Posted on Mar 21, 2022
Should I go to IG for HIPAA Violation by my 1SG and PSG?
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So I'm going through the medboard process and I had a telephonic appointment to give a summary of my medboard process so far, I told my Leadership I did not want them present due to HIPAA, the next day I get cussed out and intimidated by my 1SG who told me I cannot invoke HIPAA regs, appointment comes around and I am in the PSG office in my appointment the caller than spouts off things I didn't want my leadership knowing about which I filed claims for and got approved by the VA I am currently on 4 permanent profiles due to medical conditions and my PSG heard all my medical conditions that I currently have and claimed, can I go to IG about this toxicity, intimidation and HIPAA Violations?
Toxic Leadership
Inspector General
Career Counselor
Career Advice
Posted >1 y ago
Responses: 120
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Well if any one has ever attended a BN or BDE Command and Staff then you will know that every one on profile or going through a MEB/PEB or a MAR2 are all reviewed and discussed with a shit ton of other leadership listening. Hell the S1 clerk who sets up the slides probably may know more about the medical readiness of said Soldiers than there own chain of command and chain of concern!
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I gotta ask - because it seems like your only intention of joining the military was get a medical/disability related discharge out of the military.
A PFC with four different medical profiles? Four? I've heard of one, and sometimes after an injury even two. But four, for a junior enlisted? Going to Medical and collecting profiles must be a full-time job for you. Meaning, what do you do besides go to medical appointments? How did you make it through MEPS, Basic and MOS training with so many medical problems or conditions, or did you? Service members with even one permanent profile undergo a Medical Retention Board and Physical Evaluation Boards to determine fitness for further military duty. How did you get four profiles and still remain active? Or is this your first Medboard?
HIPAA regulations are not like your other civil rights, they only apply to healthcare employees or organizations, or contractors and vendors who need health care information (HCI) to do their jobs. Put simply, they have to protect your HCI and may not disclose it without your permission. That said, you absolutely had the right to tell the medical board on that call that your 1SG was listening in and you didn't approve. That's the first thing OIG will ask - did you tell anyone? No? Then you consented or this was not a knowing violation by them. Unaware violations are minor infractions and in the scheme of OIG investigations, probably rate too low on their matrix to even dedicate time with. They'll refer you to the DOJ's Office of Civil Rights where again, unless this is a case of repeated, unaware violations, the most they will do is note the office it came from in case there are other complaints.
Toxic Leadership and Intimidation accusations are largely subjective. Coming from a PFC with a record like yours, you'll need further examples. One anecdotal story isn't a pattern and that's what needs to be established.
A PFC with four different medical profiles? Four? I've heard of one, and sometimes after an injury even two. But four, for a junior enlisted? Going to Medical and collecting profiles must be a full-time job for you. Meaning, what do you do besides go to medical appointments? How did you make it through MEPS, Basic and MOS training with so many medical problems or conditions, or did you? Service members with even one permanent profile undergo a Medical Retention Board and Physical Evaluation Boards to determine fitness for further military duty. How did you get four profiles and still remain active? Or is this your first Medboard?
HIPAA regulations are not like your other civil rights, they only apply to healthcare employees or organizations, or contractors and vendors who need health care information (HCI) to do their jobs. Put simply, they have to protect your HCI and may not disclose it without your permission. That said, you absolutely had the right to tell the medical board on that call that your 1SG was listening in and you didn't approve. That's the first thing OIG will ask - did you tell anyone? No? Then you consented or this was not a knowing violation by them. Unaware violations are minor infractions and in the scheme of OIG investigations, probably rate too low on their matrix to even dedicate time with. They'll refer you to the DOJ's Office of Civil Rights where again, unless this is a case of repeated, unaware violations, the most they will do is note the office it came from in case there are other complaints.
Toxic Leadership and Intimidation accusations are largely subjective. Coming from a PFC with a record like yours, you'll need further examples. One anecdotal story isn't a pattern and that's what needs to be established.
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PFC Jaymes Shrader
Severe car wreck and surgeries started two genetic conditions I had no idea about also had a labram tear that left me immobile for months then the joint and spinal diseases caught on. My leadership didn't know what was going on and neither did I so I was sent to a rheumatologist and told me that the conditions I have were most like caused by the car wreck I also got a septic join infection that required surgery and now I have limited mobility in my left elbow so the four permanent profiles are hearing, left elbow, spine and legs. Ik it's far fetched as hell and I hate it I haven't been able to run for 8 months now and I limp when walking I just got off my cane back in March and my brace for my knees last month.
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Suspended Profile
PFC Jaymes Shrader it’s not far fetched at all. Things happen. Hopefully you get the medical attention you need to increase your quality of life.
Cpl Brad MarkW
PFC Jaymes Shrader - so you don't want your command to know about your medical conditions but have no problem listing them on a social media site?
Look, I am sorry you've got those medical issues and I apologize if I seem uncaring or unsympathetic. However, the fact that your command is so hostile to your situation tells me there's more to the story. That's none of my business so I'll bow out and wish you the best of luck and hopefully a return to full health.
Look, I am sorry you've got those medical issues and I apologize if I seem uncaring or unsympathetic. However, the fact that your command is so hostile to your situation tells me there's more to the story. That's none of my business so I'll bow out and wish you the best of luck and hopefully a return to full health.
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PFC Jaymes Shrader
Cpl Brad MarkW there many more that I didn't feel comfortable knowing the ones I listed are the ones I'm okay with sharing
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You are already on your way out the door so why would you make your life even more difficult? Sounds to me like you want some sort of revenge.
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Like others have said, utilizing the IG route isn’t going to accomplish what I think you’re desiring. If you’re at the Med Board process, I’m assuming that you’re separating - so my thought would be, what’s the use. If you need someone to talk to or talk with, I recommend a chaplain or a trusted leader within your unit. Keep your laundry within your house and all will be better for it. HOOAH?
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Gunny Pepper is mostly spot on, if a bit blunt and possibly arrogant (I'd still be honored to work with you, though, Gunny.)
I think you should take option 1. Keep your head down, do your job, and wait for the med board to finish. Most important, you have learned a hard lesson: your medical history is YOUR business only, no one else's. If you think this is bad, wait until a civilian employer finds out, they'll drop you like a hot potato and possibly work you over in the process. The typical response from a civilian employer when you invoke FMLA or ADA rights is to terminate your job even though it's clearly against the law. They won't just lie down and take static from you, they WILL call your bluff and force you to file a suit...if anyone will take your case.
If you followed instructions from TAP class and filed legitimate claims with the VA, that's definitely not malingering. Make sure you are honest with them, then you're good to go.
Your current chain of command will be out of your life soon. Buckle down, do your job, and separate when it's time.
Your chain of command has done you a favor causing a MINOR issue over your medical history, now you know why it's confidential.
Welcome aboard the USS Back Yard. Enjoy your cruise!
I think you should take option 1. Keep your head down, do your job, and wait for the med board to finish. Most important, you have learned a hard lesson: your medical history is YOUR business only, no one else's. If you think this is bad, wait until a civilian employer finds out, they'll drop you like a hot potato and possibly work you over in the process. The typical response from a civilian employer when you invoke FMLA or ADA rights is to terminate your job even though it's clearly against the law. They won't just lie down and take static from you, they WILL call your bluff and force you to file a suit...if anyone will take your case.
If you followed instructions from TAP class and filed legitimate claims with the VA, that's definitely not malingering. Make sure you are honest with them, then you're good to go.
Your current chain of command will be out of your life soon. Buckle down, do your job, and separate when it's time.
Your chain of command has done you a favor causing a MINOR issue over your medical history, now you know why it's confidential.
Welcome aboard the USS Back Yard. Enjoy your cruise!
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GySgt Kenneth Pepper
I just noticed your post and appreciate your thoughts. Being blunt is definitely one of my opportunities for improvement. I just have a problem tolerating selfish, foolish questions being masked with "toxic leadership".
I was amazed by how much disparity there was in the responses to his question.
I was amazed by how much disparity there was in the responses to his question.
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HIPPA is mainly for civilian doctor /patient confidentially. When it comes to the Military you have a lot of different set of rules. Can you file a complaint, yes you can, you write your congressmen? You got a better chance. Pick your battle wisely. Your chain of command goes higher than your Rank.
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There is a mitary command exception to HIPPA. Covered entities may disclose protected health information to a Commander that exercises authority over a sService member, or another person designated by the Commander (1SG, PL, PSG) to allow then to determine a number of relevant things - like fitness for duty, fitness for certain assignments or any other activity essential for a military mission. HIPPA was not violated in that call if there was a proper comman authority for the release of that information and it served a proper military purpose.
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PFC Jaymes Shrader
Yes but sitting in on a medical appointment is not one of them 1SG and even then the commander has to delegate(not a 1SG) who has the proper authorities to see the MINIMAL medical information not a whole list of phi that was given out during this appointment
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1SG (Join to see)
PFC Jaymes Shrader normally the command maintains a standing list of who may obtain a service member's medical information. So, if your1SG, PSG, or TL is on the list they have been designated. What is considered the minimum information to be collected is case specific. If the medical information is deemed reasonably necessay by the command a service member's entire medical record be accessed. That is the real issue, what is reasonably necessary. If the command makes the decision that access to a SM's entire medical record is necessary and can justify it, then the provider can release it. Just because a SM has a different opinion of what is necessary does not mean the command was wrong. But regardless of any of this, the medical provider is not required to release that information. Unless the situation meets certain limited exceptions the provider can choose not to release the information. Also, just because the information was released to SM's command does not mean it is now public and can be used for any purpose.
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OMG really?
Your being Medically Boarded. The Chain of Command is in the Loop no matter what title you want to put on it. I would say there is more to this story than we are reading here.
But for the sake of the system my advice to you is to tread lightly and let your CoC do there collective Jobs you will find your Med board goes faster. FYI your CoC provides information that is important to your Med Board and the results. If you kick them out of the loop Then your support Group/COC can be more of a hinderance rather than assistance During the process. Unless your providing information that is not factually correct then i see no problem with them being involved. According to what you have typed here you have several profiles, THE COC ALREADY KNOWS! quit stirring the stink pot. At this point if i was in your COC i would be more than happy to get you all the assistance you need to go home, You're only slowing the process. JMTC
Your being Medically Boarded. The Chain of Command is in the Loop no matter what title you want to put on it. I would say there is more to this story than we are reading here.
But for the sake of the system my advice to you is to tread lightly and let your CoC do there collective Jobs you will find your Med board goes faster. FYI your CoC provides information that is important to your Med Board and the results. If you kick them out of the loop Then your support Group/COC can be more of a hinderance rather than assistance During the process. Unless your providing information that is not factually correct then i see no problem with them being involved. According to what you have typed here you have several profiles, THE COC ALREADY KNOWS! quit stirring the stink pot. At this point if i was in your COC i would be more than happy to get you all the assistance you need to go home, You're only slowing the process. JMTC
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SFC Robert Walton
SFC Corey Pitt If your going to down vote others comments at least be Honorable enough to post a reason why. Not strike in the dark and run.
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Suspended Profile
SFC Robert Walton I actually did leave a comment, I’m just unsure why it didn’t post. Regardless, my issue with your post is that it is inaccurate in stating that the CoC is in the loop no matter what, which would make this soldier believe that they did no wrong in this situation. The fact of the matter is that the Command forced this young soldier to have a medical appointment with the 1SG and PSG in the room. The soldier stated he did not want them in the room and despite him voicing his concerns and disapproval, they verbally assaulted him and bullied their way into a space they weren’t welcome. This is a HIPAA violation for the simple fact that the provider went well beyond what information limits the Military Command Exception policy states the Commander is able to receive. The MCE policy states that providers are authorized, not required, to disclose minimal PHI about the soldier and the policy does not authorize the Commander access to the soldier’s medical file unless explicitly stated approval by the soldier. The soldier declined their suggestion to be present, they forced their way in the room, the provider gave detailed medical information on conditions the soldier is suffering from, and the PSG (who isn’t part of the CoC) attended as well, yet you seemed to have conveyed to the soldier that he was rocking the boat and is causing trouble. I did agree with you that there was more to the story, and obviously this is one-sided, as I also had questions in my original statement. However, the soldier did speak on additional information regarding this situation and spoke to the HIPAA representative and IG resulting in an investigation where each office he spoke to agreed the command overstepped and broke the law. My issue is you rendered an opinion while admitting to not having crucial facts and seemingly blamed the soldier for this situation while not taking a step back to see just how bad the Command handled this situation. This is why I voted down.
https://www.health.mil/Reference-Center/Fact-Sheets/2022/01/05/Info-Paper-Military-Command-Exception-and-Disclosing-PHI-of-Armed-Forces-Personnel
https://www.health.mil/Reference-Center/Fact-Sheets/2022/01/05/Info-Paper-Military-Command-Exception-and-Disclosing-PHI-of-Armed-Forces-Personnel
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Private, HIPPA only applies to your medical records and/or conversations with your Dr. Now, here is where we separate civilian from the military. Your chain has a right to know if you are physically or mentally capable of carrying out your duties or if you are a danger to your unit. The military has its own regulations on the treatment of medical records. You have every right to visit the IG and explain what your issues are but be advised that you had better have witnesses and/or documentation relating to your complaint. Command should not be freely discussing your medical history in an unofficial environment. Leaders should know better.
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Too many unknown variables here and we’re only getting one side of the story. Ultimately it boils down to, you can go to the IG for anything. Now wether or not they accept your complaint is on them.
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68X here. Privacy and consent for disclosure of PHI/PII are always going to be there. When it comes to the medboard process your chain of command with be integrated with your care. They are the ones that the behavioral health team keeps in contact with. There's really a long trail of paperwork that is filled out, and somewhere along the line there was justification for a medboard to be initiated from your care provider in conjunction with being unfit for duty and not retainable.
From a behavioral health perspective, to be a PFC and possibly have less than 2 years of service with 4 permanent profiles raises many red flags with all medical units and command.
You can do a few things regarding IG. No one can stop you from going to IG and initiating an investigation.
Before pursuing the legal realm, go to your outpatient behavioral health and seek guidance about your stress and situation in the meantime.
With the remaining time in your army know that no matter what you do shit trickles downhill.
From a behavioral health perspective, to be a PFC and possibly have less than 2 years of service with 4 permanent profiles raises many red flags with all medical units and command.
You can do a few things regarding IG. No one can stop you from going to IG and initiating an investigation.
Before pursuing the legal realm, go to your outpatient behavioral health and seek guidance about your stress and situation in the meantime.
With the remaining time in your army know that no matter what you do shit trickles downhill.
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HIPAA, the Health Information Portability and Accountability act of 1996, is an often referred to and misunderstood thing. It regulates under what circumstances persons who have access to certain health information may share with others. It does not prohibit anyone from asking or listening.
Sure, you can go see the IG about anything. Then they can explain to you that if you consented to a third party being in your interview, it is unlikely that a HIPAA violation occurred. In addition, it is the responsibility of the person/s who holds protected health information to comply. It is not your sergeant's responsibility to plug his ears and not listen.
An unanswered question here is what was the nature of this telephonic appointment and why was your PSG there in the first place?
If you don't feel you can have a conversation about this with the PSG or 1SG, then make an appointment with the Commander, who has ultimate responsibility.
Meanwhile a trip to talk with a neutral party, i.e., the Chaplain or a counselor might be most helpful.
Sure, you can go see the IG about anything. Then they can explain to you that if you consented to a third party being in your interview, it is unlikely that a HIPAA violation occurred. In addition, it is the responsibility of the person/s who holds protected health information to comply. It is not your sergeant's responsibility to plug his ears and not listen.
An unanswered question here is what was the nature of this telephonic appointment and why was your PSG there in the first place?
If you don't feel you can have a conversation about this with the PSG or 1SG, then make an appointment with the Commander, who has ultimate responsibility.
Meanwhile a trip to talk with a neutral party, i.e., the Chaplain or a counselor might be most helpful.
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PFC Jaymes Shrader
There was an intervention and everything has been dealt with sir, the appointment was a medical appointment which prior to I had asked my chain of command not to be there, my 1SG insisted the day before that my PSG be there which is classified as an unlawful order due to the nature of the appointment, my HPI was released to unwanted parties due to my PSG being there.
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MAJ (Join to see)
I am glad you got this sorted out.
The HIPAA issue is always the responsibility of the provider or holder of the information. As in many things, it is not always as simple as it seems.
When a patient is in an exam room or a telehealth interview, it is inferred that protected health information (PHI) will be discussed. It can also be inferred that any third party present is there with the consent of the patient. Unfortunately this is not always correct. This puts the provider in the position of having to ask the patient if it is OK to proceed with that third party present. As you can imagine, this seldom happens unless there is an obvious problem.
Now you know. If you are having a health care visit, or even talking to a clerical person at the front desk, and there is someone you don't want to divulge PHI to, be sure to speak up.
The HIPAA issue is always the responsibility of the provider or holder of the information. As in many things, it is not always as simple as it seems.
When a patient is in an exam room or a telehealth interview, it is inferred that protected health information (PHI) will be discussed. It can also be inferred that any third party present is there with the consent of the patient. Unfortunately this is not always correct. This puts the provider in the position of having to ask the patient if it is OK to proceed with that third party present. As you can imagine, this seldom happens unless there is an obvious problem.
Now you know. If you are having a health care visit, or even talking to a clerical person at the front desk, and there is someone you don't want to divulge PHI to, be sure to speak up.
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Not only should you contact the IG but you should also contact your Congressman just in case the IG doesn’t do their job.
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HIPAA Privacy Rules don't seem to fit the circumstances your complaint refers to. HIPAA only applies to health plans, health care clearinghouses, and healthcare providers that conduct certain healthcare transactions electronically, none of these conditions seem to have been violated. The fact that someone was present and you knew they were present, is not a violation of HIPAA Privacy Rules. You had the opportunity to inform those who were conveying the information that there were others present and you did not feel it appropriate that the individuals present should be privy to your personal health information. If you did state that and they continued, you might have a complaint, but it's doubtful. Health care providers may disclose the necessary protected health information to anyone who is in a position to prevent or lessen the threatened harm, including family, friends, caregivers, and law enforcement, without a patient's permission.
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I guess the better question is, if there is nothing to hide with all your medical issues that you want to get paid for, What's the problem?
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Suspended Profile
Hmmm. Med Board. REally. Your profile pic marks you as young and healthy. What's the real deal here? Just asking, as a nosey old army nurse.
PFC Jaymes Shrader
The real deal rn is you're being counterproductive as well as ignorant, if the comment doesn't pertain to the question and your only here to be demeaning and inconsiderate.
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Well... let's go over the myriad of issues here. You can request for intervention by your CO, if you jump to the IG, you are going to rip open a hornets nest. If you had command members there under duress, that's intimidation. If you didn't tell the medical personnel they were in the room, that's on you. From a command perspective, the only time I went to medical appointment/exam with a Marine or Sailor was when I had a malingering individual or it had something to do with confinement. If neither had to do with you, do your research and approach it by the right process. If either applied, if you file a complaint, your departure from the service may be "extended" in lieu of investigation.
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I personally would NOT, as it would make a difficult situation even more so for you. I would however, have mentioned to person on the phone that you were not in a private setting, and let them know who was there. It is on the Health professional and you as to whether the call proceeds or not (and in your case, it sounds like it should).
The last bit of advice I can offer is document EVERYTHING! Dot the I's and cross the T's.
The last bit of advice I can offer is document EVERYTHING! Dot the I's and cross the T's.
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