California Sample Letter for Medical Records Release in Social Security Disability Action

State:
Multi-State
Control #:
US-0959LTR
Format:
Word; 
Rich Text
Instant download

Description

This form is a sample letter in Word format covering the subject matter of the title of the form.

How to fill out Sample Letter For Medical Records Release In Social Security Disability Action?

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FAQ

The United States Social Security Administration. | SSA.

SSA and its affiliated State disability determination services use Form SSA-827, "Authorization to Disclose Information to the Social Security Administration (SSA)" to obtain medical and other information needed to determine whether or not a claimant is disabled.

A medical source statement is a form completed by your doctor summarizing how limited you are physically and mentally as a result of your conditions. This document will help the SSA determine whether you are disabled.

The office is listed under U. S. Government agencies in your telephone directory or you may call 1-800-772-1213 for the address. You may send comments on our estimate of the time needed to complete the form to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401.

You can get your Social Security Statement (Statement) online by using your personal my Social Security account. Your online Statement gives you secure and convenient access to estimates for retirement, disability, and survivors benefits you and your family may be eligible for.

This form is to authorize a medical doctor or nurse practitioner to release medical information.

The following instructions are for completing the preprinted paper Form SSA-3368 (Disability Report ? Adult). The Disability Determination Services (DDS) uses the information on the 3368 to develop medical and other evidence that can be used to establish the correct onset date.

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California Sample Letter for Medical Records Release in Social Security Disability Action