Whether workers compensation can contact your doctor is complicated. Short answer, before the workers compensation company hires its own attorney to defend the claim, the claims adjuster or the nurse case manager can try to talk to the injured worker’s doctor about the medical diagnosis and treatment. The doctor does not have to speak to the insurer people, but as a practical matter, most do. It is unclear if the health care providers feel an obligation to do so since the workers compensation insurer is paying their bills, but occasionally they do it before a claim is decided or even in denied claims. In Wisconsin, most workers compensation insurance companies take the position that Wis. Stats. Sec. 102.13 obviates the physician-patient privilege. Another view is that Sec. 102.13 only lets down the privilege “to any condition or complaint reasonably related to the condition for which the employee claims compensation” and engaging the doctor in conversation or even answering written questions may stray afield of such matters. Most adjusters do not interfere with the treatment and are satisfied with access to medical records. The adjusters or nurse case managers who engage the doctor most likely do so to influence the doctor’s opinions on causation or extent of disability. Most worker’s compensation adjusters and nurse case managers would take issue with this characterization.
Most times this issue comes up when the insurance company has hired an attorney to defend a previously denied claim and the lawyer takes it upon himself to write or contact the treating doctor, for “clarification.” In Wisconsin, there is an ethical reason that the defense attorney should not be contacting the treating physician regarding the injured workers medical treatment. In Steinberg v. Jensen, 194 Wis. 2d 439, 474 (Wis. 1995) the Wisconsin supreme court stated:
“In addition, as a matter of public policy, we hold that defense counsel may not engage in ex parte “discovery” with the plaintiff’s treating physicians. Unlike a simple ex parte communication, ex parte discovery is akin to a private question and answer session wherein the lawyer asks questions designed to elicit previously unknown information from the physician. Such a practice is improper because it can easily lead to the inadvertent disclosure and consequent discovery of confidential information.” This prohibition would apply to anyone directed by the attorney such as a claims adjuster or nurse case manager. Not all respondent attorneys feel Steinberg applies to workers compensation cases, but since the prohibition is ethically based, the nature of the litigation should not matter.
The solution is for the treating doctors to refuse engaging with anyone except the patient or his/her representative. McCormick Law Office in Milwaukee, Wisconsin Back Injury Attorneys.
