Social Security

Retention Date: 04/02/2025

A. Purpose

This emergency message serves as an update of the eSignature/Upload Documents process and identifies newly included forms and evidence. Additionally, this message serves as notification that eSignature/Upload Documents is nationally available for field offices (FO) and Workload Support Units (WSU) use as of March 22, 2024.

B. Background

Executive Order (EO) 14058 Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government requires SSA to develop a mobile-accessible, online process so that any individual applying for or receiving services from SSA can upload forms, documentation, evidence, or correspondence associated with their transaction without the need to visit or mail information to a local office. To comply with EO 14058, SSA created the eSignature/Upload Documents tool which allows first party customers to electronically sign (when a signature is required), upload, and submit certain forms and evidence to SSA from their personal desktop and mobile devices. eSignature/Upload Documents gives the agency an opportunity to modernize our interactions with customers, offer a more robust, secure electronic service delivery channel, and automate some manual paper processes, reducing the need for customer visits and calls to our offices.

C. eSignature/Upload Documents History

· On July 8, 2023, the Upload Documents initial release included 10 forms not requiring signatures and 52 pieces of evidence for technicians to request from customers. The release included Boston Region FOs and WSUs, as well as the existing 52 nationwide Technician Experience Dashboard (TED) beta offices.

· On September 23, 2023, eSignature/Upload Documents released 38 forms to submit using the electronic signature (eSignature) functionality.

· On March 30, 2024, eSignature/Upload Documents authentication requirements were adjusted to allow customers with standard credentials to sign into the application. The SSA-7050 was removed as a form technicians can request from customers. In addition, the SSA-820 and SSA-821 were added to the list of forms that can be requested due to their high agency use. In TED, new functionality was added for technicians to mark forms and evidence as received when submitted via channels other than eSignature/Upload Documents (e.g., fax mail, in-office).

D. SSA Business Process Before eSignature/Upload Documents

Prior to the initial release of eSignature/Upload Documents, we accepted forms and evidence in-person and some forms and evidence by:

· Mail,

· Analog Fax,

· eFax,

· iClaims,

· iAppeals, or

· Oral Attestation

Additionally, customers could and still can, electronically complete and submit the following ten forms using Adobe Document Sign that are available on ssa.gov: CMS-40B, SSA-455, SSA-1696, SSA-820, SSA-821, HA-85, HA-86, SSA-552, HA-4608, and SSA-1693.

E. eSignature/Upload Documents Technician Process Instructions

1. Using eSignature/Upload Documents

During any customer interaction (e.g., taking an initial claim, performing a redetermination, or completing a post-entitlement action) technicians will follow normal business processes to determine whether they require additional forms or evidence, including identity proofing the customer using standard agency procedures. If any evidence or forms on the lists in Sections H, I and J of this EM are required to process the action, the technician can offer the customer the option to submit the documents electronically via eSignature/Upload Documents.

Exceptions - Do not use eSignature/Upload Documents if:

· The technician is unable to speak to the first party customer to obtain consent to perform business electronically.

· Original evidence and/or a certified copy of evidence is required.

· The customer is not the claimant, recipient, or beneficiary (e.g., the customer is a Representative Payee, Legal Guardian, Appointed Representative).

· Customer has an eServices block.


NOTE: Technicians should only request customers submit types of evidence listed in section J that the agency would accept as uncertified copies under existing procedures.

2. Technician Experience Dashboard (TED)

Initiating an eSignature/Upload Documents task for a customer begins in TED. The technician starts by adding the eSignature/Upload Documents task to the customer interaction. They will then obtain the customer's consent to receive a one-time email from SSA, containing an access link and instructions for eSignature/Upload Documents. When obtaining a customer’s email to record in TED, the technician will be able to view the email address previously registered with my Social Security, when applicable. The customer can choose to receive the one-time email at the previously registered my Social Security email address, or at a different email address which the technician will enter and verify.

Next, the technician will select the forms and evidence types needed from the customer within the forms and evidence table in TED. Once all required forms and evidence types are selected, the technician generates and sends the email request to the customer by utilizing the “submit” button. The customer will now have 30 days to submit the requested forms and evidence via eSignature/Upload Documents before the task in TED will automatically close.




Figure 1 Select Forms and Evidence


Once customers successfully submit forms or evidence through eSignature/Upload Documents, the requested forms and evidence are automatically routed to the technician who requested the information and a pending task is created in the “Pending Cases” tab within TED. If the requested forms or evidence should not be returned to the technician who sent the request, they can transfer the eSignature/Upload Documents task to another technician or office within TED. However, this must occur prior to receiving the forms or evidence from the customer in order to profile to the correct technician or office. To transfer a task, select the icon from the “Actions” column and choose the appropriate transfer option.



Figure 2 Transfer Function Screen


3. Request for Evidence Letter

After initiating the request for forms and/or evidence through TED, the technician must send a paper request letter SSA-L1043 using the Document Processing System (DPS) that includes the due date for the request. If the request for evidence is related to an initial claim, technicians should review GN 01010.410 Subsection C.1 for processing instructions. GN 01010.410 Subsection C.2 of the policy references follow-up requests and using the SSA-L1045 notice.

Technicians should also review GN 01070.325 for instructions on handling evidence requests in post-entitlement situations.

NOTE: Customers will not see a due date in eSignature/Upload Documents, but customers will be able to submit forms and evidence within 30 days of the initial TED request. After 30 days, the customer can no longer submit online and will need to submit requested forms or evidence via mail, efax, in-office visit, or request a new eSignature/Upload Documents link be sent.

4. Manually Marking Documents as “Received” in TED

When customers submit their forms and evidence via another business channel (e.g., in-office, mail, efax) while an eSignature/Upload Documents task is pending in TED, the technician can mark that document as received to complete the task.

When more than one document request is pending on an eSignature/Upload Documents task, the technician will have the option to:

· Select “Mark all as Received” (i.e., to indicate that all requested information in the task was received), or

· Select “Mark Received” for individual documents.

Please note, the eSignature/Upload Documents task will remain open until all the documents are marked as received or until the task expires after 30 days.




Figure 3 Mark Documents Received in TED

5. WorkTrack

Once customers successfully submit forms or evidence through eSignature/Upload Documents, the requested forms and evidence are automatically routed to the technician who requested the information and a pending task is created in the “Pending Cases” tab within TED. The assigned technician is notified of successful document submissions in TED.




Figure 4 Alert in TED


After reviewing the submitted forms and/or evidence and taking necessary action(s) (e.g., taking an initial claim, performing a redetermination, or completing a post-entitlement action), the technician will follow normal workload procedures regarding form or evidence retention. (GN 00301.286)

If a customer submits a form or evidence via eSignature/Upload Documents that was not requested by the technician and is not on the approved list, print the document from WorkTrack and mail it back to the customer with a notice explaining why we are unable to accept the submission. As an example, if a customer submits a birth certificate, print the birth certificate from WorkTrack, return it to the customer, and advise them via written notice of SSA’s rules regarding acceptability of documentary evidence. (GN 00301.015 and GN 00301.030)

If a customer submits a form that requires a signature and is not included in eSignature/Upload Documents, advise the customer that we cannot currently accept it via the online method and they must submit it through other business channels, such as mail or in person at their local office.

If a customer submits a form or evidence that was not requested by the technician but is on the approved list of non-signature forms or evidence, process the form or evidence. If the customer combines multiple forms or multiple pieces of evidence into a single submission, the technician will need to break out the documents in WorkTrack and reassign appropriately (e.g., a customer submits an SSA-3441 at the same time they submit an SSA-561, the technician will then need to profile the SSA-3441 and SSA-561 separately in WorkTrack).

NOTE: Forms and evidence requested through TED generally will not require additional profiling in WorkTrack unless the customer sends multiple forms or multiple pieces of evidence in a single submission. The documents will be automatically routed to the technician who requested the information.

IMPORTANT: Please note the reference to “eSignature/Upload Documents” is NOT the same as the “Upload” in WorkTrack. The latter is a feature within the WorkTrack application that allows for batch imports into WorkTrack when an electronic document is available.

F. eSignature/Upload Documents Business Process for Customers

eSignature/Upload Documents can be used to serve Title II, Title XVI, and Title XVIII beneficiaries and recipients, as well as individuals who do not currently receive benefits from SSA. Customers can only use eSignature/Upload Documents to submit evidence or forms electronically on their own behalf.

Once a customer completes their interaction with a technician where the need for a certain form or evidence has been identified, they will receive an email from SSA containing a link to the application. To enter, the customer will select the link within the email and authenticate using existing credentials or will be prompted to create them to enter the application. Within eSignature/Upload Documents, the customer can download forms. The customer will then complete and save the forms on their personal computer or mobile device. Then, the customer can upload, and submit the requested forms and evidence within eSignature/Upload Documents. The submission of forms requiring signature use eSignature/Upload Documents’ electronic signature (“eSignature”) functionality (See Section G for more information).

The forms requested from the customer will be completed in one of two ways depending on the form:

· PDF Version – requires the customer to download, complete, save, and upload for submission.

· NEW! Webform Version – requires the customer to complete the requested information on the screen and then submit (See Section H for more information).

Evidence can be submitted by uploading a scanned image or photo of the requested documentation.

Upon upload completion, the customer will receive onscreen confirmation of their submission. Additionally, they can view prior submissions on the past request tab.

G. eSignature

eSignature/Upload Documents’ eSignature functionality reduces the need for paper processes by automating workflows allowing customers to electronically sign and submit certain forms.

To electronically sign and submit a form that requires a signature within eSignature/Upload Documents, after uploading the completed form, the customer will read one of the two Electronic Signature statements shown below. Depending on the form submission type (PDF or Webform), which will appear on the Review and Submit screen, the customer will apply their electronic signature by selecting the checkbox (a required field) and then clicking the “Submit” button.

NOTE: The Electronic Signature statement is written to allow for the individual’s eSignature to apply to multiple signature fields for the same individual on a single form. As an example, the SSA-632-BK Request for Waiver of Overpayment Recovery has multiple signature fields for the beneficiary. When the customer selects the eSignature checkbox, their electronic signature will be applied to all signature fields on the form. Please note that forms that require signatures from multiple individuals cannot be submitted in eSignature/Upload Documents at this time, however, they may still be available on ssa.gov (see Section D above).

When the electronically signed form is received in WorkTrack, the technician will find the details of the eSignature on the last page of the uploaded form. This page will display the customer’s name, personal information, date, time the electronic signature was received, and tracking data. A test case example of the eSignature page is shown below.

IMPORTANT: All forms requiring signature must be submitted separately in eSignature/Upload Documents to ensure that the correct electronic signature page is appended to the form, and that the form is profiled correctly in WorkTrack. Additionally, technicians should process each form separately (see Section E.5).

If a customer uploads more than one form requiring signature in a single submission, the electronic signature receipt label appended to each will only show the form information that coincides with the requested submission. For example, if a technician sends the customer a request for an SSA-821 and the customer includes both a completed SSA-821 and an SSA-546 in the same eSignature/Upload Documents submission, the eSignature page attached to the forms in WorkTrack will be labeled as an SSA-821. If this happens, the technician will need to request a new SSA-546 to obtain the signature for that form.

The Electronic Signature statement will only be displayed to customers who are responding to a request for a form that requires a signature. If you receive a form requiring a signature that is submitted in response to a technician request for a document that does not require signature (e.g., technician requests Overpayment Related Documentation and the customer groups an SSA-632 with the overpayment related documentation), you must reject the form requiring a signature because the customer was not prompted to apply their electronic signature within eSignature/Upload Documents; therefore, the electronic signature page will not be appended to the form. Forms requiring a signature must be signed electronically within eSignature/Upload Documents; disregard any signature or marking that may appear on the signature line of an uploaded form.

H. NEW! Fillable Webforms

New in April 2024, eSignature/Upload Documents now offers customers the ability to complete certain forms as a fillable webform rather than a PDF version. Our new fillable webforms will be a static, mirrored version of the paper form that will enhance the customer’s submission process and improve their experience. Customers will simply answer the form related questions as they appear on the screen, apply their electronic signature, and submit the form. All forms completed in eSignature/Upload Documents via the webform version will appear in WorkTrack the same as forms completed via the PDF version. The first form available in this new option, and new to eSignature/Upload Documents, is the SSA-827 – Authorization to Disclose Information to SSA.

I. Forms Available for Use with eSignature/Upload Documents

1. Release 1 Forms

· SSA-561-U2 Request for Reconsideration

· SSA-3368-BK Adult Disability Report

· SSA-3369-BK Work History Report

· SSA-3373 Function Report – Adult

· SSA-3441-BK Disability Report – Appeal

· HA-501 Request for Hearing by Administrative Law Judge

· HA-520 Request for Review of Hearing Decision/Order

· HA-4631 Claimant’s Recent Medical Treatment

· HA-4632 Claimant’s Medications

· HA-4633 Claimant’s Work Background



2. Release 2 Forms



· SSA-1-BK Application for Retirement Insurance Benefits

· SSA-2-BK Application for Wife’s or Husband’s Insurance Benefits

· SSA-3 Marriage Certification

· SSA-8 Application for Lump Sum Death Payment

· SSA-25 Certificate of Election for Reduced Spouse’s Benefits

· SSA-44 Medicare Income-Related Monthly Adjustment Amount-Life Changing Event

· SSA-150 Modified Benefit Formula Questionnaire

· SSA-521 Request for Withdrawal of Application

· SSA-546 Worker’s Compensation Public Disability Benefit Questionnaire

· SSA-632-BK Request for Waiver of Overpayment Recovery

· SSA-634 Request for Change in Overpayment Recovery Rate

· SSA-640 Financial Disclosure for Civil Monetary Penalty (CMP) Debt

· SSA-754-F5 Statement of Marital Relationship

· SSA-760 Certification of Support

· SSA-765 Response to Notice of Revised Determination

· SSA-766 Statement for Self-Employment Income

· SSA-769-U4 Request for Change in Time/Place of Disability Hearing

· SSA-773 Waiver of Right to Appear, Disability Hearing

· SSA-789 Request for Reconsideration - Disability Cessation - Right to Appear

· SSA-795 Statement of Claimant or Other Person

· SSA-2490-BK Application for Benefits Under a U.S. International Social Security Agreement

· SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire

· SSA-2574 Information About Joint Checking/Savings Account

· SSA-2855 Statement of Funds You Received

· SSA-2935 Authorization to the SSA to Obtain Personal Information

· SSA-3885 Government Pension Questionnaire

· SSA-4111 Certification of Election for Reduced Widow(er)’s and Surviving Divorced Spouse’s Benefits

· SSA-4162 Childcare Dropout Questionnaire

· SSA-4178 Marital Relationship Questionnaire

· SSA-5062 Claimant’s Statement About Loan of Food or Shelter

(Note: The SSA-7050 was removed from eSignature/Upload Documents on March 30, 2024)

· SSA-7104 Partnership Questionnaire

· SSA-7156 Farm Self-Employment Questionnaire

· SSA-7157-F4 Farm Arrangement Questionnaire

· SSA-8000-BK Application for Supplemental Security Income (SSI)

· SSA-8001-BK Application for Supplemental Security Income (SSI) (Deferred or Abbreviated Application)

· SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information

· SSA-8552 Interview Confirmation



3. Release 3 Forms



· SSA-820-BK Work Activity Report – Self Employment

· SSA-821-BK Work Activity Report – Employee



4. New to eSignature/Upload Documents - Fillable Webforms



· SSA-827 - Authorization to Disclose Information to the Social Security Administration

J. Evidence Available for Use with eSignature/Upload Documents

1. Release 1 Evidence

· Bank Document

· Bankruptcy Documents

· Burial Contract

· Change of Address Related Document

· Child Support Documentation

· Claimant Correspondence

· Claimant Supplied Medical Evidence

· Claimant's Change of Address Notification

· Claims Earnings Related Document

· Co-Owner Statement-Not Allowed to Cash

· Critical Inquiries or Critical Payment System (CPS) Related Document

· Critical/Dire Need Request

· Custody Documents

· Earnings Discrepancy Doc

· Earnings Inquiry Request

· Education Records-Non-Medical

· Employer Prepared Earnings Statements

· Estate Document or Signed Statement

· Filing for Other Benefits Records

· Foreign Related Document

· Fraud Allegation Document

· Fraud Related Document

· Government Pension Offset

· Hospital Records

· Impairment Related Work Expense (IRWE) Documentation

· Income Tax Return

· Inheritance Document or Signed Statement

· Inpatient Hospital Records

· Life Insurance Policy or Assignment

· Medicare/Medicaid/Health Insurance

· Municipal, Corporate, and Government Bonds

· Mutual Funds

· Overpayment Related Document

· Pay Stubs

· Pension Related Documents

· Prison Records

· Special Wage Payment Document

· SSI Income and Resources Documents

· SSI Living Arrangement/ISM Documents

· State Disability Benefits Statement

· Stock Ownership

· Tax Form/Returns

· Temporary Institutionalization

· Trust Agreement and Amendments

· Trust Court/Legal Documents

· Trust Financial Records

· Unearned Income

· VA Disability Rating Verification

· Wage Verification

· Waiver Related Document

· Windfall Elimination Provision

· Worker's Compensation Document


2. April 2024 Release – 27 Additional Evidence Types

· Behavioral Health Hospital Discharge

· Child Born Out of Wedlock Document

· Claimant's Revocation Letter of Auth Rep Related Evidence

· Prison Release Documentation

· Deemed Marriage Related Claim Evidence

· HIV Related Document

· Hospital NGRI Discharge

· IEP School Related Evidence

· Legal Guardianship / Conservatorship documents

· Long-Term and Short-Term Disability Related Evidence

· PASS Application Related Evidence

· Randolph Sheppard Program Document

· Rent Document

· Reopening Supporting Documentation

· Self-Employment Tax Related Evidence

· SSDI EXR Supportive Documents

· SSI Disposal of Resources Proof

· SSI EXR Supportive Documents

· SSI Hospital Discharge

· SSI Interim Assistance Reimbursement documents

· SSI Life Insurance/Cash Surrender Value Document

· SSI Out of the Country Evidence

· SSI Savings Bond Documentation

· STAT Blind Only Dec Related Evidence

· Uninsured Medicare/State Buy-In Letter

· Work Related Evidence - VR Services/Special Conditions/Job Coaching

· Work Related Out of Pocket Expenses

Direct all program-related and technical questions to your Regional Office (RO) support staff using vHelp or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns or problems to their Central Office contacts.

References:
Executive Order (EO) 14058 Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government
GN 00301.015 Acceptance of Evidence
GN 00301.030 Acceptability of Documentary Evidence
GN 00301.286 Electronic Evidence Documentation and Retention
GN 01010.410 Failure to Submit Essential Evidence
GN 01070.325 Requesting Evidence/Documents
Upload Documents Technician Desktop Guide