Your Client Was Treated at a Hospital in Kabul. Now You Need Those Records.
A contractor working on a USAID-funded project in Afghanistan falls from scaffolding and breaks his femur. Local nationals rush him to a nearby hospital. He receives emergency surgery, spends four days recovering, and eventually gets medevaced to Germany and then home. Six months later, he hires you to pursue his DBA claim.
You need those Kabul hospital records. The surgical notes, the imaging, the discharge summary. Without them, the carrier will argue there is a gap in the medical evidence chain. But the records are in Dari. The hospital has no electronic medical record system. And nobody at the facility has heard of HIPAA or a medical records release form.
This scenario plays out constantly in DBA practice. ClaimTrove data shows over 30,631 OWCP coverage card filings spanning dozens of countries. Contractors get injured in Afghanistan, Iraq, Kuwait, Qatar, and across Africa. Initial treatment happens at whatever facility is closest: a local civilian hospital, a military field clinic, or a coalition medical facility. The records generated at that point of first contact become critical evidence, and obtaining them requires a different playbook than pulling records from a stateside hospital.
Why Are Foreign Medical Records So Difficult to Obtain?
The fundamental problem is that no international equivalent of HIPAA exists. In the United States, you send a signed authorization and the hospital produces records within 30 days. Overseas, the process depends entirely on the country, the facility, and who you know on the ground.
In Afghanistan and Iraq, many hospitals operate on paper-based systems. Records may be handwritten in Arabic, Dari, or Pashto. Filing systems range from organized to nonexistent. Some facilities retain records for years. Others discard them after the patient leaves. If your client was treated in 2012 and you are filing a claim in 2025, those records may simply be gone.
The good news: most foreign hospitals cooperate with direct requests. Letters rogatory, the formal international legal mechanism for cross-border evidence requests, are almost never necessary in DBA cases. A well-drafted letter from your firm, accompanied by the client's written authorization and a reasonable records fee, usually works. Many DBA practitioners have established relationships with fixers or local attorneys in high-volume countries like Afghanistan, Iraq, and Kuwait who can facilitate records retrieval in person.
Military medical facilities present a different challenge entirely, and attorneys handling claims from DBA injuries in Afghanistan encounter this frequently. Your client may have been treated at a Role 3 hospital at Bagram or Kandahar before those facilities closed. Those records exist somewhere in the military health system, but accessing them requires navigating TRICARE and Defense Health Agency procedures rather than civilian records requests.
What Translation Standards Do ALJs Require for Foreign Medical Evidence?
The distinction between certified and non-certified translation matters more than many attorneys realize. A certified translation includes a signed statement from the translator attesting that the translation is accurate and complete. The translator does not need to be a court-certified interpreter. They need to be competent in the relevant language and willing to sign a certification statement.
Administrative law judges in OALJ proceedings generally accept certified translations without requiring the translator to testify. ClaimTrove's database of over 5,022 OALJ decisions includes cases where foreign medical evidence was central to the dispute. In those cases, the ALJ focused on two questions: Is the translation certified? Does the translated content support the medical opinions in the record?
Non-certified translations create problems. Carriers routinely object to uncertified translations, arguing the court cannot verify accuracy. Even if the ALJ admits the document, its evidentiary weight drops. You are handing the carrier a procedural argument that distracts from the merits of your case.
Medical terminology adds another layer of complexity. A general translator may render a Dari-language surgical report into English but miss critical medical nuances. "Fracture" might be translated accurately, but the specific type of fracture, the surgical approach described, or the prognosis language could be mangled. Use translators with medical terminology experience whenever possible. The cost difference is modest, and the evidentiary value is substantially higher. Understanding how maximum medical improvement determinations work in DBA cases makes clear why precise translation of treatment records and prognosis language matters at every stage.
How Do You Handle Military Medical Facility Records?
Contractors injured in combat zones often receive initial treatment at U.S. military medical facilities. Role 1 aid stations, Role 2 forward surgical teams, and Role 3 combat support hospitals all generate medical records. These records are maintained by the Defense Health Agency and are accessible through specific channels.
For treatment at military facilities, the request goes through the Military Health System. If your client was treated as a civilian contractor at a military hospital, the records should be in the Armed Forces Health Longitudinal Technology Application (AHLTA) or its successor, MHS GENESIS. Request records through the servicing military treatment facility or, if the facility has closed, through the National Personnel Records Center.
TRICARE records require a separate request. If your client received follow-up care through TRICARE after medevac, those claims records are maintained by the TRICARE regional contractor. A signed authorization from your client directed to the appropriate TRICARE regional office will produce claims data, but not necessarily the underlying clinical notes.
The timeline challenge is real. Military facilities in Afghanistan and Iraq have largely closed. Records from closed facilities migrate to archive systems, and retrieval times stretch from weeks to months. Start the records request at the beginning of your case, not when you need them for a hearing. Experienced practitioners send military records requests simultaneously with their initial client intake process to avoid delays later.
What Practical Steps Improve Your Success Rate with Foreign Records?
Build your records retrieval strategy around the injury location and the type of facility. The approach for a civilian hospital in Kuwait differs from a field clinic in rural Afghanistan.
For civilian hospitals in Gulf states (Kuwait, Qatar, UAE, Bahrain), medical records systems are relatively modern. Many facilities have English-language medical staff and can produce records in English or with minimal translation needs. A formal letter with your client's authorization, sent via email and followed by a phone call, usually produces results within 30 to 60 days. Payment of a records fee in the range of $50 to $200 is standard.
For facilities in conflict zones, you likely need a local contact. DBA practitioners who handle volume in Afghanistan or Iraq maintain relationships with local attorneys or fixers who can visit facilities, pay fees, and retrieve physical copies of records. The cost is higher, often $500 to $1,500 including the local contact's fee, but the alternative is no records at all.
For embassy or consulate medical units, contact the relevant agency directly. State Department medical units maintain their own records systems. If your client received treatment at an embassy health unit, the request goes through the agency, not the host country's medical system.
Document everything about your retrieval efforts. If records are genuinely unavailable, you need to show the ALJ that you made reasonable efforts to obtain them. A paper trail of letters sent, fees paid, and responses received (or not received) supports a secondary evidence argument. You can then rely on your client's testimony, stateside medical opinions based on the available evidence, and any contemporaneous documentation like medevac records or incident reports.
Knowing where your client worked and which medical facilities served that location is half the battle. The contract location determines the universe of possible treatment facilities. ClaimTrove's employer and contract data spans 43,298 prime contract awards across dozens of countries, helping you map the operational context for your client's injury. Understanding employer obligations for medical benefits under Section 7 strengthens your argument for why these records matter and who bears the cost of obtaining them.
How Do You Authenticate Foreign Medical Records for an OALJ Hearing?
Authentication of foreign documents in OALJ proceedings is less burdensome than in federal court. The OALJ operates under relaxed evidentiary rules compared to Article III courts. You do not need apostilles or consular certifications in most cases. But you do need to establish a foundation for the documents you submit.
The standard approach combines three elements. First, a certified translation with the translator's attestation. Second, a declaration from the person who obtained the records (your local contact, your client, or a records custodian) describing how and where they were obtained. Third, the original-language documents alongside the translations, so the ALJ and opposing counsel can verify the translation if challenged.
Carriers sometimes retain their own translators to challenge your translations. This is more common in high-value cases where the medical evidence is pivotal. Prepare for this by using translators with documented credentials and medical terminology experience. If your translator has a certification from the American Translators Association or equivalent body, note that in the certification statement.
One tactical consideration: submit foreign medical records early in the proceedings. If you wait until the hearing to introduce translated foreign records, the carrier will object on grounds of surprise and request a continuance to obtain its own translation. Submitting records with your pre-hearing statement eliminates this delay and signals to the ALJ that you have a thorough, well-documented case.
For attorneys managing DBA claims for expat employees on permanent overseas assignments, foreign medical records are not a one-time challenge. These claimants may have years of treatment records from foreign providers, requiring ongoing translation and authentication throughout the life of the claim.
If you want to identify where your client's injury occurred, which contracts operated at that location, and what medical facility context applies to your case, run a ClaimTrove investigation. Thirty seconds of research replaces hours of guesswork about the operational environment behind your client's claim.