Can a commander request medical results from providers?

SPC Private RallyPoint Member — Mon, 24 May 2021 09:12:42 -0400

So recently I found out my commander had asked my PCM for some results on some issues I'm having with my heart. I didn't even know my results yet because I was waiting on my follow up, but someone the commander was able to get it before me without signing anything saying that I give permission

Response by SFC Private RallyPoint Member made May 24 at 2021 9:26 AM

SFC Private RallyPoint Member — Mon, 24 May 2021 09:26:37 -0400

Under the Military Command Exception, a covered entity may disclose the PHI of Service members for authorized activities to appropriate military command authorities. It is important to note that this exception does not require covered entities to disclose PHI to commanders, it only permits the disclosure. If disclosure is made, then only the minimum amount of information necessary should be provided. Further, the Exception does not permit a Commander’s direct access to a Service member’s electronic medical record, unless otherwise authorized by the Service member or the HIPAA Privacy Rule.

(From a PDF info paper that's in the second link).

https://www.health.mil/Military-Health-Topics/Privacy-and-Civil-Liberties/HIPAA-Compliance-within-the-MHS/Military-Command-Exception

The Health Insurance Portability and Accountability Act (HIPAA) permits protected health information (PHI) of Armed Forces personnel to be disclosed under special circumstances. Commonly referred to as the Military Command Exception, covered entities such as military treatment facilities may disclose the PHI of Armed Forces personnel to Command authorities for authorized activities.

These activities include fitness for duty determinations, fitness to perform a particular assignment, or other activities necessary for the military mission. PHI disclosed to military command authorities, while no longer subject to HIPAA, remains protected under the Privacy Act of 1974.

https://www.army.mil/article/46296/release_of_protected_health_information_to_commanders

It seems a little grey area since commanders can request PHI to determine readiness...but not sure about the direct access to medical records. You may want to see about talking to patient advocacy at the hospital. Perhaps JAG? It's a bit iffy the commander got the results before you did.

Military Command Exception

Learn more about the Military Command Exception; specifically, as it relates to the HIPAA Privacy Rule and applicable DoD issuances in that a DoD covered entity (CE) may use or disclose the protected health information (PHI) of Armed Forces members for activities deemed “necessary by appropriate military command authorities to assure the proper execution of the military mission.”

Response by SSgt Christophe Murphy made May 24 at 2021 9:29 AM

SSgt Christophe Murphy — Mon, 24 May 2021 09:29:44 -0400

There are exceptions made for Military Commands. There are clear rules that manage it. If you feel that your HIPAA rights were not upheld speak to patient relations but I would walk through everything before you ring that bell because they are probably within the boundaries of Military Command Exception. https://www.health.mil/Military-Health-Topics/Privacy-and-Civil-Liberties/HIPAA-Compliance-within-the-MHS/Military-Command-Exception

Military Command Exception

Response by LT Brad McInnis made May 24 at 2021 10:42 AM

LT Brad McInnis — Mon, 24 May 2021 10:42:40 -0400

Military commanders have the right to question the health of people in their unit, if readiness is a factor. I, nor did any Commanders I ever worked for, use it. If you feel your commander went around you and violated your rights, I would schedule office hours (or whatever you call a meeting with them) and ask them about it. Always give the commander the chance to answer if they chose to, before going outside the unit for resolution. If you aren't provided reasonable response, then you can go to your health provider and talk to them about next steps.

I hope you are okay, and everything works out.

Response by CSM Darieus ZaGara made May 24 at 2021 10:54 AM

CSM Darieus ZaGara — Mon, 24 May 2021 10:54:19 -0400

In short they can request and update on your health. In fact, depending on the result the physician would be obligated to disclose the primary issue. There is nothing nefarious about it.

Response by SSG Brian G. made May 24 at 2021 12:04 PM

SSG Brian G. — Mon, 24 May 2021 12:04:17 -0400

Your commander is responsible for the readiness and state of his unit. Your health condition affects that. He has a right to inquire as to your health state but the information he or she can obtain is limited. They do not need your authorization for this but do require it if there is a broader disclosure to be made.

Response by CPT Private RallyPoint Member made May 24 at 2021 4:39 PM

CPT Private RallyPoint Member — Mon, 24 May 2021 16:39:18 -0400

Medical providers will sometimes call the commander directly if there is a significant readiness or safety concern. “This Soldier should not be doing physical activity until we get a better idea of what’s going on,” “this Soldier is non-deployable due to behavioral health issues,” etc. If you were put on a temporary or permanent profile, they entered it into an automated system that the commander can view.