The Attorney General of Texas 

July 7, 1980 

MARK WHITE 

Attorney General 

Honorable Ii. S. Harris, Jr., Chairman Opinion No. NH-202 

Texas Industrial Accident Board 

LBJ State Office Buftdhg Re: Release of worker’s comAustin, Texas 767ll pensation claim files to certain 

governmental agencies. 

Dear Mr. Harris: 

You ask what information, if any, the Texas Industrial Accident Board 

may make available from work&a compensation claim files to certain 

federal and state agencies. The United States Treasury Department seeks 

information regarditg the income of claimants’ attorneys. The State Bar of 

Texas inquires regard@ the conduct of attorneys. The Texas Department 

of Human Resources inquires regard@ welfare fraud, and the United States 

Social Security Administration wishes to have information about the awards 

claimants receive so that social security benefits might be integrated with 

them. The Occupational Safety Board of the State Department of Health 

ale0 seeks information. 

In Is77 the Texas Legislature amended the workmen’s compensation 

law by addirg section 9a to article 6307, V.T.C.S., specifying 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. . . claim . . . open or pendirg . . . 

or 00 appeal . . . or. . . the shject matter of a 

s&sequent suit where the aarrier is 

shrogated . . . the information shell be 

furnished as provided in this section. . . . The 

Board will furnish the requested information... 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; or 

(6) the State Board of Insurance. 

p. 651 
. . 

Honorable H. S. Harris, Jr. - Page Two G4W-2021 

A third-party litigant . . . is entitled to the information 

without regard to whether . . . the . . . claim is still pending. 

(cl All information of the Industrial Accident Board concerning 

any person who has been finally adjudicated to be a 

fraudulent claimant as provided in this section is snot 

confidential. . . . 

(Emphasis added). Other provisions allow the board to release limited information to 

employers interviewing job applicants that lwve a multipl~claim history if written 

authorization from the employee is obtained. The act makes it the &ty of the Attorney 

General to investigate allegations of fraud relating to a claim, specifying that the 

Attorney General is to “cooperate with professional grievance committees, law enforcement officiels, the Industrial Accident Board, and other state agencies in the investigation 

and prosecution of fraudulent practices.” Legislative committees can obtain information 

to use for legislative purposes. &, V.T.C.S., art. 8307, subsections cd), (e)(l), (11. Of 

noteworthy importance is a somewhat ambiguous provision, st&ection 61, which 

provides: 

(ml Any information pertain@ to a. . . file which is confidential 

by virtue of . . . this Act shall retain such confidentiality 

when released to any investigative, legislative, or law 

enforcement eency include the attorney general, district 

attorneys, grand juries, or legislative committees. 

It also makes criminal the furnishirg or receipt of such information to or by persons not 

entitled to get it directly from the board, but the act allows release of any information in 

statistical form not disclosing names or identities. I&., V.T.C.S., art. 8307, s& sec. (n). 

This 1977 statute reflects legislative reaction to a Texas Supreme Court decision in 

1976, Industrial Foundation of the South v. Texas Industrial Accident Boa&, 540 S.W.2d 

:rn confidential, 

the claim files of iniured workers were ordinarilv avaIlable to anv&e tmder the state’s 

Open Records Act, article 6252-17a, V.T.C.S. S& also Attorney General Open Records 

Decision No. 8 (1973). 

The initial provisions of section 9a clearly limit claim file information to certain 

persons and state agencies only, and then in certain situations only - i.e., when a claim is 

being prosecuted or is otherwise involved in litigation, and when a prospective employer 

secures authorization from the claimant. Because one of the purposes of the act is to 

uncover and punish fraud, however, see Attorney General Opinion H-B94 (19781, it is 

argued that the statute makes such sormation available to any governmental egency 

investigating any type of fraud, whether the suspected fraud relates to the worker’s 

compensation claim file at issue or not. It is argued that stisection (ml implies as much. 

p. 652 
, 

Honorable H. S. Harris, Jr. - Page Three (MWw-202 ) 

We oennot sgree that the “investigation” provision is so broad. Subsections (e) and 

(g) of the statute read in part: 

(e)(l) The attorney general shall promptly investigate any allegation of fraud . . . relating to any claim. In order to carry out 

the requirements of this section, the attorney general is 

vested with complete power to investigate and prosecute any 

and all allegations of fraudulent claim practices which may 

be stimitted to the Board or . . . uncovered through the 

attorney general’s own efforts. The attorney general shall 

cooperate with professional grievance committees, law 

enforcement officials, the Industrial Accident Board, and 

other state agencies in the investigation and prosecution of 

fraudulent practices. It shall be the responsibility of the 

attorney general to prosecute those cases in which he finds 

the reasonable probability that acts of fraud exist before all 

hearings of the Board or on appeal from the &termsuch hearmgs. 

. . . . 

(e)(3) If the Attorney General finds that a reasonable probability of 

fraud exists, the attorney general shall request a hearing and 

the Board shall set the matter for hearing. . . . 

. . . . 

After this hearing, . . . Iilf the Board determines that the 

claimant has been fraudulent in any or all of his claims for 

corn n&ion the Board shall then classify that claimant as a 

lFiisbm;imallt.. . . If the Board determines that any 

other person except an employer under investigation has been 

fraudulent in connection with a claim for compensation, the 

Board may . . . report its find& to the appropriate 

professional grievance committee, law enforcement officials, 

or other state agencies for pmsecution, or both. . . . 

(Emphasis added). 

Ii is quite clear that the anly “fraudulent practices” the act seeks to discover and 

punish are those relating to claims for compensation cognizable by the Industrial Accident 

Board. The direction that the attorney general “cooperate” with other agencies cr 

professional associations - or that files, when “released” to them, retain their 

confidentiality - looks to the time such claims have been determined by the board to be 

tainted with fraud and thereafter referred by the board to such egenciea or associations. 

p. 653 
Honorable H. S. Harris, Jr. - Page Four (NWw-2o2l 

Although the State Board of Insurance may be given claim file information when a 

claim is beh prosecuted or is otherwise in litigation, and other agencies in their roles as 

employers may obtain certain information rpcn written authorization, see V.T.C.S. ert. 

9309g, S l5(b), no agency other than the Attorney General is to be given 8cce.w to a claim 

fle in order to %vestigate” fraudulent practices unless the board has determined that 

worker’s compensation fraud exists with respect to such claims and refers the matter to 

selected agencies IX associations for prosecution. Moreover, only those agencies which 

could bve obtained the material directly from the board may be given access to it 

thereafter. 

Absent a court order, there are no paramount federal laws which would require the 

release of such information to the federal sgenciea seeking it, and there are no state laws 

which require its release to the state agencies. Statistical information, of course, is 

avagable to the Occupational Safety Board and others. V.T.C.S. arts. 5182, SS 14, 15; 

9307, S 9afnX 

We conclude you may not divulge any information, other than txmidentifyirg 

statistical information, in any worker’s compensation file to any of the @rgancies named 

unless the board bs determined that fraud exists with respect to such claims and that the 

agencies named are the epproprlate ones to prosecute or discipline the wrongdoers. 

SUMMARY 

The Texas Industrial Accident Board may not divulge any information other than nonidentifying statistical information, in any 

worker’s compensation claim file to certain federal or state 

agencig unless the board determines that fraud exists with respect 

to such claims and that those agencies are the appropriate ate6 to 

prosecute or discipline the wrongdoers. 

MARK WHITE 

Attorney General of Texas 

JOHN W. FAINTER, JR. 

First Assistant Attorney General 

TZL L. HARTLEY 

Executive Assistant Attorney General 

Prepared by Bruce Youngblood 

Assistant Attorney General 

p. 654 
, 

Honorable H. S. Harris, Jr. - Page Five (NW-202) 

APPROVED: 

OPINION COMMVTEE 

C. Robert Heath, Chairman 

Bob Gammege 

Sue Lowe 

Bruce Youngblood 

p. 655