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I will be traveling soon to the US and I will have in my carry on a couple of personal documents including medical records of a friend who is already in US.

Is there a reasonable chance that Customs & Border Protection will go through the documents and ask questions about them, or, even worse, confiscate them?

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    On what grounds do you think they could seize the documents? – phoog Jun 7 '18 at 18:17
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    @RobertColumbia HIPAA does not criminalize the possession of medical records, does it? – phoog Jun 7 '18 at 20:15
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    Check out this video of a Def Con talk from a few years back. The very knowledgeable speaker mainly talked about tech (laptops, phones, etc) being searched at the border, but he also talked about your rights in general when entering or exiting the US and interacting with CPB officers. – sam Jun 7 '18 at 22:17
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    Reasonable chance? No. But the USA border guard has already been ruled to be outside of law (at least the Constitution) so anything goes. – chx Jun 8 '18 at 12:31
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    @RobertColumbia only applies to covered entities, and in order to be a covered entity, you'd have to be either a service provider or business associate of a provider. If you're just carrying something for a friend, HIPAA is unlikely to apply, though you could put the records in a sealed envelope with a note that it's confidential medical information. – barbecue Jun 8 '18 at 14:10
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U.S. Customs and Border Protection (CBP) agents are allowed to go through the documents and ask you questions about them, under practically any circumstances, even without suspicion of any criminal activity. The question of if there is a "reasonable chance" they will do so is mostly at the discretion of the agent you encounter and often times, in the agency's own words, "completely random" (see the bolded statement in section quoted below).

CBP provides an explanation of this authority and additional guidance they issue to agents on their public website at https://www.cbp.gov/travel/cbp-search-authority.

A U.S. Customs and Border Protection (CBP) officer's border search authority is derived from federal statutes and regulations, including 19 C.F.R. 162.6, which states that, "All persons, baggage and merchandise arriving in the Customs territory of the United States from places outside thereof are liable to inspection by a CBP officer." Unless exempt by diplomatic status, all persons entering the United States, including U.S. citizens, are subject to examination and search by CBP officers.

[...]

CBP Officers use diverse factors to refer individuals for targeted examinations and there are instances when our best judgments prove to be unfounded. Although CBP does use information from various systems and specific techniques for selecting passengers for targeted examinations, a component of our risk management practices is the use of a completely random referral for a percentage of travelers.

[...]

(emphasis mine)

Within the related link on the above page to "U.S. Customs and Border Protection Policy Regarding Search of Information" you can find the guidance agents use in regards to search, seizure, and additional handling of information in documents and electronic devices.

[...]

B. Review of Information in the Course of Border Search

Border searches must be performed by an officer or otherwise properly authorized officer with border search authority, such as an ICE Special Agent. In the course of a border search, and absent individualized suspicion, officers can review and analyze the information transported by any individual attempting to enter, reenter, depart, pass through, or reside in the United States, subject to the requirements and limitations provided herein. Nothing in this policy limits the authority of an officer to make written notes or reports or to document impressions relating to a border encounter.

C. Detention and Review in Continuation of Border Search
(1) Detention and Review by Officers. Officers may detain documents and electronic devices, or copies thereof, for a reasonable period of time to perform a thorough border search. The search may take place on-site or at an off-site location. Except as noted in section D below, if after reviewing the information there is not probable cause to seize it, any copies of the information must be destroyed. All actions surrounding the detention will be documented by the officer and certified by the Supervisor.

[...]

Section D of that document outlines the reasons information/devices may be kept and includes: "Retention with Probable Cause", "Other Circumstances" (i.e. items specifically related to customs and immigration but not criminal), "Sharing", and "Destruction"

If the documents don't meet any of the criteria for retention/review, they should not be taken from you or retained by the agency.

Also worth noting, there are special handling instructions for certain types of documents: "business information", "sealed letter class mail" (you may know it as first class/registered mail but it must be transiting the postal system - not in possession of an individual/parcel service - to qualify for special handling), "attorney-client privileged material", and "identification documents". In regards to this specific question though, there seems to be no such special instructions for medical information.

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  • Some searches are more random than others. – user58558 Jun 8 '18 at 16:36
  • A much better answer than the accepted one. I would only add that the Electronic Frontier Foundation has published articles on border searches, albeit focused on searches of digital devices. Here is what I believe to be the most recent. – kdgregory Jun 9 '18 at 11:40
  • @kdgregory while this answer is more detailed than mine, it does not address the probability that CBP officers would search or seize the documents, which really is infinitesimally low. It also does not address the question of (permanent) confiscation, only of prolonged detention. This answer addresses what they can do, which I don't think is much in question, rather than what they will do. So I wonder whether it's really "much better." – phoog Jun 11 '18 at 18:29
  • @phoog I believe it does address the question "Is there a reasonable chance that...," by pointing out there is no way to know with any certainty due to individual agent discretion and purposely random search behavior. Any difference between "prolonged detention" and "(permanent) confiscation" will be mostly meaningless; information taken, provided it's possession is not itself criminal, will eventually be returned. Additionally, what is retained has varying schedules for how long it remains under government control. Would including that in the answer improve it? – John-M Jun 12 '18 at 6:22
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The chance of their going through them is quite low. The chance of their seizing the documents is even lower, unless they decide that the documents are evidence of a crime.

I suppose they would also seize them and destroy them if they are infested with insects.

The documents themselves don't have any monetary value and are not subject to import duties in any event. There would be no reason for CBP to seize them.

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    Now, if your important medical documents are infested with insects, I suppose you've got bigger problems than US Customs... – Sebastian Lenartowicz Jun 9 '18 at 18:49
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Unless you are already on a watch list as a suspected smuggler, criminal, or terrorist, the chances you will be asked about any papers unrelated to travel (e.g., onward/return ticket) are pretty much zero. Unless mention is made in these records of narcotics or the like, they will be uninterested even if for some reason they decide to look. Having said that, I would certainly make a copy to leave at home, to guard against any other type of misfortune, such as a lost or stolen bag.

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    I wouldn't entirely say "unless you are already on a watch list." If they doubt your intentions as a visitor, it's possible they could search your belongings for evidence that you plan to work or overstay or otherwise do things inconsistent with what you claimed. And that could include looking through personal papers. But that's still not going to happen unless they're suspicious of you for some reason; most everyone will pass through without any kind of search. – Zach Lipton Jun 7 '18 at 18:27
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    @ZachLipton furthermore, even if that does happen, the chance that CBP would take interest in someone's medical records is fairly small, although I suppose it could lead to additional questions about immigrant intent. None of that would lead to the seizure of the documents. – phoog Jun 7 '18 at 18:33
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    +1 for pointing out there are other types of misfortune, aside from issues with CBP. – Soron Jun 8 '18 at 12:17

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