Health Information Management

HIPAA Q&A: Does HIPAA address "return to work notes"?

HIM-HIPAA Insider, August 26, 2013

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Submit your HIPAA questions to Editor Jaclyn Fitzgerald at and we will work with our experts to provide you with the information you need.

Q. Our human resources department does not ­accept certificates of work absences without diagnoses. If the certificate does not have the diagnosis, they do not accept it and deduct the period of absence as regular days accumulated vacation or salary, rather than days sick.

Many doctors do not want to write the diagnosis because of the HIPAA law. Employees often do not want to report their diagnosis or medical reason for absence to their employers for confidentiality reasons.

How does HIPAA apply in this situation? In what section of HIPAA can I find if the employee is covered by HIPAA?

A. HIPAA does not specifically address "return to work notes," and these would not be exempt under HIPAA from the requirement that the disclosure be authorized by the patient. That is, the provider, who is a covered entity, would need your written permission to release any information to your employer.

However, employment law varies from state to state, and HIPAA doesn't address employee health records. Therefore, while your physician is not allowed to release information to your employer without your written permission (unless you have a workers' compensation claim, and then only information directly pertaining to the injury may be released), nothing in HIPAA forbids employers (who are not covered entities) from asking you to provide that written permission and/or diagnosis information to authorize the use of sick leave.

Editor’s note: Chris Simons, MS, RHIA, director of health information and privacy officer at Cheshire Medical Center/Dartmouth-Hitchcock in Keene, N.H., provided these answers for HCPro’sMedical Records Briefing newsletter.

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