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Dwayne B.
Dwayne B., Lawyer
Category: Employment Law
Satisfied Customers: 32325
Experience:  Employment Law Expert
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In late 2015 my employer issued all employees a form that it

Customer Question

In late 2015 my employer issued all employees a form that it said it needed filled out in order to seek out potential new health insurance quotes. The form was front and back and asked very detailed questions (i.e., Do you have or have you ever suffered from chronic immunity deficiency problems, etc.). My employer mandated that these forms be filled out then turned back in, to then be forwarded to the necessary insurance firms. I refused to fill the form out, stating that I could not be assured that my employer- or anyone in my company, for that matter- would not see, read, view or otherwise be privy to the information I'd provided on that form. I was not satisfied that my medical history could adequately be secured, so I refused to fill out the form. My employer mandated that the form be filled out and turned in, so I did.... without revealing any detailed information about my medical status or condition. Now, I find that my insurer is refusing to provide needed medication to maintain my immune system, and my employer suggested it was because I filled out the form way back when, refusing to reveal my medical history.
Submitted: 9 months ago.
Category: Employment Law
Customer: replied 9 months ago.
For every question posed on the form, I checked the "No" box. This was the only way I could be assured that my privacy was maintained. I had no way of knowing who would see the form, where the form would go next, how long the form would sit on my employer's desk (as the office staff moved in and out of the open, unlocked office area), and just how secure the paperwork chain was.
Customer: replied 9 months ago.
I initially refused to fill out the form, simply by turning it back in with the written notation at the bottom stating that I do not believe it was any of my employer's business what my medical history was (other than mandatory random drug testing), and that I was not comfortable with the seemingly open and haphazard means by which the information was to be handled once it left my possession. When pressed to fill out the form later by management, I checked all the "No" boxes all the way down the side of the page.
Expert:  Dwayne B. replied 9 months ago.

Hello and thank you for contacting us. This is Dwayne B. and I’m an expert here and looking forward to assisting you today. If at any point any of my answers aren’t clear please don’t hesitate to ask for clarification. Also, I can only answer the questions you specifically ask and based on the facts that you give so please be sure that you ask the questions you want to ask and provide all necessary facts.

I read your facts, is there a specific question with which I could assist?

Customer: replied 9 months ago.
Well, I am paying for health insurance that I cannot fully use because my insurer is refusing to pay for my medication. As I said, my employer suggested the refusal is directly linked to my refusal to fill out that medical questionnaire. Was the questionnaire legal under HIPPA regulations? Was my employer in violation in issuing the form for completion? Was my employer in violation of securing the form adequately? To my knowledge, the form would have been turned in to a 26-year old trucking company dispatcher, and I have no idea where the form would have ended up or who could potentially have laid eyes on the form. If my insurer is refusing to provide the medications for which I believe I am entitled (and paying monthly for under the ACA), is my insurer liable in any way because of my employer's lax paperwork oversight policies?
Expert:  Dwayne B. replied 9 months ago.

Was the questionnaire legal under HIPPA regulations? Was my employer in violation in issuing the form for completion?

Yes, the form was legal under HIPAA and no, the employer wasn't in violation.

Was my employer in violation of securing the form adequately?

There is nothing in your facts that indicates the employer failed to secure the form. You don't specify what their procedures were, just that you had no way of knowing certain things. However, this particular question is always a question of fact that has to be decided by whoever is receiving the complaint and is not something that is the same for every case.

If my insurer is refusing to provide the medications for which I believe I am entitled (and paying monthly for under the ACA), is my insurer liable in any way because of my employer's lax paperwork oversight policies?

Not that I can see. Again, you don't state what the employer was doing, you just state you don't know what they were doing. However, regardless of whether the employer failed to protect the information sufficiently under HIPAA that is a separate issue from whether the claim should be paid. If they are denying the medication based on an incorrect answer you made on the form then how the form was handled isn't an issue as to whether they should pay. The issue is whether it is a valid denial based on the answers you gave. There is no way I can know that particular answer but you can certainly file a complaint. Your first step would be to file an appeal through whatever process they have in that policy. The next step is to file a complaint either with the Department of Insurance in your state or hire a lawyer who will then send a demand letter and if no response will then file a lawsuit.

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