The SSA-3830 is not a mandatory part of development in every LBW claim. However, if
an adjudicator opts to send a form to obtain information regarding claims alleging
LBW, use the SSA-3830 instead of a locally developed form.
Send the SSA-3830 to request information from the hospital to expedite development
of LBW claims and include a signed Form SSA-827 Authorization to Disclose Information
to the Social Security Administration (SSA).
IMPORTANT: If the information on the completed SSA-3830 does not support a fully favorable
LBW allowance, develop the claim.