Medical Records and HIPAA

Medical Records and HIPAA


Completing the SSA-827 allows SOAR case managers to obtain the applicant’s medical records, in order to verify that they meet the medical eligibility criteria for SSI/SSDI.

The National Organization of Social Security Claims Representatives (NOSSCR) has compiled a list of the state statutes and regulations regarding the collection of fees for medical records.

In the process of collecting medical evidence, the DDS examiner may decide that there is insufficient information to make a determination about disability. In this case, the DDS examiner can request an evaluation from an outside source called a Consultative Exam (CE).

Tracking down medical evidence can be very challenging, especially if the treating source is unknown. Case managers must develop creative strategies and become good detectives!

Documenting Disability for Medical Providers is a free online training provided by the National Health Care for the Homeless Council.

The CE report should show not only the individual’s symptoms, laboratory findings (psychological test results), and diagnosis but also the effect of the mental disorder on the individual’s ability to function in personal, social, and occupational situations.

Documenting substance use for an application is not just about finding out how much the person uses or how often.

Understanding SSA's disability criteria helps the SOAR case manager assess the documentation necessary to support the claim of disability.

SOAR case managers play a central role in collecting medical evidence before submitting the complete application packet to SSA. In this way, when SSA completes its review for non-medical eligibility, DDS has the necessary information to make the disability determination.

On September 9th, the Social Security Administration (SSA) published proposed revisions on their medical evidence rules in the Federal Register (pdf), including the proposal to expand the list of Acceptable Medical Sources to include Advanced Practice Registered Nurses (APRNs). SSA invites the public to comment on the proposed changes before November 8th. This is your chance to learn about the proposed changes and have your voice heard!

As we announced in September, the Social Security Administration (SSA) invited comments on proposed changes to how they evaluate medical evidence, including adding Advanced Practice Registered Nurses (APRNs) as acceptable medical sources. We are excited to announce that SSA published the Final Rule in the Federal Register this morning, which will go into effect for any applications filed on or after March 27, 2017.

On September 26, 2016 the Social Security Administration (SSA) published new rules updating how they will evaluate mental disorders, which will go into effect on January 17, 2017.

A new SSA ruling clarifies existing regulations which require that claimants and/or their authorized attorney or non-attorney representatives inform SSA about, or submit all evidence known to them that relates to their disability claim. This article will discuss the purpose of the ruling, outline key requirements, and present a few scenarios which a SOAR practitioner may encounter.


The second webinar in our "Completing Quality SOAR Applications" series was held on June 27, 2018 and focused on how to optimize medical records collection and approach SSA’s Listings of Impairments for expediting your SOAR claim.

Issue Briefs

This issue brief, developed by the SAMHSA SOAR TA Center, provides strategies for forming partnerships, examples, and a sample agreement to help hospitals and community programs create collaborations that are mutually beneficial.

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