FAQ

Mental health treatment records are a necessary and integral part of the evidence needed for DDS to make a disability determination for someone alleging mental illness as an impairment. You are permitted and encouraged to support a claimant’s application with the disclosure of your records (with proper authorization). The records that are excluded from this authorization are “psychotherapy notes,” which are a specific type of note not typically a part of most medical records, especially in publicly funded settings.

As HIPAA defines the term, “psychotherapy notes means notes recorded in any medium by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Excluded from “psychotherapy notes” are medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

If you keep psychotherapy notes separate from your other medical records, you can send the set of records without the psychotherapy notes. If you do not keep psychotherapy notes separate from other parts of the medical records, you can legally disclose all of the records. However, you can choose to black out or remove the parts of the records that would be considered psychotherapy notes. Another option is to prepare a report that details the critical current and historical aspects of the applicant’s treatment and functional information, such as a SOAR Medical Summary Report.

For more information, see SSA’s Fact Sheet for Mental Health Care Professionals.

Generally speaking, medical providers are not legally bound to provide records to a third party. They are not required to provide records to DDS, either. However, HIPAA regulations require healthcare providers to provide individuals copies of their own records: 

"The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more “designated record sets” maintained by or for the covered entity.”

We hear from most SOAR providers that they are able to get medical records from most sources. Some states have special laws that cover access to records for disability applications. We also do our best to build relationships with commonly used providers and the medical records departments to try to improve those relationships, and clarify and expedite processes.

As the claimant’s representative (using the SSA-1696 Appointment of Representative Form), you can request a copy of the claimant’s previous and current files, which include the medical records SSA and DDS received with the application. These documents are generally provided on a CD. This is allowed under the Privacy Act (5 USC § 552a (b)) “An individual may give SSA written consent to disclose his/her personal information to a third party of his/her choosing.”

Note: When using the SOAR process, staff will want to collect the medical records and submit them to DDS rather than the other way around. The reason for this is to ensure that the DDS receives all pertinent information. However, obtaining a CD from DDS can be useful when you assist an individual who has already applied and been denied.
Source: https://secure.ssa.gov/poms.NSF/lnx/0203305001

The SOAR TA Center does not have funds available to pay for SOAR in local organizations and there is no dedicated source of funding for SOAR programs. And yet, all 50 states participate in SOAR at some level by reallocating existing resources; by securing funding through federal and state grants or foundation funding; or by establishing collaborations with hospitals and criminal justice systems.

To support local organizations, the SOAR TA Center developed resources and tools for funding and sustainability, based on best practices from SOAR programs around the country. The SOAR TA Center also maintains a webpage dedicated to upcoming funding opportunities, which is updated frequently with new resources.

HIPAA requires medical providers to release the patient's records within 30 days after the request is received (https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/ind…). Some states have laws that require the release of medical records in fewer than 30 days.

Most states prohibit the re-release or “further release” of records once they have been released to an entity that originally requested them. However, if you send a request for records using the SOAR Process, which includes (1) a signed SSA-827 Authorization to Disclose Information and (2) a signed Agency Authorization to Release Information (either using the sample on the SOAR Tools & Worksheets page or your agency’s HIPAA compliant release), you will be able to send those records on to SSA.

Also included on the SOAR Tools & Worksheets page is a Medical Records Request Letter, which explains the purpose of the records request. This process of sending two releases is permitted under the HIPAA Privacy Rule as a “compound authorization.” The regulation can be found in the Code of Federal Regulations: Title 45 Part 164 Section 164.508. Source: Code of Federal Regulations: Title 45

When providers of substance use services (drug and alcohol) release records, they are required to include the following notice from the CFR Title 42:2.32:

“This information has been disclosed to you from records protected by Federal confidentiality rules (42 CFR part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.” Source: http://edocket.access.gpo.gov/cfr_2002/octqtr/42cfr2.32.htm

However, the law allows the records to be disclosed to any entity the person names in the consent. When you complete the SSA-827: Authorization to Disclose Information to SSA be sure that it specifically mentions the release of drug and alcohol treatment records.

You should be able to use the copy of the authorization that you have to request the records. According to a clarification letter drafted by the Director of the Office of Civil Rights on April 25, 2003, “A copy, facsimile, or electronically transmitted version of a signed authorization is also a valid authorization under the Privacy Rule.”
Source: https://www.socialsecurity.gov/disability/professionals/documents/HHS-OCRfeedback.pdf

Absolutely! The U.S. Department of Housing and Urban Development (HUD) Continuum of Care Program (CoC) plays a key role in ending homelessness in communities and states. HUD’s description of the program includes: “The Continuum of Care (CoC) Program is designed to promote communitywide commitment to the goal of ending homelessness; provide funding for efforts by nonprofit providers, and State and local governments to quickly rehouse homeless individuals and families while minimizing the trauma and dislocation caused to homeless individuals, families, and communities by homelessness; promote access to and effect utilization of mainstream programs by homeless individuals and families; and optimize self-sufficiency among individuals and families experiencing homelessness” (emphasis added)

SOAR is critical in HUD’s mission to promote access to Social Security disability benefits for individuals with disabling conditions. This access helps promote housing stability and prevents future homelessness for these individuals. As a result, SOAR should be included in local CoC plans to end homelessness.