Is there a database of DOT Physicals available to doctors?

@Ridgeline I think you either missed my point or I did not do a good enough job of explaining it. What I was attempting to say was all medical information is covered by HIPAA. When you engage in something that is subject to Federal or State regulatory compliance you have to surrender some of your rights under HIPAA. It does not mean a driver's HIPAA rights are 100% gone. Take a look at this warning found on the MSCA-5875!!!! That warning is NOT for the driver. It is directed to ANYBODY with access to this data to be careful and not violate the person's medical privacy!

 

Just to be fair, I looked at the 2002 law as the 1991 law would not matter as HIPPA didn't exist until 1996. Didn't find anything in there about a HIPPA exemption. Just because a regulatory body want to regulate something, doesn't mean they can contradict an already established law. Look at the recent Supreme Court ruling slapping the EPA down for overreaching.

Now I will say that law is long, so I coulf have missed where congress gave FMCSA authority to ignore other law, so until it's pointed out the exact law you are still wrong. Sorry, but you are.

 

Personally, i could care less if my medical history was published on the front page of the New York Times.
There are more thing's to worry about than HIPAA.

 

Well, I don't know Moose, we may be talking about different approaches to this, but I see some here don't understand there is no limit or surrendering partial information when it comes to fulfilling the regulatory needs of the DoT and the states. The exemption is in the law, the US DoT/FMCSA has stated that the exemption exists but is unsure how it actually applies beyond drug testing. However, the HHS said it covers all DOT requirements, which includes physicals.

HIPAA only applies to medical professionals, as I have been saying.

And to clarify all of this again how it got there, the US DoT has the job of regulating transportation as part of the interstate commerce clause and it is a constitutional duty. They can not do a job of ensuring operator fitness for public safety with an obstacle like HIPAA because of the control the person has on their private medical information >>>> Congress agreed with the US DoT that any limitations will prevent the regulation of interstate commerce and wrote a preemptive limit to follow legislation in the Transportation Act of 1991, which limited the use of privacy to stop the regulation of the operator and their fitness.

When there is an accident, the US DoT doesn't have to run to the courts to secure a warrant, like in a plane crash, they contact the last known examiner for their records and the examiner complies. There is no HIPAA involved because of the exemption. If they find other issues which lead to another doctor, they can't hide behind HIPAA because of the exemption.

I have a quick example of a driver who lied on their DOT long form, he was diabetic but didn't disclose it. He had an accident, the investigation revealed that he had a diabetic incident and the state DoT enforcement agency contacted the examiner who released the long form, nothing was on the form about the medication that was found in the truck or his having it. They contacted his PCP who tried to hide behind HIPAA but could not and had the lawyers involved. It went to court, and the court told the doctor there is an exemption to HIPAA for the purpose of public safety and released the info.

Where HIPAA comes into the scene is how the records are handled, how they are stored (which isn't really enforced), and how the information is communicated to third parties.

There was a joke of a scene in Grey's Anatomy a while back, two doctors were talking about cases, and one when asked about a specific person, the other doctor said "I can't talk about it because of HIPAA" which is bullsh***. They can talk among themselves within the same organization but if they are talking to a person outside of the facility, they can not disclose specific identifying information about the person, not the medical condition of the person.

About me - I have 10 years of dealing with this specific law when I was a consultant for medical practices because the work I did had to do with direct access to medical records. I have sat in on many discussions about it, talk to many lawyers, and went to a crap load of conferences. As much as there is a lot of confusion and an awful lot of bullsh**** created over the law in this industry, it comes from people who haven't been working with it.

The medical industry has taken a bad position with HIPAA, it is all about covering the ***** of the workers in these practices and facilities, a lot of these nurses and clerks are utter morons when it comes to this law, they go to one or two conferences and think they know everything about it.

EDIT - I forgot to reiterate one thing, as a carrier/fleet owner, HIPAA does not apply to my company or anyone in the company. Like I said I can tell anyone about any driver or have anyone look at their driver's jacket with their long form in it. I can openly discuss a driver's medical condition >>>> BECAUSE I DO NOT FALL UNDER HIPAA.

However, the law I am supposed to follow and IS enforce is the ADA. ANY AND ALL medical information has to be secured and I have to maintain limited access to, by the regulations of the ADA.

I'm not wrong.

Here is what you can do, contact a lawyer who deals with this, ask them what the limitations of the law are and if there are exemptions, they will tell you exactly what I have said. What you missed, and will state this again, the law only covers medical professionals, it does not cover anyone else.

The exemption is to prevent the operator from impeding the US DoT from doing its duty of regulating the operator by determining the fitness of the operator.

By the way, the EPA operates under its Charter, there is no direct constitutional duty to regulate emissions, but there is a legislative duty as the US DoT as part of its charter has a direct constitutional duty to regulate interstate commerce. The SC has yet to even address this issue, the lower courts have refused to allow cases about the exemption to go through because Congress told the courts that is off-limits.

 

I wonder if we are talking about 2 different things. I 100% agree HIPPA only applies to medical professionals. Trucking companies can give their gardener a copy of the long form if they so choose. At least in regards to HIPPA.

I'm talking about the Op''s question though. Can medical examiners submit information between themselfs? I.e. a medical database.
And sorry, but HIPPA simply does not allow a medical professional to give that data to anyone unless there is a release.

Any you have yet to provide a law that says otherwise. You are starting to look the fool from not being able to back up what you are saying.

 

I was actually looking for another thing when I came across this FMCSA webpage.

Are the DOT medical examinations covered by HIPAA?
Answer:
Regulatory requirements take precedence over the Health Insurance Portability and Accountability Act (HIPAA) of 1996. There are potential subtle interpretations that can cause significant problems for the Medical Examiner. What information must or can be turned over to the carrier is a legal issue, and if in doubt, the examiner should obtain a legal opinion. Federal Motor Carrier Safety Regulation 391.43 does not address or prohibit the sharing of medical information by Medical Examiners.

Last Updated : April 1, 2014

I get the impression the FMCSA is telling MEs to get a legal opinion if they have questions. So based on this the FMCSA is saying they have regulatory authority that is more important than HIPAA. I have the idea that a person wanting to challenge this will have to file a Federal Lawsuit against the USDOT/FMCSA.

Good luck!

 

Not based on that clear warning clearly written on the MSCA-5875 I posted in #51. As I quoted in my last comment the FMCSA has stated in their opinion their regulatory authority "takes precedence" over HIPAA. The rights under HIPPA are still present. Any agency or carrier that mishandles medical information gained by the FMCSA regulatory authority that might cause a release in my opinion has exposed themselves to serious legal liability.

When it comes to medical information being released between medical professionals you are right that said information is indeed covered by HIPAA. The problem comes when you are attempting to get a physical and the ME demands more information from you to finish. If you either don't sign a release or fail to get the information said ME has no other choice than to follow the rule found in 391.43(g)(4). As a result, you are no longer qualified to operate a CMV as defined by 10,001 NOT 26,001.

 

Hippa only applies to medical professionals and a few others like medical insurance. HIPPA is very specific on who it applies to. If a 3rd party,, like a trucking company, that is not a medical professional, has health information it simply isn't covered by HIPPA. It might be covered by other laws, but not HIPPA.
So yes, a trucking company is not breaking HIPPA laws by giving a long form away as they are not covered by HIPPA to begin with.