SSA 827 Form

An SSA 827 form is also known as an Authorization to Disclose Information. It is completed by someone applying for or requesting reconsideration for social security disability or social security supplemental income. When you complete this form, it authorizes the Social Security Administration the right to gain access to educational, medical, occupational, and other records that could help them determine whether you need benefits. If this form is not signed and returned, the applicant is generally denied because the SSA cannot get the information they need to make a decision.

What is a SSA 827?

The SSA 827 form is known as an Authorization to Disclose Information. It is used by the Social Security Administration, and submitting the form allows them to use your personal information. This includes educational records, medical reports, and other information that may be needed to determine your eligibility for social security benefits.
This form should be submitted along with the initial application for disability, supplemental security income, or other social security benefits. This will ensure that the application can be processed as quickly as possible. Failure to submit this disclosure could result in the application being rejected by the Social Security Administration.
Filling out the form is fairly simple. It requires personal information such as name, social security number, and contact information. Completing and signing this form allows the Social Security Administration to use future information from the next 12 months as well.

Most Common Uses

The Form SSA-827 is commonly used a claimant’s written request to a medical source or other party to release information.  These sources include doctors, hospitals, schools, nurses, social workers, friends, employers, and family members.  Form SSA-827 is also used as authorization for the claimant’s sources to release information to the SSA.

Form SSA-827 is designed to ensure that the claimant has the information necessary to make an informed consent and ensure that claimants are advised of the specifics of the disclosure.

Components of a SSA 827

A form SSA-827 contains the following sections:

  • Information about whose records to be disclosed
  • Purpose
  • Signature
  • Witness Signature

Legal Considerations

You can obtain copies of the SSA-827 form from your local Social Security office or download the form online.  The SSA uses the information that you provide on this form to obtain your medical records from doctors, hospitals, clinics, and schools.  The information obtained will be used to process your Social Security Disability claim.  Without this form, the SSA cannot obtain the records it needs to process your application and your claim for disability benefits will be denied.

When you are filling out your SSA-827, you will need to have the form witnessed.  If you have no one to witness the form for you, you can go to the Social Security office and sign it there.  One of the representatives will serve as a witness for you.

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Sample SSA 827 Form


Sample SSA 827 Form

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