Getting Your Power Back” & How to Use the HIPPA Act In your Defense
This is an article about my journey through the annulment process. My primary goal for this article is to convey a ray of hope for other Respondents going through this experience. My secondary goal is to educate other Respondents about their “rights” concerning psychological evaluations. Psychological evaluations are also referred to by the Tribunal as “expert witness statements. They are frequently used by Tribunals to make decisions about the validity of marriages. The first thing as a Respondent that you need to be aware is concerning your “right” not to be psychologically evaluated. You also have a right not to have your written and/or verbal testimony psychologically evaluated by any type of mental health professional. If you chose to consent to a psychological evaluation or have your testimony evaluated, please make sure you sign a consent form that lists the names of all individuals to whom you consent to have the psychological evaluation revealed.
I would highly recommend that you not consent
to a psychological evaluation or to having your written/verbal
testimony evaluated, because more than likely it may be used
against you! If you refuse and the Tribunal is determined to
complete a psychological evaluation against your wishes, you need
to put in writing to the Tribunal that the Tribunal cannot
disseminate any of the information contained in the psychological
evaluation about you to anyone without your written consent,
especially to your former spouse. Furthermore, any
information in the psychological evaluation that pertains to you
cannot be used by the Tribunal in the annulment proceedings. They
can only be used if you consent for it to be used. Psychological
evaluations are considered “protected health information” by the
U.S. Department of Health + Human Services.
YOU AS THE RESPONDENT: How To Get Your Power Back
In March, 2011, I received a letter from my local Tribunal stating that my former husband had petitioned for an annulment. As most Respondents I was exceptionally shocked as we had been divorced for almost 28 years. Little did I know what a whirlwind of emotions and experiences I was about to enter.
After we had both completed our Questionnaire testimonies, the Tribunal sent a letter advising me that I could read his testimony. I made the arrangements to do so. On the day I arrived at the Tribunal I was shocked to discover that there was an “expert” psychological evaluation present for me to review as well. The psychological evaluation was completed only on both my testimony and my former husband’s written testimony. The psychological evaluation was completely slanted in favor of my former husband’s testimony and his two witnesses. The mental health professional who completed the evaluation also diagnosed me with a possible mental illness and actually gave me a DSM-IV diagnosis. It is important to remember here, that this mental health professional never met me, did not know me and made a psychological evaluation about my behaviors described by my former husband and his two witnesses that had occurred over 30 years ago. That is a remarkable feat to be able to go back and diagnosis someone’s behaviors that had occurred over 30 years ago, and base that diagnosis not on the person’s testimony but only on the testimony of a former husband and his two witnesses’ testimony.
I am a Psychiatric Registered Nurse and Psychiatric Licensed Clinical Social Worker. I have worked in state psychiatric hospitals and jails for almost fifteen years. I have read and written many psychiatric/ psychological evaluations during my career. As a LCSW, I am licensed to perform psychological evaluation and provide psychiatric diagnosis when appropriate. However, I have to say I have never seen one formatted and written like the one presented in my Tribunal case. It was completely biased and unprofessional and the expert’s name and signature were not present on the evaluation; nor the date the evaluation took place.
I was extremely upset when I read the details of the evaluation. I was angry due to the fact that my former husband lied in his testimony about me, as had the witnesses. I was also angry because I am a mental health professional and I work in the mental health field. I started to wonder if this could in fact affect my job, my career, my ten years of education and many years of experience.
As I was reading the testimony at the Tribunal office, I was also sitting with a nun who is a member of the Tribunal who was watching my every move as I read all the material I was allowed to read. If you are not aware, if you do want to review testimony presented in an annulment proceeding, be aware someone will be present with you the entire time. Your behavior will be evaluated and I can only assume will also be judged and reported accordingly. So although I was very angry, I had to hold myself together so I would not present like the mentally ill person the Tribunal mental health professional diagnosed me to be.
I did ask the nun, who was present, who was the mental health professional expert who completed the psychological evaluation. She reported that the Tribunal would not reveal the person’s name. I did advise her that I was a mental health professional and that both of my state licenses mandated that if I completed a psychiatric evaluation that I reveal my name and credentials. I further stated that the person completing the evaluation was not acting within the ethical boundaries of their profession and their state license. She did not say one word.
After I left the Tribunal office, I went to my car and cried I was so hurt and angry by everything I had read. I felt defeated and powerless. I felt that there was no way I could overcome all the horrible things that were said about me in all the testimonies and psychological evaluation. I could literally feel my self-esteem leaking out of me much like a balloon slowly deflating. It would be a long time again before I would feel strong and confident.
After I had a good cry, later that day I contacted Jan at Save our Sacrament. With her help, consistent care and support, I was able to chip away, a little at a time, the mountain of evidence against me.
I started to feel angry again and the anger provided me with some much needed energy which I required to overcome all of those barriers. I started by contacting the Vicar of the Tribunal. I typed a letter to him which I hand delivered the same date. It stated that given the enormous evidence against me that I would be providing witnesses statements. I did not ask him, I told him in a very nice manner. I stated that when I had originally responded to my former husband annulment testimony I did not ask friends and family members to be a witness. I advised him that I did not want to involve them because my divorce had taken place twenty-eight years ago. The same day I hand-delivered my letter, I received a phone call from my Advocate advising that I would be allowed to provide witness testimony.
That evening, I called a dear life long personal friend and asked if she would be one of my witnesses. I also asked my brother who has been a minister and missionary for thirty years to testify to the validity of my marriage and character. I further contacted four mental health professionals with whom I had recently worked. I asked if they would write a letter to the Tribunal testifying to my mental health as an individual and to my professionalism as a RN and LCSW. I also sent to the Tribunal pictures of our small wedding and reception, as well as pictures being active in the Catholic Church so they could see the quality of person I was. All of my witnesses sent in all their required documents in the time-frame required by the Tribunal. I had no idea what the outcome of all of this was going to be, but little by little it all came together.
January 2012, the Tribunal sent me a letter stating I could review all “the acts” that had been presented. I made an appointment and read each and every word of all the testimony including the psychiatric evaluation. Again an elderly nun sat in the room with me and watched my every move. This time she sat next to me and watched me. It was very intimidating. But after reading all of the testimony I felt very good about everything. I felt I had refuted all of my former husband’s negative testimony, as well as his witnesses and the psychiatric evaluation. The packet of information that was mine, the Respondent’s packet, was neat, thick, very organized and impressive. I felt I had a very good chance of upholding the validity of my marriage. I left the Tribunal hoping for the best but knowing I also had to prepare for the worse, as most marriages are annulled. I left the Tribunal building thinking the next time I would be contacted would be to know the outcome of the annulment process.
May 30, 2012, I received another letter from the Tribunal advising that a “new act” had been presented in our annulment proceedings and that I could review it. A copy of the letter was also sent to my former husband. I called the Tribunal immediately and spoke with an Administrative Assistant. I asked her what new information had been presented. She stated that the “Defender of the Bond” had requested that another psychological evaluation be completed of both of our testimonies and all testimony presented in the case. I asked her if my former husband would be allowed to read this new psychological evaluation also. She stated he would.
I was furious. I was fuming mad. But I just sat still for a few minutes and thought about this situation. I realized, heck, I am a mental health professional and I cannot complete a psychological evaluation in absentia (meaning that the people I am evaluating are not present). I reminded myself, that as a mental health professional it is unethical for me to offer a professional opinion/ diagnosis/ evaluation unless I have conducted an examination of the person and that person has granted me the permission to do so. (This ethical rule is known as the Goldwater rule. The Goldwater rule is a precept of medical ethics promulgated by the American Psychiatric Association (APA). It forbids psychiatrists, as well as other mental health professionals, from commenting on individuals' mental states without examining them and being authorized by them to make such comments. It is Section 7.3 of the APA's ethics principles. )
I also know as a mental health professional that I am not allowed to disseminate medical records without the written consent of the individual. This is known as HIPAA: Health Insurance Portability and Accountability Act. All medical and mental health records are considered “protected”. This means that you must sign a consent form to disclose medical information about you to only those people you authorize.
So I decided right there and then to type a Cease and Desist letter to the Tribunal. I wanted to stop them from allowing my former husband from reviewing the psychological evaluation. I had no expectation that the Tribunal expert or experts would write a positive evaluation on my part. I stayed awake a good part of the night composing the letter because I wanted it to be professional and I wanted the Tribunal to take it very seriously.
Below is brief excerpt of the letter I sent to the Tribunal (re the HIPAA Act)
This letter is to inform the entire (name of the local) Tribunal that: I have never provided written or verbal consents or permission to the (name of my) Tribunal for a psychological evaluation of my personal testimony or any written or verbal communication.
It is unethical for a mental health professional to perform a psychological evaluation of an individual or their written or verbal communication without their written consent. It is also illegal and unethical for a mental health professional to provide personal psychological information to anyone, especially my former husband, without my written consent. I have never provided the (name of the local) Tribunal my written consent to disclose my personal health or mental health information to anyone – especially my former husband.
This continued unauthorized dissemination of my private health care information has been, and continues to be of great detriment to my welfare, and is a clear violation of the HIPAA privacy rules. Enclosed please find a 25 page summary of the Health Insurance Portability and Accountability Act (“HIPAA”). Please include this HIPPA summary in the file with the other Annulment Proceedings already filed there – for your future reference.
I am requesting that you and the entire (name of the local) Tribunal to “cease and desist” the continued dissemination of any and all private health and mental health information to unauthorized parties concerning the (name of my annulment) annulment proceedings. This is a clear violation of my rights.
If the Tribunal fails to take immediate action, I will be filing a complaint to the person and address immediately below, informing them that the (name of the local) Tribunal and the mental health professionals who performed psychological evaluations are in fact violating the HIPPA Act.
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
Coincidentally, the next day I was scheduled to be off work to attend my high school reunion. I dropped off the letter at 9am on my way to my reunion. At exactly 10:15am the same day, the Tribunal’s Administrative Assistant called me on my cell phone requesting a date that could I meet with the Vicar of the Tribunal (the head judge). When I saw “Tribunal” come up on my cell phone - I thought “oh my goodness”, I am in trouble now". I could hardly speak I was so nervous and scared. She and I arranged a date for two days later. I did ask her if this meant that no one could read the new expert’s psychological evaluation (meaning my former husband). She stated yes and that the Vicar was currently reading the HIPAA information contained in my letter.
After we hung up the phone, I was literally shaking inside. I wanted to cry but I couldn’t. I also couldn’t talk about it to my classmates. They were friends but not close enough friends that I felt I could discuss this level of intimate information. I stayed at my reunion but needless to say I could not enjoy interacting with my former schoolmates. My mind was completely occupied with the phone call and how promptly the Tribunal called me back. It did not enter into my mind that perhaps I put them on “notice”. All I could think of was that I was in trouble. This event really “triggered” me to feel much like a bad little girl who was in trouble and I was being sent to the Principal’s office. Perhaps it was because I was at a “school” event but more than likely it was just that as a child and adult I have always been terrified of Authority Figures. When faced with having to deal with Police or Judges and someone in “real authority” I often regress to feeling like a child. And that is what happened here. It took me almost 24 hours to “snap” out of it and to feel emotionally like an adult again. But this took a great effort on my part, and I am a mental health professional. I can only imagine what this type of situation could and would do to someone else without the professional skill I possess.
By the date of the appointment, I was emotionally ready. I walked into the room to meet the Vicar. In the room also present was the nun who sat with me when I read the annulment proceedings. That was a shock to me to walk into the room and have to face two people. Again, I felt very intimidated because it felt like two against one, as they sat directly across from me. I quickly did some self-talk with myself. I told myself I would be ok and that I was as strong as they were. I sat straight in my chair, looked both of them in the eye and answered the Vicar’s questions. Actually there were not so much questions as there were statements from the Vicar telling me why the Tribunal uses expert testimony to aid them in the annulment process. I added my mental health expertise and stated that I understood their need for the information however they could not coerce the information from me, the Respondent. I further stated that it was the Petitioner who had to prove his case and he could not do that by forcing me to have a psychological evaluation. I stated firmly that I had not authorized the Tribunal to complete a psychological evaluation of my written or verbal testimony.
I further added that I had definitely not consented for the Tribunal to release private health information about me in the form of their psychological evaluation to anyone, let alone my former husband.
The Vicar stated he understood and then he asked me what I thought they should do. I stated, “I had no idea” and that I thought they had a dilemma on their hands. The Vicar further discussed that no other Respondent had ever mentioned the HIPAA regulations and that my local Tribunal and some other ones were looking into how HIPAA would affect them. He then switched to casual conversation with me and verbalized that most Respondents really do not become involved in the annulment process. He stated that most of the time, they don’t even respond. He then admitted that they really did not know how to provide support to Respondents. This opened the door for me to speak with him concerning a number of things. I let him know that I was very dissatisfied with how the Tribunal responded to me as a Respondent. To begin with I said I could understand why Respondents did not respond. I stated that I felt that they probably felt defeated before they even started. I advised the Vicar concerning the Tribunal website. I advised him that there was no information for Respondents on how to proceed and uphold the validity of their marriage. I conveyed that there was a lot of information for the Petitioner but none for the Respondents. I went on to instruct him that the Advocate assigned to me, the Family Life Director, never assisted me at all.
I also advised him that all the technical and emotional support I needed and received, I received from Jan L. with Save Our Sacrament and not from my Advocate. At this point I was on a roll, and said that for the whole annulment proceedings I felt as though I was being bullied by the Tribunal – the same Tribunal who was supposed to be helping me uphold the validity of my marriage. I stated that because I felt like I was being bullied it took me quite a while to get my bearing and to figure out how to respond to the annulment process in a way that I could uphold my marriage.
In this brief conversation I also let him know that I was a mental health professional with, at that time, over ten years of experience and I considered myself a strong person emotionally and psychologically. And I told him and the nun present that if I felt that way I could only imagine what happens to other Respondents without all of my experience and again why perhaps many Respondents do not respond to the annulment process. During my whole conversation, I kept my voice calm, hands down and looked both of them in the eye – switching eye contact between the two of them.
The Vicar thanked me for informing him of the difficulties I encountered and he mentioned a couple of things he was going to do to “correct things”. One of things he stated he wanted to do was to update the website to include more information for Respondents. (To this day nothing has been done to the website.) While he was discussing various topics with me after that, he let slip in an off-hand way that he thought that my former husband had not proven his case. He caught me completely off guard when he said it. For a moment I had to “check” myself and I said to myself “did he say what he just said”…because I couldn’t believe it. I made no comment about his statement. I ended the meeting by stating I had other commitments to attend to and thanked him for meeting me with me.
As bad as I thought it was going to be, it really ended with me being in charge of the meeting almost the entire time. I felt the “tides had changed” as I walked out the huge Tribunal doors. They did not seem as big as more. I had entered several times and this time I felt triumphant. All those months that I felt like a victim, that I felt powerless, and that I felt so overwhelmingly depressed…well, all of those horrible feelings ended suddenly. All of a sudden I felt powerful. I had gotten my power back, my confidence and my self-esteem. I felt extremely proud of myself and I felt I had a very good chance of being able to uphold the validity of my marriage. My little deflated balloon was now gloriously inflated and flying all over the sky.
On September 30, 2012 I received a letter from the Tribunal stating: “on September 27, 2012 the Tribunal reached a decision that the nullity of your marriage to (my former husband) had not been proven”. What was funny was that I always thought if and when that day came I would feel extremely happy. I had envisioned myself going “whoopee” while I threw my hands in the air, celebrating. I did not feel happy and I did not feel like celebrating. I did not feel extremely sad either. I felt like the right thing had been done. I did not feel much like anything other than just plain old proud. I felt very proud of myself for standing up for myself and what I believed to be the right thing to do. I felt proud I had stuck it through.
Today, my marriage has been over for thirty years this December, 2016. I often wonder “What if we had stayed married”? But I also wonder “If I had stayed married would I be the person I am today?” The answer always comes back that more than likely I would not. So it is a mixed bag of emotions. What I do know for sure, for me, is that through it all God was with me. He was guiding my hand, guiding me to the right people. I also knew that if I was not successful in upholding the validity of my marriage, God would still be there to support and guide me onward to the next set of life’s lesson. My life would not have been over if the outcome had turned out differently; it just would have been different.
I would like to take this opportunity to express how grateful I am to Jan L. and Save Our Sacrament. I do not know where I would be today without her support, caring and guidance. I would probably have made it through the process but not with the grace I did. She alone was able to help me keep my head and emotions intact and stable. Because of that I was able to be objective and reasonable and give the Tribunal exactly what they needed to uphold the validity of my marriage.
I present the information in this article with the hope that it can help others in presenting their cases. It is my way of paying back just a small token of what I received from Jan L. and Save Our Sacrament.