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Workers Compensation Release Of Information Form Template for England and Wales

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Key Requirements PROMPT example:

Workers Compensation Release Of Information Form

"I need a Workers Compensation Release Of Information Form for our manufacturing company that allows sharing medical information with both our insurance provider and occupational health team, with specific provisions for maintaining GDPR compliance and a validity period until December 2025."

Document background
The Workers Compensation Release of Information Form is essential when an employee needs to authorize the sharing of their medical and personal information following a workplace injury or illness. Used throughout England and Wales, this document ensures compliance with data protection regulations while facilitating necessary information exchange between healthcare providers, employers, and insurers. The form specifies what information can be shared, with whom, and for what duration, protecting both the worker's privacy rights and the employer's need to process compensation claims effectively.
Suggested Sections

1. Employee Information: Basic details including name, address, employee ID, and contact information

2. Employer Information: Company details and relevant contact information

3. Purpose of Release: Specific reason for information release and intended use

4. Scope of Authorization: Specific types of information being authorized for release

5. Duration of Authorization: Time period for which the authorization remains valid

6. Consent Statement: Clear statement of employee's consent to release information

Optional Sections

1. Third Party Recipients: Additional section listing other parties authorized to receive the information, used when information needs to be shared with multiple parties

2. Specific Exclusions: Section detailing information explicitly excluded from the release, used when certain sensitive information should be withheld

Suggested Schedules

1. List of Authorized Recipients: Detailed list of individuals or organizations authorized to receive information

2. Specific Records Requested: Itemized list of specific records being requested

3. Privacy Notice: Detailed information about data protection rights and procedures under UK GDPR and Data Protection Act 2018

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions




















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Relevant Industries
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UK GDPR: The UK General Data Protection Regulation governing the processing, handling and sharing of personal data in the UK post-Brexit

Data Protection Act 2018: The UK's implementation of data protection laws, working alongside UK GDPR to regulate personal data processing

Health and Safety at Work etc. Act 1974: Primary piece of workplace safety legislation that sets out employers' responsibilities regarding worker health and safety

Employers' Liability (Compulsory Insurance) Act 1969: Requires employers to maintain insurance to cover compensation for workplace injuries and illnesses

Social Security (Claims and Payments) Regulations 1979: Regulations governing how workers' compensation claims should be made and processed

Access to Medical Reports Act 1988: Legislation governing access to medical reports for employment or insurance purposes, including workers' rights to view reports

Medical Act 1983: Regulates medical practice and the handling of medical information in the UK

Human Rights Act 1998: Incorporates European Convention rights into UK law, particularly Article 8 regarding right to privacy

Industrial Injuries Benefit legislation: Covers the assessment and payment of benefits for workers who are injured or become ill due to their work

Social Security Contributions and Benefits Act 1992: Framework legislation for various social security benefits, including those related to workplace injuries

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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