Form SSA-827 Instructions

If you’re filing a Social Security disability claim, odds are high that the Social Security Administration will ask you to complete and sign Form SSA-827. This form allows the SSA to gather pertinent information so they can approve or deny your claim in accordance with federal law.

In this article, we’ll go over how to complete the form, as well as frequently asked questions about the form and the disclosure of your personal information.

Let’s begin with step by step instructions on completing Form SSA 827.

How do I complete Form SSA-827?

Let’s walk through this one-page form, step by step.

Top

At the top of the form, you’ll enter the following information on behalf of the claimant:

  • Full name: First name, middle name, last name
  • Complete Social Security number
  • Birthday: Month, date, year

Towards the middle of the form, you’ll see an information box. Leave this box alone, as it is for SSA use only.

form ssa 827, top

Bottom

On the bottom half of Form SSA-827, you’ll complete the following:

Purpose

Check the box to indicate if your request is only to determine whether you are capable of managing your benefits only.

Signature field

You will need to sign in either blue or black ink, only.

Basis for authority to sign

If you are completing this form on someone else’s behalf, you must indicate what authority you have to sign for them. This could be because you are one of the following:

  • Parent of a minor child
  • Legal guardian
  • Personal representative in another capacity

If you are a personal representative, you’ll need to provide a written explanation. You may also need to sign in the extra space provided, if state law requires two signatures.

Date signed

Enter the date of signature. Please note that Form 827 is effective for one year beyond this date, unless rescinded before expiration.

Address

Enter the street address, followed by city, state, and zip code, for the claimant. Also provide a telephone number where you can be reached.

Witness

The form instructions indicate that federal law does not require a witness signature. However, state law may require one or two witness signatures. Generally, your local SSA office will know the applicable state law if you complete this form in person.

If required, each witness will need to provide a phone number or address where the SSA can contact them.

Form ssa-827, bottom

Video walkthrough

Frequently asked questions

What is Form SSA-827?

Form SSA 827 allows for the disclosure for certain information from third parties to the Social Security Administration for the purpose of making a decision on a Social Security claim.

Can I use Form SSA-827 for medical release?

According to the SSA website, Form SSA-827 complies with all aspects of the Health Insurance Portability and Accountability Act of 1996. This form may be used for the disclosure of all medical records, to include substance abuse treatment records and mental health records.

Do I need a witness to complete Form SSA-827?

According to the form instructions, federal law does not require a witness to complete Form SSA-827. However, state laws may require one or two witness signatures. The form contains witness signature fields for entities that may be subject to more stringent state law requirements.

Is Form SSA-827 available in Spanish?

Yes. You may download a Spanish version of the form from the SSA website.

Who might release my information with Form SSA 827?

This form should allow the following third parties to provide information to the SSA that is pertinent to your claim:
-Medical providers
-Educational sources
-Social workers & rehabilitation counselors
-Consulting examiners used by the SSA
-Employers, insurance companies, and worker’s compensation programs
-Friends, family, neighbors, or public officials

Where can I find Form SSA-827?

You may find this Social Security form on the SSA website. For your convenience, we’ve included the latest version below.

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