Identification Number:
EM-19008
Intended Audience:All RCs/ARCs/DDSs/ADs/FOs/TSCs/PSCs/
OCO/OCO-CSTs/OHO/OARO
Originating Office:DCO ODD
Title:SSA-827 and Substance Abuse Records
Type:EM - Emergency Messages
Program:Title II (RSI); Title XVI (SSI); Disability
Link To Reference:
 
Retention Date: August 31, 2019

A. Purpose


This EM provides guidance on procedures to follow if a medical provider declines to share substance abuse treatment records for a claimant or a beneficiary despite a proper electronic or paper request for records utilizing the SSA-827 form.

B. Background

One of the critical components of adjudicating disability claims is requesting evidence related to the claimant’s alleged disability from various providers, including mental health providers and substance abuse treatment providers. When SSA requests medical records on behalf of the claimant, SSA includes a completed form SSA-827 under which the claimant authorizes the release of all records related to the claimant’s treatment, hospitalization, and outpatient care for their alleged impairments, including those related to drug abuse, alcoholism, or other substance abuse. The claimant or a parent, guardian, or other personal representative authorizes this disclosure on the form by signing it.

The Department of Health and Human Services (HHS)’s regulations at 42 CFR Part 2 protect the confidentiality of certain substance use disorder patient records. The Substance Abuse and Mental Health Services Administration (SAMHSA), within HHS, is responsible for 42 CFR Part 2 and is the contact for comments on these regulations. Recently, some medical providers have declined to share certain mental health and/or substance use disorder patient records arguing that the SSA-827, as it currently stands, does not comply with the requirements of 42 CFR Part 2. This causes significant delays in acquiring these records on behalf of the claimant, which further delays the processing of their disability claim(s).

C. SAMHSA Guidance on SSA-827 as it relates to 42 CFR Part 2

Based on the issues in acquiring patient records protected under 42 CFR Part 2 from some providers, SAMHSA has recently released a guidance letter indicating that providers may rely on an otherwise valid SSA-827 form to disclose records protected by 42 CFR Part 2 to SSA, without concern that SAMHSA will initiate, recommend, or support enforcement action against providers for such disclosures. A copy of the letter is attached below.

If a medical provider declines to share evidence related to a claimant due to alleged non-compliance with 42 CFR Part 2, then SSA representatives are to direct their attention to this letter from SAMHSA as a way to alleviate the provider’s concerns. If medical providers continue to express concerns despite being referred to the SAMHSA guidance letter, please notify your Regional Office (RO) who will contact the Office of Disability Determinations (ODD).

SAMHSA Letter.pdfSAMHSA Letter.pdf

Direct all program-related and technical questions to your Regional Office (RO) support staff or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns or problems to their Central Office contacts.

EM-19008 - SSA-827 and Substance Abuse Records - 03/20/2019