The office can get the same injury and workers’ compensation claim information as the employee, but it cannot access or disclose privileged or confidential information, and it cannot make confidential information public.
Sec. 404.111. ACCESS TO INFORMATION. (a) When assisting an injured employee, the office is entitled to the same access to information related to the employee's injury and workers' compensation claim as the employee or any other party to the claim. (b) The office may not access information under Subsection (a) that is an attorney-client communication or an attorney work product, or other information protected by a privilege recognized by the Texas Rules of Civil Procedure or the Texas Rules of Evidence. (c) In furtherance of assisting an employee under Section 404.105(a)(2), the office may not access information under Section 404.111(a) to which the employee is not otherwise entitled. If the office possesses any information made confidential by the Texas Workers' Compensation Act or any other laws of this state to which the employee is not otherwise entitled, that information may not be disclosed to the employee or any other party assisting an employee under Section 404.105(a)(2). Nothing in this subsection prohibits or alters the office's duty to notify appropriate law enforcement authorities under Section 404.1015(c). (d) Repealed by Acts 2011, 82nd Leg., R.S., Ch. 289, Sec. 8, eff. September 1, 2011. (e) The office may not make public any confidential information provided to the office under this chapter. Except as provided by Subsection (c), the office may disclose a summary of the information that does not directly or indirectly identify the individual or entity that is the subject of the information. The office may not release, and an individual or entity may not gain access to, any information that: (1) could reasonably be expected to reveal the identity of a health care provider or an injured employee; (2) reveals the zip code of an injured employee's primary residence; (3) discloses a health care provider discount or a differential between a payment and a billed charge; or (4) relates to an actual payment made by a payer to an identified health care provider. (f) Information collected or used by the office under this chapter is subject to the confidentiality provisions and criminal penalties of Section 402.091. (g) Information on health care providers and injured employees that is in the possession of the office, and any compilation, report, or analysis produced from the information that identifies providers and injured employees is not: (1) subject to discovery, subpoena, or other means of legal compulsion for release to any individual or entity; or (2) admissible in any civil, administrative, or criminal proceeding. (h) Notwithstanding Subsection (e)(2), the office may use zip code information to analyze information on a geographical basis. Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005. Amended by: Acts 2009, 81st Leg., R.S., Ch. 1261 (H.B. 673), Sec. 5, eff. September 1, 2009. Acts 2011, 82nd Leg., R.S., Ch. 289 (H.B. 1774), Sec. 4, eff. September 1, 2011. Acts 2011, 82nd Leg., R.S., Ch. 289 (H.B. 1774), Sec. 8, eff. September 1, 2011. SUBCHAPTER D. OMBUDSMAN PROGRAM