The short answer
CHAMPVA keeps your health and claim records private under VA rules, though VA can use them for treatment, payment, and operations without asking. Use VA Form 10-5345a to get your own records and VA Form 10-5345 to send them to someone else. To fix an error, send a written amendment request.
How does CHAMPVA protect my records?
Through VA's privacy rules. 38 CFR 17.279 is the CHAMPVA confidentiality rule, and it applies VA's broader privacy rules in 38 CFR 1.460 through 1.582. Those include extra protections for certain sensitive information, such as substance use, HIV, and sickle cell records, and VA's Privacy Act rules on access and correction.
The CHAMPVA Guidebook privacy section explains how this works day to day. VA processes claims and supporting documents, which can include medical records. It may use or share that information without asking you each time for:
- treatment;
- payment, such as deciding and paying a claim; and
- health care operations, plus other uses the law allows or requires.
That is not unlimited sharing. Disclosures outside those purposes generally need your written authorization, and some sensitive records have added protections.
Who holds the records I need?
That depends on the record. A CHAMPVA claim record is not the same as your doctor's chart.
| Records you want | Where to ask |
|---|---|
| CHAMPVA claim, billing, or payment records | VHA Office of Integrated Veteran Care Privacy/FOIA Office, PO Box 700, Spring City, PA 19475 |
| CHAMPVA eligibility or enrollment records | CHAMPVA Eligibility, PO Box 137, Spring City, PA 19475 |
| Notes, tests, or therapy records from a community provider | That provider's medical records office |
| Records from care at a VA facility, including CITI care | That VA facility's records office or VA's online health tools |
The Guidebook says records of community and foreign care are kept by the provider who gave the care. VA may only have what was sent with the claim.
How do I get a copy of my own claim records?
Use VA Form 10-5345a, Individuals' Request for a Copy of Their Own Health Information. The Guidebook names this form for CHAMPVA claim records.
- Decide exactly what you need: the beneficiary, claim, dates of service, and documents. A specific request is easier to fill than "everything."
- Fill out and sign the form.
- Ask the receiving office what identification it needs. If someone is signing for you, ask what proof of their authority to include.
- Send it to the office that holds the records, not the claims address. Keep a copy and note when you sent it.
How do I let someone else receive my records?
Use VA Form 10-5345, Request for and Authorization to Release Health Information. This is for sending records to a third party, such as a lawyer or another insurer.
- Name the recipient and their address, the purpose, the records, and the date range.
- Make the separate choices the form asks for on certain sensitive conditions.
- Choose when the authorization ends.
- Sign, date, and keep a copy.
An authorization covers only what it describes. If you later revoke it, disclosures already made cannot be undone.
How do I correct a CHAMPVA record?
Send a written amendment request. This is different from asking for a copy and different from appealing a coverage or payment decision.
Who should get the request?
- A CHAMPVA record held by VA: The Guidebook sends amendment requests to Eligibility, Enrollment and Verification (EEV), PO Box 137, Spring City, PA 19475, fax 303-331-7809. Name changes, Social Security number changes, and changes to sex at birth are examples that need a formal request.
- A routine update to your application: VA's after-applying instructions let you update personal details, insurance, or school status without a new application. See What Happens After You Apply for CHAMPVA.
- A community provider's notes: Ask that provider. VA cannot rewrite another provider's chart.
- VA facility records: VA's Privacy Act request guidance sends these to that facility's Privacy Officer.
What should the request say?
Sign and date it, and include:
- your name, contact details, and enough information for VA to find the record;
- the exact document, field, or entry you dispute;
- the correction you want, why the current entry is wrong, and copies of supporting documents; and
- a request for written acknowledgment and a written decision.
A simple format works: "I request amendment of the CHAMPVA record identified below. It currently says [X]. It should say [Y] because [reason]. Supporting documents are enclosed."
How long does VA have to respond?
Under 38 CFR 1.579, VA must acknowledge the request in writing within 10 business days and normally decide within 30 business days, unless unusual circumstances get in the way. That is a processing standard, not a promise VA will make the change. If you hear nothing, follow up with the office or its Privacy Officer.
What if VA says no?
The denial will be in writing with reasons and appeal instructions. Under 38 CFR 1.580, Privacy Act amendment appeals go to VA's Office of General Counsel. Follow the address in your denial letter. If the appeal is also denied, you can file a short statement of disagreement, and VA must include it whenever it shares the disputed record later.
A record correction does not reverse a claim or eligibility decision. For those, use the CHAMPVA decision review options.
What if I think my information was shared improperly?
Write down what was shared, when, who received it if you know, and why you think it was wrong. The CHAMPVA Guidebook lists VA privacy offices for complaints and also says you can complain to the U.S. Department of Health and Human Services Office for Civil Rights. The Guidebook says you will not be penalized for filing a privacy complaint.
Do not put Social Security numbers or medical details in an unsecured message or public post.
What should providers keep in mind?
Share only the beneficiary information a claim or other permitted purpose needs, and follow your organization's privacy procedures. Submitting a claim does not give an office permission to release a patient's full history. See the CHAMPVA Claim Data Checklist for what a claim needs.