How to Retrieve Your Own Medical Records

When we evaluate potential vaccine cases, our team at Shannon Law Group likes to look at the potential client’s medical records. In vaccine cases, the medical records play a crucial role in proving a client’s entitlement to compensation, as well as to our own assessment of a petition’s reasonable basis.

Obviously, in certain scenarios, we may want to sign your case up without seeing your medical records. Cases, where the injuries are apparent and serious, may not need a closer examination of the records.

However, in other cases, many attorneys will want to see your medical records before they agree to sign your case up.

How do I get my medical records?

Getting your own medical records can be tricky. Health care providers have tried to turn their medical record departments into for-profit schemes. Others outsource medical record retrieval to third parties. Lawyers, patients, and providers have fought over access to records and the cost in producing them for years.

Just recently, the United States District Court for the District of Columbia addressed issues surrounding a patient’s right to access his or her own records. In Ciox Health LLC, v. Alex Azar, et. al., a medical record retrieval company called CIOX challenged restrictions that the Department of Health and Human Services (HHS) had placed on what companies are allowed to charge for delivering medical records.

For many years, HHS limited those charges to a “patient rate.” It was understood that patients wouldn’t be charged excessive fees for their own records. However, in 2016, HHS expanded this rate to include third parties like lawyers and insurance companies. CIOX (and others) were in danger of losing millions of dollars, so they sued HHS.

As a result, third parties are no longer entitled to obtain your records at the “patient rate.” However, nothing is preventing you (the patient) from doing so.

A provider cannot charge you to access your records, even if you have not paid for the services you received from that provider. The only charge you’ll have to pay is a reasonable cost for copying and mailing your records to you.

You also get to choose how you want the records prepared – electronically or paper. Most of the time the costs to prepare these records are nominal.

What do I need to request my records?

If you want to get your records quickly and efficiently, contact your medical providers ahead of time and asking for the medical records department.

Most providers these days have specifically tailored medical record request forms that they insist you use. Ask them for a copy, or where to find one. While you’re at it, ask them for a fax number to send the completed form back to them.

There are also form letters that we use to help our clients retrieve their own records. These letters track the language in federal statute 45 CFR § 164.524, which governs individuals’ access to protected health information (PHI).

What kinds of records should I get?

The answer to this question varies based upon your situation. Many of these forms list out the various types of records that may be included in production. These could include, emergency room records, therapy records, progress notes, nurses’ notes, radiology reports, medical bills, x-rays, MRI films, etc.

Most of the time, if you only need the records for an attorney’s evaluation, you won’t need the x-ray and MRI films. Just the basics will do.

When I look at medical records, I want to see a medical history, a physical examination, a diagnosis, and a treatment plan. This tells me all I need to know about the nature of your injury and possible future treatment.

How long do they have to comply with my request?

By statute, medical providers must act on your request within 30 days. They can either deny your request for one of the very limited reasons, request an extension of 30 additional days, or provide you access.

What happens if they refuse?

As long as you’ve complied with all of the statutory requirements for requesting your records and you’ve waited out the extension periods, you may file a complaint with the Office for Civil Rights.

They will then investigate your complaint and may take action if you were unlawfully denied access to your medical records. These complaints must be brought within 180 days of the violation. Medical providers who do not comply with these requests may be subject to civil penalties.