McRae v. Arby's Restaurant Group, Inc.
313 Ga. App. 313
| Ga. Ct. App. | 2011Background
- McRae sustained a work-related esophageal burn in 2006; employer began income benefits and she authorized medical information release for 90 days via Form WC-207.
- In 2009 a treating gastroenterologist opined 65% permanent impairment after maximum medical improvement; McRae sought hearings on TTD and PPD in 2009–2010.
- Employer sought ex parte communications with the treating physician; physician refused without patient’s express permission.
- ALJ ordered McRae to authorize ex parte talks with employer’s counsel or have hearing removed; Appellate Division affirmed; superior court upheld.
- Major question: whether the Act requires authorization for ex parte physician-counsel communications and whether HIPAA privacy applies in workers’ compensation proceedings.
- Court held that the Act does not compel ex parte authorization and that HIPAA Privacy Rule applies, limiting ex parte access and preserving medical privacy.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether OCGA 34-9-207(a) requires a claimant to authorize ex parte physician communications | McRae argues information includes non-tangible thoughts; ex parte talks violate privacy. | Employer argues statute authorizes disclosure of information and communications to pursue benefits. | No; information does not require ex parte talks in exchange for benefits. |
| Whether HIPAA Privacy Rule prohibits ex parte physician communications in workers’ compensation | Privacy protects non-disclosed medical information; ex parte talks threaten privacy. | HIPAA permits disclosures as necessary to comply with workers’ compensation laws. | HIPAA applies; it permits disclosures necessary to comply with workers’ compensation requirements, not a blanket exemption. |
| Scope of 'information' under OCGA 34-9-207(a) for physician disclosures | Information includes mental impressions and non-written knowledge. | Information means tangible medical records and documents. | Information encompasses more than tangible records; includes relevant non-tangible knowledge, but not to compel ex parte talks. |
| Whether the Act's purpose requires treating physicians to be accessible ex parte to continue benefits | Compulsory participation in workers’ comp warrants streamlined access to records. | Ex parte access is necessary for efficient processing and fraud reduction. | Not required; employee privacy and safety concerns justify limiting ex parte communications. |
Key Cases Cited
- Baker v. Wellstar Health Systems, 288 Ga. 336 (2010) (medical privacy protection under Georgia Constitution and Bodily privacy limits ex parte)
- Moreland v. Austin, 284 Ga. 730 (2008) (HIPAA privacy protections apply to health information)
- Busch v. State, 271 Ga. 591 (1999) (statutory construction avoid absurd result; information means broader than tangible records)
- Clarke v. Samson Mfg. Co., 177 Ga. App. 149 (1985) (context of workers’ compensation; relevance to non-adversarial process)