Work calling doctor fraudulently claiming to be my physician

[Dasgasmagas]

Arizona: I am a PT working in a SNF. Almost 7 weeks ago now I was struck by a car while cycling and wound up with a fractured clavicle. This put me on medical leave. My facility has been STRUGGLING to find coverage for me. Typical time frame for return to work for heavy lifting after conservative treatment for a fractured clavicle is 7-12 weeks (I have to lift 300+lb patients). 2 weeks ago I went for a follow up at the ortho office and the PA I've been seeing since start of care, in her best clinical judgement, wrote a note to work and filled out disability and medical leave forms for 12 weeks status post date of injury. Two days ago, a physiatrist employed by my company (I am nor never was under her care), calls my orthopedist, and without seeing me or even contacting me, the orthopedist discharges me back to work with no restrictions effective two days ago (mind you this orthopedist has never even seen me face to face). Typically a follow up is required with diagnostic imaging to d/c as there's always variables such as risk for re-injury or malunion. I find out as the physiatrist from my work calls me and tells me she has got great news, that she was able to get me releasedown to work effective immediately. At this point I am still experiencing some discomfort and pain with certain shoulder positions and lifting objects > 20lbs. I told her this and she states that she didn t know, and I need to see him ASAP because she is not sure how him releasing me back to work will affect my STD and medical leave. She had absolutely no business calling him in the first place and he breached HIPPA by spealing to her about my case. In disbelief, I call his office three times and two different front desk people verify that this return to work Note actually exists. I scheduled a follow up with him next Thursday, but seriously, WTF? I also happened to have recorded all conversations and have text messages as well. What do you guys think I should do now and what laws were violated?

 

[Dasgasmagas]

Sorry for the grammar

I am typing this in my smart phone so I realize I have some grammatical errors and spelling mistakes. The physiatrist that called was never involved in my care.

 

[quincy]

I am typing this in my smart phone so I realize I have some grammatical errors and spelling mistakes. The physiatrist that called was never involved in my care.

Was your injury work-related? You should be looking at the driver of the car that hit you for relief .

 

[LdiJ]

Was your injury work-related? You should be looking at the driver of the car that hit you for relief .

I think that you missed the point. He is risking further injury if he goes back to work too soon, and someone who was not his doctor and was not involved in his care has convinced another doctor to authorize him to return to work before he feels he is ready, and before other's directly involved in his care felt that he was ready. They want him back because they are shorthanded. That has nothing to do with the liability for the original accident.

I believe that you were interpreting the "struggling to find coverage" as having to do with insurance, when it actually has to do with finding people to cover his shifts and patients.

 

[quincy]

I think that you missed the point. He is risking further injury if he goes back to work too soon, and someone who was not his doctor and was not involved in his care has convinced another doctor to authorize him to return to work before he feels he is ready, and before other's directly involved in his care felt that he was ready. They want him back because they are shorthanded. That has nothing to do with the liability for the original accident.

I believe that you were interpreting the "struggling to find coverage" as having to do with insurance, when it actually has to do with finding people to cover his shifts and patients.

Ah. I might indeed have misread the post. I skimmed. That said, what seems to be needed is his own doctor contacting the workplace with the work restrictions.

I am surprised that any doctor who has not examined him would provide recommendations. If that is the case, the doctor can be reported to the state for investigation.

I will read the post through again, though, to see if I am still reading the legal concern wrong. My real work is getting in the way of my posting here.

 

[Dasgasmagas]

Clarification

The injury was not work related. I'm already in a settlement with the drivers insurance which is completely unrelated to this new turn of events. I'm heading in for a second opinion with another ortho on Wednesday that is unaware of the current circumstances.

 

[quincy]

The injury was not work related. I'm already in a settlement with the drivers insurance which is completely unrelated to this new turn of events. I'm heading in for a second opinion with another ortho on Wednesday that is unaware of the current circumstances.

OK.

Well, you have no PRIVATE cause of action for a HIPAA violation but you can report the doctor who offered your employer a medical opinion on your ability to work based on your medical records, if that doctor was not authorized to access your medical records and never saw you as a patient. This seems especially inappropriate if your own doctor examined you and provided your workplace with your workplace restrictions already.

A second opinion by another orthopedist seems a good idea.

Good luck.

 

[Dasgasmagas]

Interesting.

I appreciate your opinion, but you either don't understand me correctly or you don't understand HIPPA privacy acts correctly.

 

[Zigner]

I appreciate your opinion, but you either don't understand me correctly or you don't understand HIPPA privacy acts correctly.

Says the poster who doesn't even know that it's HIPAA.

 

[Proserpina]

I appreciate your opinion, but you either don't understand me correctly or you don't understand HIPPA privacy acts correctly.

Please tell us what you think HIPAA does and doesn't provide.

 

[quincy]

I appreciate your opinion, but you either don't understand me correctly or you don't understand HIPPA privacy acts correctly.

What exactly do you think I do not understand about the Health Insurance Portability and Accountability Act (HIPAA)?

Here is a link to the US Department of Health and Human Services information on HIPAA (designed for professionals):

http://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/

If you need help interpreting what is said by HHS, I will do what I can to assist in your understanding.

 

[AdoptADog]

If I am reading the OP correctly, it wasn't his doctor contacting the orthopedist, but his employer. Unless the OP gave permission for the ortho to release information to his employer, is that not a breach of HIPAA?

ETA: Depending on what exactly was stated by the ortho during the conversation releasing the OP back to work.

 

[Zigner]

If I am reading the OP correctly, it wasn't his doctor contacting the orthopedist, but his employer. Unless the OP gave permission for the ortho to release information to his employer, is that not a breach of HIPAA?

I don't believe anybody said it's not...

 

[Dasgasmagas]

Further clarification

Here's what you guys are missing. By the way, I'm a Healthcare provider so it's myour job to know HIPPA. 1) Authorization. A covered entity must obtain the individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.44 (since the physiatrist calling was in no way involved with my care, my written permission must be provided). 2) Minimum Necessary. A central aspect of the Privacy Rule is the principle of “minimum necessary” use and disclosure. A covered entity must make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request. (Therefore, at most the ortho could have provided his medical opinion on my ability to return to work which was provided on a prior note. He does not have permission to speak with the physiatrist about details involving my case in depth, which were discussed and I have physiatrist admitting to this in a recorded call. Also, nothing should have been discused to the extent where his medical opinion is changed as a result without consultation with the patient).

Since my co-worker, the physiatrist, was not involved in my care, there was written or implied consent on my part to disclose, and since more than the minimum necessary information was discussed, again I repeat, this WAS a violation of HIPAA.

I really hope that either you guys misunderstood me, or at least are not lawyers (because that is a scary thought).

 

[Dasgasmagas]

Also

I'm using a cell phone, the auto correct on this thing is funny