Complete a separate SSA-827 for each provider or facility

This authorization is valid for 12 months from the date you sign it

Include pharmacies — medication records support your disability claim

Social Security Disabilityeasy

Authorization to Disclose Information

SSA-827 · SSA

Authorization allowing SSA to collect medical and other information from providers, hospitals, and other sources for disability determination.

Form Details

Total fields: 20
Auto-fillable: 16 (80%)
Time without BeneFill: 15 minutes
Time with BeneFill: 5 minutes
Time saved: 10 minutes
Filled by: patient
Frequency: one time

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Where to Submit This Form

📬

Return to SSA with your disability application

https://secure.ssa.gov/ICON/main.jsp

🏢

In person at your local SSA office

https://secure.ssa.gov/ICON/main.jsp

Required Attachments

📎 Completed SSA-827 for each medical provider (doctor, hospital, therapist, pharmacy)

Processing Time

Processed as part of your disability claim.

What Happens Next

SSA will send this authorization to each listed provider to request your medical records directly.

Tips for This Form

✓ Complete a separate SSA-827 for each provider or facility
✓ This authorization is valid for 12 months from the date you sign it
✓ Include pharmacies — medication records support your disability claim

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the SSA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.