The most important part of a Social Security Disability claim is the claimant’s medical records. The medical records provide evidentiary proof of the claimant’s disability. As of May 15, 2013, the Florida Department of Health is proposing a Rule that will increase the cost of obtaining one’s own medical records. This article is asking everyone who reads it to contact a Florida legislator to encourage him or her to introduce and support legislation that would allow disability claimants to obtain a copy of their own records for free where such records are to be used to support a disability claim.
Medical Records in a Social Security Disability Claim
In the initial application for Social Security disability benefits the disabled applicant identifies all of his or her medical providers to the Social Security Administration (SSA) so the Social Security claims handler can obtain the medical records and evaluate the claim. In our experience, however, these are the limitations in the way Social Security evaluates the medical records:
- Social Security only requests the records once. If the medical provider does not provide the records, Social Security does not follow up with the provider and re-request the records. The records simply do not become part of the claim. This means important records are not part of the evaluation, even if the medical provider was extremely backlogged or simply misplaced the request.
- Social Security does not request any records after the initial claim. It is up to the claimant to: (1) obtain and submit any missing records; and (2) update his or her own medical records at each stage of the appeal process
Medical Records in the State of Florida are Already Expensive to Obtain
This is where it gets expensive. Most Florida residents are shocked when they discover the cost of obtaining medical records. Florida Administrative Code Rule 64B8-10.003 provides: “Recognizing that patient access to medical records is important and necessary to assure continuity of patient care, the Board of Medicine urges physicians to provide their patients a copy of their medical records, upon request, without cost, especially when the patient is economically disadvantaged.” Keep in mind this is only a suggestion. I can tell you that in my experience I have only seen a provider provide medical records without cost a handful of times out of thousands of requests. The current Rule goes on to state:
“(2) For patients and governmental entities, the reasonable costs of reproducing copies of written or typed documents or reports shall not be more than the following:
(a) For the first 25 pages, the cost shall be $1.00 per page.
(b) For each page in excess of 25 pages, the cost shall be 25 cents.
(3) For other entities, the reasonable costs of reproducing copies of written or typed documents or reports shall not be more than $1.00 per page.”
That means patients pay a dollar for the first 25 pages of records from a provider and a quarter for each page after 25. For “other entities”, including a disability applicant’s attorney, the cost is $1.00 per page regardless of the number of pages. That means for 100 pages of emergency room records, it would cost $100 to obtain a copy of such records.
A Proposed New Rule Will Make It More Expensive For Patients Too
Proposed Rule 64B8-10.003 amendments are intended to set forth a single fee for reproducing medical records, which will make it more expensive for patients to obtain their own records! Here is how the above rule will change (the strike-through language is to be removed from the new rule):
(2) For patients and governmental entities, the reasonable costs of reproducing copies of written or typed documents or reports shall not be more than the following:
(a) For the first 25 pages, the cost shall be $1.00 per page.
(b) For each page in excess of 25 pages, the cost shall be 25 cents.
(2) (3) The For other entities, the reasonable costs of reproducing copies of written or typed documents or reports shall not be more than $1.00 per page.
In short, the Proposed Rule eliminates the part where the cost shifts to a quarter a page after the first 25 pages for patients. It will cost patients a dollar per page for every page to cover the provider’s “copy costs”, even if the records are produced in an electronic form such as on a CD.
Contact a Florida Legislator to Make Medical Records Free For Disability Applicants
We need to contact our legislators to introduce and support legislation that allows disability claimants to obtain their records for free to be used in disability claims. You can determine the name and contact information for your representative here: Find Your Florida Legislator. Write your legislator a request to support ground-breaking legislation in favor of disability applicants. You can advise the legislator that this has been successfully done in other conservative states, and even give him or her a “public policy” reason as to why such legislation should be supported. Here is what I wrote:
“Hi, Senator Evers. My name is Nick A. Ortiz. I am a Board Certified Social Security Disability Advocate and I represent disability claimants in Social Security disability claims. One of the biggest costs to claimants in filing disability claims is the cost of obtaining one’s medical records. It costs $1.00 per page of records plus other administrative “search” fees to obtain records to use in disability claims. We would like to see legislation passed, as it has already been done in the conservative states of Nebraska and Texas, which provides that disability claimants do not have to pay for a copy of their records. What is the public policy behind this? Once the medical records are utilized in a claim (and the claimant presumably wins), this will allow Medicaid and Medicare to pay bills for indigent patients (or former patients).
Nebraska Revised Statute 71-8405 (http://nebraskalegislature.gov/laws/statutes.php?statute=71-8405) provides:
“(1) A provider shall not charge a fee for medical records requested by a patient for use in supporting an application for disability or other benefits or assistance or an appeal relating to the denial of such benefits or assistance under:
(a) Sections 43-501 to 43-536 regarding assistance for certain children;
(b) The Medical Assistance Act relating to the medical assistance program;
(c) Title II of the federal Social Security Act, as amended, 42 U.S.C. 401 et seq.;
(d) Title XVI of the federal Social Security Act, as amended, 42 U.S.C. 1382 et seq.; or
(e) Title XVIII of the federal Social Security Act, as amended, 42 U.S.C. 1395 et seq.
(2) Unless otherwise provided by law, a provider may charge a fee as provided in section 71-8404 for the medical records of a patient requested by a state or federal agency in relation to the patient’s application for benefits or assistance or an appeal relating to denial of such benefits or assistance under subsection (1) of this section.
(3) A request for medical records under this section shall include a statement or document from the department or agency that administers the issuance of the assistance or benefits which confirms the application or appeal.”
I would welcome the opportunity to discuss this with you further.”
Feel free to copy what I wrote and submit a letter to your representative in Florida (or in any other state). Together we can make a difference.
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