Records Access and Confidentiality practice questions for the CHST exam

A worker signed a dated written authorization allowing his occupational clinic to release his existing medical records to an outside consultant. The authorization had no special conditions. The clinic sent the records to the consultant in the first month. Three months after signing, the worker gives the clinic a signed written statement revoking the authorization. The next day the consultant asks the clinic for another copy of the same records. What should the clinic do?

1. A.Release the copy, because the authorization has not yet reached its one-year limit.
2. B.Decline the request, because the written revocation ends the clinic's authority to make further releases from that point on.
3. C.Release the copy, because the consultant already received the records and the revocation cannot affect them.
4. D.Decline the request only after the employer agrees in writing that the revocation is valid.

In March, an employee signed a written authorization allowing the clinic to release his exposure-related medical records to a named representative. The form has all required elements, is within its one-year limit, and has not been revoked. It does not mention future records. In June, the employee has a new medical evaluation, and the representative asks the clinic for those results under the March authorization. What is the correct response?

1. A.Do not release the results under this form, because they did not exist on the date of authorization and the form does not expressly authorize release of future information
2. B.Do not release the results, because an authorization automatically expires 90 days after signing unless renewed
3. C.Release the results, because the named representative is entitled to all information about the employee's exposure
4. D.Release the results, because any authorization still within its one-year period covers all of the employee's records, including new ones

You are the CHST on a renovation project. A laborer works daily in a room where the contractor stores several drums of a toxic solvent. The drums have never leaked, and no air sampling has been done. The superintendent says the laborer is not "exposed" for records-access purposes because no release has occurred and no contact has been documented. The solvent is stored on site for the work and is not present the way it would be in a typical non-occupational setting. How should you respond under the standard?

1. A.The laborer is considered exposed only if a past exposure has already been recorded in a medical record.
2. B.The laborer is exposed only if air sampling later documents a measurable concentration.
3. C.The superintendent is correct, because exposure requires actual contact with the substance, which has not been shown.
4. D.The laborer is considered exposed, because the definition includes potential (accidental or possible) exposure when the substance is stored in the workplace in a way that differs from typical non-occupational situations.