Arguably, the federal prison system has one of the worst grievance processes for medical complaints in the nation, according to a recent study by Prison Policy Initiative.

PPI used Data Liberation Project research from 2014 to 2024 and found that less than 1% of the medical grievances — the “Administrative Remedy Program” — filed in the federal prison system were granted.

“[A] startling 98% of medical grievances were rejected for reasons ranging from the bureaucratic (such as using the wrong size sheet of paper) to the substantive (actually being denied on the merits of the complaint),” PPI revealed.

In jails and prisons across the country, prisoners use various forms of grievance systems to file complaints; this often includes medical issues.

In California, prisoners may file a CDCR Form 602-HC, Health Care Grievance, to address matters dealing with medical, mental health, or dental issues. Section 3999 of the California Code of Regulations, Title 15, is where many of the regulations regarding medical may be located. Other non-medical issues may be addressed using a CDCR Form 602-1, Grievance.

“A functioning grievance system is an important lifeline for incarcerated people, who have very little leverage to affect their circumstances,” PPI wrote. “It’s especially important for health-related matters, given that incarcerated people suffer from illness and disease at rates far exceeding that of the general public, and their access to medical care is highly constrained and notoriously awful.”

According to federal and state law, prisoners must exhaust administrative remedies with a grievance before moving to a state or federal court. Technically, a grievance is a pretrial pleading, and in most cases arguments, claims, and complaints raised in them are binding in a court of law.

The PPI study provided a 10-year overview of about 66,000 federal medical grievances filed January 2014 to January 2024. Almost one-third (32%) of the complaints were rejected. The stated reason was “improperly filed.” Another 51% of the complaints were closed after administrative appeal reasons.

“In particular, the dental and mental health grievance categories had the highest rates of these rejections,” it was reported. “Seventy-eight percent of dental and 83% of mental health grievances were tossed out for administrative reasons.”

Of the 65,712 complaints studied over a decade, 940 were granted relief, according to the study. The grievance subjects with the highest number of cases in which the system denied relief was: 1) Delayed or lack of access to medical care; 2) Improper or inadequate medical care; and 3) Prescription medication.

“As the data show, federal prisons don’t reject most grievances on the merits,” PPI reported. “Instead, most are rejected because incarcerated people fail to navigate administrative rules for submitting complaints, so their grievances are never actually judged on their merits.”

“[I]n the end, a system does what it is designed to do, not what it is intended to do, and the federal grievance system rejects nearly every medical complaint filed by incarcerated people, often for vague or trivial reasons,” PPI wrote.