Can Texas open confidential workers' compensation claim files to another state agency so it can offer injured workers rehab services?

Texas AG Opinion JM-966: Who Can See a Workers' Comp Claim File

Plain-English summary

Two Texas agencies wanted to work together more efficiently, and the question was whether the confidentiality of workers' compensation files let them. The Texas Industrial Accident Board handled workers' comp claims. The Texas Rehabilitation Commission helped injured workers get back on their feet with vocational rehabilitation services. The law already required the Board to spot injured workers who might benefit from rehab and refer them to the Commission. Under the existing system, the Board's own staff combed through claims, mailed eligible workers a notice about rehab services, and sent the Commission a copy of that letter, which told the Commission the worker's name, address, and file number.

Both agencies thought they could do better if Rehabilitation Commission employees could look at the claim files directly. That would let the Commission pinpoint eligible workers more accurately and take the initiative to reach out, instead of waiting for the worker to make contact. The Board's chairman asked the Attorney General whether that was allowed.

The answer was no, and it came down to a confidentiality statute with a closed guest list. Article 8307, section 9a of the civil statutes says information in a worker's claim file is confidential and may be furnished only to a specific set of recipients: the claimant, the claimant's attorney, the insurance carrier, the employer at the time of the injury, third-party litigants, the State Board of Insurance, and the Texas Department of Human Services. The Texas Rehabilitation Commission is nowhere on that list. When a statute spells out exactly who may receive confidential information, that list is treated as complete, and an agency left off it does not get access.

The agencies had a natural argument: the Board is required by another statute, section 7 of article 8306, to cooperate with the Rehabilitation Commission and help injured workers connect with rehab services. Doesn't that duty to cooperate imply that the Commission should be able to see the files it needs to do the job? The Attorney General said no. The duty to cooperate and the duty to keep files confidential are not in conflict, and the cooperation statute does not create a hidden exception to the confidentiality statute. The Board can carry out its cooperation duty in other ways, and importantly, the Commission can get the information it needs once the injured worker actually becomes its client, at which point the worker's own participation opens the door. For example, the Commission can arrange medical care relevant to the worker's rehabilitation. But it cannot go rummaging through confidential claim files of people who are not yet its clients.

The Attorney General leaned on an earlier opinion, MW-202 from 1980, which had faced the same kind of pressure. There, the Board had been asked to release claim-file information to various federal and state agencies that were also not on the section 9a list. That opinion refused to widen the list, even when doing so might have served the general policy behind the law, because no higher federal or state law required the disclosure. The same logic applied here. The bottom line: the Industrial Accident Board may not disclose confidential worker claim files to Rehabilitation Commission employees.

Currency note

This opinion was issued in 1988. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Texas overhauled its workers' compensation system after this opinion. The old law (articles 8306 and 8307, V.T.C.S., including the section 9a confidentiality provision) was repealed and replaced by the current workers' compensation law, now in the Labor Code, and the Industrial Accident Board was replaced by other agencies. The confidentiality rules and the list of who may access claim information have changed. Anyone dealing with access to workers' compensation records today should consult the current Labor Code rather than the article and section numbers used here.

Who this opinion affected (as of 1988)

The Texas Industrial Accident Board: The opinion told the Board it could not open confidential claim files to Rehabilitation Commission staff, even to improve rehab referrals.

The Texas Rehabilitation Commission: The opinion confirmed the Commission's access to claim information comes after a worker becomes its client, not through direct review of confidential files.

Injured workers: The opinion protected the confidentiality of their claim files from disclosure to an agency not authorized by statute to see them.

Common questions

Could Rehabilitation Commission staff review workers' comp claim files?
No. In this opinion the Attorney General concluded that article 8307, section 9a made the files confidential and did not list the Texas Rehabilitation Commission among the authorized recipients, so the Board could not let its employees review the files.

Who was allowed to see a claim file?
Under section 9a, the claimant, the claimant's attorney, the carrier, the employer at the time of the current injury, third-party litigants, the State Board of Insurance, and the Texas Department of Human Services (plus files of adjudicated fraudulent claimants, which were not confidential).

Didn't the Board have to cooperate with the Rehabilitation Commission?
Yes, but the Attorney General concluded that duty did not create an exception to the confidentiality law. The cooperation could be carried out in other ways and after the worker became a Commission client.

How could the Commission still help injured workers?
Once a worker became a client of the Commission, it could provide services such as medical care relevant to rehabilitation, drawing on its authority under the Human Resources Code.

Background and statutory framework

Section 7 of article 8306, V.T.C.S., requires the Industrial Accident Board to promptly analyze each notice of injury and, if it concludes vocational rehabilitation is indicated, to inform the injured employee of the services and facilities available under the Texas Rehabilitation Commission, immediately notify the Commission of such a case, and cooperate with the Commission in providing services and facilities to injured employees. Under the Board's practice, its employees reviewed claims to identify apparently eligible claimants, notified them by mail, and sent the Commission a copy of the letter, disclosing the claimant's name, address, and file number. Both agencies wanted to increase referrals by having TRC employees review claimants' files directly, which would allow more accurate identification and shift the burden of initiating contact to the Commission.

Section 9a of article 8307, V.T.C.S., provides that information in a worker's claim file is confidential and may not be disclosed except as provided in that section. If a workers' compensation claim for the named claimant is open or pending at the time of a record search or request, the Board furnishes the requested information or record check only to the claimant, the attorney for the claimant, the carrier, the employer at the time of the current injury, third-party litigants, the State Board of Insurance, or the Texas Department of Human Services. Information concerning a person finally adjudicated to be a fraudulent claimant is not confidential.

This confidentiality provision was addressed in Attorney General Opinion MW-202 (1980), which considered whether section 9a barred the Board from releasing claim-file information to certain federal and state agencies not listed in section 9a(b). That opinion stated that the initial provisions of section 9a clearly limit claim-file information to certain persons and state agencies only, found no paramount federal or state laws requiring release to the agencies seeking it, and refused to broaden the access provisions despite arguments that a broader construction would be consistent with the policy underlying the confidentiality provision.

Based on the plain language of section 9a and the reasoning of MW-202, the Board may not permit Texas Rehabilitation Commission employees to review workers' claim files. The Board's duty to cooperate with the Commission under section 7 of article 8306 can be carried out after the injured worker becomes a client of the Commission, for example in the provision of medical care relevant to the individual's vocational rehabilitation (see V.T.C.S. art. 8306, section 7 (association shall furnish treatments necessary to restore the employee's physical capacity or relieve pain, but not for any other phase of vocational rehabilitation); Human Resources Code sections 111.052(b)(1) (authority of TRC to cooperate with other agencies) and 111.051(b)(6) (authority of TRC to contract with health care providers for physical restoration and other rehabilitation services)). The duty to cooperate does not conflict with the duty to maintain the confidentiality of claim files under section 9a, and section 7 of article 8306 does not provide a basis for an implied exception in favor of TRC to the section 9a confidentiality provision.

Citations

Statutory authority:

• Article 8306, section 7, V.T.C.S. (Board's duty to notify and cooperate with the Texas Rehabilitation Commission)
• Article 8307, section 9a, V.T.C.S. (confidentiality of workers' claim files; authorized recipients)
• Human Resources Code, section 111.051(b)(6) (TRC authority to contract for physical restoration and rehabilitation services)
• Human Resources Code, section 111.052(b)(1) (TRC authority to cooperate with other agencies)

Cases: none cited.

Prior Attorney General opinions referenced: MW-202 (1980).

Source

• Landing page: https://www.texasattorneygeneral.gov/opinions/jim-mattox/jm-966
• Original PDF: https://www.texasattorneygeneral.gov/sites/default/files/opinion-files/opinion/1988/jm0966.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor OCR errors may remain; the linked PDF is authoritative.

October 19, 1988

Mr. Joseph C. Gagen
Chairman
Texas Industrial Accident Board
1st Floor, 200 E. Riverside
Austin, Texas 78704

Opinion No. JM-966

Re: Authority of the Industrial Accident Board to permit Texas Rehabilitation Commission employees to review confidential worker claim files to assist the board (RQ-1444)

Dear Mr. Gagen:

You ask whether the Texas Industrial Accident Board may allow Texas Rehabilitation Commission employees to review workers' confidential claim files to assist the board in identifying injured workers who may be eligible for vocational rehabilitation services from the commission.

Section 7 of article 8306, V.T.C.S., requires the board to notify the Texas Rehabilitation Commission (TRC) about injured workers who might benefit from vocational rehabilitation:

Upon receipt thereof, the Board shall promptly analyze each notice of injury incurred by an injured employee covered under this law. If the Board concludes that vocational rehabilitation is indicated, [it shall] take the necessary steps to inform the injured employee of the services and facilities available to him under the Texas Rehabilitation Commission and the Board immediately shall notify said Commission of such case. . . . The Board shall co-operate with said Texas Rehabilitation Commission with reference to the work of said Commission in providing said services and facilities to injured employees covered under the provisions of this law. . . . (Emphasis added.)

V.T.C.S. art. 8306, section 7.

At present, board employees review claims to identify claimants who appear to be eligible for TRC services. These persons are notified by mail of the available services and encouraged to contact the commission. The Rehabilitation Commission is sent a copy of the letter and thereby learns the claimant's name, address, and file number.

You state that both agencies would like to increase referrals and that review of claimants' files by TRC employees would permit more accurate identification of persons eligible for TRC's services, and would shift the burden of initiating contact from the claimant to the commission. The workers' claim files are, however, covered by the confidentiality provision of article 8307, section 9a, V.T.C.S., and you are concerned that this provision would prevent TRC employees from reviewing the claim files.

Section 9a of article 8307, V.T.C.S., provides in part:

(a) Information in a worker's claim file is confidential and may not be disclosed except as provided in this section.

(b) If there is a workers' compensation claim for the named claimant open or pending before the Industrial Accident Board or . . . [other circumstances not relevant] at the time a record search or request for information is presented to the Board, the information shall be furnished as provided in this section. . . . The Board will furnish the requested information or a record check only to the following:

(1) the claimant;

(2) the attorney for the claimant;

(3) the carrier;

(4) the employer at the time of the current injury;

(5) third-party litigants;

(6) the State Board of Insurance; or

(7) the Texas Department of Human Services.

. . . .

(c) All information of the Industrial Accident Board concerning any person who has been finally adjudicated to be a fraudulent claimant . . . is not confidential . . . .

V.T.C.S. art. 8307, section 9a.

This confidentiality provision was addressed in Attorney General Opinion MW-202 (1980). That opinion considered whether section 9a of article 8307, V.T.C.S., barred the Industrial Accident Board from releasing information in workers' claim files to certain federal and state agencies not listed under section 9a(b) as entities expressly authorized to receive it. The opinion stated that "[t]he initial provisions of section 9a clearly limit claim file information to certain persons and state agencies only . . . ." Attorney General Opinion MW-202 at 2 (1980). There were no paramount federal laws which required such information to be released to the federal agencies seeking it, nor any state laws which required its release to the state agencies. The opinion refused to broaden the access provisions of section 9a despite arguments that this construction would be consistent with the policy underlying the confidentiality provision.

We conclude, based on the plain language of section 9a and on the reasoning and conclusion of Attorney General Opinion MW-202, that the Industrial Accident Board may not permit employees of the Texas Rehabilitation Commission to review workers' claim files. The board's duty to cooperate with the Rehabilitation Commission under section 7 of article 8306 can be carried out after the injured worker becomes a client of the commission, for example, in the provision of medical care relevant to the individual's vocational rehabilitation. See V.T.C.S. art. 8306, section 7 (association shall furnish treatments necessary to restore employee's physical capacity or to relieve pain, but not for any other phase of vocational rehabilitation); Hum. Res. Code sections 111.052(b)(1) (authority of TRC to cooperate with other agencies), 111.051(b)(6) (authority of TRC to contract with health care providers for physical restoration and other rehabilitation services). The board's duty to cooperate with TRC is not in conflict with its duty to maintain the confidentiality of claim files in accordance with section 9a of article 8307, V.T.C.S. Section 7 of article 8306, V.T.C.S., does not provide a basis for finding an implied exception in favor of TRC to the section 9a confidentiality provision.

SUMMARY

Section 9a of article 8307, V.T.C.S., prohibits the Industrial Accident Board from disclosing confidential worker claim files to employees of the Texas Rehabilitation Commission.

JIM MATTOX
Attorney General of Texas

MARY KELLER
First Assistant Attorney General

LOU MCCREARY
Executive Assistant Attorney General

JUDGE ZOLLIE STEAKLEY
Special Assistant Attorney General

RICK GILPIN
Chairman, Opinion Committee

Prepared by Susan L. Garrison
Assistant Attorney General