One of the biggest hurdles in many individuals’ claims for Social Security disability benefits is gathering all of the relevant medical records. No matter how severe your conditions are, your claim may be denied for lack of medical evidence.
Many states have laws that waive or limit the amount of money medical providers can charge for providing copies of medical records when the request is made in connection with a Social Security disability or Supplemental Security Income (SSI) claim. Other states have limits that apply to all requests, regardless of purpose, while other states have no limits at all.
The list of states which prohibit charging for medical records in connection with a Social Security disability or SSI claim now include: California (one free copy if unrepresented), Connecticut, Kentucky (first copy free), Massachusetts, Michigan (if indigent), Minnesota (if indigent), Nebraska, Nevada (first copy free), New York, Ohio (first copy free, plus one update free), Oregon, Rhode Island, Tennessee (if indigent), Texas (first copy free), Vermont, and West Virginia (one free copy of indigent).
Separately, the HIPPA Privacy Rule permits a medical provider to impose a “reasonable, cost-based fee,” which may include only the cost of labor for copying the requested records, whether in paper or electronic form; supplies for creating the paper copy or electronic media (e.g., CD or USB drive); postage, when records are requested to be mailed; and preparation of an explanation or summary of the medical records, if agreed to by the patient. See 45 CFR § 164.524(c)(4). The fee may not include costs associated with verification, documentation, search and retrieval, maintaining systems, recouping capital for data access, storage, or infrastructure, or other costs not listed above, even if such costs are authorized by state law. See also U.S. Department of Health & Human Services, Individuals’ Right under HIPAA to Access their Health Information, 45 CFR § 164.524.
If you or someone you know is unable to work due to a medical condition, please contact us for a free case evaluation!
Source: https://www.nosscr.org/state-medical-records-payment-rates (all state rules included)
By: Thomas A. Klint of Premier Disability Services, LLC®