Medical Records in Social Security Disability Cases

According to the Bureau of Labor Statistics, the jobless rates for disabled workers continue to be a significant issue. Financial hardship and unemployment are forcing some disabled workers to seek aid from the Social Security Administration (SSA). While the SSA has made strides to reform claim processes, disabled claimants still face other frustrations in submitting their disability claims. One of these major obstacles is the rising cost of medical records.

In making a claim for disability, medical evidence is a crucial component of the disability application. In the absence of significant proof or observations of a qualifying disability, many applications will be denied. Word of mouth is not enough. The SSA evaluators require documentation from credible medical professionals and facilities.

As a claimant seeking benefits, obtaining one's medical records can be a daunting and expensive task. Under the Health Insurance Portability and Accountability Act (HIPAA), a patient has the right to see, receive copies and seek corrections to their records. Also under HIPAA, providers may charge "reasonable" costs or fees for providing these medical records. Furthermore, special rules and regulations apply for records being obtained for social security disability claims. Still, many claimants have found the costs of obtaining records makes filing an adequate claim almost impossible.

Many states have statues that limit the fees that doctor's offices and facilities can charge a patient. In North Carolina, state law, § 90-411, provides reasonable charges and maximum fees for purposes including social security disability applications. The fees are on a graduated scale which takes into account lower per page costs for larger records.

In order to request records in North Carolina, the patient, patient's representative or the patient's parents must make a formal and detailed request. However, in many cases, where facilities use outside duplication services, records will not be forwarded until full payment is received. For those workers that have limited resources, records fees may be too burdensome to pay. While claimants can have the SSA obtain records to support their claims, these applicants are not able to obtain personal copies or review records before consideration by the Administration.

Disabled workers face additional frustrations during hard economic times. While federal agencies work to reform processes, non-governmental service providers need to also review their practices that burden our nation's more vulnerable citizens.

The disability claims process can be difficult and complex. If you are seeking benefits for your disability, speak to an attorney to help you navigate this process, ensure you are able to obtain the information you need for your claim and help you receive the benefits to which you may be entitled.