How to Get Your Medical Records After a Possible Malpractice Incident
Quick Links
- Your Medical Records Belong to You
- What Medical Records to Request
- How to Request Your Medical Records the Right Way
- How a Medical Malpractice Lawyer Can Help
- What Patient Portals Leave Out
- What to Do If Your Request Is Delayed or Denied
- What to Look for in Your Medical Records
- Medical Record Terms and Their Meanings
- Take the First Step Toward Getting Your Medical Records
Making the request the right way helps ensure you receive the full documentation, not just summaries or limited portal information. With a complete record, it becomes easier to understand what happened during your care and whether anything may have been missed.
If something about your treatment doesn’t feel right, having your records can make it easier to identify gaps, ask the right questions, and decide what to do next.
Your Medical Records Belong to You
Getting your medical records is not about asking for a favor. They are your records, and you have the right to request and receive a copy.
Under federal Illinois law, including the Health Insurance Portability and Accountability Act (HIPAA), you have the right to access your medical records, and providers are generally required to respond within 30 days in most cases. They can charge a reasonable fee, but it must be limited to reasonable, cost-based fees, such as copying or electronic delivery.
Understanding how to find medical malpractice records starts with having access to the complete file, not just selected portions. If something feels incomplete or unclear, it is worth asking questions or getting help to make sure you have everything you need.
What Medical Records to Request
When you request your records, it is important to ask for more than just summaries or basic reports. To get a complete understanding of your care, you should request records such as:
How to Request Your Medical Records the Right Way
Many people start by calling their doctor’s office to request their records. That approach can lead to delays or incomplete information.
Medical records are usually handled by a separate department, often called Health Information Management or Medical Records. Contacting that department directly is the most reliable way to move your request forward.
In most cases, you will need to submit a written request and verify your identity. It also helps to be specific about what you are asking for to help avoid confusion and reduce back-and-forth.
Starting the process the right way can save time and frustration. If the process becomes difficult or unclear, speaking with an attorney can help you understand your options.
How a Medical Malpractice Lawyer Can Help
Getting your records on your own can take time, especially if there are delays or missing information. A medical malpractice lawyer can step in and handle the request for you with your written authorization.
At Levin & Perconti, we regularly work with hospitals and providers to obtain complete records and understand what should be included to avoid delays.
What Patient Portals Leave Out
It is easy to assume that your patient portal has everything you need, but it rarely does. Portals are designed for convenience and often only show select information, such as visit summaries, test results, and appointment details.
Full medical records include much more. They can contain detailed notes, internal documentation, imaging, and other records that are not available through a portal.
If you are trying to understand what happened during your care, the complete record is what matters. Relying solely on portal information can leave out important details.
What to Do If Your Request Is Delayed or Denied
It is not uncommon to encounter delays, high fees, or incomplete responses when requesting your records. You may be told something is unavailable or receive only part of what you asked for. If that happens, it can help to take the following steps:
- Follow up in writing: Ask for the status of your request and use clear language, such as, “I am requesting a complete copy of my medical record, including all notes, reports, billing records, and internal documentation.”
- Question high fees: If the provider quotes a large amount, ask for an itemized breakdown of the charges.
- Contact a supervisor: If you are not getting a clear response, ask to speak with a supervisor in the Medical Records or Health Information Management department.
- Keep a paper trail: Save your request, all responses, and the dates of each follow-up.
- File a complaint if needed: If the provider still does not comply, you can file a complaint with the Office for Civil Rights.
- Get legal help: If delays continue or the response still seems incomplete, a lawyer can help move the process forward.
What to Look for in Your Medical Records
Once you have your records, the next step is understanding what they show. You do not need medical training to spot potential issues, but you should know what to look for.
Focus on timing, consistency, and how events are documented. Gaps between entries, vague descriptions, or notes that do not match your memory can signal that something is missing or unclear.
Also, pay attention to entries that appear out of order, are added later, or are inconsistent with earlier documentation. These issues can raise concerns about the accuracy of the record, sometimes referred to as the manipulation of electronic health records. If anything stands out or does not make sense, a medical malpractice lawyer can review the records and help you understand what they may show.
Medical Record Terms and Their Meanings
Medical records often include abbreviations and terms that can be difficult to understand at first glance. Knowing a few of the most common terms can help you better follow what happened during your care and spot anything that seems off.
- H&P (History and Physical): A summary of your condition at admission, including symptoms and initial findings.
- Attending vs. Resident: The attending is the primary doctor, while a resident is a doctor in training involved in your care.
- SOAP notes: A format used to document care, including symptoms, findings, assessment, and plan.
- PRN: As needed, often used for medications not given on a fixed schedule.
- AMA: Against medical advice, meaning a patient chose to leave or decline care.
- C/O: Complaining of, used to record what a patient reports feeling.
- HPI: History of present illness, describing recent symptoms and condition.
Take the First Step Toward Getting Your Medical Records
Getting your records is the first step in understanding what happened and deciding what to do next. If you are trying to figure out how to get your medical records, we are here to help.
At Levin & Perconti, we help people review their records, identify potential concerns, and understand their legal options. If something does not feel right about your care, you do not have to figure it out on your own. Call (312) 332-2872 or contact us online to take the next step.
Legally Reviewed by
Bonamarte, IV
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Since 2005, Michael Bonamarte IV has been a passionate advocate for victims of negligent conduct, corporate malfeasance, and medical malpractice. He has won numerous awards and recognitions, including Best Lawyers in America and Super Lawyers’ Rising Star. He has presented for the American Association for Justice, the AAJ Nursing Home Litigation Group, the John Marshall Law School, and numerous other legal associations. He regularly lectures at Chicago-area aging organizations about nursing home abuse. His writings have been published by the American Bar Association, the Chicago Daily Bulletin, and numerous other prestigious publications.
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