Posted on 11/19/2004 8:10:39 AM PST by NormsRevenge
When Kathie Shuler heard from a local chiropractor who offered to treat her injuries, warning bells went off.
How did Wood Chiropractic & Rehabilitation know who she was and, odder yet, that she'd recently been hurt at work?
Shuler, a 50-year-old Bakersfield resident, didn't know that by appealing her workers' comp case on Aug. 6 that what she thought was her personal information officially became public -- a record made available for a small fee to anyone who asks.
The same thing happened to 218,000 Californians last year, according to figures from the California Commission on Health and Safety and Workers' Compensation.
Like Shuler, their personal information such as Social Security numbers, addresses and codes identifying injured body parts has been passed from the state to subscribers who provide it to doctors, lawyers, and others.
Some who get the information may be using it to drum up business. If so, that's illegal.
Shuler became suspicious her medical information had gone beyond her doctor when she received a direct-mail solicitation from Wood Chiropractic on Sept. 22.
The letter caused her to start asking questions of the state and others. The trail eventually led her to James Donato, who is believed to be a Colorado attorney.
Shuler said Donato told her he had previously supplied information to Wood Chiropractic.
But, Shuler said, Donato also told her he had not supplied Wood Chiropractic any names since May -- months before she appealed her claim. Shuler wonders if that's true.
Donato, or companies he operates, has used a public records loophole to get medical information about workers' comp patients in California since the late 1990s.
He has also tried unsuccessfully to access public information in least two other states. In 1999 Arizona blocked his company, Health Information Association, from accessing traffic accident reports for commercial purposes. The following year, Delaware denied his company information on traffic collisions because it wasn't based in the state.
Although California's workers' comp division doesn't technically "sell" patients' medical or personal information, it does provide information about appealed claims to anyone who pays an access fee.
Anytime a patient challenges treatment or benefits, their name enters the division's database.
Say, for example, you believe your back was strained on the job but your assigned doctor doesn't think anything is wrong.
If you officially dispute the doctor's decision, your case pops up in the database.
Once there, it's public record.
"When you file a workers' comp claim, you're going to court," said James Robbins, an attorney with the division. That's why the information is then opened to other eyes.
The division's database is divided into two main sections, each with regular subscribers.
One, called Edex (pronounced ee-decks) allows users to exchange information about specific cases via computer.
The other section is called the "new case opening" list. It was from that section Shuler's information made its way out to the world.
That's the same section where 218,000 disputed cases in California showed up when filed last year.
There are just 16 subscribers to that information.
Some are big names in the health care industry, like Blue Cross and Kaiser Permanente. Others are large "lien recovery" companies who file liens on behalf of others.
One subscriber is James Donato.
"Mr. Donato is in a special category," said Robbins, the lawyer for the workers' comp division.
Donato pays $600 a month for the new-case data, information delivered straight to his computer, Robbins said.
For years, Donato was the lone new-case subscriber signed on under a clause that allows access to "any person with a journalistic purpose."
Now there are three others.
While Donato doesn't get patient Social Security numbers, he does get names, addresses and a three-digit code that specifies body parts injured.
The code for a jaw? 141.
Head? 100.
The back is divided into different levels -- 420 includes muscles, spine and spinal cord -- while a wrist and hand have separate codes.
"We're cognizant of the fact identity theft is a major problem," Robbins said, adding: "We're aware we have a repository of information" that could be used for fraud.
The division of workers' comp does everything it can to protect privacy rights, he said.
But there's the thorny problem of open government and, more slippery, the definition of "journalistic purpose."
"We cannot decide that The Bakersfield Californian and Sacramento Bee are legitimate, but somebody who wants to write a newsletter" isn't, Robbins said. "That's not the kind of decision government gets to make."
Donato declined to comment for this story about his business.
He did, however, say: "A person in Bakersfield is disgruntled. Unfortunately ... federal courts have a different opinion than that woman has."
Bakersfield chiropractor Jeffery Wood also declined to comment.
Robbins said the division investigated Shuler's case history.
Her claim had never been searched under the Edex database where Wood Chiropractic holds a client number.
But it did enter the new-case list, to which Donato subscribes.
If Wood Chiropractic, Donato or any other database customer was found to be using information unlawfully -- in other words, for commercial purposes, as in a direct-mail solicitation -- the workers' comp division would block the user's access.
For a direct subscriber like Donato, simply giving that information to someone not entitled to it under state rules would be a violation, Robbins said.
"We have never been provided with any evidence (Donato) has been misusing that information," Robbins said. "If we found out he was reselling it for an unpermitted use, we would take action to terminate his access."
Shuler's research has also gotten the attention of state Sen. Jackie Speier, a Bay Area Democrat who's embraced privacy rights.
"It's outrageous," Speier said about Donato's and others' access to information most people assume is private. Speier's office is looking into possible legislation about the issue.
Shuler said she feels as if she's been violated.
She's speaking up because she's convinced there are thousands of other people in the same boat.
"I'm not the only one this has happened to," she said.
opps....... another example of to much government.... unilaterism ... lets see what other set of words can we get them to choke on......
So much for HIPAA requirements. Sheesh.
"Donato, or companies he operates, has used a public records loophole to get medical information about workers' comp patients in California since the late 1990s."
Another lawyer that deserves to be in jail.
For those who bath in the public trough the traditional considerations of privacy must be abandon.
If I have to support my neighbor I'd sure like to know why and for how much and how long.
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