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The United States Social Security Administration. | SSA.
This form is to authorize a medical doctor or nurse practitioner to release medical information.
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.
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.
Here are some tips for writing an effective disability appeal letter: Indicate Your Name and Claim Number at the Top. ... Point Out Any Mistakes or Oversights. ... Supply Missing Medical Information. ... Attach Medical Records or Any Additional Evidence. ... Stick to the Point. ... Be as Detailed as Possible. ... Be Polite and Professional.
To Whom It May Concern: I am writing to request consideration as a person in critical need for my Social Security disability. I require my claim to be processed as a dire need case because I cannot afford food, medicine, or shelter. I am attaching (list your attachments) to prove my circumstances are critical.
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.