CONFIDENTIALITY AND INFORMATION REQUESTS
109.71, 149.43, 1347.12, 1347.15, 2317.02, 3701.243, 4123.27, 4123.88,
4123-3-22, 4123-15-03, 4123-16-01, 4123-16-08.
Health Insurance Portability and Accountability Act (HIPAA) of 1996 (specifically 45
Human Resources and Legal memos that relate to confidentiality, information
requests and subpoenas.
Percy, Chief of Operational Policy, Analytics and Compliance (Signature on
07/30/14; Rev. 09/17/14; 12/12/14
purpose of this policy is to ensure BWC protects the information of injured workers
and employers that is legally defined as confidential and not public record. BWC
only discloses information to an entity legally entitled to receive it.
policy applies to BWC Field Operations.
legally protected information relating to data, such as any injured worker
data that contains a name or any other identifier and which describes anything
about, done by or done to a person. This includes, but is not limited to,
medical information, Insurance Services Office (ISO) reports or information
regarding whether the person has a workers’ compensation claim.
for purposes of this policy and as defined by HIPAA, this is the information
HIPAA excludes from psychotherapy notes. It includes information about medication
prescription and monitoring, counseling session start and stop times, the modalities
and frequencies of treatment furnished, results of clinical tests and summaries
of the following items: diagnosis, functional status, the treatment plan,
symptoms, prognosis and progress to date.
to the claim:
injured worker, employer, injured worker authorized representative or employer
for purposes of this policy, an individual legally vested with enforcement rights
who generally works for a city, county or state public employer and can be
either “traditional” (e.g., police officer) or “non-traditional” (e.g., certain
park rangers, tax agents or liquor agents).
for purposes of
this policy and as defined by HIPAA, these are notes recorded (in any
medium) by a health care provider who is a mental health professional
documenting or analyzing the contents of conversation during a private
counseling session or a group, joint or family counseling session and that are
separated from the rest of the individual's medical record.
Public: for purposes
of this policy, any person not a party to the claim, including a spouse or
relative to the injured worker.
any document, device, or item, regardless of its physical or electronic form or
characteristic (i.e., paper, documents, photocopies, maps, drawings,
photographs, email, computer disks, audio, and video tape recordings) that is
created by a public office, received by a public office or coming under the
jurisdiction of a public office. A public record serves to document the
organization, functions, policies, decisions, procedures, operations, or other
activities of the office and is kept by the public office. The law provides
many exceptions that exempt certain types of records from public disclosure.
Redact: to obscure or
remove (text) from a document prior to publication or release.
1. It is the policy
of BWC to ensure staff complies with applicable state and federal statutes,
rules, policies and directives related to accessing and releasing confidential information.
information that is not public record is not releasable to a requester without first
determining that the person or entity requesting the information is legally authorized
to receive the information.
information contained within a larger document that is releasable shall be
redacted when it is subject to a public record request.
4. It is the policy
of BWC that:
a. A party to the
claim may see all information in the claim unless otherwise specified in this
i. Managed Care
Organizations (MCOs) associated with the claim may receive information in the
claim and are bound to preserve the confidentiality of the information and comply
with BWC’s sensitive data transmission policies when communicating with BWC.
associated with the claim may receive information in the claim and are bound to
preserve the confidentiality of the information and comply with BWC’s sensitive
data transmission policies when communicating with BWC.
b. Information determined
to be confidential pursuant to this policy shall not be:
i. Viewed in the
ii. Released to
anyone, including the parties to the claim.
5. It is the policy
of BWC to require staff to comply with the applicable BWC Human Resource
policies and procedures on confidentiality, information requests and sensitive
data. In addition, BWC shall maintain confidentiality regarding:
information if the psychiatric condition is not allowed or not being requested
in the claim.
b. BWC shall redact
references to psychiatric condition(s) if the condition(s) is not allowed in
the claim and shall house the original unredacted document(s) in the
c. Psychiatric information
in the following situations, even if the psychiatric condition is allowed or being
requested in the claim:
i. When a
physician, psychiatrist or psychologist determines that psychiatric information
is detrimental to the injured worker, BWC shall not release information to the
injured worker. BWC may release the information to a physician, psychiatrist
or psychologist who is designated by the injured worker or by his/her legal
ii. Psychotherapy notes
a) Neither Ohio law
nor rule defines mental health notes; however, the Health Insurance Portability
and Accountability Act (HIPAA) created standards when dealing with the privacy
of health information, which helps to prevent the improper use of one’s medical
b) BWC policy shall
reference mental health notes as psychotherapy or non-psychotherapy.
notes remain confidential, and HIPAA requires a separate specific release for psychotherapy
notes are not:
i) Viewable in the claim;
ii) Releasable to
anyone, including a party to the claim.
iii) Exception: if a
party to the claim submits psychotherapy notes that were directly obtained from
the treating physician pursuant to a signed release from the injured worker, in
support of (or in opposition to) a motion, then the psychotherapy notes may be
immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS);
i. Medical records
that contain information regarding HIV/AIDS testing/conditions that are not
allowed in a claim and have not been requested to be allowed are confidential.
ii. BWC shall redact
references to HIV/AIDS if the condition(s) is not allowed in the claim and
shall house the original unredacted document(s) in the “CONFIDENTIAL” folder.
iii. BWC shall redact
references to HIV/AIDS in copies of documents released in response to public
statutorily not subject to release
i. BWC shall not
release the residential and familial information of:
a) peace officers
as defined in R.C. 109.71;
b) Peace officers, parole
officers, probation officers, bailiffs, prosecuting attorneys, assistant
prosecuting attorneys, correctional employees, community-based correctional
facility employees, youth services employees, firefighters, emergency medical
technicians (EMT), or investigators of the bureau of criminal identification
and investigation (BCCI) as defined in R.C. 149.43 (A)(1)(p).
ii. BWC shall not
release to anyone, other than a party to the claim or a provider attached to
the claim, any information that discloses any of the following in respect to
an injured worker whose occupation is statutorily not subject to release
identified in section IV.A.5.d.i. without a specific release for this
a) Address, except
for the state or political subdivision;
pertaining to referral or participation in an employee assistance program;
c) Telephone number
(including emergency phone number);
d) Social security
e) Financial or
f) Beneficiaries of
employment benefits (from any source);
g) The identity and
amount of any charitable or employment benefit deduction by the employer from
the employee’s compensation (unless the amount of the deduction is required by
state or federal law);
h) Name of family
iii. BWC shall not release
to anyone, other than a party to the claim or a provider attached to the claim,
the following information in respect to the spouse, former spouse, or the
child of an injured worker whose occupation is statutorily not subject to
release identified in section IV.A.5.d.i. without a specific release for
b) Telephone number
(including emergency phone number);
c) Social security
e) Financial or
iv. BWC shall not
release information pertaining to the injured worker’s spouse, former spouse
and children if an injured worker dies and his/her occupation is statutorily
not subject to release identified in section IV.A.5.c.i.
v. If an injured
worker is identified in a claim whose occupation is statutorily not subject
to release identified in section IV.A.5.d.i. and the injured worker has any
other claims, BWC must protect information regarding the injured worker, spouse,
former spouse, and children of the injured worker in all of the
injured worker’s claims.
requests for claim documents
1. It is the policy
of BWC that a member of the public, including a person listed as designee on www.bwc.ohio.gov,
shall not review claim information without signed written consent from a party
to the claim.
a. If a person has
a signed consent from a party to the claim, the person is entitled to obtain or
review information in a claim.
b. If a person does
not have a signed consent from a party to the claim, the person is not entitled
to any information in a claim, including whether or not a claim exists.
c. If a non-party
to the claim has a durable power of attorney (POA) or proof of guardianship
granted by the courts, a copy is required to be on file prior to disclosing any
information. Refer to Custody, Guardianship, Power of Attorney and
Incapacitation policy and procedures for more information.
d. Exception: if
the injured worker is unable to communicate, BWC may talk with a family member
without an authorization/release.
2. When a party to
the claim requests information, BWC shall verify the individual is a party to
the claim. Validation includes three or more of the following:
a. Claim number;
b. Date of injury;
representative’s identification number (if appropriate);
d. Employer’s Federal
Tax Identification number (if appropriate);
e. Injured Worker’s
i. Current address;
ii. Date of birth;
iii. Last four digits
of social security number.
3. BWC Human
Resources has specific policies and procedures for staff regarding public records,
journalists and bloggers requests.
4. BWC shall make a
claim available for inspection at a time during regular business hours.
5. BWC shall only
honor authorizations executed within a year of the request for information.
6. It is the policy
of BWC to require staff to comply with the agency public records policy.
7. If an injured
worker has multiple claims, BWC may share information amongst those claims if
those claims may have an impact on the claim at issue.
8. BWC, during the
investigation of a claim, may request information that is necessary to the
processing of the claim or contact a non-party to the claim for additional
information. BWC shall use discretion and sound judgment in discussing claim
issues, so as not to disclose confidential information.
BWC staff may
refer to the corresponding procedure for this policy entitled “Procedure for CLAIM
CONFIDENTIALITY AND INFORMATION REQUESTS” for further guidance.