obsidian-vault/projects/kobe-va/kobe-va-medical-records-request.md

Template Letter: Requesting Childhood Medical Records for Kobe

Purpose: Request medical records from childhood providers to document developmental delays, diagnoses, and functional limitations for VA dependent benefits claim.

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Template for Pediatrician / Primary Care Provider

[Date]

[Provider Name / Medical Records Department]
[Clinic/Hospital Name]
[Address]
[City, State ZIP]

Re: Medical Records Request for [Kobe's Full Legal Name]
Date of Birth: [MM/DD/YYYY]
Patient ID / Account #: [if known]

Dear Medical Records Department,

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].

Purpose of Request

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:

• Developmental delays and milestones
• Diagnoses and treatment history
• Functional limitations and impairments
• Educational accommodations and services

Records Requested

Please provide all available records including:

Clinical Documentation:

• Complete medical history and physical exams
• Well-child visit notes (all ages)
• Sick visit notes and acute care records
• Growth charts and developmental screening results
• Immunization records

Diagnostic Records:

• Psychological evaluations
• Developmental assessments
• Speech/language evaluations
• Occupational therapy evaluations
• Any IQ testing or cognitive assessments
• Lab results and diagnostic test reports

Specialist Referrals:

• Referral letters to specialists
• Specialist consultation notes
• Treatment recommendations
• Follow-up documentation

Educational/Developmental:

• School health records (if maintained by your office)
• Letters documenting need for special education
• Documentation of developmental delays
• Functional limitation assessments

Medication History:

• Prescription records
• Medication management notes
• Response to treatment documentation

Specific Timeframes of Interest

Early Childhood (Birth - Age 5):
Documentation of when delays were first noticed, early intervention services, developmental milestone tracking.

School Age (Age 5 - Present):
Ongoing treatment, educational impact, functional limitations, progression of condition.

Preferred Format

• Electronic records (PDF via secure email to: [your email])
• Paper copies (mailed to address below)
• CD/USB (mailed to address below)

Authorization and Release

Patient Information:

• Full Name: [Kobe's Full Legal Name]
• Date of Birth: [MM/DD/YYYY]
• Social Security Number: [XXX-XX-XXXX] (optional, for identification)
• Address: [Kobe's current address]

Requesting Party:

• Name: [Your Full Name]
• Relationship: Father / Legal Guardian
• Phone: [Your Phone Number]
• Email: [Your Email]
• Address: [Your Mailing Address]

Purpose: VA Dependent Benefits Claim Documentation

I authorize the release of the above medical records to:

• Frederick Book (parent/legal guardian)
• AND/OR directly to: Department of Veterans Affairs

Signature: ________________________________
Printed Name: [Your Full Name]
Date: _______________

Notarization: (if required - check with provider)

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Delivery Address

Mail records to:
Frederick Book
[Your Street Address]
[City, State ZIP]

Questions? Contact me at:
Phone: [Your Number]
Email: [Your Email]

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Additional Notes

Timeline:

• Allow 30-45 days for processing (HIPAA allows up to 30 days, but extensions are common)
• If records are urgent, note "TIME-SENSITIVE: VA CLAIM DEADLINE [date]"

Fees:

• Most providers charge per-page copying fees (typically $0.50-1.00/page)
• Some charge administrative fees ($25-50)
• Ask about fee waiver for VA benefits purposes
• Some states limit medical record fees - check Illinois law

Follow-Up:

• Call 10-14 days after mailing to confirm receipt
• Get name of person handling request
• Ask for estimated completion date
• Keep copy of request letter for your records

If Provider No Longer Exists:

• Check with state medical board for record custodian
• Contact hospital system if practice was acquired
• Try state health department archives

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Providers to Contact

Create a tracking list:

Provider Name	Dates Seen	Request Sent	Follow-Up	Received
[Pediatrician Name]	[Years]	[ ] //___	[ ] //___	[ ] //___
[Specialist Name]	[Years]	[ ] //___	[ ] //___	[ ] //___
[Hospital/Clinic]	[Years]	[ ] //___	[ ] //___	[ ] //___

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Key Points to Emphasize

What VA Needs to See:

1. When the disability began (early childhood preferred)
2. What the diagnoses are (formal, from medical professionals)
3. How it affects daily function (ADLs, learning, social skills)
4. Progression over time (stable vs. worsening)
5. Treatment history (medications, therapies, interventions)

Timeline is Critical:

• VA wants to see the disability existed before age 18 (or before age 23 if in school)
• Earlier documentation = stronger claim
• Continuous treatment history shows permanence

What Makes Records Valuable:

• Specific diagnoses with DSM/ICD codes
• Functional assessments (what child can/can't do)
• Developmental milestone delays documented
• Need for special education services
• Comparison to age-appropriate norms
• Provider statements about permanence/prognosis

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Sample Follow-Up Phone Script

When calling to check status:

"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].

The request is for VA dependent benefits documentation, so it's fairly time-sensitive.

Can you tell me:

1. Have you received my request?
2. What's the estimated completion date?
3. Is there anything else you need from me?
4. What will the cost be?

Thank you!"

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If Records Are Incomplete

What to do if provider says "we don't have that":

1. Ask specifically what they DO have
2. Request index/summary of available records
3. Ask about storage/archive - older records may be off-site
4. Get statement documenting what's missing (helps explain gaps to VA)

Sample request: "If you don't have the complete records, could you please provide:

• A summary of what you DO have
• Dates of service you can verify
• A statement documenting that records prior to [year] are no longer available

This will help explain the gap in documentation to the VA."

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Privacy Tip

HIPAA Right of Access:

• You have absolute right to your child's medical records
• Providers MUST provide them (with limited exceptions)
• 30-day response time is federal law
• If denied, ask for written explanation and escalate to state health department

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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.

Track everything - VA claims live and die by documentation!