TN 4 (12-19)

DI 81001.030 Claimant or Representative Requests a Copy of the Claims Folder

A. Access and disclosure

The access and disclosure policy for records maintained by the Social Security Administration (SSA) is the same for electronic and paper records.

For specific topics on access and disclosure, see the following references:

Section Title Section(s)
Access to SSA Records GN 03340.000
Law and Regulations — Disclosure/Confidentiality GN 03301.000
Disclosure/Confidentiality Information GN 03300.000
Certification of Copies of Documents and Extracts from Records GN 03360.025
Subpoenas and Court Orders GN 03330.000

NOTE: 

Disability Determination Services (DDS) must comply with their individual State laws regarding access and disclosure of records.

REMINDER: Refer to GN 03305.005C for restrictions on parental disclosure of a minor child’s medical records and GN 03340.035D concerning parental access to a minor child’s medical records.

If the request for a copy of the claim folder is submitted via subpoena of court order, see GN 03330.000 - Subpoenas and Court Orders.

B. Request received in Disability Determination Services or Telephone Service Center (TSC)

  1. 1. 

    Request for entire claim folder

    If the DDS or TSC receives a request for a copy of the entire claim folder forward the request to the servicing Field Office (FO) for copying unless there is a requirement to involve the Regional Office in responding to such requests.

    NOTE: 

    DDS and TSC offices do not have access to all systems that contain “official folder material.”

  2. 2. 

    Request for medical evidence

    If the request is limited to documents used to make a medical determination (for example, medical records and consultative examination reports), and the DDS has jurisdiction of the case at the time of the request, the DDS can provide a copy of the medical evidence. This includes any documents in sections E. Disability Related Determination (blue) and F. Medical Records (yellow back) of the electronic folder (i.e., medical evidence of record (MER), Consultative Examination reports).

    If the TSC receives the request for a copy of medical evidence only, it should forward the request to the office of jurisdiction.

    NOTE: 

    If the case is a Certified Electronic Folder (CEF), provide a copy of the medical evidence on CD. If the official folder is a Modular Disability Folder (MDF), provide a paper copy of the medical evidence.

C. Folder copy request received in FO, Workload Support Unit (WSU), Office of Hearings Operations (OHO), Office of Appellate Operations (OAO), or Processing Center (PC)

If an FO, WSU, OHO, OAO or PC receives a request for copy of a folder, and the case is a CEF, provide a copy of the folder on CD. If the official folder is paper, forward the request to the FO of jurisdiction to provide a paper copy of the folder.

NOTE: 

If the FO receives a request to copy a case pending at OHO, forward the request to the OHO office with jurisdiction of the case. If the FO receives a request to copy a case pending at the Appeals Council, forward the request to the Appeals Council branch with jurisdiction of the CEF, noted in the Hearings, Appeals and Litigation Law (HALLEX) Manual I1-3-0-7.

If the WSU receives a request to copy a case that has already been closed or is pending at any appeal level, forward the request to the FO of jurisdiction. FOs should follow the steps above to provide a copy of the folder.

The CEF does not contain all documents that comprise the official folder. To copy a CEF to CD, see Copying a Certified Electronic Folder (CEF) to Compact Disk (CD) - DI 81001.035.

REMINDER: Cases pending in the Office of Quality Review (OQR) may have SSA-831s or Personalized Disability Notices (PDN) that do not reflect the final decision. To avoid providing copies of folders without final decisions, do not make a copy of a CEF unless the office copying the CEF has jurisdiction of the case.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0481001030
DI 81001.030 - Claimant or Representative Requests a Copy of the Claims Folder - 12/05/2019
Batch run: 12/05/2019
Rev:12/05/2019