Medical Record Fees Put Hoosiers At a Disadvantage

June 17, 2020

When applying for Social Security disability benefits, you must show the Social Security Administration (SSA) that you have a qualifying condition and that you are receiving treatment. You prove that by submitting your medical history when you apply.

But in Indiana, health records lay behind a paywall. And in some cases the fees for copying records are so high that applicants can’t afford them.

The SSA will request your medical history. They tend to deny applicants who cannot prove that they have a qualifying condition or that they are receiving treatment — two things that medical records can prove. If you don’t send your medical history because you can’t afford copying fees, you could be denied.

No Hoosier should be denied disability because of their economic status. If you are unable to pay for your medical records, you may be able to get the fee waived. And if you have an attorney help you file, then they may negotiate a smaller fee on your behalf.

Your Right to Your Medical Records

You have the right to request a copy of your medical records from your healthcare provider. Under federal law, medical providers can only charge a “reasonable, cost-based” fee for labor and copying supplies. But in Indiana, your healthcare provider can charge you much more.

According to Indiana law, charges for copying medical records may not exceed:

• One dollar per page for the first 10 pages
• 50 cents per page for pages 11 through 50
• 25 cents per page for page 51 and higher

On top of charging for each page, you could also be charged:

• Up to 20 dollars service fee
• Up to 20 dollars certification fee
• A 10 dollar fee if you need the records within two business days
• Shipping costs for paper copies

If you have been treating regularly, you may have hundreds of pages of medical records. Individuals with a longer history of treatment may have thousands of pages.

Let us assume that you have 350 pages of medical records. Your healthcare provider could charge over 150 dollars for a copy. And that’s just from one doctor. What if you’re seeing multiple specialists? What if you’ve had to switch doctors and need to request records from both offices?

Even at a few cents per page, the fees can add up. If you are disabled and unable to work, 150 dollars may be an insurmountable obstacle to applying for disability benefits.

How can I reduce the fee?

The law does state that your healthcare provider will consider waiving or reducing the fee if you request the records for your own use and “the charges will cause an undue financial hardship.” If you are disabled and unable to work, it’s likely that the exorbitant copying fees will cause financial hardship.

Guidelines passed by the U.S. Department of Health and Human Services in 2016 further restricted that fee to $6.50 for patients who request a digital copy of their records to be sent to a third party (like a Social Security disability lawyer or case manager). If you request a digital copy of your records be sent to a law office, your healthcare provider cannot charge more than $6.50.

Can a Social Security disability attorney get my records for me?

Yes, a Social Security disability attorney can gather your medical records if they have your written permission to do so. In fact, they will do all the legwork for you: filing your initial claim or appeal, calling your doctors, making formal requests for records, and sending records to the SSA while keeping track of deadlines.

While this can make your life easier, it can be more expensive. Even though they are working on your behalf, your disability attorney can be charged more for medical records because the same fee limitations don’t apply to third parties.

This is a fairly recent change to the fee structure. At one point healthcare providers and covered entities generated substantial revenue by charging third parties over the $6.50. In 2016, the Department of Health and Human Services (HHS) declared that the $6.50 fee limitation also applied when a third party requested private health information on behalf of a patient. This led to severe economic losses and eventually a lawsuit was filed. In January 2020, a federal court struck down the third party fee limitation. Now entities can charge the full state-mandated rate or independently calculated rates when a third party requests records.

What does this mean for you? Even though you’ve given your disability attorney permission to get record copies on your behalf, your healthcare providers can charge them more than the $6.50 fee. These costs will be reflected in your attorney bill. So while you wouldn’t have to do the work, you may end up paying the full copying fee.

Help from an Indiana Social Security Disability Attorney

At Hensley Legal Group, we believe everyone deserves professional legal representation regardless of financial status. We only bill our clients if we get them approved for Social Security disability benefits, and even then we are only paid from past due benefits. If you aren’t approved, then our services are free.

The disability application process can be complicated and tiring. If you would like more information on filing for disability, you can download our ebook 8 Mistakes to Avoid When Filing for Social Security Disability Benefits for free. No matter where you are in the application process, an Indiana Social Security disability attorney can help. Call Hensley Legal Group today or contact us online to schedule a free consultation.