Medical Records and HIPAA

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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. Remember the DDS examiner rarely meets the applicant and determinations are based solely on the medical evidence gathered.

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.

The SOAR curriculum focuses on individuals with mental illness and co-occurring disorders. However, SOAR critical components can also be used effectively for adults who have HIV/AIDS.  Here is additional information that will be helpful when assisting this population.

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!

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.

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

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

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.

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).

On September 9th, the Social Security Administration (SSA) published proposed revisions on their medical evidence rules in the Federal Register, 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!

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.

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.

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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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