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Form SSA-827

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Form SSA-827

Updated January 08, 2024

Form SSA-827, the Authorization to Disclose Information to the Social Security Administration (SSA), authorizes the SSA to access personal information for processing disability benefits claims. The SSA needs consent to review an applicant’s medical records, education records, and other information to determine their eligibility for disability programs.

Table of Contents

When Is It Required?

Form SSA-827 is required as part of the application process for Social Security Disability Insurance and Supplemental Security Income. The SSA will contact medical providers and other institutions to gather evidence needed for evaluating the claim.

Because the SSA-827 expires after 12 months, and because some agencies require individual authorization, an applicant may need to submit the form more than once.[1] It is required for the following purposes:

  1. Determining an applicant’s eligibility to enroll in disability programs
  2. Renewing an applicant’s eligibility for disability programs
  3. Assessing an applicant’s capability of managing benefits

Representative Payment Program

In some cases, SSA-827 is used not to evaluate benefits eligibility but to assess a beneficiary’s ability to manage the payments. If the SSA finds that the beneficiary cannot manage their benefits payments independently, they will appoint a representative payee to collect and administer payments on the beneficiary’s behalf.[2] The payee is generally a trusted friend, family member, or organization.

What Information Does It Cover?

Hands with pen filling out SSA-827 form

By signing Form SSA-827, an applicant grants the SSA permission to review personal records pertinent to their disability claim. The SSA reviews information about an applicant’s health, their inability to sustain work, and how their daily tasks are impacted by their disability. This includes:

  • All medical records — treatment, hospitalization, and outpatient care; mental health information; genetic and other testing; substance abuse history
  • Education records — copies of tests or evaluations; teacher’s observations
  • Other information — relevant information regarding work and daily activities

In addition to past records, the SSA will be able to access information created after the date of signature for as long as the authorization is valid.

How to File

Hand holding envelope addressed to Social Security office.

The claimant or a parent, guardian, or personal representative can fill out the SSA-827. The witness signatures are optional.[3] Once completed, mail or deliver the form to a local Social Security office.

Form Sections (12)

Form SSA-827 can be completed by the individual authorizing release or a representative acting on their behalf. If the individual is a minor, their parent or guardian should complete the form. The person completing the form should read the entire form carefully before filling out the first page.

1. Personal Information

The person releasing their information must provide their full legal name, social security number, and date of birth on the top right of the form.

2. Information For Release

The form describes the information the authorization covers, including medical files, work-related documents, and records from educational institutions.

3. Sources of Information

The authorization gives the SSA permission to access information from medical sources, educational sources, social workers, employers, family, acquaintances, and other relevant parties.

4. Recipients of Information

In addition to the SSA, the state agency processing the case will have access to the files released.

5. Purpose

Usually, Form SSA-827 is collected as part of the benefits application process. It is also used when the SSA evaluates whether a benefits recipient can manage their payments independently. The person preparing the form should check the box in this section if the authorization is only for determining the recipient’s capability of managing benefits.

6. Expiration

The authorization is valid for 12 months from the date the form is signed, unless it is revoked.

7. Individual Signature

The individual authorizing disclosure of their records must sign the form in blue or black ink unless someone else is assigned signing authority on their behalf.

8. Signing Authority

If the subject of the disclosure is not signing the form, the person signing must select the appropriate box to indicate whether they are a parent, guardian, or other personal representative.

9. Date Signed

The form must be dated to initiate the authorization.

10. Contact Information

The person releasing releasing information should provide their phone number and address.

11. Witnesses

One or two witnesses may sign the form and provide their phone number(s) or address(es), although witness signatures are not required by federal law.

12. Additional Details

The second page of the form includes a detailed explanation of the authorization process, a privacy act statement, and other legal information.

FAQs

How do I revoke my SSA-827?

Anyone can revoke their authorization at any time by sending a written statement to a Social Security office. Those revoking authorization should also send copies to any sources they want to prevent from sharing information with the SSA. The SSA will still be able to use information accessed before the authorization is revoked.

Who qualifies for disability benefits?

The SSA has a strict definition of qualifying conditions for disability benefits.[4] To qualify for Social Security Disability Insurance, an applicant must also have met certain work requirements. Prospective applicants can use the online Benefit Eligibility Screening Tool to learn about programs for which they might be eligible.

Sources

  1. Instructions for Completing the SSA-827
  2. Representative Payment Program
  3. Information on Form SSA-827
  4. How You Qualify