Social Security Administration (SSA) · United States

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Authorization to Disclose Information to the Social Security Administration (SSA)

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JustFill is not affiliated with Social Security Administration (SSA). This is an independent third-party tool to help you complete Form SSA-827. Always download the current blank form from the official source and verify your completed copy before signing or submitting. Official Form SSA-827 from Social Security Administration (SSA)

Quick answer

Form SSA-827, Authorization to Disclose Information to the Social Security Administration (SSA), is a release that lets your doctors, hospitals, schools, and employers send SSA the records it needs to decide a disability claim. It is completed and signed by the claimant (or their representative). JustFill lets you fill it online for free, then download the completed PDF for signing.

Form
Form SSA-827
Issued by
Social Security Administration (SSA)
Country
United States
Cost to fill
Free

What is Form SSA-827?

Form SSA-827 is the Authorization to Disclose Information to the Social Security Administration (SSA), the consent form that allows SSA and the state Disability Determination Services to collect the records they need to evaluate a disability claim. By signing it, you authorize all of your medical sources (hospitals, clinics, doctors, mental health and substance-abuse providers, VA facilities), along with schools, social workers, employers, and others who know about your condition, to release records to SSA. The form names whose records are involved (name, SSN, date of birth), describes what may be disclosed, lists from whom and to whom, states the purpose, and notes that the authorization is good for 12 months from the date you sign. It ends with the individual's signature, address, and phone, plus a witness signature. The current edition is Form SSA-827 (6-2007), OMB 0960-0623. With JustFill, the AI detects each field on the PDF, so you can type or dictate your details, handle scanned copies, and finish without Adobe Acrobat.

Download the Form SSA-827 form PDF — free

The official Form SSA-827 PDF is free to download from the Social Security Administration at ssa.gov/forms. JustFill opens that same PDF in your browser so you can fill it and download a completed copy with no Adobe Acrobat required.

Get the official Form SSA-827 PDF from Social Security Administration (SSA)

Who fills out Form SSA-827?

  • An adult applying for Social Security Disability Insurance (SSDI) or SSI who must authorize record release.
  • A parent or guardian completing the form on behalf of a minor child applying for benefits.
  • An appointed representative payee or personal representative signing for a claimant who cannot sign.
  • A disability attorney or advocate preparing the authorization as part of a claimant's application packet.
  • A witness who knows the claimant, signing to confirm the identity of the person authorizing disclosure.

Field-by-field breakdown

What each section of Form SSA-827 asks for. JustFill’s AI will detect these fields automatically when you upload the PDF — review the breakdown below so you know what to enter.

Whose records (name)

Full name (first, middle, last) of the person whose records are being disclosed.

SSN and date of birth

The claimant's Social Security number and birth date used to identify the right records.

Of what / what is disclosed

Pre-printed scope covering medical records, mental health, substance abuse, and education records related to your ability to perform tasks.

From whom

The sources authorized to release records: medical, educational, employers, counselors, and others who know your condition.

To whom and purpose

States that information goes to SSA and the state agency processing your case, to determine eligibility for benefits.

Expires when

Notes the authorization is valid for 12 months from the date signed.

Individual signature

The claimant's signature, date signed, street address, city, state, ZIP, and phone number.

Witness signature

Signature and phone or address of someone who knows the claimant or is satisfied as to their identity.

Common mistakes to avoid

  • 1Using an X mark or unsigned form without a witness signature, which SSA requires when the claimant signs with a mark.
  • 2Leaving the date signed blank, since the 12-month validity period is measured from that date.
  • 3Signing on behalf of someone else without checking the box and explaining the basis for authority (parent, guardian, or representative).

How JustFill helps you complete Form SSA-827

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Related forms

SSA (Social Security Administration)

Form SS-5

Form SS-5: Application for a Social Security Card

U.S. Department of Veterans Affairs (VA)

VA Form 21-526EZ

VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits

CMS (Centers for Medicare & Medicaid Services)

CMS-L564

CMS-L564: Request for Employment Information (Medicare)

Internal Revenue Service (IRS), U.S. Department of the Treasury

Form 1040

Form 1040, U.S. Individual Income Tax Return

Frequently asked questions

Yes. It is a free public-domain form from the Social Security Administration, and filling it online with JustFill is free too.
Download the official PDF from ssa.gov/forms, or open it in JustFill, which loads the same form so you can complete and save it.
Yes. JustFill's AI detects each field, so you can type your details online and download the form, though SSA generally requires an original ink signature before submitting.
It authorizes your doctors, hospitals, schools, and employers to release records to SSA so it can decide your disability claim.
The authorization is good for 12 months from the date you sign it. JustFill makes it easy to refill and download a fresh copy when needed.
Yes. You can revoke it in writing at any time, except where a source has already acted on it. JustFill can help you fill a new one if you reauthorize.

Official source: Form SSA-827 on Social Security Administration (SSA)’s website

JustFill is an independent product and is not affiliated with, endorsed by, or sponsored by Social Security Administration (SSA) or any government agency. Always verify your completed form on the official version before signing or submitting.