Searched by Diagnosis Code: What the Pentagon's Medical Record Reviews Mean for Every Federal Employee's Confidential File
Federal employee medical privacy is suddenly a live question. Federal News Network reported this week that service members are being identified for separation through their electronic health records, searched by diagnosis code. Whatever you think of the underlying policy, the part every federal employee should watch is not the policy. It is the method.
What the Documents Show
Three documents described in the reporting lay out the mechanism.
First, an internal Air Force email from July 31 says the Office of the Secretary of Defense has identified service members "who may have a current diagnosis or history of or exhibit symptoms consistent with gender dysphoria in their electronic healthcare record."
Second, a Defense Department memo from March 2025 already described medical record review as the primary means of identifying those service members.
Third, an internal Army order issued last month bars commanders from broadly searching health records themselves, but allows them to act on reports from higher headquarters that a soldier's records show a past diagnostic code. The searching did not stop. It moved up the chain.
A lawyer representing many of these service members says the method is also catching people who are not transgender at all: people who had a mastectomy or a hysterectomy, and people whose records carry a diagnosis code that was entered so they could get treatment for something else.
The Privacy Act Framework
The Privacy Act of 1974, 5 U.S.C. § 552a, generally bars an agency from disclosing your records without your written consent. But the statute contains an exception for agency employees who have a need for the record in the performance of their duties. That exception is doing an enormous amount of work right now.
None of this is final. The matter remains in litigation.
Why Civilian Federal Employees Have a Stake
If you have ever handed over medical documentation to your agency for a reasonable accommodation, for FMLA leave, or for a fitness-for-duty examination, you were told it goes into a confidential file. The open question is what "confidential" means once someone higher up decides they need it.
Most agency handling of medical documentation is lawful. But if an agency took what you provided for an accommodation and used it against you, that is a different case, and it is one federal employment attorneys handle.
What You Can Do
If you are in uniform and have been flagged, get to military defense counsel this week, not after you have sat with it.
If you are a civilian federal employee, the Privacy Act allows you to request an accounting of disclosures from your agency, meaning a record of who your agency has given your information to. Ask for it. Knowing who has seen your medical file is the first step to understanding whether it has been handled properly.
Legal Disclaimer: This content is for general informational purposes only and does not constitute legal advice. Federal employment situations are fact-specific and time-sensitive. Please consult a qualified federal employment attorney about your specific situation. You can contact Southworth PC at attorneysforfederalemployees.com.