Medical evidence is a statement offered by a medical source (physician, psychologist,
or other qualified medical practitioner), based on his or her evaluation, examination,
or treatment of the beneficiary that gives insight on the beneficiary’s ability to
manage or direct the management of benefits.
This evidence usually takes the form of a statement signed by the medical source who
conducted the examination or a person authorized to sign such certifications (e.g.,
a medical records librarian). For instructions regarding unsigned medical evidence,
see GN 00502.050B.4.
The Form SSA-787 (Physician’s/Medical Officer’s Statement of Patient’s Capability
to Manage Benefits) is the usual vehicle for obtaining medical evidence of capability.
However, you may use other forms or summary reports from the medical source if they
include the information as described above.
Medical evidence must have a signature of the medical source who conducted the evaluation,
examination, or provided the treatment, or a person authorized to sign such certifications.
The field office (FO) sends the Forms SSA-787 and SSA-827 (Authorization to Disclose
Information to the Social Security Administration) directly to the medical source.
If the medical source does not mail the completed SSA-787 directly back to the Social
Security Administration (SSA) with a wet signature or a rubber stamp signature, the
FO may accept the completed SSA-787 if the medical source:
Directly mails the completed SSA-787 with a wet signature or a rubber stamp signature
to the beneficiary instead of SSA;
Faxes the completed SSA-787 directly to SSA; or
Provides a completed photocopy of the SSA-787 directly to SSA.
If the FO questions the authenticity of the SSA-787, follow GN 00502.040A.2, in this section.
You must scan all completed SSA-787’s you obtain, and any other paper medical evidence
obtained for your capability determination, into NDRed or eView per GN 00502.050B.1.