Generally, the field office (FO) obtains one signed Form SSA-827 from the claimant at each adjudicative level (initial, reconsideration, and hearing) to process disability claims or continuing disability reviews.

If the adjudicating component (for example, the disability determination services (DDS)) needs an additional original, signed and dated Form SSA-827 in addition to the one obtained by the FO, the adjudicating component obtains the form.

For information on responsibilities when the claimant fails to provide a signed Form SSA-827, see DI 23007.005.

The SSA or DDS employee may use the attestation process in DI 22501.007E, in this section, to obtain a signed and dated Form SSA-827 under the following conditions:

1. 1. 

   The claimant is one of the following:

   • •

     an adult (age 18 or older) who is signing on their own behalf, or

   • •

     a child (under age 18) who is signing on their own behalf, or

   • •

     a child whose claim is being pursued by an individual with the authority to sign on behalf of a child claimant (for example, a parent or guardian).

2. 2. 

   The individual signing the Form SSA-827 chooses to sign using the attestation process in one of the following situations:

   • •

     During a FO disability interview (for example, in office, video conference, or teleclaim interviews); or

   • •

     Via face-to-face or telephone contact with an SSA or DDS employee (for example, Form SSA-827 expired prior to adjudication).

We do not permit attestation when:

1. 1. 

   The claimant has not reviewed Form SSA-827.

   Claimants must have the opportunity to review Form SSA-827 before we permit attestation.

2. 2. 

   The individual chooses not to attest.

   At any time before completing the attestation process, the individual can opt out of the attestation process, and continue with the paper (pen and ink signature) process.

   If the claimant chooses not to submit Form SSA-827, see DI 11018.005 for FO responsibilities when a claimant fails to cooperate.

1. 1. 

   The SSA or designated State agency employee (the employee) confirms the individual’s (claimant or form signer) intent to sign Form SSA-827 and to authorize disclosure of information to SSA. If the individual agrees, the employee attests to the individual’s intent to authorize disclosure by clicking the “Attest, Submit, and Print” button in the EDCS or eView. The employee's act of attesting to these facts documents the individual’s agreement. The process of the individual agreeing and the employee attesting constitutes a signature.

2. 2. 

   SSA systems then propagate the individual’s name (that is, “Electronically Signed By (first, middle, last name, and suffix)”), the date, and the individual’s identity information (based on information already collected) on an electronic version of Form SSA-827. In addition, SSA systems propagate the employee’s information (that is, “Attested by SSA or Designated State Agency Employee (first initial, last name)”) and office phone number, city, state, and ZIP code in the witness block on the electronic version of the form.

3. 3. 

   The employee provides a printed, paper copy of the signed Form SSA-827 to the individual for their records.

In any situation where we permit attestation, follow these steps where one signature is required:

1. 1. 

   Contact the individual by telephone or in person. For represented claimants, follow instructions in GN 03910.050 and DI 31001.010.

2. 2. 

   Verify the claimant’s identity by confirming information on the Numident. For more information on identifying claimants, see GN 00203.020A.2.

   IMPORTANT: If you cannot confirm the individual’s identity, or have any doubt as to the individual’s identity, do not continue with the attestation process. Instead, obtain a pen and ink signed, paper Form SSA-827 from the individual.

3. 3. 

   Access the SSA-827 eAuthorization screen in eView.

4. 4. 

   Provide the individual with the opportunity to review Form SSA-827.

   NOTE: For telephone contacts, provide a copy of Form SSA-827 in advance (such as by mail) or direct the individual to a copy of the form online. http://www.ssa.gov/online/ssa-827.pdf

   IMPORTANT: Do not continue with the attestation process if the individual has not had the opportunity to review Form SSA-827. Mail the paper Form SSA-827, or direct the individual to a copy of the form online. http://www.ssa.gov/online/ssa-827.pdf

   Proceed with the attestation process once the individual has reviewed the form, or obtain a paper Form SSA-827 with a pen and ink signature.

5. 5. 

   For child claims that do not require two signatures, select or enter the name of the individual authorized to sign Form SSA-827 (when an individual’s name is entered, the address and telephone number must be entered). If someone other than the child is signing, select the basis for that individual’s authority to sign the form (that is, parent of minor, guardian, or other personal representative). If a personal representative signed the form, explain the individual’s “authority to sign” in the space provided. For more information about personal representatives, see DI 11005.056C.

6. 6. 

   Read the scripted language found on the SSA-827 eAuthorization screen in eView.

7. 7. 

   Indicate the individual’s intent to authorize disclosure by selecting “Yes” or “No.”

8. 8. 

   If “Yes,” attest to the individual’s intent to authorize disclosure by clicking the “Attest, Submit, and Print” button.

   NOTE: The system automatically adds the signed Form SSA-827 to the EF. You do not need to fax the form into the EF.

9. 9. 

   If “No,” select the reason for declining and provide the individual with the opportunity to complete a paper Form SSA-827 with a pen and ink signature.

10. 10. 

    Mail the printed copy of the signed Form SSA-827 to the individual for their records.

In any situation where we permit attestation, follow these steps where two signatures are required or the claim is an EDCS without an associated electronic folder:

1. 1. 

   Contact the individual by telephone or in person. For represented claimants, follow instructions in GN 03910.050 and DI 31001.010.

2. 2. 

   Verify the identity of the signer using the processes described in GN 03380.005 and GN 00203.020.

3. 3. 

   Provide the individual(s) with the opportunity to review Form SSA-827, per the instructions in DI 11005.056D.2.d.1.

4. 4. 

   Proceed with attestation only after the individual has reviewed the form.

5. 5. 

   Print Form SSA-827.

6. 6. 

   Read the scripted language as written in DI 11005.056D.2.e.

7. 7. 

   If the person agrees to the script, indicate the individual’s intent to sign on the paper printed SSA-827 by writing the claimant’s name in the “Individual authorizing disclosure” box, or if the individual intending to sign is someone other than the claimant, indicate the individual’s intent to sign by:

   • •

     Writing the claimant’s name in the “Individual authorizing disclosure” box;

   • •

     Marking the appropriate entry in the “IF not signed by subject of disclosure” relationship block;

   • •

     Writing the parent/guardian/other personal representative’s name in the box below the checkboxes;

   • •

     Ensuring the “Date Signed” box is completed with the date of attestation; and

   • •

     Document the attestation by:

     • –

       Writing in the “Witness” box, “Attested by SSA or Designated State Agency Employee followed by your first initial and last name”;” and

     • –

       Writing the office phone number, city, state, and zip code.

8. 8. 

   Electronically document the attestation with a notation that includes:

   1. a. 

      that the individual agreed to sign the SSA-827 via attestation;

   2. b. 

      the date of agreement; and

   3. c. 

      the first initial and last name of the technician who took attestation.

9. 9. 

   For EDCS/eView claims, electronically document attestation with the required notation using the subject section of the Form SSA-5002 Report of Contact Form (ROC) or in the appropriate case note section of the Disability Case Processing System (DCPS).

10. 10. 

    For EDCS exclusion claims without an associated electronic folder, electronically document the attestation by following the appropriate procedures below:

    1. a. 

       FO: Document attestation with the required notation and that the cases is non-electronic on the Report of Contact (RPOC) in Modernized Claim Systems (MCS) for T2 claims and Consolidated Claim Experience (CCE) for T16 claims.

    2. b. 

       DDS, DPB/DPU: Document attestation with the required notation on a case note entry in the Disability Case Processing System (DCPS)

    3. c. 

       OHO: Document the attestation with the required notation on a Report of Contact (ROC) in the Electronic Non-Medical system (ENM).

    4. d. 

       OAO: Document attestation with the required notation on a ROC in ENM.

11. 11. 

    Scan/Fax/Upload the valid, completed paper Form SSA-827 into the electronic folder (EDCS/eView) or Evidence Portal, associate with the paper folder, or upload into ENM system where applicable.

12. 12. 

    Provide a copy of the scanned completed paper Form SSA-827 to the individual.

• •

  DI 11005.055 Completing Form SSA-827 (Authorization to Disclose Information to the Social Security Administration (SSA))

• •

  DI 11005.056 Signature Requirements for Form SSA-827