Paxson Question of the Month (Vol. 6: Work Comp Records Requests)

Each month, we feature a real question asked by one of your fellow ICS members through Paxson, our closed-system AI assistant built just for Illinois chiropractic physicians. Paxson provides quick, accurate, and member-directed support on a wide range of topics—from insurance issues and licensure requirements to documentation, compliance to social media posts, and more.

These featured questions offer valuable insights you can use in your own practice—and serve as a reminder that help is just a click away.

Have a question? Paxson is ready when you are at www.ilchiro.org/paxson.

Work Comp Records Requests

ICS Member Question – “When an opposing attorney sends for All records on a workers compensation without a signed records release from patient. Am I obligated to send more than dates of service related to that accident”

Paxson’s Response:

When you receive a request from an opposing attorney for “all records” on a workers’ compensation (WC) case without a signed HIPAA authorization from the patient, your obligations are as follows:

1. Workers’ Compensation Records Related to the Injury

– Under Section 8(a) of the Illinois Workers’ Compensation Act, you are required—upon written request—to furnish full and complete reports and permit records to be copied by the employer, employee, their dependents, or any party to a compensation proceeding, or their attorneys, but only as it relates to the WC injury.

– If you want to receive payment for your services, you must submit any and all records regarding your patient’s WC injuries.

2. HIPAA and Privacy Considerations

– The HIPAA Privacy Rule allows you to disclose protected health information for workers’ compensation purposes without the patient’s authorization—but only to the extent necessary to comply with state law and only as it relates to the WC injury.

– You are not required or permitted to release records unrelated to the WC injury without a signed HIPAA authorization from the patient.

3. Requests for “All Records”

– If the request is for “all records” (including those not related to the WC injury), you should not release unrelated records without a signed HIPAA authorization from the patient.

– The best practice is to request a signed HIPAA authorization from the requesting party for any records not pertaining to the WC injury.

– If you receive a subpoena requesting “any and all records,” you should also request a signed HIPAA authorization before releasing unrelated records.

Summary:

You are obligated to send records and reports only related to the workers’ compensation injury without a signed patient authorization. For any other records (unrelated to the WC injury), you should not release them unless you have a signed HIPAA authorization from the patient.

Would you like a sample response template you can use to communicate with attorneys when you receive these types of requests? This can help you clearly state your obligations and protect patient privacy.

ICS Member Follow-up:

“Yes, one that doesn’t really say we have records but that if we did have other records… Hope that makes sense”

Paxson’s Response:

Absolutely, that makes perfect sense. Here’s a sample response template you can use when replying to an attorney’s request for “all records” in a workers’ compensation case—this template does not confirm or deny the existence of other records, but clarifies your obligations and the requirements for any unrelated records:

—

Sample Response Template

Dear [Requesting Attorney/Party],

This letter is in response to your request for “all records” pertaining to [Patient Name] in relation to the workers’ compensation claim for [specific injury/incident or date of injury].

In accordance with Section 8(a) of the Illinois Workers’ Compensation Act and applicable privacy regulations, our office will provide records and reports that are directly related to the injury or condition for which the workers’ compensation claim has been filed.

Please note that, pursuant to HIPAA and state law, any records unrelated to the workers’ compensation injury or claim cannot be released without a valid, signed HIPAA authorization from the patient. If you require records beyond those pertaining to the workers’ compensation injury, please provide a signed authorization for our review.

If you have any questions or require further clarification, please let us know.

Sincerely, 

[Your Name/Practice Name]

—

You can copy and paste this text into your preferred format or letterhead.

Would you like a checklist to help your staff process these types of records requests consistently and compliantly?

ICS Member Follow-up:

Yes

Paxson’s Response:

Here is a checklist you can use to help your staff process records requests related to workers’ compensation cases, ensuring compliance and protecting patient privacy:

—

Workers’ Compensation Records Request Checklist

1. Review the Request

   – Confirm the request is related to a workers’ compensation claim.

   – Identify the specific injury or incident referenced.

2. Determine the Scope of Records Requested

   – Is the request for “all records” or only those related to the WC injury?

   – Does the request include a signed HIPAA authorization from the patient?

3. Segregate Records

   – Gather only those records directly related to the workers’ compensation injury or claim.

   – Do not include unrelated records unless a valid, signed HIPAA authorization is provided.

4. If Request Is for “All Records” Without Authorization

   – Prepare only the records related to the WC injury for release.

   – Use the provided response template to communicate with the requesting party.

   – Request a signed HIPAA authorization if unrelated records are being requested.

5. If a Subpoena Is Included

   – Do not ignore the subpoena.

   – If it requests unrelated records, respond with the template and request a signed HIPAA authorization.

   – Document all communications and responses.

6. Documentation

   – Keep a record of the request, your response, and any authorizations received.

   – Note the date and details of all communications with the requesting party.

7. Release of Records

   – Release only the records pertaining to the WC injury unless a signed HIPAA authorization is received for additional records.

   – Ensure all disclosures comply with the “minimum necessary” standard.

8. Follow-Up

   – If there are any questions or unclear requests, seek clarification from the requesting party.

   – Document all follow-up actions.

—

You can copy and paste this checklist into your internal procedures or staff manual.

Would you like help adapting this checklist for your specific office workflow or adding it to your staff training materials?

ICS Member Follow-up:

Yes

Paxson’s Response:

Great! To tailor this checklist for your specific office workflow or staff training materials, I’ll need a bit more information:

1. Who typically handles records requests in your office (e.g., front desk, billing, office manager)?

2. Do you have an existing process or software for tracking records requests?

3. Are there any unique steps or requirements in your office (such as a specific approval process or documentation method)?

4. Would you like the checklist to include reminders about documenting communications or using specific forms/templates your office already uses?

Once you provide a bit more detail, I can adapt the checklist to fit seamlessly into your current procedures or training resources.

ICS Member Follow-up:

“No I think I have it thanks so much !”

Paxson’s Response:

You’re welcome! If you ever need more resources, have questions about compliance, CE, insurance, or anything else related to chiropractic practice in Illinois, just let me know. I’m here to help with checklists, regulatory updates, member benefits, and more. Have a great day!