Chapter 5 – Adult Custody and Security Operations

52030.3.13 Employee Medical Record

• A record concerning the health status of an employee which is made or maintained by a physician, technician, or other health care personnel.

  • Employee medical record includes:

  • Medical and employment questionnaires or histories (including job description and occupational exposures).

  • The results of medical examinations (pre-employment, pre-assignment, periodic, or episodic) and laboratory tests (including x-ray examinations and all biological monitoring).

  • Medical opinions, diagnoses, progress notes, and recommendations.

  • Descriptions of treatments and prescriptions.

  • Employee medical complaints.

  • Employee medical record does not include:

  • Physical specimens; e.g., blood or urine samples which are routinely discarded as a part of normal medical practice and are not required to be maintained by other legal requirements.

  • Records concerning health insurance claims if maintained separately from the employer’s medical program and its records, and not accessible to the employer by employee name or other direct personal identifier; e.g., social security number, payroll number, etc.

  • Records concerning voluntary EAPs (alcohol, drug abuse, or personal counseling programs) if maintained separately from the employer’s medical program and its records.