The normal doctor-patient relationship is one of strict confidentiality. This confidentiality is challenged when the patient’s injury is part of a workers’ compensation claim.
When you lodge a workers’ compensation claim, you complete a Claim Form, which includes a “consent authority”. In doing so you agree that the insurer can collect and use your personal information for the purposes of assessing and investigating the claim. You also agree that the insurer can disclose personal information to various third parties and collect information from those parties. This includes a very broad list of third parties such as the employer, doctors and other allied health providers, investigators, auditors, other insurers, government regulators (such as WorkCover WA) and lawyers and law enforcement agencies.
All up that is a pretty extensive list of people who potentially can be given your medical information.
Privacy in the twenty-first century is a very fluid concept. Many younger patients do not share my concerns about personal privacy and willingly publish details of their private life on forums such as Facebook. But for most doctors, sending patients' medical records to a third party goes against some very fundamental medical principles. It is certainly not how we normally practise. I cannot even talk to your close family relatives about your medical condition without your permission.
And yet it is not uncommon for a patient with a work injury to come to their first consultation with an employer representative or rehabilitation provider in attendance. Now that can be a good sign that the employer really does care about their worker and is engaged in their injury management plan. But there is no requirement for that person to be present during our consultation. In fact, WorkCover stipulates that an employer cannot insist on being present during a medical examination.
WorkCover recently published guidelines -“Insurer and Self-Insurer Principles and Standards of Practice”. Standard 1.4 regarding privacy and consent states: “The confidentiality of a worker's personal and health information is paramount. Identified misuse or unauthorized disclosure will have consequences”.
WorkCover goes further in Item 3.5 regarding medical reports. “Insurers must only request medical reports and health information relevant to assessing the nature, cause and extent of an injury”.
One simple example of why you should preserve your privacy where possible:
If surgery is being planned, your surgeon may need to ask questions like “have you ever used intravenous drugs?” and “have you ever had a sexually transmitted disease?” Your surgeon needs to know if you have hepatitis or HIV but your employer and insurer certainly do not.
There are times where we do need to get all parties into the room, for example with case conferences. A case conference would generally include the patient and possibly representatives from the insurer, employer, vocational rehabilitation and allied health. These are “planning meetings” for the overall management of the claim. They are not medical consultations. A medical consultation can be conducted on the same day but you are certainly within your rights to request for that consultation to be conducted privately.
“Can I refuse to sign the consent authority?”
WorkCover advises that refusing to sign the consent authority may affect the insurer's ability to assess your claim and as such may result in significant delays in the claim process.
In summary, an injured worker does relinquish their privacy in relation to health matters relevant to the injury, but not to matters unrelated to the injury. And the insurer is obliged to protect the confidentiality of the information they gather.
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Subiaco WA 6008
Dr David Colvin consults at:
Western Orthopaedic Clinic
- These rooms are part of St John of God Subiaco Hospital.
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Dr David Colvin operates at:
St John of God Subiaco Hospital
12 Salvado Rd,
Subiaco WA 6008