Wednesday, November 3, 2010

Medical Records Free for Disability Applicants in Georgia

A common complaint from applicants for Social Security is the sometimes large charges imposed upon them by hospital and physicians in exchange for providing copies of their records. This condition has gradually worsened as more and more hospitals outsource their records departments to companies whose sole purpose is to copy and supply records. Their very existence depends on charging for records up to statutory limits. When a person spends an appreciable amount of time in the hospital they create an enormous amount of paper that must then be supplied to Social Security. Without this paper evidence, a case may be incapable of succeeding, but without money, medical records are frequently withheld.

Though every state is different in the way they treat requests for medical records, Georgia is pretty clear. In O.C.G.A. §31-33-3, a fee schedule for medical records copies is laid out succinctly such that provider and document services are limited in what they can charge for duplication. The last sentence of Section (a) if this statute is most relevant, and reads,

This subsection shall not apply to records requested in order to make or complete an application for a disability benefits program.”

This sentence is read in a variety of ways, but in no other portion of the law are fees discussed for copies made in support of a disability benefits program (Workers Compensation DOES have its own fee schedule). I read this sentence to the benefit of my clients, and it appears that courts seem to agree. In the 2008 Georgia Court of Appeals Case, Smart Document Solutions, LLC v. Hall, 290 Ga.App. 483, 659 S.E.2d 838 (Ga.App. 2008), the Court noted at page 485 that “The fee exemption, therefore, includes requests for disability benefits…”.

This seems to be a clear intent by the Georgia judiciary (and legislature) to ensure that people who are unable to work (and thus are unable to pony up for hundreds of dollars of records) have access to the medical records which may for them unlock health insurance and monthly assistance. Unfortunately, there are overly aggressive or uninformed copy companies that are now attempting to require advance payments before pulling documents. Some examples of these charges include estimates of total pages, and well as “convenience” charges that are levied. In most cases a stern phone call or letter will remove barriers such as this, but it is important to remember that as a Claimant or Practitioner, we have the ability to request that the judge issue a subpoena of the records. Certainly this is a less desirable outcome than simply getting the records, and I have heard anecdotally that some folks are paying the $10 (which comes out of the client’s pocket), but it is important to remember that when companies erect monetary barriers to securing medical records for a Georgia disability applicant, they are breaking the law and violating public policy, plain and simple.

For questions about your disability case, contact Thomas O’Brien at Feiler & Associates.

6 comments:

  1. It is great that GA has free medical records. One of the biggest issues I have come across is people not having the resources to acquire the necessary medical documentation in order to be awarded benefits.

    Which is one of the main reasons I have started to post articles on the closest places to receive reduced cost medical care in big cities.

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  2. Thanks for reading and posting. Is there something that you think that I have overlooked?


    workers compensation rates georgia

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  3. I just read the court opinions for the case you cited. Smart Document was upset that the Workers Comp Board was setting their fee schedule lower than the state law allowed. Smart Document argued that Workers Comp is not a disability program and should not be exempt from the Health Records Act. The court disagreed and upheld the Workers Comp Board's right to set their own fee schedule. How do you reconcile the contradiction that the Workers Comp is a disability benefit (and according to you should therefore be free of charge) but the Workers Comp Board is allowed to set a fee schedule for the duplication of records?

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  4. “This subsection shall not apply to records requested in order to make or complete an application for a disability benefits.
    I take this sentence to mean the fees outlined shall not apply, not that the records should be free. With the rising cost of everything and the decline in reimbursements, why should the burden of retrieval time, ink, paper and postage be the responsibility of the Dr. or hospital? SSA office pays $15 per request when they request records and they are the program in which the statute refers.

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  5. There is a very aggressive disability attorney in our city who insists that all medical records requested by her firm from our medical office shall be free of charge. She states that this would include records as "proof of ongoing disability" or for "disability appeals relative to cessation." We do not believe this is the intent of the subsection. We feel the original intent was meant to apply to an initial application for disability- not for an appeal and not for proof of a patient's ongoing disability. By labeling herself a disability attorney, she takes advantage of this subsection to get out of paying for any records while lining her pockets with generous proceeds of patients' disability settlements. All physicians' offices are bullied into complying with her demands in order to avoid a board complaint.

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