Medical/Professional Relations
Fact Sheet for Mental Health Care Professionals:
Supporting Individuals' Social Security Disability Claims
Information from you, as a mental health professional, is vitally important to support claims for Social Security Disability Insurance and for Supplemental Security Income benefits. Form SSA-827 (Authorization to Disclose Information to the Social Security Administration)(PDF) legally permits you to make the necessary disclosures of information consistent with applicable laws, including the Health Insurance Portability and Accountability Act (HIPAA), the Substance Abuse Act and the Family Educational Rights and Privacy Act (FERPA).1
Social Security’s Release Form Authorizes
Your Disclosure
Individuals or their authorized representatives complete and sign the
SSA-827 when they file a disability application. This form legally authorizes
you and other professionals to release medical records, even if your
name(s) are not specifically listed.2 A copy, facsimile or electronically
transmitted version of this signed form is acceptable.3 You are complying
with all relevant federal and state laws and regulations when you release
your patient’s (or student’s) medical records as authorized
by the SSA-827.
The request for your records will most often come
from a state agency that makes disability determinations for the Social
Security Administration (SSA). These agencies are usually called Disability
Determination Services (DDS) but the agency name may be different in
your state. If the claimant has appealed a decision, you may receive
a request for evidence from an Administrative Law Judge in SSA’s
Office of Disability Adjudication and Review.
When evaluating mental disorders, information from treating sources is
essential to accurately assess the onset and severity of claimants’ impairments
and their effect on functional capacity. This applies to new claims, determinations
of continuing eligibility for current beneficiaries, and appeals. With
your timely response to requests for information, your patients may more
quickly start (or continue) to receive cash benefits and Medicare or Medicaid.
Without your records, the decision may be made based on the results of
a one-time consultative examination by a medical professional unfamiliar
with your patient.
You can also help assure more accurate and timely decisions for your patients
by submitting your records electronically as described below. Electronic
processes can make it quicker and easier for medical and other claimant
records to be transferred securely, eliminating mail time and automating
handling.
Full Disclosure Is Permitted
The signed SSA-827 specifies that the authorization permits you to disclose all of your patient’s medical or educational information to Social Security and DDS offices for the time period requested. That means you do not have to apply the “minimum necessary standard” before disclosing medical records.4 Social Security must consider the claimant’s complete, relevant medical record for at least 12 months prior to the claim, including assessment of the combined effect of multiple impairments that individually may not be severe. In addition, both HIPAA and the SSA-827 permit you to disclose “information created within 12 months after the date (the release is) signed.”5 (Providers in Puerto Rico should also refer to local law for guidance.)
Psychotherapy Notes, as Defined by HIPAA, Can Be Protected
Social Security recognizes the sensitivity and
extra legal protections that concern psychotherapy notes (also called “process” or “session” notes)
and does not need the notes. 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.
Psychotherapy notes excludes 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 if kept separately. Another option is
to prepare a special report detailing the critical current and longitudinal
aspects of your patient’s treatment and their functional status.6
HIPAA Permits Electronic Transmission of Records
HIPAA was intended to encourage the efficient electronic exchange of
health information. Social Security record gathering procedures support
HIPAA safeguards for transmitting medical records.7 Records can be uploaded
to Social Security’s Electronic Records Express secure website
or safely faxed via Social Security’s dedicated lines directly
into your patient’s electronic claim file. The secure website meets
all HIPAA-related security requirements. It uses confidential usernames
and passwords and sophisticated encryption to protect records submissions.
Your Information Will Not Be Re-Disclosed
Without Consent
Social Security will not re-disclose medical records it receives to other
entities or individuals, without prior written consent, except in the
very limited manner permitted or required by federal law and regulations.8
Additional Information Sources
Please see www.socialsecurity.gov/disability/professionals for more information on the SSA-827. This also provides a list of DDS
Professional Relations Officers and their contact information for specific
questions.
See www.hhs.gov/ocr/hipaa for HIPAA privacy rules, HHS formal guidance
and FAQs.
Visit www.ssa.gov/ere for general information about Electronic
Records Express and a demonstration of how to use the secure website.
If you would like to register to use Social Security’s secure website
to send patient records, send an E-mail to electronic-records-express@ssa.gov,
call 1-866-691-3061 or contact one of your state’s Professional
Relations Officers (see link above).
Publication No. 64-103
Unit of Issue - HD (one hundred)
ICN available Spring 2008
January 2008
1 See www.socialsecurity.gov/disability/professionals/ssa827_informationpage.htm for the form, reference material, and other legal points. The SSA-827 fully complies with HIPAA (45 CFR 164), and other federal and state laws and regulations including the Substance Abuse Act (42 CFR Part 2), FERPA (34 CFR Parts 99 and 300) and applicable state law.
2 Both HIPAA and 42 CFR Part 2 permit authorization forms to include "the . general designation of the program or person permitted to make the disclosure" [45 CFR 164.508(c) (1) (ii)]. "This. will permit a patient to consent to disclosure from a category of facilities or from a single specified program" [42 CFR Part 2, 52 Federal Register 21799 (June 9, 1987)].
3 See Health and Human Services (HHS) frequently asked questions (FAQs) at: www.hhs.gov/hipaafaq/use/index.html.
4 Providers can rely on the authorization to define what can be released (45
CFR 164.502(b) (2) (iii)). The signed SSA-827 permits full disclosure of all
requested information. See the HHS
FAQs.
5 See the HHS
FAQs.
6 See www.socialsecurity.gov/disability/professionals/greenbook/index.htm.
Select adult or pediatric and scroll down to the heading for Mental Disorders.
7 45 CFR 164 Subpart C.
8 Privacy Act of 1974, Freedom of Information Act, and federal regulations
per 20 CFR 401.