Initial vault setup
- VA strategy documents for Fred - Kobe VA dependent benefits documents - Infrastructure overview - Home dashboard - Obsidian config Created by Funky (OpenClaw) on Thu Feb 5 02:54:14 UTC 2026
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projects/kobe-va/kobe-va-medical-records-request.md
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projects/kobe-va/kobe-va-medical-records-request.md
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# Template Letter: Requesting Childhood Medical Records for Kobe
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**Purpose:** Request medical records from childhood providers to document developmental delays, diagnoses, and functional limitations for VA dependent benefits claim.
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---
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## Template for Pediatrician / Primary Care Provider
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**[Date]**
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**[Provider Name / Medical Records Department]**
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**[Clinic/Hospital Name]**
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**[Address]**
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**[City, State ZIP]**
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**Re: Medical Records Request for [Kobe's Full Legal Name]**
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**Date of Birth:** [MM/DD/YYYY]
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**Patient ID / Account #:** [if known]
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Dear Medical Records Department,
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I am requesting a complete copy of medical records for my son, **[Kobe's Full Legal Name]**, who was a patient at your facility from approximately **[start year]** to **[end year]**.
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### Purpose of Request
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These records are needed to support a **VA dependent benefits claim** for my son, who has a permanent disability. The Department of Veterans Affairs requires documentation of:
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- Developmental delays and milestones
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- Diagnoses and treatment history
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- Functional limitations and impairments
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- Educational accommodations and services
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### Records Requested
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Please provide **all available records** including:
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**Clinical Documentation:**
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- [ ] Complete medical history and physical exams
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- [ ] Well-child visit notes (all ages)
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- [ ] Sick visit notes and acute care records
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- [ ] Growth charts and developmental screening results
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- [ ] Immunization records
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**Diagnostic Records:**
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- [ ] Psychological evaluations
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- [ ] Developmental assessments
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- [ ] Speech/language evaluations
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- [ ] Occupational therapy evaluations
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- [ ] Any IQ testing or cognitive assessments
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- [ ] Lab results and diagnostic test reports
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**Specialist Referrals:**
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- [ ] Referral letters to specialists
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- [ ] Specialist consultation notes
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- [ ] Treatment recommendations
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- [ ] Follow-up documentation
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**Educational/Developmental:**
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- [ ] School health records (if maintained by your office)
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- [ ] Letters documenting need for special education
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- [ ] Documentation of developmental delays
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- [ ] Functional limitation assessments
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**Medication History:**
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- [ ] Prescription records
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- [ ] Medication management notes
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- [ ] Response to treatment documentation
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### Specific Timeframes of Interest
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**Early Childhood (Birth - Age 5):**
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Documentation of when delays were first noticed, early intervention services, developmental milestone tracking.
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**School Age (Age 5 - Present):**
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Ongoing treatment, educational impact, functional limitations, progression of condition.
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### Preferred Format
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- [ ] **Electronic records** (PDF via secure email to: [your email])
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- [ ] **Paper copies** (mailed to address below)
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- [ ] **CD/USB** (mailed to address below)
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### Authorization and Release
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**Patient Information:**
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- Full Name: [Kobe's Full Legal Name]
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- Date of Birth: [MM/DD/YYYY]
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- Social Security Number: [XXX-XX-XXXX] (optional, for identification)
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- Address: [Kobe's current address]
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**Requesting Party:**
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- Name: [Your Full Name]
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- Relationship: Father / Legal Guardian
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- Phone: [Your Phone Number]
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- Email: [Your Email]
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- Address: [Your Mailing Address]
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**Purpose:** VA Dependent Benefits Claim Documentation
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**I authorize the release of the above medical records to:**
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- Frederick Book (parent/legal guardian)
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- AND/OR directly to: Department of Veterans Affairs
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**Signature:** ________________________________
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**Printed Name:** [Your Full Name]
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**Date:** _______________
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**Notarization:** *(if required - check with provider)*
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---
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### Delivery Address
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**Mail records to:**
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Frederick Book
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[Your Street Address]
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[City, State ZIP]
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**Questions? Contact me at:**
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Phone: [Your Number]
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Email: [Your Email]
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---
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## Additional Notes
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**Timeline:**
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- Allow 30-45 days for processing (HIPAA allows up to 30 days, but extensions are common)
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- If records are urgent, note "TIME-SENSITIVE: VA CLAIM DEADLINE [date]"
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**Fees:**
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- Most providers charge per-page copying fees (typically $0.50-1.00/page)
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- Some charge administrative fees ($25-50)
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- Ask about fee waiver for VA benefits purposes
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- Some states limit medical record fees - check Illinois law
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**Follow-Up:**
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- Call 10-14 days after mailing to confirm receipt
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- Get name of person handling request
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- Ask for estimated completion date
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- Keep copy of request letter for your records
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**If Provider No Longer Exists:**
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- Check with state medical board for record custodian
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- Contact hospital system if practice was acquired
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- Try state health department archives
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---
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## Providers to Contact
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**Create a tracking list:**
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| Provider Name | Dates Seen | Request Sent | Follow-Up | Received |
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|---------------|------------|--------------|-----------|----------|
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| [Pediatrician Name] | [Years] | [ ] ___/___/___ | [ ] ___/___/___ | [ ] ___/___/___ |
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| [Specialist Name] | [Years] | [ ] ___/___/___ | [ ] ___/___/___ | [ ] ___/___/___ |
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| [Hospital/Clinic] | [Years] | [ ] ___/___/___ | [ ] ___/___/___ | [ ] ___/___/___ |
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---
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## Key Points to Emphasize
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**What VA Needs to See:**
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1. **When** the disability began (early childhood preferred)
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2. **What** the diagnoses are (formal, from medical professionals)
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3. **How** it affects daily function (ADLs, learning, social skills)
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4. **Progression** over time (stable vs. worsening)
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5. **Treatment history** (medications, therapies, interventions)
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**Timeline is Critical:**
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- VA wants to see the disability existed **before age 18** (or before age 23 if in school)
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- Earlier documentation = stronger claim
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- Continuous treatment history shows permanence
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**What Makes Records Valuable:**
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- Specific diagnoses with DSM/ICD codes
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- Functional assessments (what child can/can't do)
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- Developmental milestone delays documented
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- Need for special education services
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- Comparison to age-appropriate norms
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- Provider statements about permanence/prognosis
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---
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## Sample Follow-Up Phone Script
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**When calling to check status:**
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"Hi, I'm calling to follow up on a medical records request I sent on [date] for my son [Kobe's name], date of birth [DOB].
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The request is for VA dependent benefits documentation, so it's fairly time-sensitive.
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Can you tell me:
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1. Have you received my request?
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2. What's the estimated completion date?
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3. Is there anything else you need from me?
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4. What will the cost be?
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Thank you!"
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---
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## If Records Are Incomplete
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**What to do if provider says "we don't have that":**
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1. **Ask specifically** what they DO have
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2. **Request index/summary** of available records
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3. **Ask about storage/archive** - older records may be off-site
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4. **Get statement** documenting what's missing (helps explain gaps to VA)
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**Sample request:**
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"If you don't have the complete records, could you please provide:
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- A summary of what you DO have
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- Dates of service you can verify
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- A statement documenting that records prior to [year] are no longer available
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This will help explain the gap in documentation to the VA."
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---
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## Privacy Tip
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**HIPAA Right of Access:**
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- You have absolute right to your child's medical records
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- Providers MUST provide them (with limited exceptions)
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- 30-day response time is federal law
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- If denied, ask for written explanation and escalate to state health department
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---
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**This template is ready to customize and send. Fill in the bracketed fields and mail certified mail (return receipt requested) to create paper trail.**
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**Track everything - VA claims live and die by documentation!**
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