Important SSD Question - Need Advice

I need your help.  I've had two Dr's call me lately regarding my SSD paperwork.  Apparently they both recently got new requests regarding my SSD application.  My Endocrinologist's office advised that he said he does not treat me for a disabling condition and therefore wanted to send something back saying they need to foward the request to my "back doctor".  At the time, I asked them just to not send a reply because I don't want a "negative" report in my file.  I hope this was correct, but I'm not sure.  He treats me for the Human Growth Hormone Deficiency.  I take shots everyday for the rest of my life.

So today I got a call from my psychiatrist's office.  Apparently they got a new request for ALL records from my history up until May 2010.  Last time he sent in only a list of diagnoses and medications on a form he completes as relatively standard.  SSD already sent me to their own psychiatrist and I had a copy of his determination sent to my Dr.  My Dr read me the report and it was "positive" for me receiving SSD....very much so.  So, since that time I've continued seeing my Dr and have made "progress" (which may not be the best for my SSD request) and also I have made some very personal comments that would be added into my notes.  These comments could hurt some people I love who work in government positions (if they are incorrectly used/released).  That being said, if I have ALL of my notes sent, then they could be introduced into court (I think) and I REALLY don't want that information released.  It's all true, but again, it could really hurt people I love and I do not want that at all.  I had to make the decision to allow ALL information to be sent or to have another "summation" sent, which would sort of replicate what was done before.  Again, they had their own Dr do an eval so I'm not sure what benefit I could gain from releasing additional information.

Please give me advice on this.  I know I am supposed to give all medical information and that all segments of my medical/psychological being are evaluated to determine SSD, but I'm at a loss regarding this part.  I have already been denied once, so this is the appeal.  Should this one be denied (as it likely will), I will hire an attorney (but I wanted to wait just in case they really followed their own guildelines and approved me this time).   Naturally that would save me some serious money in the long run.  My medical conditions are completely within the guidelines of those which should be "automatically" approved (even though they denied on the first filing).

Any advice would be greatly appreciated. 

PALady,

This is the info that I was kind of looking for.  I believe he does have a partitioned file (with psychotherapy notes in a separate section), but I'm not sure of the way they are maintained.  He and I have spoken of this issue before and he does not like to release notes.  I will be seeing him again very soon and will discuss the submission of notes/info with certain information "black marked" should we have to submit it after all.  For now, I think they are going to have to get the summation instead. 

I've used a great number of psychological evaluations in court during my career, but never were psychotherapy notes introduced.  These were criminal cases, but your post has sort of sparked a memory where the release of information is concerned. 

I see this Dr because he helps me and has helped me through a very rough time in my life.  I have honest, valid, and very candid discussions with him about incidents that caused my PTSD and other areas of concern.  These were things that should not have happened and I don't want them to be known by others.  My friend sees her Psych for the purpose of eventually getting disabiliy....that was discussed upfront and that is all they discuss in the WEEKLY meetings.  He sends everything to SSD and she hears everything he notes (as he dictates with her in the office and it is always about her decline).  After dictation, they discuss why he said what he did and how it related back to her "disability".  It means for a slightly different perspective on sending notes.  SSD sent both of us to be evaluated by their own Dr's for additional information, so I guess I can see why they do that.  

Don't get me wrong....she is IMHO disabled (as am I), but we choose to go about the process a little differently.  No judgement here on her part......just consideration of the situation.   

This call (these calls) has/have certainly thrown me in to a tail spin right now.  I expected further evaluation, however, the SS department information on disability that they provide on their web site said the first appeal was a re-evaluation of the information on the original application and consideration of  any additional disabliing conditions.  It looks like quite a bit more than that from here.

I appreciate the responses!

I'm also not complaining about the disability process (as a whole), although I do find it insane about people who are approved for NOTHING while others who so honestly cannot work are denied. 

Thanks again!

Best to you.

I did only give permission to release the summation and not the notes (or the rest of the file).  I have not signed another release since the first one and it was only for that summation.  I'm going to give them a quick call again (just in case) and make sure things were done right.  Like you, I understand that HIPPA is only as good as the people who follow the guidelines.  You can never take back things that are said or done (once they have been said or done).

Great advice as always!

Thanks!

Update:  I just called the office and they are going to make sure of what was done/sent and call me back.  Either way, they do not send the psychotherapy notes (no matter what).  Only the progress notes are sent, however, some personal information such as "arguing with child/husband" or something like that could be included.  The files are separated by section, but information is kept in the same physical file. 

Apparently they are as concerned as I am about releasing information to anyone.  I actually remember the first meeting I had with him that we discussed releasing information and he was against it almost completely except under direct court order. 

I'll be waiting on the call for verification, but I feel sure they didn't release anything controversial or detrimental.  I can honestly say that this Dr's office is the most private of any I have ever seen.  There are only two Dr's and there are separate waiting rooms to prevent violation of patient confidentiality.  There is also virtually no wait to see the Dr because they only schedule one patient at a time with about 10 minutes between visits (I guess for making notes).