Disclosures for workers’ compensation

§164.512(l) Standard: Disclosures for workers’ compensation. A covered entity may disclose protected health information as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.

Audit Inquiry

Are policies and procedures in place regarding disclosure of PHI for the purpose of workers’ compensation, that are consistent with the established performance criterion?

Obtain and review policies and procedures related to disclosures of PHI for workers’ compensation or other similar programs for consistency with the established performance criterion.
Obtain and review a sample of documentation of disclosures for the purpose of workers’ compensation; elements to consider include, but are not limited to, whether the disclosure is authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.