Getting Your Medical Records: Rights, Procedures, and Privacy

You may need to get copies of your medical records for a number of reasons. If you're involved in a personal injury lawsuit, medical records may be a key element of the case.

For example, if you file a legal claim after a car accident, you may need to prove that the accident—and not some pre-existing medical condition—caused your injuries. Or the extent of your injuries may be in dispute. And medical malpractice claims often hinge on interpretation of the plaintiff's medical records.

Outside of the legal realm, patients sometimes need their medical records to provide them to a specialist or new doctor. Read on to learn about your right to obtain your medical records, and how to go about getting them.

HIPAA and Your Right to Medical Records

The federal Health Insurance Portability and Accountability Act (HIPAA) gives patients the right to obtain a copy of their medical records from most health plans and health care providers, with a few exceptions.

Who May Get Medical Records Under HIPAA?

According to HIPAA, you may request:

Your own medical records. You can submit a request to access or obtain your own "protected health information" (medical records), or direct the health care provider to transmit your records to a designated third party.

Someone else's records, if you're a designated representative. You may request someone else's medical records if they give you permission, in writing, to act as their representative (in a power of attorney or similar document). For example, if your elderly parents designate you as their representative, medical providers must provide you with your parents' medical records if you make a request to obtain them.

Someone else's records, if you're their legal guardian. Likewise, if you are appointed as the legal guardian of another adult, you have the legal right to get that person's medical records. Learn more about adult guardianships and conservatorships.

Your children's medical records, with some exceptions. For the most part, parents and legal guardians can obtain their children's medical records. There are a few exceptions to this rule. A parent might not get access to a child's records if:

• the child has consented to medical care, and parental consent isn't required under state law
• the child gets medical care at the direction of a court, or
• the parent agrees that the minor and the medical provider have a confidential relationship.

Records of deceased persons in certain circumstances. If you're the personal representative of an estate—either designated by a will or appointed by a court to settle a deceased person's affairs—HIPAA gives you access to the deceased's medical records. In addition, if you're related to a deceased person and certain information in that person's medical file relates to your own health, HIPAA lets you access that information.

What Medical Records Can You Get Under HIPAA?

HIPAA gives patients the right to get copies of all of their medical records. Patients also have the right to view—usually at the medical provider's offices—their original medical records.

HIPAA does allow health care providers to withhold certain types of medical records, including:

• psychotherapy notes
• information the provider is gathering and compiling for lawsuits, and
• medical information that the provider believes could reasonably endanger your life, your physical safety, or the safety of another person.

Usually, if the provider denies your request for medical records, it must provide you with a denial letter. In some cases, you may be able to appeal the denial.

How Long Does a Medical Records Request Take Under HIPAA?

HIPAA requires medical providers to provide copies of medical records within 30 days of your request. If it will take more than 30 days to meet your request, the medical provider must give you a reason for the delay.

Some states require a quicker turnaround. For example, in California, providers must allow patients to see their records within five days of the request, and must provide copies of those records within fifteen days.

Can an Insurance Company Get My Medical Records?

No insurance company (whether it's yours or someone else's, like the other driver's insurer after a car accident) has the legal right to obtain your medical records without your consent and authorization. You have a near-total right of privacy when it comes to who can or cannot see your medical records.

But if you're making an insurance claim in which you're seeking compensation for injuries or some other health issue (like a car insurance claim), you're placing your current health and wellness at issue, and the insurance company almost certainly won't offer you a fair injury settlement without reviewing your medical records. In this situation, most insurance claimants will obtain the relevant medical records and transmit them to the insurance company (making sure what's sent over is limited to what's relevant to the claim).

If a lawyer is representing you as part of your insurance claim or lawsuit, the standard course of action in this situation is for you (the client) to complete an "authorization for the release of medical records" or similarly-named form, giving your lawyer the legal right to obtain medical records related to your case.

Learn more about insurance company requests for medical records and medical exams in an injury claim.