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Old 02.01.2011, 18:20
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Doctor patient confidentiality.

Hi all!

Longtime lurker on this forum. Mostly looking for tech faq.
Not now though. The thing is Im suffering from back problems, herniate discs. I havnt been able to work for the last two and a half months. Im going back in two weeks. Starting out with 50% and hopefully moving on to fulltime.

Ive had multiple exams and also doing physiotherapy. The general consensus is I should be fully fit, problem is noone can give a specific date.

The thing is, last week I got a letter from the HR dept. asking me to sign a paper that waives the doctor-patient confidentiality. This to let Groupe Mutuel, my firms insurance company, contact my doctors and discuss my case. The paper has no info for how long they can do this and no info if they are going to let me know when they do contact my doctors.

So, my question is, are they allowed to do this?
Feeling slightly paranoid, although I dont have anything to hide.

I would be grateful for any suggestions.

Cheers T.
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Old 02.01.2011, 18:29
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Re: Doctor patient confidentiality.

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Hi all!

Longtime lurker on this forum. Mostly looking for tech faq.
Not now though. The thing is Im suffering from back problems, herniate discs. I havnt been able to work for the last two and a half months. Im going back in two weeks. Starting out with 50% and hopefully moving on to fulltime.

Ive had multiple exams and also doing physiotherapy. The general consensus is I should be fully fit, problem is noone can give a specific date.

The thing is, last week I got a letter from the HR dept. asking me to sign a paper that waives the doctor-patient confidentiality. This to let Groupe Mutuel, my firms insurance company, contact my doctors and discuss my case. The paper has no info for how long they can do this and no info if they are going to let me know when they do contact my doctors.

So, my question is, are they allowed to do this?
Feeling slightly paranoid, although I dont have anything to hide.

I would be grateful for any suggestions.

Cheers T.

Explain to HR that your medical notes are personal and confidential, and ask them to explain the ramifications if you refuse. You can ask for the questions to be submitted via yourself, and you can filter any replies back.

If you choose to allow access , add a time constraint to the permission, i.e. valid for one week only , expires in a month etc. Also state that all questions must relate to your specific illness and general questions will not be allowed.

Appear to be co-operative , but not to your detriment.
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Old 02.01.2011, 18:32
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Re: Doctor patient confidentiality.

In this case it would appear that your company in insured with Groupe Mutuel to continue to pay your salary whilst you are off (or at least the difference if you are working 50%), this is known as Lohnfortzahlungsversicherung. It is logical that the insurance company would want to know what exactly is going on and how long they are likely to be on the hook for. After all, which insurance company writes a blank cheque?

If you do not cooperate you may find that the insurance company will refuse to continue paying. If this happens your employer will most likely stop paying you also as it is likely made clear in your working terms and conditions that you are insured for your salary if you fall ill and it is not actually the company paying once the "transition" period has ended (which may be a few weeks/ 2-3 months, I am not sure exactly).

So, if you have nothing to hide, you may want to comply with the request.

Here by the way here is a link to a document (in German I am afraid) which explains about the insurance, gives the legal background, and also more interestingly gives an idea of how long a company has to pay you if you fall ill in various cantons. It appears to vary not only by canton but by seniority.

Last edited by Snoopy; 02.01.2011 at 18:39. Reason: link added
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Old 02.01.2011, 18:41
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Re: Doctor patient confidentiality.

Don't be worried, I agree with Snoopy, just co-operate and sign the form. You have nothing to loose. If you are very overweight you should do lots of swimming and dieting.

If you don't sign it you have evrything to loose! Legally you cannot be fired while you are ill, but if you don't co-operate with Mutuell they will not pay up and then the company will not pay you, or might fire you when you get better

.
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Old 02.01.2011, 18:48
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Re: Doctor patient confidentiality.

Thanks for your speedy replies.

I have to say that for me giving up confidential info about me is a big thing.
I DO realise that they arent that thrilled to just continue to sign cheques.

The thing that strikes me is that there is no expiring date on this form.
Guess I will have to give them a call.

Again, thanks.
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Old 02.01.2011, 19:06
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Re: Doctor patient confidentiality.

If this is a letter that is being written up by your HR department then I would insist (or at first suggest) they put in a clause that stipulates they an contact your doctor about this specific incident. So they can't poke around in your other health issues. And/or as clause say this permission is granted for the time that you are out of work related to this issue. Any other things they want to find out they need to ask you again for permission.

I can't imagine they will refuse to narrow down their "powers". Maybe I'm naive though!
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Old 02.01.2011, 21:41
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Re: Doctor patient confidentiality.

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If this is a letter that is being written up by your HR department then I would insist (or at first suggest) they put in a clause that stipulates they an contact your doctor about this specific incident. So they can't poke around in your other health issues. And/or as clause say this permission is granted for the time that you are out of work related to this issue. Any other things they want to find out they need to ask you again for permission.

I can't imagine they will refuse to narrow down their "powers". Maybe I'm naive though!
The OP only gave us the gist of the letter from HR. It could be that this is already specified.
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Old 02.01.2011, 21:52
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Re: Doctor patient confidentiality.

Nope. I was given a letter from GM. They ask for for full disclosure. No specifics. They want total access to my doctors.

And again, I really dont have any skeletons (pun) in my closet.

Im writing them a mail saying that they can have access but only until Im fully fit. Not so sure though as my Hausartz referred to them as "idiots with stupid questions".
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Old 02.01.2011, 22:03
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Re: Doctor patient confidentiality.

Can Teddyboxx demand to see all correspondance between all parties, or to be present if there are meetings involved?

Teddyboxx: Perhaps you will want to run this by a lawyer, to determine exactly where you stand.
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Old 02.01.2011, 22:34
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Re: Doctor patient confidentiality.

As a patient that was put through the ringers in this regard my advice is "It's time to Lawyer up! You have good reason to feel paranoid as insurance companies have only one goal and that is to get you off their books at all costs. They hire doctors who have certain privileges unbeknown to you who and can even lurk into your hospital files (is this legal here or not I don't know) There strategy is to deny deny and deny all your rightful claims. They are experts in denial games and will string you along until you have no other recourse or resources left to fight any longer. Don't be fooled by the friendly attitudes of claims adjusters they will use all information against you in the end. Trust me as I know what I speak of. I have been down this road and continue to live with a chronic condition after being kicked out of my employment and off all disability payments. You will be on your own if you believe their lies.
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Old 02.01.2011, 22:39
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Re: Doctor patient confidentiality.

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As a patient that was put through the ringers in this regard my advice is "It's time to Lawyer up! You have good reason to feel paranoid as insurance companies have only one goal and that is to get you off their books at all costs. They hire doctors who have certain privileges unbeknown to you who and can even lurk into your hospital files (is this legal here or not I don't know) There strategy is to deny deny and deny all your rightful claims. They are experts in denial games and will string you along until you have no other recourse or resources left to fight any longer. Don't be fooled by the friendly attitudes of claims adjusters they will use all information against you in the end. Trust me as I know what I speak of. I have been down this road and continue to live with a chronic condition after being kicked out of my employment and off all disability payments. You will be on your own if you believe their lies.
But that was not in this country was it?
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Old 02.01.2011, 23:20
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Re: Doctor patient confidentiality.

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As a patient that was put through the ringers in this regard my advice is "It's time to Lawyer up! You have good reason to feel paranoid as insurance companies have only one goal and that is to get you off their books at all costs. They hire doctors who have certain privileges unbeknown to you who and can even lurk into your hospital files (is this legal here or not I don't know) There strategy is to deny deny and deny all your rightful claims. They are experts in denial games and will string you along until you have no other recourse or resources left to fight any longer. Don't be fooled by the friendly attitudes of claims adjusters they will use all information against you in the end. Trust me as I know what I speak of. I have been down this road and continue to live with a chronic condition after being kicked out of my employment and off all disability payments. You will be on your own if you believe their lies.
If the OP works for a Swiss company and adopts this approach I feel trouble approaching at great speed. Let's face it, the OP hasn't worked for 2 1/2 months, you don't think the insurance company is entitled to find out what the situation is exactly?

IMHO you have given the OP crappy advice, but as I said that is just my opinion and the OP will have to decide for himself.
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Old 02.01.2011, 23:22
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Re: Doctor patient confidentiality.

If you have nothing to hide, sign the letter, put a expiration time on it, say ok up to 30 June 2011, send a copy yourself to your doctor.

If after this date GM still feel the need to consult with your doctor, they can re-issue the request or simply you could agree to prolong it for another fixed period. Keep your doctor in the loop and make sure he knows on 1st July 2011 patirent/doctor confidentiallity returns as normal.
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Old 03.01.2011, 10:24
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Re: Doctor patient confidentiality.

Don't worry, this letter is standard issue for anyone on extended sick leave, and it is perfectly legal; I've been through this process before.

I asked my doctor about it, and he said that you are normally entitled to 90 (?) days of sick leave a year, no questions asked. However, after this period has elapsed, your employer's insurers and the state do an evaluation to see if you are in need of disability assistance from the state. To do such an evaluation they need access to your medical records. You will certainly not be forced back to work, and your sick leave pay isn't in danger.

Such an evaluation is necessary to help identify those people who might be out of the work force for a long time, and who may require extra support. If you are sick you will continue to be on sick leave, no problem. But if it turns out that your career and illness/disability are really incompatible (e.g. panic disorder and air traffic controller), the disabilities office would offer re-training in another less stressful line of work to help get you back in the workforce. Likewise, a manual labourer with chronic back problems would be much better off retraining for a new job than having constant injuries and extended periods of sick leave over their entire career. At least that's how it was explained to me by my doctor.

Seeing as you will (hopefully) be going back to work shortly, you might not have to worry about any of this. I was back at work before my 90 days were up and so in the end I didn't have to go through this stuff with the insurers.

I do have some references to the relevant laws on some paperwork at home, I'll try and remember to post some links when I get home from work.

Best wishes for a speedy recovery

H.

PS-

Last edited by HeatherM; 03.01.2011 at 10:55. Reason: Forgot the well wishes!
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Old 03.01.2011, 10:52
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Re: Doctor patient confidentiality.

I do agree with the fact that your company wants to know more about your situation.

However, I completely disagree with their formal request of a waiver. Doc-Patient confidentiality is basically above everything. Especially the waiver does not mention a specific time period or reason for asking, or what is supposed to be asked to the doctor.

I was in this situation in the past and asked HR to define their request and also informed my doctor that HR will call.

He then asked HR to define and rephrase their questions more formally.

Personally I would never ever sign a paper that gives away information on a 100% base.

Your doctor can also issue a certificate " Arztzeugnis" for HR. This is in most cases sufficient enough.
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Old 03.01.2011, 10:59
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Re: Doctor patient confidentiality.

I think what sounds sketchy is actually a standard procedure. They have their own committee put together after a while you were being paid, so the company insurance (not yours) can kick in. For this committee of their own insurance docs, it is necesarry to open your files so they can assess if you are entitled (it's more for your employer's sake adn their insurance) to be supported further. I think different companies, insurance policies and different illnesses have that don't-ask window different length. I think what is clumsy wording is just a normal protocol, I wouldn't worry about it especially in your case of herniated disks. You could ask for explanations, in a non threatening way, or try to limit the access, but I think if you do, it might come out slightly suspicious. If you word it well, ie coming from a different country, etc. I doubt they won't explain. I would do all through registered writing though, no emails, or calls.
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Old 03.01.2011, 13:08
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Re: Doctor patient confidentiality.

Thanks again for all replies.

So, Ive read all of your posts with great interest. Im going to send them a letter and explain my views on confidentiality and hopefully they will agree on a expiry date, 90 days.

Oh, I saw Ive made an error in my first post. Ive been on sickleave for 1 1/2 months. 45 days.

And again, thanks. I didnt expect such an avalanche of posts from my first post.

Cheers.
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Old 03.01.2011, 13:14
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Re: Doctor patient confidentiality.

Wow! So many people who say it’s standard procedure so that means it’s okay. What (blind) trust in insurance companies and employers. In fact, it is relatively common that much more information is requested than is needed and what happens to that information one it is electronically entered into some system or another is not clear.

I agree with armandair: ask the HR to define their request or write out a letter giving the insurance company permission to talk to your doctor, making clear you have given your doctor strict instructions to discuss only those issues involved in the medical case at hand. This is more important in my view than a unlimited waiver with a time limit. In other words, you are waiving the doctor-patient confidentiality on a very (case) limited basis.


The insurance company does have a limited right to information, basically a right to information which directly relates to what it is that they are paying for. Here is a link as to the possible consequences of refusing to give a full waiver:http://www.rechtssicher.ch/praxistip...eldversicherer. It is only in German, sorry, and it is not a particularly happy end, even if you do everything that you are entitled to do in terms of maintaining the confidentiality of your medical data.

Personally, I think you are right to be careful. Generally, giving a limited waiver as described above should be enough.

Good luck and get well quickly.



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I do agree with the fact that your company wants to know more about your situation.

However, I completely disagree with their formal request of a waiver. Doc-Patient confidentiality is basically above everything. Especially the waiver does not mention a specific time period or reason for asking, or what is supposed to be asked to the doctor.

I was in this situation in the past and asked HR to define their request and also informed my doctor that HR will call.

He then asked HR to define and rephrase their questions more formally.

Personally I would never ever sign a paper that gives away information on a 100% base.

Your doctor can also issue a certificate " Arztzeugnis" for HR. This is in most cases sufficient enough.

Last edited by Ziger; 03.01.2011 at 13:16. Reason: forgot link
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Old 03.01.2011, 20:18
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Re: Doctor patient confidentiality.

I guess the question is, as Clint Eastwood would say: Does the OP feel lucky?

If he feels like taking on an insurance company while not being paid, then he should try being difficult.

If, as he says, he has nothing to hide, why go looking for trouble?

It's also about the cost/benefit ratio. Sure, he might be able to win against the insurer but at what cost to himself in energy and stress. Insurance companies have money and can afford to drag out proceedings and appeals. Can the OP?

As I said: does he feel lucky?
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Old 03.01.2011, 20:46
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Re: Doctor patient confidentiality.

I was ill for nine months, and gave the blanket permission as asked - I signed a standard letter that was sent to me. It gave me no problem whatsoever. The insurance co is only trying to do its job, and hasnt got the time or inclination to ask your doctor questions out of mere curiosity. It asks what it needs to know. Your doctor knows the insurance law well, and will not give any info that is prejudicial to you. I am a health professional, so well-placed to know.

My adivce would be to sign the letter that is sent to you.
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