Medical Records for Disability Claims Information

The Social Security Administration (SSA) and the Disability Determination Services (DDS) must collect important and confidential information about a person in order to make a determination about disability benefits.  Therefore, it is important for applicants and people receiving disability benefits to understand their privacy rights for disability medical records.

When Can the SSA Access Your Personal Medical Records?

The SSA needs your permission to obtain your medical information from any of your treating doctors.  While you are not obligated to provide the SSA with your medical information, the agency can deny your request for disability benefits if it does not have enough medical information to determine whether or not you are disabled.

Medical Records Used for Disability Claims

The Privacy Act (5 USC 552a) gives people the legal right to access the medical information that the government has about them as it pertains to a social security disability benefits determination.  That information includes:

• Information kept by health care professionals;
• Medical evaluations and diagnoses; and
• Statements and observations from people who witnessed physical symptoms of the disability.

How Can You Access Your SSA Medical Records?

In order to get your medical records, you should make a written request to the SSA Field Office responsible for deciding your claim.  Generally, you and/or your designated representative have access to your records.  However, the SSA can limit your access to your own records if the agency believes that allowing you access to your records would have an adverse effect on you.   However, if you request records for review before an appeal than the SSA may not use the adverse effect rule to deny you access to your records.

Another limitation on your right to access your medical records exists if the SSA requires you to have a consultative examination to determine whether or not you have a disability.  In those cases, the SSA is not required to share the results of the consultative exam with you unless it reveals a life threatening situation.  The SSA does, however, have to share the results of the consultative exam with your treating physician, if you consent to the sharing of information.

When Can the SSA Share Your Medical Records With Others?

The SSA may also disclose your personal medical information to third parties if it has your written, dated, consent that specifically details what information is to be shared with a specific third party.

Additionally, there are certain situations when the SSA does not need your consent to disclose information.  This includes sharing information with another SSA agency on a need to know basis, responding to Freedom of Information Act requests, assisting certain government agencies, and for specific research and statistical purposes.

Penalties for Violating the Privacy Rules

There are a variety of penalties available if the SSA violates your privacy rights.  Specifically:

• The Social Security Act makes it a misdemeanor punishable with a fine of up to $1,000 and a year in prison;
• An agency official may be disciplined pursuant to the Freedom of Information Act for arbitrarily and capriciously withholding records; and
• The Privacy Act allows individuals to file civil and criminal cases against the SSA for intentionally and willfully violating your privacy rights.

Help from a Disability Lawyer

Privacy rights are important.  If you believe that your rights have been violated and that private information was shared illegally without your consent or that you were denied access to your own records then you should contact a lawyer as soon as possible.  Your lawyer will help you protect the confidentiality of your medical records, access your records, and hold anyone who violated your rights accountable for wrongdoing.