical records for “conditions or complaints reasonably related to the condition” for which you are claiming benefits, which generally means any medical records for prior treatment to the same part of your body as the work injury.

Ex parte communication

When someone working on behalf of your employer or insurance company, such as an adjuster, nurse case manager or attorney for the insurance company, corresponds with your doctor about your treatment without your knowledge or permission, it’s called ex parte communication.  At one point, the Georgia Court of Appeals decided in McRae v. Arby’s that injured workers cannot be forced to sign away their medical privacy rights–specifically, the right to refuse consent for the opposing attorney to meet alone with their treating doctor–in order to continue getting workers’ compensation disability benefits. However, that decision was overturned by the Georgia Supreme Court.

In McRae, the insurer’s attorney wanted to speak alone with the injured worker’s doctor; the doctor refused the request, so the insurer’s attorney tried to compel the injured worker to allow the meeting. The trial judge agreed with the insurance company’s attorney, the Court of Appeals did not, and the Georgia Supreme Court overruled the Court of Appeals and sided with the insurance company’s attorney.

If you’ve been hurt at work in Georgia, please contact our knowledgeable Atlanta workers’ compensation lawyers to see how we can help be your advocate during your recovery from a workplace accident, at 404-354-5432.

This article was originally published November 2013, after the Court of Appeals ruling. It has been updated to reflect the Georgia Supreme Court’s decision and for comprehensiveness.



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