NORTHAMPTON, Mass. — A new report from the Prison Policy Initiative finds that the federal prison grievance system overwhelmingly rejects complaints about medical care, raising concerns about access to health care and accountability behind bars.
In the briefing, researchers analyzed nearly a decade of federal data and concluded that the system is intended to address incarcerated people’s complaints, but instead functions as a barrier to relief.
Drawing on data obtained through the Data Liberation Project, the report found that between 2014 and 2024, approximately 98% of medical grievances filed in federal prisons were rejected. Fewer than 1% resulted in any form of relief.
The Administrative Remedy Program requires incarcerated individuals to complete multiple steps before their complaint can be considered. These include attempting informal resolution, filing a formal complaint with the prison warden, and pursuing multiple levels of appeal. According to the report, these procedural requirements often prevent complaints from advancing.
Researchers found that many grievances are dismissed not because of their substance, but due to technical issues such as missing paperwork, incorrect formatting, or failure to meet strict filing deadlines. In fact, nearly one-third of complaints were rejected for being “improperly filed,” while more than half were closed during the appeals process for administrative reasons.
The report highlights that incarcerated people face unique barriers when navigating this system. Limited access to forms, strict rules governing submissions, and restricted movement within facilities can make it difficult to comply with procedural requirements. Broader systemic issues, including lower average levels of education among incarcerated populations and restricted access to writing materials, compound these challenges.
Even when complaints make it past these administrative hurdles, success remains rare. Only about 14% of grievances were considered on their merits, and most of those were denied. Overall, just 940 out of more than 65,000 medical complaints resulted in relief during the 10 years analyzed.
The report also identifies the most common types of complaints, including delays in accessing medical care, inadequate treatment, and issues related to prescription medications. Certain categories, such as mental health and dental care, experienced especially high rejection rates. Notably, the analysis found that no grievances related to pregnancy, abortion, or child care resulted in relief.
The findings suggest that the grievance system may function less as a mechanism for resolving issues and more as a procedural hurdle that incarcerated people must overcome before pursuing legal action. Under the Prison Litigation Reform Act, individuals are required to exhaust all administrative remedies before filing a lawsuit, making the grievance process a necessary but often ineffective step.
According to the Prison Policy Initiative, the high rate of rejections raises broader questions about whether the system is designed to address complaints or to discourage them. The report argues that meaningful reform would require simplifying the filing process, ensuring independence from prison administrators, and increasing the likelihood that grievances result in timely and substantive responses.
Ultimately, the report concludes that, for many incarcerated people, the grievance system fails to serve its intended purpose as a pathway to accountability and relief, particularly in cases involving urgent medical needs.
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