Form SSA-827 — Authorization to Disclose Information to the Social Security Administration

What is Form SSA-827?

Form SSA-827 is the authorization Social Security needs before your medical sources, schools and other sources of personal information can release records about you. It lets them disclose all your medical records, as well as educational records and other information about your ability to do tasks, to Social Security and to the State agency that processes disability cases, usually called disability determination services.

It is used to decide eligibility for benefits, including looking at the combined effect of impairments, and whether you can manage your benefits. It specifically covers records about mental impairments (not psychotherapy notes), substance use, sickle cell anemia, communicable diseases including HIV/AIDS, and genetic test results, plus information created within 12 months after you sign. The authorization lasts 12 months from the date signed, and you can revoke it in writing at any time. Social Security makes copies for each source, and some States or sources may ask you to sign one form per source.

VergeHR pre-fills the name and date of birth from Files's employee records, asks who is signing and why, and prints your answers onto the official SSA-827 PDF, names with accents included. It saves the finished form in the person's folder in Files. The form says to sign in blue or black ink, so you print it, sign it, have a witness sign, and send or bring it to Social Security yourself.

Who needs to fill out Form SSA-827?

• People applying for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI) based on disability.
• Parents of children applying for SSI disability, who sign for a minor.
• Legal guardians and other personal representatives signing for an adult.
• Beneficiaries whose ability to manage their own benefits is being reviewed.

When to Use Form SSA-827

• When you file a disability claim, or when Social Security or the State agency sends you the form and asks for it.
• When Social Security asks for another one, for example because a State or a particular source requires a separate authorization naming that source.
• Tick 'capable of managing benefits ONLY' only when the authorization is just for deciding whether you can manage benefits.
• Again after 12 months if your case is still open and a new authorization is requested, since each one expires 12 months after it's signed.

What You Need Before You Start

• The full name, Social Security number and date of birth of the person whose records will be disclosed.
• If you're signing for someone else, the basis of your authority: parent of a minor, guardian or other personal representative, with an explanation.
• The signer's street address, city, State, ZIP code and phone number.
• A witness who knows the signer or is satisfied of their identity, and their phone number or address.

What’s On Form SSA-827

The 2024 edition has 2 pages. VergeHR asks for it in 3 parts:

1. Whose records to be disclosedClaimant
2. Who signs, and their addressClaimant
3. Witness contact details (optional)Claimant

How to fill out Form SSA-827, step by step

1 Whose records to be disclosed

At the top right, enter the name (first, middle, last, suffix), Social Security number and birthday of the person whose records Social Security may request. VergeHR pre-fills the name and date of birth from their employee record.

2 Of what, from whom, to whom

These sections are printed: all medical records, education records and other information about the ability to perform tasks, from all medical and educational sources, social workers, consulting examiners, employers and insurers, and others who know about the condition, to Social Security and the State disability determination services. The box on the right is completed by SSA or the DDS if needed, so leave it blank.

3 Purpose

The purpose is determining eligibility for benefits and whether the person can manage them. Tick the box only if this authorization is solely for deciding whether the person is capable of managing benefits.

4 Signature and basis of authority

The individual signs in blue or black ink. If someone else signs, tick parent of minor, guardian or other personal representative and explain. Where State law requires two signatures, the parent, guardian or representative signs on the second line. Then add the date signed, address and phone number.

5 Witness

A witness who knows the signer or is satisfied of their identity signs and gives a phone number or address. A second witness is needed if the form is signed with an 'X'.

Common Mistakes to Avoid

• Signing before reading both pages: the form asks you to read the entire form before signing.
• Signing in a color other than blue or black ink.
• Leaving out the witness's signature and phone number or address.
• Ticking 'capable of managing benefits ONLY' on a disability claim, which limits what the authorization is for.
• A representative signing without ticking and explaining their authority.
• Leaving the date signed blank: the 12-month validity runs from that date.

After You Fill It Out

Print the form, sign and date it in blue or black ink, and have your witness sign. Page 2 says to send or bring the completed form to your local Social Security office, which you can find at www.socialsecurity.gov or by calling 1-800-772-1213 (TTY 1-800-325-0778).

Social Security copies it for each of your sources. It may contact you again if a State or source requires a separate authorization for that source.

To revoke the authorization, send a written statement to any Social Security office, and a copy to any source you no longer want to disclose information. VergeHR keeps the signed form in the person's folder in Files, so you know when its 12 months run out.

Form SSA-827: frequently asked questions

Official Sources

• Blank form (PDF), published by Social Security Administration (SSA): https://www.ssa.gov/forms/ssa-827.pdf
• Official instructions and guidance: https://www.ssa.gov/forms/ssa-827.pdf
• Edition shown on this page: Form SSA-827 (06-2024) UF (OMB No. 0960-0623) (checked 2026-09-28).

VergeHR is not affiliated with or endorsed by Social Security Administration (SSA) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-09-28.

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