A paralegal preparing a personal injury or medical malpractice case for a veteran client faces a records problem that civilian cases rarely present. Service treatment records, VA treatment records, and DoD electronic health records sit in different federal custodians' hands. A request sent to the wrong custodian can stall for 60 to 90 days before anyone identifies that the file is incomplete.
Military medical records fall into three distinct categories: Service Treatment Records (STRs), VA treatment records, and DoD/DHA-held records. Third-party access through a law firm operates primarily under the Privacy Act of 1974, alongside other agency-specific confidentiality rules, and the standard claimant records workflow built for civilian providers does not carry through cleanly to federal custodians.
This article maps custodians to record types, details authorization requirements for legal teams, outlines routing logic by service era, and addresses realistic timelines and procedural complications.
What Are Military Medical Records and Who Holds Them?
A single veteran's complete medical history almost always spans multiple federal custodians. Legal teams must identify every applicable custodian before submitting requests.
The three primary categories break down as follows:
- Service Treatment Records (STRs): Records generated during active military service, including inpatient clinical records, outpatient treatment records, and dental records. For veterans who separated before the mid-1990s, the National Personnel Records Center (NPRC) in St. Louis often holds these files. The service branches discontinued retiring health records to NPRC in the 1990s, creating a custody gap for later-era veterans and making routing more dependent on service era, branch, transfer status, and treatment location.
- DoD/DHA electronic health records: Records created within MHS GENESIS (the Military Health System's current electronic health record) or predecessor systems such as AHLTA and CHCS. Requests often route through individual military treatment facilities (MTFs) or other DoD channels rather than through NPRC.
- VA treatment records: Records generated through VA health care delivery after separation. The Veterans Health Administration (VHA) is the custodian, governed by VHA Directive 1605.01 and statutes including 38 U.S.C. §§ 5701 and 7332.
A fourth custody layer exists within the VA itself. The Veterans Benefits Administration (VBA) holds C-files containing C&P examination reports, rating decisions, and STRs transferred to VA for benefits processing. VBA handles requests for C-Files, STRs, DD-214s, and C&P exams separately from VHA health records. Each custodian requires their own request.
How Does a Legal Team Obtain Authorization to Request Military Medical Records?
Federal custodians holding military medical records generally require written authorization from the individual before disclosing records to a law firm. For NPRC and VA systems of records, the Privacy Act of 1974 (5 U.S.C. § 552a) is the primary disclosure framework. For DHA and military treatment facilities, disclosure can operate through both HIPAA and the Privacy Act, and the custodian may require its own form or another compliant authorization. A standard HIPAA authorization that may work for civilian providers, therefore, does not automatically control the federal request process. The form stack differs by custodian.
Required Forms by Custodian
- NPRC: SF-180 with a signed and dated authorization from the veteran specifying what records may be released to the law firm. For non-archival NPRC requests using SF-180, the current form instructions call for a cursive signature rather than a typed signature. Authorizations are valid one year from signature.
- VHA (VA treatment records): VA Form 10-5345, commonly used by legal teams requesting VA treatment records, requiring the patient's signature and a selected expiration date. In some VA representation contexts, VA Forms 21-22 or 21-22a may also support access, but they do not replace the usual facility-level ROI workflow in every case. Sensitive diagnosis checkboxes must be reviewed and completed by the client before submission.
- VBA (benefits/claims files): VA Form 21-22a applies when an accredited attorney is appointed as the claimant's representative in a VA benefits matter and may support disclosure within that representation structure. Item 19 contains two sub-provisions addressing firm-level and named-staff disclosure. Item 23A requires the claimant's signature.
- DHA/MTF (active duty or MHS GENESIS records): DD Form 2870 is a common authorization form for disclosure through the treating MTF's Release of Information office. DHA operates under both HIPAA and the Privacy Act, so routing and acceptable forms can vary by beneficiary status, facility, and records era.
Deceased-Client Access
The Privacy Act does not cover deceased persons, but access rules still apply. NPRC requires next-of-kin (defined as an unremarried surviving spouse, parent, child, or sibling) to provide proof of death: a death certificate, a funeral director's statement, or a published obituary. NOK authorizations are valid for one year from the date of signature. For records more than 62 years old, no NOK status is required; files are archival and open to the public.
Which Custodian Handles the Request Based on Service Era?
Routing decisions belong at the front of the workflow, not after a stall notice arrives. Service era and branch of service, not record type alone, often determine which custodian holds the file.
Pre-2014 Separations
For many Army, Navy, Air Force, and Marine Corps personnel separated through December 31, 2013, records route through NPRC under the NARA records location table, often through the Department of VA Records Management Center pathway reflected in that table. But that rule is not universal: the service branches discontinued retiring health records to NPRC in the 1990s, and some later-era files may instead sit with branch-specific custodians, with an MTF, or within VA if records were transferred for benefits processing. Submit by mail to 1 Archives Drive, St. Louis, MO 63138, by fax to 314-801-9195, or through eVetRecs online. NPRC files clinical records by the name of the last treatment facility; include that facility name in the request.
Post-2014 Separations
The NARA records location table routes many post-2014 records to branch-specific custodians:
- Army (on or after 1/1/2014): AMEDD Record Processing Center
- Navy (on or after 1/1/2014): BUMED Navy Medicine Records Activity
- Air Force (on or after 1/1/2014): AF STR Processing Center
- Coast Guard (on or after 10/1/2014): USCG HSWL SC Medical Administration
Depending on branch cutoff dates, treatment location, beneficiary status, and requester status, some post-2014 DoD records may also be accessible through the milConnect website.
Active Duty and VA Care
Active duty records usually route through the service member's current duty station MTF or the Defense Health Agency, not NPRC. Veterans currently receiving VA care should have VA treatment records requested from the VA facility's ROI office using VA Form 10-5345, regardless of service era.
1973 NPRC Fire
The 1973 NPRC fire destroyed approximately 16 to 18 million OMPFs: an estimated 80% of Army records for personnel discharged November 1, 1912 through January 1, 1960, and approximately 75% of Air Force records for personnel discharged September 25, 1947 through January 1, 1964, with surnames alphabetically after Hubbard, James E. No duplicate copies existed before the fire, and NPRC's Records Reconstruction Branch now relies on final pay vouchers, Surgeon General's Office hospital admission records, morning reports, and VA claims files as alternative sources.
What Timelines and Procedural Complications Should Legal Teams Plan For?
Processing times vary significantly by custodian, and published directive timelines do not always reflect typical retrieval windows for complex requests. Legal teams should build case schedules around operational reality rather than minimum response standards.
Processing Times by Custodian
- NPRC: The NARA NDAA backlog report (June 2024) reports 90% of requests processed within 20 workdays, with medical and clinical treatment records taking up to 90 days. Fire-reconstruction cases have no published ceiling.
- VHA health records: 20 business days is the statutory standard under VHA Directive 1605.01. Budget additional time for facility-level processing.
- VBA benefits/claims files: Turnaround can be substantially longer than VHA health-record requests. That longer cycle should govern litigation scheduling.
- MHS GENESIS/DHA: No government-published timeline standard for third-party legal requests exists. Contact the specific MTF's ROI office and request written confirmation of expected processing time at submission.
Published timelines assume a clean request; common stalls include missing service or Social Security numbers, authorizations signed outside the validity window, and unclear date ranges on the records requested.
Sovereign Immunity and Touhy Regulations
The subpoena versus retrieval distinction takes on a different shape when federal custodians are involved. A civilian subpoena issued to the VA or DoD does not by itself compel production in the way a subpoena to a civilian provider might. The VA Touhy regulation at 38 C.F.R. § 14.801(c)(1) states that these regulations do not waive the sovereign immunity of the United States, and VA personnel cannot accept subpoenas signed by an attorney or Clerk of the Court to authorize disclosure. The DoD Touhy regulation at 32 C.F.R. Part 97 imposes parallel restrictions: personnel must notify their chief legal advisor upon receiving a demand, and disclosure requires written approval addressing relevance, burden, and privilege factors.
For ordinary client-authorized record retrieval, legal teams generally proceed through the applicable Privacy Act or Release of Information channel for the custodian. Touhy procedures are the relevant pathway when the request is a litigation demand for agency-controlled records or official information, or seeks testimony from VA or DoD personnel in a legal proceeding.
For litigation discovery, file a written Touhy request with the responsible federal official, including a written statement or affidavit describing the records sought and their relevance. Fees should be addressed upfront, as 38 C.F.R. § 14.810 requires payment before production.
How Service Treatment Records Strengthen PI and Med Mal Damages Claims
STRs serve an evidentiary function in personal injury litigation that goes beyond historical context. Military entrance physicals, periodic fitness assessments, and separation physicals create a government-certified longitudinal baseline.
Baseline and Causation Applications
Enlistment physicals establish medical status at entry into service; periodic physicals document whether conditions were stable, improving, or deteriorating; separation physicals provide the break point between military and post-separation status. C&P examination reports from the VA may provide useful causation support in civil litigation, depending on the court's evidentiary rules and the facts of the case.
Military Sexual Trauma Considerations
MST records require pre-request client counseling. If a service member filed a restricted report of sexual assault, related information may, in some circumstances, surface in records such as the Separation Health Assessment. Requesting the full STR set without prior discussion can inadvertently expose sensitive information through litigation discovery. Counsel should confirm the client's reporting history and assess confidentiality risks before submitting.
Multi-Custodian Chronology Assembly
Reconstructing a complete treatment timeline requires cross-referencing records from NPRC or the service branch records command, VHA facilities, VBA, and civilian providers. Once records arrive from multiple custodians, the downstream challenge is organizing thousands of pages into a defensible chronology that maps baseline, trajectory, and incident impact.
Routing Logic as the Foundation of Military Records Retrieval
Most delays in obtaining military medical records trace to custodian misrouting, not agency slowness. Service era, branch of service, current treatment status, and authorization scope determine the correct channel.
Tavrn supports the broader retrieval workflow for personal injury and medical malpractice teams, including multi-custodian chronology assembly across federal and civilian sources.
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