If the beneficiary had an evaluation, examination, or treatment by a medical source
within the past year, you must obtain a signed and dated SSA-827 Authorization to Disclose Information to the Social Security Administration. You
must send the SSA-787 and SSA-827 directly to the medical source to obtain medical evidence that is less than one year
old. Follow instructions for completing the SSA-827 in DI 11005.055.
The beneficiary or representative (someone who can act under State law, in making
decisions related to beneficiary health care) must sign the SSA-827, or an alternative Health Insurance Portability and Accountability Act (HIPAA)-compliant
authorization form, to disclose medical information. If the beneficiary refuses to
sign the form, and has no representative, and there is no older evidence in SSA records,
per GN 00502.040A.2.b, you must develop capability using other evidence, per GN 00502.040B.
If the beneficiary decides to undergo an evaluation, examination, or obtain treatment
on their own volition, ask the beneficiary to notify SSA after the examination. Then
mail a SSA-787, and signed and dated SSA-827, to the medical source. If the beneficiary is unwilling to undergo an evaluation,
examination, or treatment, do not compel them to do so solely to obtain medical evidence
If the medical source does not mail a completed and signed SSA-787 directly to SSA, follow GN 00502.040A.4.
If you receive the SSA-787, but you question the authenticity, follow GN 00502.040A.5.
For an unsigned SSA-787, other form, or summary report, follow GN 00502.040A.6.
IMPORTANT: If you receive a completed and signed other form or summary report back from the
medical source, i.e., not the SSA-787, you can accept it, but only if it fits the criteria in GN 00502.040A.1.